HEALTHCARE NEWS FLASH 16th October 2013
Table of Contents Sales & Marketing ................................................................................................................. 3 Finance ................................................................................................................................. 7 Technology .......................................................................................................................... 12 Strategy .............................................................................................................................. 18
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Sales & Marketing Preparing for New Hospital Opening, Mercy Health Aims to Sell 2 Facilities 15 October, 2013 | Becker's Hospital Review http://www.beckershospitalreview.com/hospital-transactions-and-valuation/preparing-for-newhospital-opening-mercy-health-aims-to-sell-2-facilities.html Next Month, Mercy Health in Cincinnati will open the $270 million West Hospital, a 250-bed hospital on the west side of Cincinnati, and in the process, the system is attempting to sell two of its other hospitals, according to a Cincinnati Business Courier report. The hospitals on the block include 170-bed Mt. Airy Hospital and 156-bed Western Hills Hospital, both in Cincinnati. A Mercy Health spokeswoman told the Cincinnati Business Courier several organizations are interested in buying both facilities. Depending on the buyers, Mt. Airy Hospital is likely to close altogether, leaving only a medical office building. Western Hills Hospital will close some services, but its emergency department would remain open, according to the report. West Hospital is seen as a consolidated replacement hospital for those two, and employees at Mt. Airy Hospital and Western Hills Hospital could transfer to West Hospital in the process. Mercy Health, part of Cincinnati-based Catholic Health Partners, currently has six acute-hospitals.
UnitedHealth network cuts could alienate docs, members 11 October, 2013 | Fierce Health Payer http://www.fiercehealthpayer.com/story/unitedhealth-network-cuts-could-alienate-docsmembers/2013-10-11 Doctors are pushing back against UnitedHealth for dropping about 19 percent of doctors from its Medicare Advantage network in Connecticut. The Connecticut State Medical Society (CSMS) said the decision, which would affect roughly 58,000 Medicare Advantage members just before open enrollment, could disrupt long-term relationships these patients have with their physicians, potentially leading to inconsistent care and poor health outcomes. "This comes less than two weeks before Medicare's Open Enrollment period," CSMS President Michael Saffir said in a statement. "How can seniors make informed decisions when their own doctors don't even know whether they're in the United network?"
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Saffir also questioned UnitedHealth's overall approach to the cuts. "Even if you need to cut something, you use a scalpel, not a chainsaw," he told the Connecticut Mirror. "The approach is so disruptive and abrupt that you're going to alienate both doctors and patients." But UnitedHealth is merely assessing its network to "provide higher quality and more affordable healthcare coverage for Medicare beneficiaries," Dennis O'Brien, regional president of UnitedHealthcare Networks, told the Hartford Courant. "Ultimately, our goals are to build healthcare provider networks that encourage better healthcare outcomes, foster more collaboration between Medicare Advantage plans and physicians and encourage more use of primary care." O'Brien wouldn't, however, disclose exactly how many doctors UnitedHealth is cutting from its network or whether it will make similar network changes to its other plans.
State exchanges enroll more consumers than federal marketplace 11 October, 2013 | Fierce Health Payer http://www.fiercehealthpayer.com/story/state-exchanges-enroll-more-consumers-federalmarketplace/2013-10-11 Apparently, it's good to be an insurer selling plans on state-run health insurance exchanges. As federally operated exchanges have been beset by technical glitches, the 14 state-run versions are experiencing a smoother enrollment process. "Individual state operations are more adaptable," Alan Weil, executive director of the nonpartisan group National Academy for State Health Policy, told The New York Times. "That does not mean that states get everything right. But they can respond more quickly to solve problems as they arise." Daniel Mendelson, CEO of Avalere Health, agrees. "On balance, the state exchanges are doing better than the federal exchange. The federal exchange has, for all practical purposes, been impenetrable. Systems problems are preventing any sort of meaningful engagement," he told the Times. The particularly successful states experiencing a large and steady number of enrollments--without many glitches--include California, Connecticut, Kentucky, New York and Rhode Island. New York exchange officials said 40,000 people signed up for a health plan last week, the Associated Press reported. In California, meanwhile, officials said more than 27,000 people have created accounts and partially completed an application while more than 16,000 applications were completed last week, reported the Sacramento Bee. And Connecticut boasted people younger than 35 years old accounted for almost 33 percent of its roughly 1,200 applications, a key demographic insurers hope to enroll to help offset increased costs, according to the Connecticut Mirror.
