A package of birth control pills.

U.S. rules insurers must cover birth control with no co-pay

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By Jenny Gold

A package of birth control pills.With co-payments of $10 to $35 a month, birth control pills can add up to an expensive precaution for American women, even those with private insurance.

But a new rule issued today by the U.S. Department of Health and Human Services makes those fees a worry of the past for many insured women.

Under the health overhaul passed by Congress last year, private insurers will now be required to provide women with a whole range of preventive services, including birth control, without charging a co-payment, co-insurance or deductible.

That means you, your girlfriend, wife, sister and friends who have private insurance plans can get any contraceptive approved by the Food and Drug Administration including sterilization procedures, with the insurance plan picking up the entire cost.

Condoms also are included on the FDA list of contraceptives, although it was not immediately clear if plans would consider them as part of the regulation.

The HHS decision to require insurers to cover contraception proved controversial, with anti-abortion groups arguing that contraception is against the religious beliefs of some Americans, and that some forms of emergency contraception, including Plan B, are akin to early abortion.

The final HHS decision was based on recommendations from the Institute of Medicine, an independent and well-respected research organization, but includes a special amendment allowing religious institutions that offer health insurance to their employees to opt out of the contraception requirement.

NARAL has created a handy calculator that tells you how much you might save on birth control.

These rules also do not apply to plans offered by large companies that self-insure and have been grandfathered under the law. The rules also have no effect on the cost of contraception for women without insurance.

The new HHS rule also requires that women older than 30 be eligible to receive free tests for human papillomavirus along with their annual Pap smears to detect cervical cancer. Screening for HPV, the virus that causes cervical and other cancers, can increase the chances of identifying women at risk and providing early treatment.

Other preventive services that will be offered with no co-pay include:

  • Annual preventive care visits that include preconception and prenatal care.
  • Screening for gestational diabetes.
  • Sexually-transmitted infection counseling.
  • Human immunodeficiency virus (HIV) screening and counseling.
  • FDA-approved contraception methods and contraceptive counseling.
  • Breastfeeding support, supplies, and counseling.
  • Domestic violence screening and counseling.

The new rule will take effect for private insurance plans beginning on or after August 1, 201

NARAL, an organization that advocates for women’s reproductive rights, including abortion, created a handy calculator that tells you how much you might save on birth control.

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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Medicare prepares rule to penalize hospitals with high readmission rates

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By Jordan Rau
KHN Staff Writer

This story was produced in collaboration with wapo

Sign for an emergency room.When hospitals discharge patients, they typically see their job as done. But soon, they could be on the hook for what happens after Medicare patients leave the premises, and particularly if they are readmitted within a month.

In an effort to save money and improve care, Medicare, the federal program for the elderly and disabled, is about to release a final rule aimed at getting hospitals to pay more attention to patients after discharge.

A key component of the new approach is to cut back payments to hospitals where high numbers of patients are readmitted, prodding hospitals to make sure patients see their doctors and fill their prescriptions.

Medicare also wants to pay less to hospitals with higher-than-average costs for patient care.

Medicare also wants to pay less to hospitals with higher-than-average costs for patient care. It has proposed calculating the costs by combining a patient’s hospital expenses with fees incurred up to 90 days after discharge.

The efforts, called for in last year’s health care law, are part of a push to make hospitals the hub for coordinating care. Hospital care is the largest chunk of Medicare spending; Medicare says readmissions alone cost $26 billion in a decade.

“A lot of this is very unfair.”Plus, many experts argue hospitals are the most organized actors in a splintered and often dysfunctional health system, and thus best able to take the lead in overseeing patient care.

But hospital groups complain that Medicare’s plans could punish them for things they can’t control, such as unavoidable readmissions and patients who can’t afford the costs of prescriptions.

What’s your take? Is if fair to penalize some hospitals for high readmission rates?

Or can the rule be unfair to hard-pressed hospitals?

