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News Briefs |
Updated May 12, 2008 |
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| The University of Pittsburgh Medical Center has landed its first international information technology deal. | UPMC has been chosen to provide electronic medical record gear and expertise to a group of three hospitals in Great Britain, which increases UPMC revenue from nontraditional sources at a time when government and private insurer payments for medical care have been shrinking, reported the Business Times. Work began April 21 at the Newcastle upon Tyne Hospitals, an industrial area similar to Pittsburgh and located in northeast England, while the system is scheduled to go live in February 2009, the Business Times noted. The information technology contract opens the door for further collaboration between Newcastle and UPMC, as products and services developed during installation will be co-marketed by both institutions, and a memo of understanding has been reached to allow both health systems to explore research opportunities, the Business Times added. (Pittsburgh Business Times, May 5, 2008) | |
| The CMS has taken an interest in the Medicare Payment Advisory Commission’s recommendation to increase payments to primary care physicians and may address the issue in future rulemaking, CMS Deputy Administrator Herb Kuhn told the House Small Business Committee. | MedPAC in April had recommended that Congress establish a budget-neutral adjustment to increase payments for doctors who provide primary care services. Kuhn said that, if MedPAC's suggestion is addressed, it is likely to appear in the CMS’ proposed rule on the 2009 physician fee schedule, reported Modern Physician. The American College of Physicians noted that Kuhn’s remarks represent the first indication that CMS is considering MedPAC’s recommendation to help primary care, Modern Physician added. (Modern Physician, May 8, 2008) | |
| The Bush administration proposed to crack down on the aggressive marketing of private Medicare insurance plans by outlawing unsolicited visits and telephone calls to beneficiaries, regulating commissions paid to sales agents and increasing the fines that could be imposed on insurers. | In the last two years, Medicare beneficiaries and state officials have often complained that high-pressure sales tactics led some people to sign up for unsuitable policies and, after reviewing comments from the public, federal officials intend to issue final rules before the marketing of plans for 2009 begins this October, reported the New York Times. Among other things, the proposed rules would allow agents to respond to telephone inquiries, but they could not make "cold calls" to beneficiaries, while agents would also be prohibited from offering annuities, life insurance and other non-health care related products while selling private Medicare plans, the Times added. (New York Times, May 9, 2008) | |
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| The number of medical malpractice case filings last year continued to decline in Pennsylvania but increased slightly in Philadelphia, according to data released by the Pennsylvania Supreme Court. |
Both numbers are down significantly from 2002, the year
before the state Supreme Court instituted rules to prevent venue shopping
for sympathetic juries and required lawyers to secure a certificate of merit
for their cases, and the state legislature created the MCARE Fund to help
subsidize malpractice insurance, reported the Philadelphia Business
Journal.
There were 1,617 medical malpractice cases filed statewide in 2007, compared to 1,693 in 2006 and 2,903 in 2002. In Philadelphia there were 586 filings in 2007, up slightly from 569 in 2006, but on par with numbers from 2003 through 2006, and still less than half of the 1,365 filed in 2002, while data in the four suburban Philadelphia counties were also in line with numbers from 2003 through 2006, the Business Journal noted. In Philadelphia, jury verdicts decreased in frequency and severity. There were 37 medical malpractice jury verdicts, down from 46 in 2006 and 56 in 2005, while the percentage of verdicts for the defense increased to 73 percent from 71.7 percent in 2006, 62.5 percent in 2005 and 59.2 percent between 2000 and 2003, the Business Journal reported. Statewide, the number of verdicts decreased to 185 from 229 in 2006 and 223 in 2005, while the percentage of verdicts for the defense (82.7 percent) was similar to 2006 (83.4 percent), the Business Journal said. There were nine jury verdicts resulting in awards of $10 million or more between 2000 and 2003, compared to five such jury verdicts in the past four years: three in 2004, none in 2005, two in 2006 and one last year. All but one of those was in Philadelphia, with the other occurring in 2006 in Montgomery County, the Business Journal added. (Philadelphia Business Journal, April 14, 2008) |
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Federal health officials proposed adding dangerous blood
clots in the leg and eight other conditions to the list of complications
that Medicare would not pay to treat if they were acquired at the hospital. |
Medicare set a new precedent last year by saying it would no longer pay hospitals for treating eight "never events" – conditions that occur as a result of hospital error, such as giving a patient the wrong blood type, reported the Associated Press. The newly-proposed rules add nine conditions, including: deep-vein thrombosis, ventilator-associated pneumonia, bloodstream infections with the staph aureus bacteria, and Legionnaire's disease. The government estimates that the proposed rule will save Medicare $50 million annually during each of the next three years, the Associated Press added. (Associated Press, April 15, 2008) | |