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Aetna seeks consumer dialogue about wellness 11 October, 2013 | Fierce Health Payer http://www.fiercehealthpayer.com/story/aetna-seeks-consumer-dialogue-about-wellness/201310-11 The reform law is driving insurers to implement a more consumer-focused approach in their marketing and outreach campaigns, says a senior marketing executive for Aetna. That's why the insurer launched a campaign this summer called "What's Your Healthy?" that aims to reach out to a "broader universe of consumers who know the brand but have never experienced Aetna products," Robert Mead, Aetna's senior vice president of marketing and communications, said in an interview with Forbes. Aetna launched "What's Your Healthy?" in June, using a mobile platform that combines its own mobile apps with third-party, consumer-facing apps, FierceMobileHealthcare previously reported. The campaign is part of Aetna's overall rebranding, which it started last year with a new logo and a heightened consumer focus. "We wanted to start a new dialogue, not only with our own members but with consumers at large, about the fact that we understand that everybody's definition of healthy is different," he said. The marketing campaign includes TV ads, but its primary focus is the What's Your Healthy digital hub, where consumers can create profiles and answer questions and share their definitions of healthy. "Then we can help them achieve that healthy and get there. You hear a lot about 'we don't have a good healthcare system or a sick care system,'" Mead said. "It's not only about healthcare and hospitals and doctors and tests and procedures, it's about wellness, it's about physical, mental and spiritual wellness." The next phase of the promotion, which Aetna intends to be a long-term branding platform, will include information about wellness and nutritional counseling from both in-house and outside experts, Mead added.
UCLA Health to Run 6 Clinics for Motion Picture & Television Fund 10 October, 2013 | Becker's Hospital Review http://www.beckershospitalreview.com/hospital-physician-relationships/ucla-health-to-run-6clinics-for-motion-picture-television-fund.html Los-Angeles based UCLA Health System has signed a letter of intent to take over six outpatient clinics belonging to the Motion Picture and Television Fund, a charity that provides services for workers in the entertainment industry.
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Under the pending agreement, UCLA would assume the leases for the health centers, and the 43 primary care physicians who staff them would join the UCLA Faculty Practice Group. MPTF will continue to operate its other healthcare offerings solely, such as its residential care center, long-term care unit, memory impairment unit and social services programs, according to the release. MPTF and UCLA plan to integrate their operations in late spring 2014 after completing a definitive agreement. "UCLA recognizes its obligation to help provide the highest quality patient care to residents throughout Los Angeles County, and affiliating with MPTF, which has a long history of communitybased, skilled patient care, is a significant step toward helping us achieve that goal," David Feinberg, MD, president of the UCLA Health System and CEO of the UCLA Hospital System, said in the release.
Fairview, North Memorial Health Care, Medica Create Minnesota's Largest ACO 08 October, 2013 | Becker's Hospital Review http://www.beckershospitalreview.com/accountable-care-organizations/fairview-northmemorial-health-care-medica-create-minnesota-s-largest-aco.html Minneapolis-based Fairview Health Services and North Memorial Health Care in Robbinsdale, Minn., have partnered with health insurer Medica to create Fairview and North Memorial Vantage with Medica, Minnesota's largest accountable care organization, according to Medica. Medica has had an ACO with Fairview — Fairview Health Advantage — since 2012, but the addition of North Memorial Health Care brings 26 more primary care clinics and two hospitals into the fold as well. Overall, the new ACO will include more than 2,500 primary and specialty care physicians. Current Fairview Health Advantage members will have access to the North Memorial providers Nov. 1.
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Finance Maryland Pitches New Global Payment Payer System to CMS 14 October, 2013 | Becker's Hospital Review http://www.beckershospitalreview.com/racs-/-icd-9-/-icd-10/maryland-pitches-new-globalpayment-payer-system-to-cms.html Last week, Maryland submitted a new reimbursement proposal to CMS that centered on the triple aim: health outcomes, patient satisfaction and cost controls. Maryland is the only state in the country that sets its own reimbursement rates for all payers, including Medicare and commercial carriers. It maintains this waiver from CMS as long as the state hospitals' growth in Medicare inpatient payment per admission does not exceed the national average. The Health Services Cost Review Commission oversees this "all-payer system" of hospital finance. Gov. Martin O'Malley developed the plan with the endorsement of several major healthcare organizations in the state, including the Maryland Hospital Association. The key tenets of the new all-payer model include the following: •
A permanent shift away from its current waiver and fee-for-service. Almost all hospital revenue will come from global payments.
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A five-year model would pay hospitals based on Medicare per-beneficiary total hospital cost growth.
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The model would require Maryland's Medicare per-beneficiary total hospital cost growth to be at least $330 million less than the national benchmark over five years.
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Maryland would limit its annual all-payer per capita total hospital cost growth to 3.58 percent, or the 10-year average growth rate of the state's economy.
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Quality targets would become standard. These include reducing Medicare 30-day readmissions to the national rate over five years. In addition, Maryland hospitals would aim to achieve an annual 6.89 percent reduction in the 65 most potentially preventable hospital-acquired conditions.
If Maryland's model is not extended after the fifth year, or if it is terminated early, Maryland hospitals would then transition to the national Medicare payment systems — thus ending Maryland's federal waiver. State officials said the proposed all-payer model is expected to both reduce healthcare expenditures in the state and improve the quality of care.
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"Our goal is a healthcare system that enhances patient care, improves health outcomes and lowers costs," Gov. O'Malley said in a news release. "As we see around the country, the fee-for-service status quo leads to ever-increasing costs with often mediocre outcomes. In Maryland, we're making better choices. The innovative approach we're submitting…will produce better results at lower costs by incentivizing quality of care, not quantity of care." No timeline was given on when CMS would make a decision on the proposal.
