All Entries in the "Regulation" Category
GMSI Live: Health reform panel talks on new bill passed by House
The Greeley Medical Staff Institute (GMSI) Symposium opened its doors this morning to attendees of the plenary session, “Healthcare reform: What it means for hospitals and physicians.” Just hours after the House of Representatives voted to pass its version of the healthcare reform bill, otherwise known as HR 3962, the Affordable Health Care for America Act, moderator Richard A. Sheff, MD, CMSL, chair and executive director of The Greeley Company joked that many sleepy-eyed attendees, like him, may have also stayed up to watch the House vote of 220-215. The hotly debated issue shocked many as both Republicans and Democrats came to a final vote.
Panelists Jonathan H. Burroughs, MD, MBA, FACPE, CMSL, John Maa, MD, FACS, and Kirk Mathews, MBA, debate what healthcare reform will look like in the coming months. (HospitalistLeadership.com Photo / Karen M. Cheung)
With panelists Jonathan H. Burroughs, MD, MBA, FACPE, CMSL, John Maa, MD, FACS, and Kirk Mathews, MBA, the GMSI Symposium opening session similarly focused on the issues of bundled payments, a public option, and what and when to expect healthcare reform.
Although unclear when the Senate will vote on the healthcare reform bill, many wait with held breathes for reform to become reality.
Reform: Quality, Cost and Access… Access to what?
I have been extremely interested in watching the debate on health ______ reform. I intentionally did not fill in the blank because this has become a bit of a moving target. Of course, this debate began as a discussion on healthcare reform. But somewhere along the line, someone changed the terminology. Now, we no longer hear President Obama discuss healthcare reform, but health insurance reform. I am perfectly okay with this term because I believe it more accurately depicts what the current proposals have become.
Most would agree that early on in the reform debate, three main issues were identified as being central to any meaningful reform—quality, cost, and access. The current bills under consideration in both the House and the Senate contain some elements of all three. However, they all place heavy emphasis on access and do precious little to address quality and almost nothing to address cost (except increase the cost, but that is another blog post). But these bills also beg the question: Access to what? Access to actual healthcare or access to health insurance? Clearly, if you study these bills, they are more focused on providing access to health insurance, and thus, the appropriate shift in the terminology by President Obama and others.
Many physicians favor public option
I just read about a recent study conducted by the Robert Wood Johnson Foundation to gauge physician’s reactions to healthcare reform.
Sixty-three percent of physicians support some type of government-backed healthcare reform, says the study, which appeared in the New England Journal of Medicine .
Check out this article from United Press International.
I’d love to hear what physicians out there think–and why! Comment below.
Contest entry: Hospital quality summit
Here’s another helpful hint about quality from one contest entry submission.
Director of Quality, Rosemary O’Gara, RN, CPHQ, CPHRM, of East Orange General Hospital developed a nursing quality summit, which is a monthly meeting in which managers address quality variances in the same way that budget variances are discussed and reviewed.
At the meeting, they review the following items:
- Falls
- Restraints
- Pressure ulcers
- Pain managements
- Medication reconciliation
Rosemary says, ”Quality outcomes have significantly improved since inception of the summit in September 2008.”
Keep those contest entries coming, and you could win the free registration to The Greeley Medical Staff Institute Symposium (Nov. 8-9, Naples, Fl)!
We’ll share the entries on the blog and select the best one at the end of the month.
To enter the drawing, submit your best practice, tool, or tip to us. Find more details here!
Contest entry: Physician hotline for patient and physician satisfaction
Keeping patients and physicians happy sometimes requires some creative thinking. We liked this tip that came from Gloria Ziegler, CPCS, medical staff services director of Val Verde Regional Medical Center.
Gloria says that her institution strives to improve patient and physician satisfaction. How do they accomplish that goal?
The Val Verde Regional Medical Center currently uses a physician hotline for physicians to call reference any complaints, praises, or new ideas that might be helpful in improving patient/physician satisfaction.
She says,
“We also have established a patient/customer hot line to deal with any concerns that our community might have dealing with their care at our facility. Our administration works extra hard to assure that anyone having concerns or issues which need to be resolved are addressed in a timely manner. We are the only facility in town within a 300-mile radius and must work extra hard to keep our patients from going to San Antonio or San Angelo for care.”
Thanks for sharing!
Keep those contest entries coming, and you could win the free registration to The Greeley Medical Staff Institute Symposium (Nov. 8-9, Naples, Fl)!
We’ll share the entries on the blog and select the best one at the end of the month.
To enter the drawing, submit your best practice, tool, or tip to us. Find more details here!
Are concierge hospitalists coming?
I recently had the opportunity to have lunch with a member of the board of directors of a company called MDVIP and was fascinated by their business model. MDVIP helps primary care physicians transition from a traditional practice model to a concierge practice. This company was featured in a recent article on CNNmoney.com.
