Health Policy News and Views
Compiled by Benita M. Dodd
Vice President, Georgia Public Policy Foundation
If you want a job done right: Does your doctor’s gender make a difference? A Canadian study found that found female physicians outperformed their male counterparts on certain metrics of care. Researchers studied physicians who treat elderly patients with diabetes and measured compliance with three parts of standard treatment: prescribing periodic eye exams, scheduling annual physical exams and keeping patients on a mix of three specific medications. It found that 75 percent of women required patients to undergo an exam compared with 70 percent of males; 71 percent of female physicians recommended the three specific medications compared with 67 percent of the males, and 39e percent of women asked patients to undergo a complete physical exam compared with 33 percent of male physicians. Interestingly, the younger the physician, the narrower the gender divide was between performance on the metrics
But if you want greater productivity: Male physicians had higher productivity, reporting nearly 1,000 more procedures per year compared with female physicians. (Probably because they refused to stop to ask for directions.) Source: Becker’s Hospital Review
CEO compensation and the machine that goes ‘ping:’ A Harvard study released this week found that CEOs at nonprofit hospitals around the country had an average compensation of $595,781 in 2009, with no association between CEO pay and hospital quality. Publicly available measures of quality – readmission rates, mortality rates and how closely hospitals’ providers followed a number of publicly reported care guidelines – were not linked to pay. Instead, CEOs at hospitals with advanced technology tended to have substantially higher pay, and the only quality-related metric linked to CEO compensation was patient satisfaction. On average, the group of hospitals with the highest patient satisfaction scores paid their CEOs nearly $626,000 while CEOs of hospitals in the group with the lowest scores earned $574,000, according to the study. Source: Becker’s Hospital Review
Costly conditions: Hospital stay costs in 2011 totaled about $387 billion. According to the Agency for Healthcare Research and Quality, Medicare and Medicaid picked up most of the inpatient hospital tab – 63 percent, or $242.9 billion. Commercial insurers covered 29 percent, or $112.5 billion, while the remaining $17.1 billion went toward uninsured hospitalizations. The other $14.5 billion was labeled as “other/missing,” according to AHRQ. Which inpatient conditions were most expensive? The costliest conditions are below (and No. 1 is the reason to stay away from hospital stays):
1. Septicemia (except in labor) – $20.3 billion
2. Osteoarthritis – $14.8 billion
3. Complication of device, implant or graft – $12.9 billion
4. Liveborn (general childbirth) – $12.4 billion
5. Heart attack – $11.5 billion
6. Spondylosis, intervertebral disc disorders, other back problems – $11.2 billion
7. Pneumonia (except caused by tuberculosis and STDs) – $10.6 billion
8. Congestive heart failure – $10.5 billion
9. Coronary atherosclerosis – $10.4 billion
10. Adult respiratory failure – $8.7 billion
Emory hospitals make national Top 10 list: The University HealthSystem Consortium has named Emory University Hospital and Emory University Hospital Midtown to its Top 10 list for quality as part of the organization’s 2013 national UHC Quality Leadership Awards. Emory University Hospital, which includes Emory University Orthopaedics & Spine Hospital, is ranked No. 2; Emory University Hospital Midtown is No. 3.
Pamper preference? As patients’ experiences become more important to a hospital’s reputation, hospitals are increasingly going the extra mile to provide a positive experience for their patients The New York Timesreported recently on hospitals with hotel-like luxuries to improve the patient experience. Henry Ford Health System in Detroit hired a former executive from the Ritz-Carlton Group to improve in-hospital dining and other patient amenities; St. Dominic Hospital in Jackson, Miss., offers medical spa services, and New York’s Mount Sinai Medical Center offers butler services and high thread-count sheets. But hospitals don’t need to go the extra thread count for customer service. Optimizing the admissions and check-in process can do it, according to Anna Pappas, president of KnowQ Solutions. The right technology can “give hospitals the opportunity to reduce patient wait time and enhance their experience while also improving the business process and gathering real-time information,” Pappas says. If you’ve been at a hospital recently, you know the hurry-up-and-wait is a pain in the neck … especially if you have a pain in the neck already.