New York Grants $200M to Hospitals, Providers for Hurricane Sandy Recovery 11 October, 2013 | Becker's Hospital Review http://www.beckershospitalreview.com/racs-/-icd-9-/-icd-10/new-york-grants-200m-to-hospitalsproviders-for-hurricane-sandy-recovery.html New York Gov. Andrew Cuomo has awarded $200 million to various hospitals, healthcare providers and social groups to help cope with the expenses and repairs suffered from Hurricane Sandy last year. The New York government awarded the grants based on a request for proposals. Five hospitals received the extra funding: •
New York University Langone Medical Center in New York City received $22.3 million for uncompensated operating costs. NYU Langone previously received $114 million in federal aid related to the hurricane.
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South Nassau Communities Hospital in Oceanside received $6.6 million to establish an urgent care center in Long Beach. The funds are expected to replace 162-bed Long Beach Medical Center, which has still remained closed since the storm hit. South Nassau and LBMC had been in talks about a potential merger throughout the course of this year.
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Long Island Jewish Medical Center in New Hyde Park received $2.9 million for unreimbursed operating costs.
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Brookdale Hospital and Medical Center in Brooklyn received $2.3 million for unreimbursed operating costs and renovation expenses.
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Richmond University Medical Center in Staten Island received $482,000 to cover repair damages and other costs.
"Nearly one year after Superstorm Sandy hit New York, the state's healthcare and human service providers continue to serve communities recovering from the storm, even while many of these organizations themselves are still getting back on their feet," Gov. Cuomo said in a news release. "This funding will help providers cover significant costs resulting from the storm, including repairs and renovation of critical facilities, unreimbursed expenses and ongoing services to impacted New Yorkers."
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New York officials estimated Hurricane Sandy caused $42 billion in damage, with $3.1 billion of that total representing damage to hospitals and healthcare organizations. Most of the healthcare costs fell within New York City, especially among hospitals within the New York City Health and Hospitals Corp. and NYU Langone.
California Hospital Group Proposes Ballot Initiative for Medi-Cal Provider Fee 10 October, 2013 | California HealthLine http://www.californiahealthline.org/capitol-desk/2013/10/california-hospital-group-proposesballot-initiative-for-medi-cal-provider-fee The California Hospital Association on Wednesday filed a ballot initiative for the November 2014 ballot that would set the percentage the state gets from a fee levied on hospitals and designate how the money is to be spent. The action, which required notification to the state Attorney General's Office, would lock in place current practices and is not the result of any disagreement with the Legislature, said Jan EmersonShea, association vice president. “It will make sure that funds from the hospital provider fee are used for the purpose they were intended on an on-going basis,” Emerson-Shea said. “In times past the state had taken more into the general fund than we had agreed to. Because the current Legislature cannot bind a future Legislature, we have to go to the ballot and have a voter amendment to the Constitution. It is not the result of any disagreement, however, just a safeguard.” The announcement came a day after Gov. Jerry Brown (D) signed SB 239, which extends the hospital fee for three years at the same time it reverses Medi-Cal cuts for some hospital skilled-nursing facilities. “This is a huge win, getting that bill signed was our top legislative priority,” said Emerson-Shea, whose association was a sponsor of the bill. SB 239, authored by Sen. Ed Hernandez (D-West Covina) and Senate Pro Tem President Darrell Steinberg (D-Sacramento), extends for three years the Medi-Cal quality assurance fee that has been assessed on hospitals since 2009. A portion of the fee goes to the state General Fund for medical programs for children, a portion is given as grants to hospitals and a portion is used as seed money to attract federal funds. In 2013, the fee raised $3 billion. The state received $620 million, some $40 million went to hospitals as grants and the remainder was used as leverage to attract an additional $1.9 billion in federal funds, Emerson-Shea said. It is estimated that extending that fee for three more years beginning next year will generate $3 billion for the state's General Fund and attract some $10 billion in new federal money for California hospitals, Emerson-Shea said.
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The bill also reversed a 10% cut in Medi-Cal reimbursements to 100 skilled nursing facilities in urban hospitals. Hospital officials said the cuts may have caused some hospitals to close, triggering the transfer of elderly and ill patients to different facilities. Also signed into law Tuesday was SB 191 by Sen. Alex Padilla, (D-Pacoima) that extends the ability for counties to collect fees for local emergency medical services, with 15% of that fee ear-marked for pediatric trauma care. The law allows counties to collect a $2 penalty on every $10 assessment on certain criminal and vehicle code violations. The bill extends the law for three years beyond its original sunset date, Jan. 1 2014.
HAIs Cost Society $147B Annually in US 04 October, 2013 | Becker's Clinical Quality & Infection Control http://www.beckershospitalreview.com/quality/hais-cost-society-147b-annually-in-us.html When considering both direct and indirect societal costs, healthcare-associated infections in U.S. acute-care hospitals cost between $96 billion and $147 billion annually, according to an article published in The Journal of Medical Economics. Researchers reviewed the healthcare literature for previously published systemic reports, clinical studies and component cost reports to compile the estimate, which is the first to estimate the full societal costs of HAIs, according to the article. The study concludes the complete cost of HAIs makes them as problematic as leading public health issues like cancer, heart attack, stroke and diabetes and should merit substantial increases in infection control research and funding.