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| An expansion in Pennsylvania's Children's Health Insurance Program helped add more than 15,000 children to the program in a year, according to the state Department of Insurance. | The program, one of the country's oldest and most successful, grew by nearly 3,000 from February to April, leaving about four percent of children in the state without health insurance, one of the lowest percentages in the country, reported the Tribune-Review. Pa.’s CHIP waiting list emptied during the past year, one year after the state got permission from the federal government to increase income eligibility – to about $42,000 for a family of two and $66,600 for a family of four, the Tribune-Review added. (Pittsburgh Tribune-Review, May 3, 2008) | |
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| The Medicare Health Support program, a three-year experiment to see whether disease management can prevent expensive hospital visits for people with chronic conditions like congestive heart failure and diabetes, may cost more than it saves. |
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| Health insurers are beginning to mine their patient data to look for drug safety red flags. | WellPoint Inc., in collaboration with the Food and Drug Administration, plans to launch one of the first real-time drug-surveillance systems: starting early next year, the insurer will systematically scan the medical information of more than half of its 35 million members to look for hidden patterns or spikes in medical problems that might be linked to certain medication or combination of drugs as they happen, reported the Wall Street Journal. Until now, the drug-safety monitoring system used by the FDA has been spotty, slow and passive, relying largely on harried doctors and drug companies to report problems they see crop up with patients, and capturing less than 10 percent of bad reactions, the Journal added. (Wall Street Journal, April 15, 2008) | |
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| West Penn Allegheny Health System turned a $6.9 million net profit in the first six months of fiscal 2008, up 67.7 percent from the same year-ago period. | The positive outcome can be attributed largely to the effects of a 2007 debt refinancing – including a $5 million reduction in interest expense and a $6.7 million bump in investment earnings, reported the Post-Gazette. Without the investment income, the hospital network actually recorded a $12 million operating loss in the six months ended Dec. 31, which is slightly worse than an $8 million operating deficit in the same six-month period a year ago, the Post-Gazette noted. West Penn is still in the midst of a turnaround that began with the 2000 merger of Allegheny General Hospital and Western Pennsylvania Hospital, and the system is working its way through an integration of services designed to reduce expenses and improve efficiency, the Post-Gazette noted. (Pittsburgh Post-Gazette, April 8, 2008) | |
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| After struggling financially for years, Mercy Jeannette Hospital has finalized its sale to Excela Health, in an effort to stem losses while continuing to provide local hospital care and hundreds of jobs to the Jeannette area. | The hospital, founded in 1959 by the Sisters of Charity of Seton Hill in Greensburg, lost $6.5 million from its operations last year, while it has now been renamed Excela Health Westmoreland Hospital at Jeannette, and joins Frick Hospital in Mount Pleasant, Latrobe Hospital and Westmoreland Hospital (Greensburg) under the Excela name, reported the Post-Gazette. While some services, such as obstetrics, are moving to other Excela facilities, the hospital will continue providing emergency care; inpatient care, including medical, surgical and critical care service; and advanced diagnostics, the Post-Gazette added. (Pittsburgh Post-Gazette, May 8, 2008) | |
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| Erie’s Community Health Net is transferring its obstetrical services to Saint Vincent Health Center, beginning June 1. | Community Health Net, which treats about 15,000 patients a year – most of whom have no health insurance or are covered by Medicaid – transferred the practice to Saint Vincent because they could no longer afford to operate it themselves, while the obstetric office lost between $100,000 and $125,000 in 2007, reported the Erie Times-News. Saint Vincent said it will be able to offer the service for less money because it already has physicians under contract to provide obstetric services, the Times-News added. (Erie Times-News, April 4, 2008) | |
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| The Pennsylvania Patient Safety Authority released its 2007 Annual Report outlining a strategic plan that aligns its activities more closely with its educational and quality improvement mission. |
Selected initiatives are aimed at educating hospital boards
in their role in promoting patient safety, creating an online forum for more
routine sharing of best practices and lessons learned among patient safety
officers and creating a patient safety liaison pilot program that will offer
health care facilities on-site education or quality improvement assistance
from the Patient Safety Authority. The data in the 2007 Annual Report shows
that there is substantial variation in the number of reports submitted by
different health care facilities.
