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It takes a village to tackle hospital ER overcrowding

October 8th, 2015

by Scott Kashman

Around the country there is often discussion about emergency room (ER) overcrowding. Realistically, not all ERs really get overcrowded. Down in Southwest Florida, however, they do.

Last season (known as late fall/winter), the area experienced a surge in population--and we experienced an even larger surge of patients coming into our ERs and hospitals.

This coming season, we are trying a different approach that we can build on through the season and throughout the year. This requires our health system and key community partners to provide a more coordinated approach to delivering healthcare in our community.

=> Read more!

Value-based care: Will the industry ever be ready to ditch fee-for-service?

October 8th, 2015

by Ilene MacDonald

The Triple Aim. Bundled Payments. Accountable care organizations. FierceHealthcare has written countless articles about these initiatives to move the healthcare industry away from fee-to-service to payments for value-based care.

Despite all that attention--and the federal government's push to quicken the pace of the transition--healthcare providers haven't made much progress.

In fact, this week--on the same day we ran a special report on the evolution of accountable care organizations--PwC Health Research Institute (HRI) released a new report that says while healthcare executives publicly praise the move to value-based care, they privately drag their feet while they wait for a successful model to emerge before they take on the risk.

"It was striking to us when we did report on the national landscape of progression on alternative payments just how low and difficult the transition has been for the healthcare industry, Ceci Connolly, director of HRI, told me during an exclusive interview.

>>Read the full commentary at FierceHealthcare

Not using the Medicare wellness visit is making people sick

October 8th, 2015

by Anthony Cirillo

Ask most healthcare CEOs the utilization rate for the Medicare Annual Wellness Visit (AWV) and they will probably not know it. While it is reimbursable, the cost/benefit ratio favors practices sticking to what makes them money. They need to see the bigger picture.

The AWV reimburses on average $117 per visit, and to capture all of the documentation necessary to financially benefit the practice, it requires approximately 45 minutes. And if you don’t code properly, well, that’s another story.

Most find the AWV time-consuming, tedious and a financial burden.

There is a marketing term called loss leader. It’s the idea that you provide a product or service that is an enticement to help grow the number of customers you have. You may break even or lose money. But that is the cost to introduce new people to you.

For healthcare organizations, the gamble is that once they have experienced the care you offer they will come back and tell others.

=> Read more!

When hospital CEOs issue clinical directives, healthcare suffers

October 1st, 2015

by Thomas Dahlborg

“If there is a surgical intervention option as well as another treatment option available, make sure you go the surgical route.”

“Are you serious, Jim?” I responded. “The CEO of your hospital said this to your new podiatric surgeon?”

“Yes. We had recently brought on this podiatric surgeon and the hospital CEO made it very clear to him early on that the expectation is increased numbers of surgeries and if, in fact, there are multiple treatment options the surgical option overrides all others.”

“So a hospital administrator is now making specific healthcare decisions for the patients, families and clinicians at your hospital?”

“That’s exactly right. It is shameful, it is harmful and it is wrong. And yet it is happening.”

This is an excerpt from a recent discussion I had with a former rural hospital medical director and current quality improvement expert. And, unfortunately, even though I want to say I am surprised, I am not, as I have heard similar type stories quite frequently. Such as the hospital CEO (who is also a physician) telling me directly that quality of care was not his highest priority because he was focusing on the financial health of his institution.

=> Read more!

Actions speak louder than words: How mHealth is moving beyond patient engagement and improving patient care

October 1st, 2015

by Jenn Riggle

My mom always told me actions speak louder than words. The same is true with mobile health (mHealth). While health and fitness apps are helping people track the number of steps they take, mHealth’s real promise lies in its ability to provide people with tools to share their health information with their doctors and take a more active role in managing their health.

Increasing awareness about the dangers of living a sedentary lifestyle has helped drive the growing interest in health and fitness apps. Today, there are nearly 165,000 health apps available on iOS and Android, and one-third of U.S. smartphone users (46 million people) have used fitness and health apps, according to research from Nielsen.

The question is: How useful are these apps? A recent study from research firm IMS Health reported that only 36 apps represent nearly 50 percent of all downloads. In addition, of the thousands of health apps available, only 10 percent were designed to link to a medical device or sensor and 2 percent can connect to electronic health records or other IT systems used by providers.

=> Read more!

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