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News Briefs |
Updated December 31, 2008 |
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| Pennsylvania ranks 41st nationwide in amputation rate, with 1.23 lower-limb amputations per 1,000 Medicare beneficiaries. | The national average from 2003 to 2006 is 1.1 amputations per 1,000, according to the Dartmouth Atlas, which gives Pennsylvania the worst amputation rate in the Northeast – 15 percent higher than Indiana and 38 percent higher than Rhode Island and Michigan – while only 10 southern states and West Virginia have worse rates than Pennsylvania, reported the Post-Gazette. Pennsylvania's high rate of amputations reflects a large incidence of poorly controlled diabetes, while poverty and lack of health care resources and podiatrists also lead to higher rates of amputation. A diabetic patient’s life expectancy after an amputation drops to 18 months on average because of lack of mobility and added stress on the patient's already damaged heart, the Post-Gazette added. (Pittsburgh Post-Gazette, December 29, 2008) | |
| Faced with falling tax revenues and growing budget gaps, states across the country are cutting Medicaid. | Some 19 states have already lowered payments to hospitals and nursing homes, eliminated coverage, and forced some people out of the program and many are looking at deeper cuts, reported the Wall Street Journal. President-elect Obama’s stimulus plan is likely to include $100 billion in aid to the states, largely to shoulder more of the costs of Medicaid and perhaps prevent more benefit cuts or tax hikes at the state level, while some in Washington are considering using federal money to extend Medicaid to people who are unemployed and have lost their health benefits, the Journal added. (Wall Street Journal, December 26, 2008) | |
| President Bush leaves office with a health care legacy in bricks and mortar: he has doubled federal financing for community health centers, enabling the creation or expansion of 1,297 clinics in medically underserved areas. | For those in poor urban neighborhoods and isolated rural areas, including Indian reservations, the clinics are often the only dependable providers of basic services like prenatal care, childhood immunizations, asthma treatments, cancer screenings and tests for sexually transmitted diseases, reported the New York Times. Despite the clinics' unprecedented growth, wide swaths of the country remain without access to affordable primary care. In response, Democrats on Capitol Hill are proposing even more significant increases, making the centers a likely feature of any health care deal struck by Congress and the Obama administration, the Times added. (New York Times, December 26, 2008) | |
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| Pennsylvania received an overall grade of C+ and tied for 8th in the nation for its support of emergency patients in a national report card on state of emergency medicine released by the American College of Emergency Physicians (ACEP). |
The report card comes at a time when the national picture looks
bleak: job and insurance losses, a rapidly growing senior population and a
recent survey forecasting critical shortages of primary care doctors all point
to escalating emergency patient populations. The low point of Pa.’s report
card was in the category of medical liability environment where it received a
grade of D and a national ranking of 38th. The primary factors behind the low
grade revolve around high malpractice payments.