While a vast majority of hospitals are reporting serious events (events that cause harm to the patient) and incidents (events that do not cause harm to the patient), the volume varies greatly from facility to facility, which the Authority attributes largely to differences among them regarding how to interpret language in Act 13 as to what is reportable. The Authority will work with the Department of Health to offer facilities more guidance as to what should be reported to bridge the gap in facility reporting levels. (Patient Safety Authority, April 30, 2008) |
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| Drug and medical device companies should be banned from offering free food, gifts, travel and ghost-writing services to doctors, staff members and students in all 129 of the nation’s medical colleges, the Association of American Medical Colleges has concluded. |
The proposed ban is the result of a two-year effort by the
group to create a model policy governing interactions between the schools
and industry and, while schools can ignore the association’s advice, most
follow its recommendations, reported the New York Times. In addition
to the gift, food and travel bans, the report recommended that medical
schools:
(New York Times, April 28, 2008) |
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| The pace of health care quality improvement appears to be slowing, according to the Agency for Healthcare Research and Quality's fifth annual report compiling federal and state data on more than 200 quality metrics. | A composite measure of health care quality improved at a 2.3 percent average annualized rate between 1994 and 2005, with the rate falling to 1.5 percent from 2000 to 2005, reported American Medical News. In a first stab at examining the cost efficiency of the American health care system, AHRQ noted that costs, as estimated by the Centers for Medicare & Medicaid Services, jumped 6.7 percent from 1994 to 2005, although AHRQ said that cost and quality cannot be reliably compared because expenditures are comprehensively measured, but quality is not, AMNews added. (American Medical News, April 28, 2008) | |
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| Doctors who want to go paperless when ordering drugs for their Medicare patients now have a set of federal standards on how to do it, while those who are prescribing electronically already have a year in which to become compliant with the rules. | The Centers for Medicare & Medicaid Services on April 2 released final e-prescribing regulations for Medicare Part D under which physicians and pharmacies will not be required to use electronic prescriptions but must follow the new standards if they do, reported American Medical News. The regulations, set to take effect in April 2009, have four categories – formulary and benefits, medication history, fill status notification, and provider identifiers – while the standards, required by Medicare law, will govern how physicians, pharmacies and drug plans will communicate electronically to handle drug orders, AMNews added. (American Medical News, April 28, 2008) | |
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On average, Pennsylvania's hospitals are making money, but
a quarter of them are still in the red, according to a report released by
the Pennsylvania Health Care Cost Containment Council. |
Forty-one facilities, or 24 percent of the 170 general acute care hospitals statewide, lost money in fiscal 2007, while the number of hospitals with a three-year average total margin of 2 percent or less grew to 29 from 14, reported the Business Times. The average statewide operating margin increased to 4.82 percent in fiscal 2007 from 3.99 percent in 2006, while the average total margin statewide, which includes revenue from investments and other sources unrelated to patient care, grew by more than a full percentage point to 6.51 percent in fiscal 2007 from 5.39 percent in fiscal 2006, the Business Times noted. Nearly three-fourths of the increase in total margin came from growth of $341 million in operating income, the Business Times added. (Pittsburgh Business Times, April 18, 2008) | |
| For the third time in less than a year, The Western Pennsylvania Hospital and its Forbes Regional affiliate have a new chief executive officer. | Dawn Gideon – a health care consultant who once was a senior executive with the Allegheny Education Health & Research Foundation, and is currently a managing director with Huron Consulting Group in New York – will start May 5, replacing Ed Klaman, who the system said was appointed on an interim basis, reported the Post-Gazette. Klaman, who was vice president of The Western Pennsylvania Hospital from 2002 until April 2007, re-emerged from retirement last summer to run Western Pennsylvania Hospital after Mark Palmer resigned, while Palmer's exit came just a week after Jerry Fedele, chief executive of parent group West Penn Allegheny Health System, departed amid concerns about the pace of a long-promised consolidation of The Western Pennsylvania Hospital and Allegheny General Hospital on the North Side, the Post-Gazette added. (Pittsburgh Post-Gazette, April 11, 2008) | |
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The University of Pittsburgh Medical Center lost money
during the first nine months of fiscal 2008. |
Net income was a negative $7 million, compared with a gain of $459 million in the year-ago period, the drop largely due to turmoil in financial markets and the resulting pressure on UPMC's $3 billion equity and fixed-income investment portfolio, reported the Post-Gazette. Despite the overall decline, UPMC pointed to its sizable cash flow, six percent growth in admissions to its 20 hospitals, a 12 percent increase in enrollment to its insurance arm and a 12 percent increase in operating revenue, the Post-Gazette added. (Pittsburgh Post-Gazette, May 7, 2008) | |