Healthcare reform struggles plague hospitals 03 October, 2013 | Fierce Health Finance http://www.fiercehealthfinance.com/story/healthcare-reform-struggles-plague-hospitals/201310-03 Thanks to the Affordable Care Act, hospitals across the country face multi-million-dollar losses. Grady Memorial Hospital in Atlanta, for instance, expects a $45 million shortfall once the law fully kicks in, WSB-TV Channel 2 reported. The healthcare law cut federal funding for hospitals that care for the poor but intended for Medicaid expansion to offset those losses. While Grady provides medical care to more uninsured patients than any other hospital in Georgia, the state has refused to expand its Medicaid program. The Medicaid opt-out and resulting $45 million loss means 950-bed Grady may have to cut services.
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"If Georgia were to expand, we estimate we'd have an additional 40,000 patients that would be eligible under the new rolled out expansion of Medicaid," Grady President and CEO John Haupert told Channel 2. Meanwhile, Central Georgia Health System, which owns the Medical Center of Central Georgia, faces a potential $30 million loss due to healthcare reform, The Telegraph reported. As a result, the system laid off about 50 employees and implemented other budget-cutting changes, such as adjustments to some employees' hours and salaries. What's more, Central Georgia Chief Financial Officer Rhonda Perry told the Telegraph she sees about eight to 10 reports a week from hospitals across the country using similar measures to overcome challenges related to healthcare reform. Some hospitals are turning to drastic solutions. For instance, in North Carolina, the owners of Pungo Hospital plan to shut down the facility because the state has chosen to forgo Medicaid expansion. With reform implementation well underway, it seems hospitals still blame Medicare reimbursement cuts and state challenges to expanding Medicaid benefits under federal healthcare reform for layoffs and losses.
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Technology American Well launches mobile-based telehealth service 14 October, 2013 | Fierce Mobile Healthcare http://www.fiercemobilehealthcare.com/story/american-well-launches-mobile-based-telehealthservice/2013-10-14 One fast-growing telehealth service is embracing mobile devices as a platform for consumers to access healthcare. Boston-based doctor-on-demand provider American Well has announced that consumers can now connect with a physician using their iPad, iPhone or Android smartphones and tablets. Doctors accessed via the app provide users with live video consults 24 hours a day, seven days a week in 44 states and the District of Columbia. "Video telehealth is rapidly eclipsing older telephone-based doctor or nurse callback services that do not offer either the transparency or the choice consumers expect from modern services, nor the level of clinical safety, insight, documentation and care continuity that live video encounters on American Well offer," said Roy Schoenberg, M.D., CEO of American Well Systems, in a written statement. In related news, AT&T launched new cloud-based remote patient monitoring (RPM) technology that is delivered as software-as-a-service (SaaS) from Ericsson. Part of AT&T's ForHealth suite of RPM services, the SaaS offering is designed to help doctors monitor their patients over video on a tablet connected to the Internet, providing coaching, reminders and health education to help better manage chronic diseases remotely without requiring a return hospital visit. One of the benefits of AT&T RPM SaaS is that patients can use Bluetooth-enabled devices to check their vitals daily, and send the data to a cloud-based system that healthcare providers can access through a secure portal. In addition, during scheduled appointments, physicians can communicate with their patients via video. Building on the success of a two-year study that determined that videoconferencing significantly reduced hospital readmissions, Indianapolis-based St. Vincent Health has partnered with its parent organization, Ascension Health Alliance, to form a joint venture that officially launched a remote care management program with the goal of scaling the program on a national level. For the launch of the new St. Vincent-Ascension Health Alliance remote care management program, more nurses will be utilized to perform scheduled video conference calls with patients to address questions and enable them to evaluate how the patients are doing.
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A recent research report predicts that remote monitoring technologies will save nearly $200 billion by managing chronic diseases in the U.S. over the next 25 years. The report cites other estimates that suggest remote monitoring can reduce the costs for caring for the elderly in rural areas by allowing seniors to live independently and spend more time at home, while reducing the need for face to-face medical consultations, by 25 percent.