The state’s grade of C- and ranking of 23rd in access to emergency care was due specifically to the state’s need for primary care and mental health providers, high hospital occupancy rates, and low Medicaid reimbursement rates for office visits. Medicaid reimbursement for office visits are only 54.5 percent of the national average, despite a 38.1 percent increase between 2004 and 2007. On a positive note, slightly more than seven percent of children and fewer than 11 percent of adults in Pa. are uninsured compared with averages of 11.7 and 17.2 percent nationwide. Pa. also fared well in the category of public health and injury prevention with a grade of B- and a national ranking of 17th. However, negative indicators such as the state’s infant mortality rate, high smoking and binge drinking rates, lack of mandatory motorcycle helmet law, and a lower than average score on child safety seat/seat belt legislation prevented the state from receiving a higher grade and ranking. (Pennsylvania Chapter of the American College of Emergency Physicians, December 5, 2008) |
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| Open enrollment for the Medicare Part D prescription plan ends Dec. 31, and up to 300,000 eligible Pennsylvania seniors may still be without coverage. | With premiums for some plans going up Jan. 1, those already enrolled are being urged to see if a different plan works better for them, while some current beneficiaries have received notice that their monthly premiums, co-payments and deductibles will increase after Jan. 1, in excess of $50 for some families, reported the Post-Gazette. Many of Pa.’s seniors without coverage may have decided the monthly premium isn't worth it because they use so few prescriptions but, as an inducement for people to enroll sooner, premium costs go up 1 percent every year seniors delay signing up, the Post-Gazette added. (Pittsburgh Post-Gazette, December 19, 2008) | |
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| Pennsylvania's Senate Banking and Insurance Committee voted 10-to-4 to recommend against the merger of health insurers Highmark Inc. and Independence Blue Cross. | The committee's action is nonbinding and, in case Insurance Commissioner Joel Ario decides to approve the merger, the committee outlined 11 conditions that it would like to see attached to the deal, reported the Business Journal. Among the reasons the committee opposed the merger is that it would "tend to create a monopoly" by creating the seventh-largest insurance company in the country, controlling 53 percent of the overall insurance market in Pennsylvania, the Business Journal noted. The conditions the committee would like to see attached to merger approval include prohibitions against the new company entering into exclusive provider agreements with hospitals and doctors, and against charging access fees to other Blues plans that may want to use the new company's network of doctors and hospitals; while the committee also recommended that future premiums be set without regard to the member's health, the Business Journal added. (Philadelphia Business Journal, November 20, 2008) | |
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| The number of Pennsylvania adults on a waiting list for state-subsidized health insurance has reached an all-time high. | The waiting list for the adultBasic insurance program had 145,800 adults as of the beginning of December, reflecting an increase of about 15,000 since November – a record-high monthly spike, reported the Associated Press. The waiting list has been at six figures for the past several months, while the program currently serves 46,543 working Pennsylvanians who lack health insurance, but whose incomes are too high to qualify them for federal Medicaid health benefits, the Associated Press added. (Associated Press, December 24, 2008) | |
| American College of Physicians President Jeffrey Harris sent a letter to HHS nominee Tom Daschle asking that the Obama administration’s economic stimulus package include a 10 percent pay bonus for all services provided by primary care docs under Medicare for a period of 18 months. | The letter also requests that primary care practices, especially small ones, get a piece of the funding pie for health information technology; Obama has pledged to spend billions of dollars on that endeavor, reported the Wall Street Journal. The 18 months when the bonus would be in effect would stabilize funding for primary care practices, especially smaller ones, which are an essential part of the safety net that people rely on for their care, especially in tough economic times. Primary care physicians who own small practices are struggling to survive because of inadequate access to credit, losses in their own investments, slower collections and more "bad debt" and uncompensated care as their patients are unable to pay their bills and the numbers of uninsured increase. Without funding to stabilize primary care practices, the letter said, many will go under and have to close, the Journal added. (Wall Street Journal, December 18, 2008) | |