Here are some of the basics of MDVIP as I understand them:
- The patient pays an annual retainer of approx. $1,500 or $125 per month
- The practice limits the number of patients to between 300—600
- The physician is accessible to any patient around the clock by cell phone and will even meet the patient in the emergency room when an emergency arises
- The patient keeps his or her health insurance in place
- The patient must take an annual “Mayo Clinic” level physical, and the practice focuses on wellness and prevention
Wherefore art thou tort reform?
By Kirk Mathews, MBA
The more I hear about healthcare reform or “health insurance reform,” the less I hear about tort reform and the more crazed I become! I have written before (Can real health reform happen without tort reform?) about the added costs from defensive medicine. So I nearly blew a gasket, when driving down the interstate recently, I spotted a billboard that read something like this:
Have you ever had Tendonitis? Ever had problems with your Achilles tendon? Ever taken Levaquin? Then call Dewey, Cheatem, and Howe so we can sue on your behalf!
White House launches healthcare reform myth-buster site
Reality Check. It’s the name of the most recent White House initiative in administration transparency, particularly for healthcare reform. Launched last week, www.WhiteHouse.gov/RealityCheck features video clips of prominent healthcare committee members and policy makers who respond to common misconceptions regarding how healthcare reform might affect them, including myths about government rationing, senior citizen euthanasia, and the mandate to change doctors.
Following in the foot steps of recently launched www.Recovery.gov, the Reality Check Web site aims to “combat misinformation,” according to an Aug. 10 White House blog post.
In addition to the videos, the Reality Check Web site includes an FAQ section, a “contact us” box for reader feedback, and social networking links to Facebook and Twitter.
“The road ahead will surely reveal more aggressive efforts from defenders of the status quo to confuse and scare Americans with half-truths and outright lies,” states the White House blog post. “We're all too familiar with the time-tested tactics that opponents of reform have used for decades to prevent the meaningful change our health insurance system needs.”
The RealityCheck Web site does a good job of "from-the-horse's mouth," although I would like to hear more viewpoints in one video. It's definitely worth a watch.
Back to back: Three healthcare reform bills compared
As Congress goes into recess this month, more Americans are wondering what healthcare reform will look like when it takes shape. An Aug. 3 HealthLeaders Media article outlines the major components of three bills.
The HR 3200, America’s Affordable Health Choices Act, also known as the Tri-Conference Bill from the House, involves the controversial public health insurance and health insurance exchange in which patients could elect to use private insurance or a government program.
The Affordable Health Choices Act, also known as the Senate HELP Committee bill, also includes the health insurance exchange option, but with the Senate’s input, touts increased efforts regarding prevention and wellness.
And finally, the Senate Finance Committee bill has yet to be drafted but will likely include a federal mandate that all individuals possess health insurance with assistance for underserved populations.
A contrarian view of hospital medicine
By Richard Rohr, MD, MMM, FACP, FHM
I wrote several months ago about the necessity of hospital medicine. While I still think that hospitalists occupy a vital niche in the healthcare system, let’s consider a perspective that generally has not been expressed.
One of the reasons why hospitalists have become necessary is that hospitals have become unmanageable places for doctors to practice. When I finished training in 1985 and joined the medical staffs at several small hospitals, I was greeted by a vice president in each of those institutions. Each VP asked the same questions: “What can we do for you?” and “Can we buy any equipment for you?” Utilization review was rudimentary in those days; formulary controls were few and far between; and there were not many computers in nursing stations. Doctors did pretty much want they wanted to do when they wanted to do it, and hospitals catered to their whims.
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Don’t pull that plug! EMRs are here to stay
Hospitals in Arizona are pulling the plug on their EMR contracts after fervently trying for several years to comply with former governor Janet Napolitano’s executive order that all hospitals adopt EMRs by 2010, according to Healthcare IT News. Difficulties implementing electronic systems, as well as lack of funding and training, are to blame for this growing trend.
But President Obama seems determined to include EMR in his ever-evolving plan to resuscitate healthcare, so are these hospitals pulling the plug too soon? Granted, an EMR isn’t going to do you any good if you can’t afford it or launch it, or if you staff doesn’t know how to use it properly, but it is the way of the future, and you can’t just walk away from it.
Perhaps before anyone decrees that EMR is a must-have in healthcare, regulators should recruit and release a SWAT team of EMR experts—the healthcare Geek Squad, if you will—to ensure proper implementation. I mean, you wouldn’t go sky diving without first purchasing the right equipment and taking a few lessons, and you’d never go alone, would you?
Primary care and healthcare reform: Where do we fit in?
In the healthcare reform discussion, one thing that most people agree on is the need to revamp primary care and primary care reimbursement. One congressional committee has published a Discussion Draft on the House healthcare reform bill.
This bill calls for increasing Medicare reimbursement by 5% (10% if the physician practices in an area defined as a health professional shortage area) for primary care services. These services are defined as evaluation and management services, including new and established patient office visits, and “other physicians services as the Secretary determines are associated with ensuring accessible, continuous, coordinated, and comprehensive care for individuals enrolled under this part.”
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