Big data use: Providers, payers not on the same page 08 October, 2013 | Fierce Health IT http://www.fiercehealthit.com/story/big-data-use-providers-payers-not-same-page/2013-1008?utm_medium=nl&utm_source=internal Health payers are putting more stock in the effectiveness of big data and analytics tools than their provider counterparts, according to a new report published by Framingham, Mass.-based research and consulting firm IDC Health Insights. Overall, 80 percent of payer IT decision makers surveyed said that between 1 and 24 percent of their budgets were used on analytics technology; less than half (49 percent) of provider IT decision makers chose a similar path. The big data technology split mirrored the analytics split, with 77 percent of payers saying that they were investing in such tools. Only 47 percent of providers said the same. What's more, 40 percent of providers said they had no plans to budget any money for big data and analytics tools. By contrast, only 14 percent of responding payers made such a claim. Roughly 3,500 individuals participated in the survey. Report author Cynthia Burghard said that much of the hesitation on the part of providers was due to conflicting priorities, primarily, Meaningful Use efforts. "Healthcare providers are not likely to catch up in their investments or in the maturity of big data and analytics until at least 2015," she said. Research published earlier this year by consulting firm McKinsey & Co. projected that data analytics could help U.S. citizens save as much as $450 billion in healthcare costs. However, according to the report's authors, change is necessary to meeting that goal. Among some of the changes needed, they said, is a continuation of the move away from fee-for-service care, as well as recognition on the part of both providers and patients that data can be an effective tool. "[A]ll stakeholders must recognize the value of big data and be willing to act on its insights, a fundamental mind-set shift for many and one that may prove difficult to achieve," the analysis said. "Patients will not benefit from research on exercise, for example, if they persist in their sedentary lifestyles. And physicians may not improve patient outcomes if they refuse to follow treatment protocols based on big data, and instead rely solely on their own judgment."
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At Mass General, internal financial incentives key to EHR, tech adoption 08 October, 2013 | Fierce Health IT http://www.fiercehealthit.com/story/mass-general-internal-financial-incentives-key-ehr-techadoption/2013-10-08 At Massachusetts General Hospital, a program offering modest financial incentives to salaried physicians went a long way toward helping the facility to meet goals for electronic health record adoption, improved quality and efficiency and communication with patients. According to a report published this month in Health Affairs, the hospital's Massachusetts General Physicians Organization (MGPO) Quality Incentive Program has good results to report after six years. "Incentive programs like this--which can help organizations focus the attention of busy clinicians on tasks that help deliver better, more cost-effective care--are very valuable at a time when the health care system is transitioning from fee-for-service to new payment models," Timothy Ferris, medical director and co-author of the report, said in an announcement from the hospital. "One of the ways this differs from traditional pay-for-performance programs is that it was designed by physicians for physicians, who determined what the goals and priorities were." The MGPO Quality Incentive program was designed to focus on clinical priorities applying to all physicians in the program, and is funded by redirecting a portion of physician earnings. For example, measures related to adoption of an EHR system started with attending training sessions in the system, then timely incorporation of 80 percent--and then 90 percent--of outpatient notes into the system. Eventually, physicians were asked to complete final notes within eight days. "By setting realistic targets that were increased in an incremental way, we could introduce more demanding goals at a pace that physicians found tolerable," Deborah Colton, MGPO senior vice president and co-author of the report, said, according to the announcement. "We wanted goals that were important but also achievable, and hoped that physicians would meet the targets about 80 percent of the time. They actually exceeded our expectations, and 90 percent of the available funds were paid out over the six years." Last January a report from research firm Frost & Sullivan determined that technology implementation would be key to growth in the preventative health space, despite "looming challenges" like reimbursement. According to that report, a lack of provider incentives has slowed the technology adoption process, even though regulations and the economy continue to push healthcare professionals to incorporate some innovations--like electronic health records--into their care. Financial incentive programs have struggled to gain motion in the past due to the Stark law and antikickback statutes, as a report from the Government Accountability Office stated last year.
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Government, industry need to act to avoid 'unintended consequences' of EHRs 08 October, 2013 | Fierce EMR http://www.fierceemr.com/story/government-industry-need-act-avoid-unintendedconsequences-ehrs/2013-10-08 A combination of government oversight and industry action is needed to avert the "unintended consequences" of electronic health record use that adversely impact patient safety, according to Sue Bowman, senior director of coding policy and compliance for the American Health Information Management Association. Bowman, writing in AHIMA's Perspectives in Health Information Management, warns that shortcomings in EHR design and implementation create not only safety, fraud and abuse problems, but also may serve as a barrier to EHR use and adoption. "Although many system developers and policy makers believe that the risks of EHRs are minor and easily manageable, that is not the case," Bowman says. "Patient safety and quality of care are seriously compromised by flawed EHR system design or functionality or improper use. Failure to address information integrity issues in EHR systems will lead to spiraling, rather than declining, healthcare costs and medical errors as a result of the proliferation of new types of patient safety hazards." Several of Bowman's recommendations include: •
Regulation and better scrutiny of EHR systems
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A greater focus on usability and proper use
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Improvement of documentation capture processes, such as defined EHR content standards and "ethical" documentation
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Implementation of processes to promote safety of clinical-decision support systems
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Required reporting of EHR-related adverse events
EHR-related patient safety issues have long been recognized as a concern. The U.S. Department of Health & Human Services published a health IT safety action plan in July to attempt to resolve some of these issues. The HIMSS Electronic Health Record Association's vendor Code of Conduct, published in June, also focuses on EHRs and patient safety. However, neither the HHS plan nor the Code of Conduct call for new regulations or required reporting of adverse events, both of which have been recommended by the Institute of Medicine.