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| Five area hospitals have cut ties with Cigna Healthcare in the latest clash between health care providers and health insurers over payment rates. | Philadelphia-based Cigna's contracts expired recently at Mercy Fitzgerald in Darby, Mercy Philadelphia in West Philadelphia, Mercy Suburban in East Norriton, Nazareth in Northeast Philadelphia and St. Mary Medical Center in Langhorne, reported the Business Journal. Mercy said that it has been unable to reach resolution of several key issues despite many months of negotiations, and that it will continue good-faith discussions with Cigna with the hope of reaching an agreement on the terms of a new contract for its hospitals, the Business Journal noted. The absence of new contracts means the hospitals are no longer part of Cigna's hospital network, and that any patients using the hospitals for elective procedures will have to pay high deductibles and co-payments associated with going to an out-of-network provider, the Business Journal added. (Philadelphia Business Journal, November 21, 2008) | |
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| The Children's Hospital of Philadelphia and a donor have gone back to the drawing board after clashing with elected officials in a Montgomery County borough over where to build a proposed pediatric care center. | CHOP and Nicholas Karabots have scrapped their original idea to open the center on Main Street in Norristown to improve children's access to medical care, reported the Business Journal. This summer, Karabots and his wife Athena provided CHOP with one of its largest donations ever when they made the $15 million pledge to the West Philadelphia pediatric hospital, while CHOP in July said it would use the funds to open a pediatric care center in Norristown, to be called the Karabots Pediatric Care Center, the Business Journal noted. The plan was to spend $5 million to create the center and use the remaining $10 million to create an endowment to cover any operating losses, the Business Journal added. (Philadelphia Business Journal, December 15, 2008) | |
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| Joseph W. "Chip" Marshall III will resign as president and CEO of Temple University Health System Dec. 15. | Marshall said he was considering new opportunities after having been approached by other possible employers, and said the recent hiring of Edmond Notebart as senior executive for health affairs at Temple University gave him assurance that health care at Temple "will remain in good hands for years to come," reported the Business Journal. Marshall started with the health system in 1995 as a founding member of the Health System Board of Directors, became chairman of the board in 2000 and was appointed CEO in 2001, the Business Journal added. (Philadelphia Business Journal, November 6, 2008) | |
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| Independence Blue Cross said it will extend its support for the Partnership for Patient Care, a quality and patient safety effort led by southeastern Pennsylvania hospitals, with funding of $3 million through 2011. | The funding will be provided to the Health Care Improvement Foundation, a nonprofit health and safety organization that oversees the partnership’s projects, while matching funds are expected to be raised from the hospital community next year, reported the Business Journal. Launched in 2006 with three-year financial support of $1.25 million from IBC, the partnership initially focused on the prevention of hospital-acquired infections, and is working on several projects, including preventing pressure ulcers and continuing to raise awareness about antibiotic-resistant staph infections through a new campaign called "Students Fight MRSA," the Business Journal added. (Philadelphia Business Journal, December 16, 2008) | |
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| The Centers for Medicare & Medicaid Services (CMS) has launched its fourth annual health care provider satisfaction survey of Medicare fee-for-service contractors. | The Medicare Contractor Provider Satisfaction Survey (MCPSS) offers health care providers the opportunity to contribute directly to CMS' understanding of contractor performance, as well as aid future process improvement efforts at the contractor level. CMS is sending the 2009 survey, designed to be completed in about 20 minutes, to approximately 30,000 randomly selected providers, including physicians and other health care practitioners, suppliers and institutional facilities that serve Medicare beneficiaries across the country. Providers can submit their responses via a secure website, mail, fax or over the telephone. (Centers for Medicare & Medicaid Services, December 18, 2008) | |
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| The Commonwealth Fund is wading into the hospital-ratings game. | The group’s new site, WhyNotTheBest.org, includes side-by-side comparisons of 4,500 hospitals nationwide and relies on data from Medicare’s Hospital Compare Web site and from the Hospital Consumer Assessment of Healthcare Providers and Systems, a survey of patients’ experience in U.S. hospitals, reported the Wall Street Journal. Hospital-ranking programs and rating systems have proliferated in recent years, such as Leapfrog Group’s safety ratings, Healthgrades’s report cards, and Medicare’s National Voluntary Hospital Reporting Initiative, the Journal added. (Wall Street Journal, December 17, 2008) | |