Telemedicine
Expands access: Blue Cross and Blue Shield of Oklahoma has awarded Oklahoma State University (OSU) Center for Health Sciences in Tulsa $250,000 to expand the center’s telehealth network and improve access for rural residents. The OSU Telehealth Network currently extends to more than 60 sites across 49 cities and towns, and includes a mobile telehealth clinic to provide care in locations without a fixed site. The network allows rural residents to have increased access to primary and specialty care physicians from OSU.
Saves trouble and time: Telehealth appointments are a safe substitution for postoperative appointments for certain ambulatory surgery patients, according to a study published in JAMA Surgery. Researchers tracked the patients accepting a telehealth follow-up and complications 30 days after surgery in a group of about 150 patients. A physician assistant called two weeks after surgery and administered an assessment designed to screen for infection or trouble returning to daily activities. If the assessment did not detect problems, the patient was “discharged” from the telehealth appointment. Of the more than 80 patients accepting a telehealth-only follow-up, only three complications were reported. Most patients expressed high levels of satisfaction with the telehealth follow-up, according to the study. And clinic time saved was used for scheduling other patients, according to the study authors.
Saves lives: The use of a telemedicine network in ARkansa successfully reduced the number of infants born with very low birth weights and was associated with a statewide drop in infant mortality, according to a study published in September in the Journal of Perinatology. Researchers examined low birth rates and infant morbidity and mortality before and after the implementation of a telemedicine network across nine rural Arkansas hospitals with high birth rates and lack of a neonatal intensive care unit. Telemedicine was used to provide remote consults and education from specialists at the University of Arkansas for Medical Sciences. The study found a drop in deliveries of low-weight babies from 13.1 percent to 7 percent and a decline in infant mortality, from 13 percent to 6.7 percent.
Changes delivery: Blue Cross Blue Shield of Minnesota recently handed out more than 5,000 vouchers for free physician visits to state fair attendees. The vouchers are redeemable through Online Care Anywhere, an e-consultation service. Registered users can communicate live with a physician able to answer questions, make diagnoses and prescribe medications. The service, launched in 2009 for employers to offer to employees, has expanded to be incorporated into benefits packages to BCBS members across the country, as well as to anyone who logs onto the service. Now available to residents in 30 states, BCBS has plans to expand the service to all 46 states that permit telemedicine. Is it available near you? Find out here: www.onlinecareanywheremn.com/servicemap.php.
Expands knowledge: The Knowledge for Health Project, implemented by the Johns Hopkins Bloomberg School of Public Health, launched a new Web site designed to bring together accumulated global knowledge on mHealth (mobile health) programs to offer best practices. The site, mHealthEvidence.org, currently features 4,360 searchable records and reports, and will continue to expand in the coming months
ObamaCare oopsies: National Review’s Rich Lowry sums it all up: “In a White House speech, President Barack Obama assured the public that his new health-care law is up and running even in the absence of a functioning website. He told people they can call an 800 number instead of buying coverage online. Reporters duly called the number and got busy signals, or when getting through and following the directions, got referred back to healthcare.gov.
“This, no doubt, is another ‘glitch,’ the administration’s catchall word for the fact that it is almost impossible to enroll for insurance under Obamacare. It is a sign of just how bad it is that a new word has been added to describe the dysfunction, which is now occasionally referred to as ‘glitches and kinks.’ If the website ever has to be abandoned entirely, the president and his spinners will surely maintain it was undone by ‘glitches, kinks, snags, bugs and hiccups.'”
A glitch: The “Daily Show’s Jon Stewart tackled the ObamaCare fiasco in hilarious fashion. Laugh instead of crying about it when you watch his take at www.youtube.com/watch?v=2Qtx_ZcHOjw.
Quotes of Note
“Always laugh when you can. It is cheap medicine.” – Lord Byron
“There is no medicine like hope, no incentive so great, and no tonic so powerful as expectation of something tomorrow.” – Orison Swett Marden