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iPhone tool enables inexpensive endoscopic viewing 07 October, 2013 | Fierce Mobile Healthcare http://www.fiercemobilehealthcare.com/story/iphone-tool-found-cost-effective-mobileendoscopic-viewing-system/2013-10-07 iPhones can be transformed into mobile viewing systems for endoscopy at a substantial cost benefit, concludes an article in iMedicalApps. The overall cost of the "Endockscope," a new docking system that optimizes the coupling of the iPhone 4S with modern endoscopes, is $154 compared to $46,623 for a standard high-definition (HD) system, according to a related study on PubMed.gov. The objective of the study was to evaluate the ability and feasibility of an iPhone-based mobile endoscopic viewing system. Using the United States Air Force resolution target, the study compared the image resolution (line pairs/mm) of a flexible cystoscope coupled to the Endockscope+iPhone to the Storz HD camera (H3-Z Versatile). Researchers then used the Munsell ColorChecker chart to compare the color resolution with a 0째 laparoscope. Twelve expert endoscopists blindly compared and evaluated images from a porcine model using a cystoscope and ureteroscope for both systems. Finally, they also compared the cost (average of two company listed prices) and weight of the two systems. "Endockscope demonstrated feasibility of coupling endoscopes to a smartphone," states the article. "The lighter and inexpensive Endockscope acquired images of the same resolution and acceptable color resolution. When evaluated by expert endoscopists, the quality of the images overall were equivalent for flexible ureteroscopy and somewhat inferior, but still acceptable for flexible cystoscopy." The article's authors assert that the results "may have improved given the hardware development available today that includes higher resolution cameras." The article also notes that there have been a number of examples in literature of smartphone adapters for endoscopes, but to date there have been no human trials evaluating the efficacy of this technology. In related news, researchers at UCLA and the California NanoSystems Institute have developed a smartphone device that accurately determines albumin (a protein) in urine, according to an article in the peer-reviewed journal Lab on a Chip. Detection of albumin is important because if kidney damage has occurred the protein will leak into a person's bloodstream and will be present in the urine. A patient can take a urine sample and the smartphone attachment images and "automatically analyzes fluorescent assays confined within disposable test tubes for sensitive and specific detection of albumin in urine."
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Athenahealth to monitor flu activity during government shutdown 04 October, 2013 | Fierce Health IT http://www.fiercehealthit.com/story/athenahealth-monitor-flu-activity-during-governmentshutdown/2013-10-04 During the government shutdown, health IT vendor athenahealth plans to monitor flu activity and issue updates accordingly. Such activity normally is conducted by the Centers for Disease Control (CDC), which had to furlough nearly 9,000 workers during the budget fight in Washington. CDC normally issues a weekly flu report, and the media help announce disease outbreaks and launch public awareness campaigns. Without those reports, detection of flu trends could be delayed. Thanks to its database built on cloud-based architecture, Watertown, Mass.-based athenahealth has the ability to report data in real time. Its client physicians also are dispersed around the country with good statistical representation across practice types and sizes, Iyue Sung, director of core analytics, says in a blog post. Flu outbreaks generally begin in late fall, but can start earlier. Athenahealth's analysis of vaccination rates by primary care physicians parallels those of previous years, Sung writes, though those who received their shots at retail clinics, schools or the workplace were not included. So far, it has seen no evidence of early flu outbreaks. Sung says athenahealth's data tracking of the flu season last year was close to that issued by the CDC. His post doesn't say how often athenahealth plans to update its reports. There's no end in sight for the shutdown and with some of the National Institutes of Health's biomedical and clinical research initiatives put on hold, a small but desperate group of children with hard-to-cure cancer as well as a Massachusetts man's last-chance treatment for cancer are among those whose treatment may be delayed, reports the Boston Globe. However, the NIH has recalled a few furloughed workers to reopen its clinical trials registration website. Meanwhile, the GOP is trying to cobble together piecemeal funding for popular agencies such as the Veterans Administration and NIH, and painting Democrats as working against the interests of those children with cancer, according to Reuters. The VA has warned that the government shutdown will reverse its long-sought progress on reducing the backlog of disability claims. And three insurance companies say they have enrolled a small number of customers through the glitchy federal online marketplace, so it is working, reports Kaiser Health News. The Obama administration continues to attribute problems to overwhelming volume, but some IT experts say software design might also be at fault. Computer security specialists, however, have ruled out a cyberattack known as a denial of service as the cause of the delays, according to the New York Times.