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| The U.S. spends $650 billion a year more on health care than expected for a country with our GDP, according to a McKinsey report. | Although Americans are more obese than people in other developed countries they are younger and less likely to smoke than their counterparts in other countries, so the disease burden is actually slightly lower here, reported the Wall Street Journal. Most of the excess spending is going to outpatient care – including visits to doctors offices, emergency rooms and outpatient surgery centers and imaging facilities – accounting for a total of $850 billion out of the $2.1 trillion the U.S. spends on health care – about 41 percent of the total, and about $436 of $650 billion in excess spending, the Journal added. (Wall Street Journal, December 17, 2008) | |
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| Prescription drug makers updated their voluntary standards for direct-to-consumer advertising to make the ads more informative, but the measures stop short of changes sought by government and industry critics. | The companies said they will halt advertising that includes promoting prescription drugs for uses that the Food and Drug Administration hasn't approved or using actors as physicians without saying so, while the guidelines say celebrity endorsers shouldn't say they use a drug unless they actually do, reported the Wall Street Journal. The Pharmaceutical Research and Manufacturers of America, the industry trade group that issued the standards, said the aim was to address the concerns of doctors, Congress and other critics while continuing to keep patients informed about valuable treatments, the Journal noted. Critics said the changes announced don't go as far as those advocated by a panel on drug safety for the Institute of Medicine, including that companies wait two years before advertising a prescription drug directly to consumers so that its effects can be better understood, while critics also said that television ads should include the phone number at the FDA for patients to call to report a side effect. Under the voluntary standards, only print ads would include the number, the Journal added. (Wall Street Journal, December 11, 2008) | |
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| Hospital emergency departments are not as safely designed and managed as they should be and improvements in working conditions are needed, according to a study published online in the Annals of Emergency Medicine. |
Researchers surveyed 3,562 emergency medicine clinicians in 65
hospitals to examine their perceptions about their emergency department’s
safety. At all of the hospitals surveyed, respondents reported problems with
the safety of emergency care systems; for example, the majority of respondents
said that emergency departments consistently lack sufficient space to deliver
patient care.
The study also found that:
The researchers recommend the following improvements.
(Agency for Healthcare Research and Quality, December 9, 2008) |
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| St. Luke’s Quakertown Hospital, coming off the best financial year in its 78-year history, is spending nearly $20 million on two building projects and a renovation project designed to make care more accessible and to free up space in the medical center. | To bring services out to the Upper Perkiomen Valley area served by the hospital in northern Montgomery County, St. Luke’s Quakertown is building a $9 million outpatient care center that will offer a mix of primary care, specialty care, diagnostic and physical therapy services when it opens this spring, reported the Business Journal. The hospital is also spending another $7.5 million to $8 million to create a three-story bone and joint institute in Quakertown less than a quarter-mile from the main hospital, and is investing another $1 million to renovate and modernize 40 beds in medical-surgical and intensive-care units at the hospital, the Business Journal added. (Philadelphia Business Journal, November 14, 2008) | |
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| Two community hospitals in the suburbs – Brandywine Hospital in Coatesville and the former Central Montgomery Medical Center in Lansdale – now say they are closing their maternity units, bringing the number that have closed in southeastern Pa. since 1997 to 17. | According to the Maternity Care Coalition, that leaves 25 hospitals in Philadelphia and the four suburban Pennsylvania counties that have maternity units. Hospitals say that low reimbursement rates from insurance companies, especially for women on Medicaid, and the high cost of malpractice insurance often make running a maternity unit a money-losing proposition, reported the Inquirer. Abington Memorial Hospital, which purchased Central Montgomery Medical Center and renamed it Lansdale Hospital, said Lansdale’s small obstetrical unit will close Feb. 1, and that obstetricians can apply for privileges at Abington, which has a much larger program, the Inquirer noted. Brandywine's program is scheduled to close by the end of this year, while its two obstetricians have resigned and the hospital has been unable to recruit more, the Inquirer added. (Philadelphia Inquirer, November 6, 2008) | |
