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Hospital Leadership Series
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by Tony Chen
Here's a few things I've been hearing from other hospitals on the impact of this recession.
"Bad debt is going through the roof."
"Even administrative employees are being asked to take unpaid time off, go on furloughs."
"Merit increases are frozen. So are open positions."
"Surprisingly, volumes are up 5 to 8 percent from last year. It's just that we're not getting paid for the services we provided."
"We are actually having one of the strongest years in the hospital's history."
"We're actually doing okay, though we are reconsidering a major capital project."
One thing to recognize is that while we like to look at national numbers, our hospital systems all operate in local environments. Yes, all of our investment incomes were smashed, but each market (some folks say it's probably 250 to 300 local markets around the country) will have unique dynamics to deal with.
by Tony Chen
Think back just a year ago, to February 2008. Oh, things back in the "good ole" days of 2008 were so much simpler. Consider the headlines of the day brought news such as Mitt Romney winning the Maine Caucus and Ralph Nader entering the 2008 presidential campaign. The Dow was down to 12,000 from high of 14,000, while the NASDAQ vacillated around 2,500.
At the risk of sounding insensitive, let's all step back and take a deep breath for a second. Most experts agree that in 12 to 18 months, this recession will be over. Things won't go back to normal--whatever that means--but things are going to be a whole lot better than they are now, psychologically and otherwise.
by Christopher Cornue
This story has been around for a few weeks, but in case you haven't seen it: take a look at this incredible story with horrifying examples included. Let's keep these examples in mind when we're talking about our own issues stateside.
by Nick Jacobs
Last week it was my privilege to spend a few hours with an entrepreneur who compiled every quality indicator published by all 20 organizations that list themselves as having a mission that is directed toward "healthcare quality." I can't remember if there were 20 or 30,000 of them, but it was a boatload.
The entrepreneur then had a software expert create grids and graphs and quantitative tables in relational databases that would compile all of the related indicators, cross reference them, and pull them together into the appropriate job descriptions. This system was constructed to enable employers to objectively quantify these job descriptions and thus to evaluate the employees in a more appropriate, efficient, and comprehensive manner.
All of this would lead to higher quality care, reduce costs normally created from employee turnover, and lead to a better workplace and better patient care.
by Tony Chen
Since we've blogged extensively in the past about hospitals and social media, here's a quick note: Henry Ford Hospital will be sharing a live kidney cancer surgery on Twitter on Monday.
From their PR team:
Dr. Craig Rogers will lead a surgical team from Henry Ford Hospital as they perform a robotic partial nephrectomy. The public will be able to receive updates and information from OR 25 at Henry Ford Hospital, and communicate with the surgeons via the Twitter microblogging service. Henry Ford is a teaching hospital.
Also, check out Ed Bennett's tally list of Hospitals using social networking tools. Can you believe that there's 60 hospitals on twitter already? Yes, that's only about 1 percent of the all the hospitals in the country.
by Tony Chen
I encountered two very interesting articles recently about the health care/hospital sector. One was a narrated chart from McKinsey (free registration required) that basically showed value creation by healthcare sector over the last 20 to 25 years. As you can guess, the bottom line (yes, the one at the bottom all by its lonesome) represents providers. Since 1985, the provider sector was the only sector in healthcare to underperform the S&P 500.
by Tony Chen
Regardless of your political affiliation, yesterday was a historical moment; we have just elected the first African-American President of the United States. As I stayed up to watch Senator Barack Obama's speech after two long years of campaigning, I was struck by three main thoughts while putting on my hospital impact blogger hat:
by Christopher Cornue
Most likely, everyone is familiar with the Premier Demonstration Project of the past 4+ years. For those who are not … in summary, it was an opportunity for hospitals to voluntarily report their quality data to CMS through Premier, which would then be benchmarked against other hospitals. Each hospital would then be compared and would be eligible for additional payments if they achieved results in the top two deciles (20%) to baselines scores identified in Year 1 of the project. There was also an opportunity for hospitals to lose money if they fell in the bottom two deciles (bottom 20%) to baselines scores from Year 1. This project has continued beyond the original three years and will be expanding beyond the original areas of AMI, HF, Hip/Knees and Community Acquired Pneumonia.
by Tony Chen
Have 90 seconds to spare? Here are a few links on healthcare, hospitals, and innovation:
WSJ Health Blog: Overcrowded ER? Put patients in the hallway. Apparently, the data says it doesn't adversely impact quality. Nurses hate it, though some say that's exactly the point.
by Nick Jacobs
RAC is the magic bullet that CMS (Centers for Medicare and Medicaid Services) is using to describe the new federal Medicare Recovery Audit Contractor program that was officially started last week. RAC was started by the Medicare Modernization Act of 2003 to identify and correct improper payments. Third-party auditors get to keep a piece of the payments they identify and collect as inappropriate.
Not unlike the health care environment created during the Clinton Administration, there seems to be a natural assumption that hospitals are basically working day and night to game the system.
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