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Strategy Catholic Health Initiatives Signs Deal to Acquire Mercy Hot Springs 14 October, 2013 | Becker's Hospital Review http://www.beckershospitalreview.com/hospital-transactions-and-valuation/catholic-healthinitiatives-signs-deal-to-acquire-mercy-hot-springs.html Chesterfield, Mo.-based Mercy has signed a nonbinding letter of intent with Englewood, Colo.-based Catholic Health Initiatives to transfer ownership of Mercy Hospital Hot Springs (Ark.). Under the deal, CHI would acquire Mercy Hot Springs, a 282-bed hospital that includes an 80physician clinic, and it would become an affiliate of CHI's St. Vincent Health System in Little Rock, Ark. Financial terms of the deal were not disclosed. St. Vincent plans on preserving all existing physician relationships in the Hot Springs community, and officials also said they are "committed to creating a strong and integrated regional physician network." Whispers of a potential Mercy-CHI deal bubbled to the surface in September. The potential transaction comes as both Mercy Hot Springs and St. Vincent failed in separate transactions earlier this year. In June, Mercy and Franklin, Tenn.-based Capella Healthcare discontinued their negotiations to join their respective hospitals in Hot Springs due to issues with both the Vatican and the Federal Trade Commission. In July, St. Vincent and University of Arkansas for Medical Sciences in Little Rock ditched their potential merger after due diligence revealed neither system could "define a pathway that meets the goals of both institutions." Mercy and CHI officials are working toward a definitive agreement and expect the deal to close by Dec. 31. The transaction must also receive approval from both organizations' boards, as well as state, federal and Catholic authorities. Bishop Anthony Taylor of the Diocese of Little Rock has already considered the transaction "welcome news," according to a news release. Mercy is currently the sixth-largest Catholic health system in the United States with 32 hospitals. CHI is the third-largest Catholic system with 87 hospitals. Mercy Hot Springs would be the fourth hospital within St. Vincent.
Cigna Strikes 2 New Accountable Care Agreements 14 October, 2013 | Becker's Hospital Review http://www.beckershospitalreview.com/accountable-care-organizations/cigna-strikes-2-newaccountable-care-agreements.html
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Health insurer Cigna has announced two new collaborative accountable care initiatives — its version of an accountable care organization — with Santa Clara County IPA in San Jose, Calif., and Patient Physician Network in Plano, Texas. SCCIPA is a group of more than 850 primary care and specialty physicians. The group's agreement with Cigna covers more than 13,000 patients in a Cigna PPO health plan who receive care from a SCCIPA provider. PPN is a 75-physician entity made up of the Plano Physicians' Group and Huguley Medical Associates. Its accountable care agreement with Cigna includes more than 6,000 patients covered by a Cigna health plan who seek care from a PPN provider. As part of both agreements, Cigna will give the groups patient-specific data to help the physicians better track and coordinate care. Additionally, care coordinators — registered nurses employed by either group — help patients schedule appointments and guide them through the healthcare maze as part of the collaboration. Cigna will pay each group for medical and care coordination services, and SCCIPA and PPN can also be rewarded for meeting quality and cost targets through a pay-for-value reimbursement structure. Both agreements went into effect Oct. 1. With the addition of these two agreements, Cigna now has 75 collaborative accountable care agreements in 26 states.
Somerset Hospital Signs Joint Venture LOI With Conemaugh Health System 11 October, 2013 | Becker's Hospital Review http://www.beckershospitalreview.com/hospital-transactions-and-valuation/somerset-hospitalsigns-joint-venture-loi-with-conemaugh-health-system.html The board of directors at Somerset (Pa.) Hospital has signed a nonbinding letter of intent to create a collaborative partnership with Conemaugh Health System, a three-hospital system based in Johnstown, Pa. Under the deal, Somerset Hospital would remain an independent hospital. Over the next several months, the two sides will create a joint venture operating agreement to collaborate on physician practice development and improved continuity of care. Somerset Hospital and Conemaugh — located roughly 27 miles apart — expect to reach a definitive agreement by Jan. 1. Officials said the agreement, which is neither a merger nor acquisition, will "support job retention" but did not specifically say if departments or jobs would be cut. They also said "community benefit," not the Patient Protection and Affordable Care Act, was the main driver to sign a deal.
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"The trend toward hospitals working together rather than competing against one another is not going away," Somerset Hospital CEO Ron Park said in a news release. "The evolution of healthcare — and increasing market and regulatory pressures — are making collaboration necessary, particularly for community hospitals. Ultimately, the people of the region benefit when resources are used to expand rather than duplicate services."
Aetna, WellSpan Partner for Payer's First Pennsylvania ACO 10 October, 2013 | Becker's Hospital Review http://www.beckershospitalreview.com/accountable-care-organizations/aetna-wellspan-partnerfor-payer-s-first-pennsylvania-aco.html WellSpan Health in York, Pa., has partnered with Aetna for an accountable care organization, the insurer's first ACO in Pennsylvania. Aetna plans to introduce fully insured and self-insured health plans using WellSpan and the system's physician network, according to the news release. A fully insured plan will be available April 1, 2014. WellSpan will take on risk for quality and cost outcomes of Aetna's members who see the system's physicians. The agreement is based on quality, efficiency and patient satisfaction metrics, including: •
Percentage of Aetna members who receive recommended preventive care and screenings
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Improved chronic disease management
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Reduced readmissions
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Reduced avoidable emergency room visits
"We are changing the relationship between health systems and insurers and creating a model that will improve healthcare quality, efficiency and affordability," Patrick Young, president of Aetna's Pennsylvania and Delaware operations, said in the release. "Innovative relationships such as this hold much potential to improve the quality and efficiency of healthcare in our region," Kevin Mosser, MD, president and CEO of WellSpan, said in the release.
