On Capitol Hill, lawmakers resume work this week to resolve differences over legislationaimed at alleviating long wait times for medical care at the Department of Veterans Affairs hospitals and clinics after reports that some veterans may have died awaiting appointmentsand that some VA staff falsified records to cover up excessive wait times.
Five senior VA leaders – including former department secretary Eric Shinseki –have resigned in the past six weeks.
Both the House and Senate have passed bills that would allow veterans to seek medical care outside of the VA system if they meet certain conditions, including living more than 40 miles from a VA medical facility.
Dr. Kenneth Kizer
Dr. Kenneth Kizer, a former VA undersecretary for health, spoke recently with KHN’s Mary Agnes Carey about the issue of the VA contracting with outsideproviders for medical care.
Kizer, the founding chief executive officer and president of the National Quality Forum, is now director of the Institute for Population Health Improvement at the University of California, Davis.
Workers believe employer wellness programs should be all gain but no pain, according to a poll released Tuesday.
The poll from the Kaiser Family Foundation found employees approve of corporate wellness programs when they offer perks, but recoil if the plans have punitive incentives such as higher premiums for those who do not take part. (KHN is an editorially independent program of the foundation.)
Wellness programs, which are encouraged under the federal health law, are structured in various ways. In some plans, the worker has to join a particular program, such as an exercise class, while others focus on outcomes, such as the employees’ blood sugar or cholesterol.
Evidence is mixed about whether any substantially improve workers’ health or lower costs to employers and insurers.
The poll found 76 percent of workers thought it was appropriate for employers to offer wellness programs that promote healthy behavior.
But a majority opposed wellness plans that had financial repercussions for workers:
62 percent did not think employers should charge higher health insurance premiums to workers who did not participate, and
74 percent said management should not charge more to those who did not reach health goals.
The Obama administration is allowing employers to link up to 30 percent of health premiums to wellness programs. Penalties and rewards for participating in a tobacco cessation program can be as high as 50 percent of the insurance plan cost.Continue reading →
SALT LAKE CITY – When a car rolls off an assembly line, the automaker knows exactly what parts, labor and facilities cost. Not so in health care, and now some health executives are trying to change that.
Although U.S. hospitals account for the single largest chunk of the nation’s $2.7 trillion in health spending, few of them can say how much it actually costs them to care for every patient they admit.
“To think that health care is this ‘ginormous’business that doesn’t understand costs is mind-blowing,” said Vivian Lee, senior vice president for health sciences at the University of Utah, an academic medical center with four hospitals and 1,330 physicians.
In 2012, Lee was stunned when she challenged senior managers and physicians to find ways to reduce spending, and “they said, ‘We don’t know what it costs, so how can we manage it?’”
Today, the Utah health system is one of a handful in the nation with a data system that can track cost and quality for every one of its 26,000 patients.
That data is shared with doctors and nurses for further input about ways to streamline cost and improve care. Continue reading →
This story is part of a partnership that includes KQED, NPR and Kaiser Health News.
Reid Kennedy, materials manager at San Francisco General Hospital, stands next to racks of saline solution. (Photo by Mark Andrew Boyer/KQED)
Hospitals across the country are struggling to deal with a shortage of one of their essential medical supplies. Manufacturers are rationing saline — a product used all over the hospital to clean wounds, mix medications and treat dehydration. Now drug companies say they won’t be able to catch up with demand until next year.Continue reading →
During a hernia operation, Dorothea Handron’s surgeon unknowingly pierced her bowel. It took five days for doctors to determine she had an infection.
By the time they operated on her again, she was so weakened that she was placed in a medically induced coma at Vidant Medical Center in Greenville, North Carolina.
Comatose and on a respirator for six weeks, she contracted pneumonia. “When they stopped the sedation and I woke up, I had no idea what had happened to me,” said Handron, 60. “I kind of felt like Rip Van Winkle.”
Because of complications like Handron’s, Vidant, an academic medical center in eastern North Carolina, is likely to have its Medicare payments docked this fall through the government’s toughest effort yet to crack down on infections and other patient injuries, federal records show.Continue reading →
A bipartisan group of senators introduced legislation on Thursday to make Medicare take the financial status of hospital patients into account when deciding whether to punish a hospital for too many readmissions.
The bill attempts to address one of the main complaints about the readmissions program: that hospitals serving large numbers of low-income patients are more likely be penalized. Continue reading →
Consumer advocacy group Public Citizen on Thursday called on 20 hospital systems to stop partnering with companies that offer low-cost screenings for heart disease and stroke risk, saying the promotions are “unethical” and the exams are more likely to do harm than good.
Hospitals say residents benefit from the testing packages, which can cost less than $150, because some will discover they are at higher risk for heart problems or stroke early enough to take steps to reduce their risks.
But some medical groups and consumer advocates object to the programs, saying they are a waste of money for most consumers.Continue reading →
Some cancer patients and their insurers are seeing their bills for chemotherapy jump sharply, reflecting increased drug prices and hospitals’ push to buy oncologists’ practices and then bill at higher rates.
Patients say, “‘I’ve been treated with Herceptin for breast cancer for several years and it was always $5,000 for the drug and suddenly it’s $16,000 — and I was in the same room with the same doctor same nurse and the same length of time’,” said Dr. Donald Fischer, chief medical officer for Highmark, the largest health plan in Pennsylvania.Continue reading →
Children and teens are more likely to wear life jackets when out on the water when adults onboard are wearing them as well — yet relatively few adult boaters in Washington state wear life jackets while boating, according to recently published studies by UW Medicine researchers at Seattle Children’s Hospital and Harborview’s Injury Prevention & Research Center.
The findings, the researchers write, underscore the important role adults can have in encouraging the young to wear life jackets when out on the water.
Wearing a life jacket has been shown to reduce a boaters risk of drowning by half. Nevertheless, nationwide only about 15% of boaters wear a life jacket or personal floatation device (PDF), and, as the new studies show, Washington state boaters do little better. Continue reading →
At Seattle’s largest safety-net hospital, the proportion of uninsured patients fell from 12 percent last year to an unprecedented low of 2 percent this spring—a drop expected to boost Harborview Medical Center’s revenue by $20 million this year.
The share of uninsured patients was cut roughly in half this year at two other major safety net hospitals—Denver Health in Colorado and the University of Arkansas for Medical Sciences Hospital (UAMS) in Little Rock, Ark.
One of the biggest beneficiaries of the health law’s expansion of coverage to more than 13 million people this year has been the nation’s safety-net hospitals, which treat a disproportionate share of poor and uninsured people and therefore face billions of dollars in unpaid bills.Continue reading →