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| After a national search, Mark L. Tykocinski, M.D., has been named dean of Jefferson Medical College and senior vice president of Thomas Jefferson University in Philadelphia. | Tykocinski will also serve as president of Jefferson University Physicians, the faculty practice plan, while the University Board of Trustees’ appointment takes effect December 1, 2008. As dean of Jefferson Medical College, Tykocinski will guide the research mission of the college and its nearly 1,000 full-time faculty, will actively implement Jefferson’s basic and translational research agenda, and will provide leadership and direction for the clinical practice plan for faculty. Before coming to Penn, Tykocinski spent 15 years at Case Western Reserve University, becoming a tenured professor in the Department of Pathology, director and founder of the Gene Therapy Facility at the CWRU School of Medicine, as well as director of the CWRU Molecular Biology Core Facility at the university’s Skin Research Center. (Thomas Jefferson University, November 10, 2008) | |
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| Gov. Rendell has extended through June 30 his executive order enabling the Pennsylvania Health Care Cost Containment Council (PHC4) to remain open. | Since July, PHC4 has been operating under an executive order that was due to expire Nov. 30, while reauthorization of the agency this summer became ensnared in an unrelated political fight between Rendell and Senate Republicans, reported the Inquirer. With that deadline approaching and without a bill he was willing to sign from the state legislature, the governor acted to save the agency, giving the General Assembly – where PHC4 enjoys broad bipartisan support – more time to pass a reauthorization bill after it returns to session in January, the Inquirer noted. PHC4 was forced to shut down briefly in July after its reauthorization was tied to an extension of MCARE abatement, while Rendell repeated his pledge not sign legislation to extend the abatement until the legislature acted on his proposal to make affordable health insurance available to the state's 800,000 uninsured adults, the Inquirer added. (Philadelphia Inquirer, November 20, 2008) | |
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| The Centers for Medicare & Medicaid Services issued its final pay rule for the 2009 physician fee schedule. | Legislation enacted in July reversed a 10.6 percent cut that took effect at the beginning of that month, while starting in January 2009, a 1.1 percent across-the-board increase will replace an additional roughly 5 percent cut that would have gone into effect if lawmakers had not acted, reported the American Medical News. Because the rule applies payment changes related to the most recent five-year adjustment in Medicare relative values for certain services, some physician specialties might see updates slightly larger than or smaller than 1.1 percent, AMNews noted. But CMS stressed that two bonus opportunities exist to more than quadruple the raise that doctors will get for the year: physicians who successfully participate in the Physician Quality Reporting Initiative will receive a 2 percent bonus on all of their Medicare payments for the year, while the program for the first time will award a separate 2 percent bonus to physicians who successfully prescribe medications electronically for their Medicare patients. Although the sums will not be paid out until sometime in 2010, after Medicare has processed all of next year's claims, this means the maximum effective raise for 2009 will be 5.1 percent, AMNews added. (American Medical News, November 24, 2008) | |
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| The Hospital & Healthsystem Association of Pennsylvania (HAP) and the Pennsylvania Medical Society (PMS) sued the state to obtain hundreds of millions in unspent dollars they say should be devoted to the MCARE Fund. | In its petition filed at Commonwealth Court, HAP said the state has violated state law and the Pa. Constitution by failing to transfer dedicated cigarette tax funds to the MCARE Fund to pay for MCARE abatement, which covers all or part of physicians' state-mandated malpractice insurance coverage, reported the Business Journal. The PMS filed its own petition with the Commonwealth Court seeking to preserve funds in a dedicated health care provider retention account earmarked for the eventual phasing-out of the MCARE Fund, which has a projected $1.8 billion unfunded liability. The PMS said the action was filed in response to remarks made on the floor of the state House in Nov. suggesting the funds could be diverted to pay for non-health care projects and to help fill a projected $500 million gap in next year's budget, the Business Journal added. (Philadelphia Business Journal, December 11, 2008) | |
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| Sen. Charles Grassley – ranking Republican on the Senate Finance Committee – is weighing proposing legislation in early 2009 that would hold nonprofit hospitals more accountable for the billions of dollars in annual tax exemptions they enjoy, aides to the Iowa senator said. | The legislation would require nonprofit hospitals to spend a minimum amount on charity care, and set curbs on executive compensation and conflicts of interest, reported the Wall Street Journal. Under the new legislation, penalties would be imposed on nonprofit hospitals that fail to meet the new requirements, while penalties could escalate from taxes and fines to stripping a hospital of its federal-tax exemption if it continues to misbehave, the Journal added. (Wall Street Journal, December 18, 2008) | |
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