Health chain buys Pacific Hospital of Long Beach 09 October, 2013 | Orange County Register http://www.ocregister.com/articles/hospital-530190-pacific-molina.html A Santa Fe Springs-based healthcare management company has acquired Pacific Hospital of Long Beach, according to an executive involved in the deal.
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The move by College Health Enterprises Inc. to purchase Pacific Hospital comes as Pacific Hospital faces state and federal investigations into alleged fraudulent spinal surgeries for workers' compensation cases. The deal was confirmed Tuesday evening by John Molina, CFO of Molina Healthcare Inc., and whose Long Beach-based company will be involved in managing the community hospital at 2776 Pacific Ave., a first in its portfolio of businesses. Molina said he expects the hospital to expand with the rollout of the Affordable Care Act, which is designed to give medical service to low-income people. “The focus of Pacific Hospital is to create access to what before had been barriers,� he said. Financial terms of the acquisition by College Health, which was founded in 1986 and operates hospitals in Cerritos and Costa Mesa, were not disclosed. The deal became effective at midnight Tuesday, said Molina. As of late Tuesday, Barry J. Weiss, president of College Health, hadn't returned a phone call seeking comment. Laura Salas Reyes, a Pacific Hospital spokeswoman, also didn't return calls seeking comment Tuesday. In September, Salas Reyes didn't respond to questions from the Register on a filing with the state's Employment Development Department that disclosed the hospital intended to lay off all 704 of its workers. However, such filings can sometimes be misunderstood. They occasionally signal a change in ownership, which may or may not involve layoffs. Molina wouldn't say Tuesday how many layoffs, if any, would occur with the sale. Molina Healthcare, a managed care insurer specializing in Medicaid-eligible families and individuals, said it will form a separate business unit to manage College Health's acute-care services at Pacific Hospital. The new Molina Healthcare unit is to be called American Family Care Hospital Management, Molina said. Molina said the newly created business unit will retain more than 300 of Pacific Hospital's 700 workers. He was uncertain how many of the employees College Health will keep. As part of the deal, College Health is to run two of Pacific Hospital's psychiatric units. One is located at the main campus, with a smaller one located at Pacific Avenue and Pacific Coast Highway. Pacific Hospital is a full-service teaching hospital with 184 licensed acute-care beds, according to a filing with the California Office of Statewide Health Planning & Development. It was purchased in 1997 by HealthSmart Pacific Inc., located in Long Beach. The sale of the hospital comes amid multiple state and federal investigations. In essence, the hospital has run afoul of a quasi-governmental carrier that makes payments on workers' compensation claims in California.
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In June, the State Compensation Insurance Fund filed a complaint in federal court in Santa Ana claiming Pacific Hospital of Long Beach and other entities affiliated with it have been running scams for years to illegally boost payments for medical services provided to injured workers. The carrier, which oversees workers' compensation claims for the state, wants to recoup some of the $160 million it has paid over the past dozen years under civil statutes used to prosecute organized crime syndicates. The Compensation Insurance Fund filed the federal lawsuit under the Racketeer Influenced and Corrupt Organizations Act against Pacific Hospital owners Michael D. Drobot Sr. and his son Michael R. Drobot Jr., the principals of HealthSmart Pacific, and several companies they operate, alleging five different schemes to illegally boost payments by the insurance fund. The Drobots couldn't be reached for comment Tuesday. The fund uncovered the alleged schemes after it launched an investigation into Pacific Hospital's bills. It had learned of reports that the Federal Bureau of Investigation had served search warrants at the hospital and an affiliated entity, Industrial Pharmacy Management. Jennifer Vargen, a spokeswoman with the Compensation Insurance Fund, declined to comment on the lawsuit Tuesday. Molina said his company is legally shielded from the lawsuit, and the investigations that are already underway. His family has deep ties with Pacific Hospital. His father, C. David Molina, the founder of Molina Healthcare, ran its emergency room from 1962 to 1994. Pacific Hospital stretches back to the Great Depression, according to the hospital's history published on its website. It was founded in 1932 by a group of civic-minded doctors.
Robert Wood Johnson, Rutgers Partner for Unique Potential Medicare ACO 08 October, 2013 | Becker's Hospital Review http://www.beckershospitalreview.com/accountable-care-organizations/robert-wood-johnsonrutgers-partner-for-unique-potential-medicare-aco.html Rutgers University, with campuses across New Jersey, and Robert Wood Johnson Health System in New Brunswick, N.J., are collaborating to form a potential Medicare ACO, according to Rutgers Today article. The ACO is called Robert Wood Johnson Partners and is unique because of Rutgers involvement in the organization, according to the report. Different academic disciplines at Rutgers, including communications, engineering and psychology, will work with the ACO to find the best way to cut costs and become patient-centered. Robert Wood Johnson Medical School became a part of Rutgers in 2013.
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"The reason for Robert Wood Johnson Medical School and Rutgers to be involved is to answer the many outstanding questions about how a system should work," Alfred Tallia, MD, chair of the department of family medicine and community health at Robert Wood Johnson Medical School, explained in the report. Robert Wood Johnson Partners is hoping to be approved as a Medicare ACO within 2014.
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