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| Reports of patients who acquired infections in Pennsylvania hospitals rose 57 percent in 2006 – a spike analysts attribute to better reporting and added categories. | According to the Pennsylvania Health Care Cost Containment Council, the state's 165 general hospitals reported 30,237 infections in 2006, for a rate of 19.2 per 1,000 cases; compared to 19,154 cases, or rate of 12.2 per 1,000, the previous year, reported the Morning Call. The council attributed the increase to significant strides hospitals made in identifying and reporting infections that came from catheters, surgery and unwashed hands, while the council required hospitals to report even more types of infections beginning in the latter half of 2005, the Morning Call noted. Because changing variables did not permit an apples-to-apples comparison from one full year to the next, the council also provided fourth-quarter results, which were more alike: infection rates for the quarter dropped from 16.3 per 1,000 cases to 15.1, a direction that council officials attributed to prevention efforts in hospitals, the Morning Call added. (Morning Call, April 10, 2008) | |
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| Leaders on the Senate Finance Committee are working to move forward on a Medicare bill that would stave off Medicare physician payment cuts. | Sen. Max Baucus (D-Mont.), who chairs the panel, and Sen. Chuck Grassley (R-Iowa), its ranking member, are working with Senate leadership to move a bill this spring that is expected to include several provisions in a bill introduced by Sen. Debbie Stabenow (D-Mich.) that would halt any cuts to Medicare physician payments over the next 18 months, reported Modern Physician. The measure would begin on July 1, staving off a scheduled 10 percent cut to physician reimbursement, while maintaining physician payments at their current level for the rest of 2008, and in 2009 implementing a 1.8 percent increase, Modern Physician added, noting that temporary halts to these types of payment reductions—triggered by Medicare’s sustainable growth-rate formula—have been implemented frequently by Congress over the past five years, Modern Physician. (Modern Physician, April 1, 2008) | |
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| The Bush administration appears to be softening a policy that states have complained hindered their efforts to expand health care coverage for poor children under the State Children's Health Insurance Program. | In a letter sent to states, the administration says it will give states more flexibility to prove that they have enrolled 95 percent of poor children from eligible families – a condition, laid out in an August directive, for using federal funds to expand coverage under SCHIP, reported the Wall Street Journal. Hardly any state meets that threshold, and since then several states have been forced to scale back their plans to expand coverage beyond children from families at twice the poverty level of $42,400 for a family of four, the Journal noted. The administration’s letter said it will qualify many of the 15 states that may not have met the criteria using data from the Current Population Survey; for example, state surveys can now be used, the Journal added. (Wall Street Journal, May 8, 2008) | |
| A bill that would prohibit discrimination by health insurers and employers based on the information that people carry in their genes won final approval in Congress. | The legislation, which President Bush has indicated he will sign, prohibits health insurance companies from using genetic information to deny benefits or raise premiums for individual policies – it is already illegal to exclude individuals from a group plan because of their genetic profile – while employers who use genetic information to make decisions about hiring, firing or compensation could be fined as much as $300,000 for each violation, reported the New York Times. Some patients worry that they may be denied jobs or face higher insurance premiums if a genetic red flag shows up in their medical records, while many who do learn that they are at higher risk for a disease opt not to ask their insurance companies to cover the costs of the genetic test, to keep the information secret. Some try to persuade medical professionals not to enter the test results in their health records; others keep the information from even their own doctors, the Times noted. The bill may be hard to enforce, some experts say, and it does not address discrimination by long-term care insurers or life insurers, the Times added. (New York Times, May 2, 2008) | |
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The Pennsylvania House approved legislation that would
impose new underwriting guidelines on health insurance plans offered to
individuals and small businesses. |
The legislation, which now moves on to the Senate, would limit the ability of health plans to consider certain factors such as health history in setting rates, while insurers could consider age and geographic region in setting rates, reported the Post-Gazette. The bill also would require insurers to spend 85 percent of premiums on health care or be required to issue rebates to policyholders, while it also would allow the Insurance Department to disapprove a rate increase request, in part, because the insurer has not operated efficiently or has not controlled costs for avoidable hospital-acquired infections or management of chronic disease, the Post-Gazette added. (Pittsburgh Post-Gazette, April 2, 2008) | |
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