“A lot of this is very unfair,” says Blair Childs, a vice president at Premier, an alliance of more than 200 hospitals. He says hospitals that don’t have a lot of money to invest in improving their oversight of former patients could end up losing more money under Medicare’s proposals, putting them in an even bigger financial hole. In particular, he says, the changes may hurt inner city hospitals.

“These are often very stressed hospitals, and they’re the ones that are going to be penalized the most.”

“These are often very stressed hospitals, and they’re the ones that are going to be penalized the most,” Childs says.

Some academics who have studied hospitals also think Medicare may be being too harsh. “The truth is the 30-day readmission is a relatively lousy quality measure for a hospital, because a lot is happening outside a hospital’s control,” says Dr. Ashish Jha, a professor at Harvard’s School of Public Health.

Medicare’s penalties could be significant-and widespread. Almost 7 percent of acute-care hospitals — 307 out of 4,498 — had higher-than-expected readmissions rates for heart failure, heart attack or pneumonia, according to Medicare data.

Under Medicare’s draft proposal, which it put out in May, penalties would start in October 2012; hospitals with the worst readmissions rates eventually could lose up to 3 percent of their regular Medicare payments.

Hospitals with patients who cost Medicare lots of money during and after their hospital stays also could be hurt. Beginning in October 2013, these spending levels would count for a fifth of Medicare’s “value-based purchasing program,” which alters hospital payments based on long list of quality measures.

“The incentives we’re putting into place have created a whole new way to think about hospital care,” says Jonathan Blum, deputy administrator of the federal Centers for Medicare & Medicaid Services, or CMS.

These initiatives come on top of other Medicare experiments that will make not just hospitals but also surgeons responsible for costs run up from complications that occur beyond the operating room. One approach is “bundled payments,” where Medicare pays a set fee for the entire cost of a patient’s treatment, including expenses after discharge.

And Medicare’s high-profile venture to create “accountable care organizations,” where teams of doctors and hospitals share the financial risks and rewards for caring for patients, would also hold hospitals partially to account for the costs of treatments that patients get elsewhere.

Hospitals “can no longer see our job as just being within the four walls we’ve built,” says Leah Binder, chief executive of the Leapfrog Group, a nonprofit that evaluates hospital quality.

CMS has limited leeway to tinker with the readmissions rule, because much of it was spelled out in the health care law. CMS has more freedom to change its plan to measure per-patient spending, as the law didn’t detail how it should work.

Regardless of what CMS ultimately decides, many hospitals are already scrambling to change how they supervise former patients, says Chas Roades, chief research officer at The Advisory Board Company, a health care consultancy.

“One of the big themes I’m hearing now across the hospital industry is, ‘We can no longer think of ourselves as just hospital companies, we have to be full-service health care managers,'” he says.

Consider Trinity Health, which owns 50 hospitals around the country, including Holy Cross in Silver Spring, Md. Before patients leave the hospital, Trinity’s nurses now set up appointments for them with their regular doctors.

They also make sure patients can get to the appointment, either by helping them figure out whether Medicare or Medicaid pays for transportation, or by paying for the trips directly.

“We’re trying to do a better job of sending them home better-prepared, rather than just saying good luck,” says Dr. Terry O’Rourke, Trinity’s chief clinical officer. But he says there are limits to what they can do: “The majority of physicians are not employed by the hospital, and we don’t have control over their practices.”

Dr. Kavita Patel, a Brookings Institution fellow and former Obama administration official, says changes occurring in both the private sector and Medicare will speed up the trend of hospitals’ overseeing the care of former patients.

For example, she says, many hospitals are buying the practices of primary care doctors, making it easier for them to arrange and oversee the care of patients after discharge. “The more hospitals realize they’re going to be held accountable, that’s where they are going to get creative,” Patel says.

KHN wants to hear from you: Contact Kaiser Health News


This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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Congress

Hospitals, doctors and state programs could feel pinch, then pain from default

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By Jordan Rau, Christopher Weaver and Jessica Marcy
KHN Staff Writers

Hospitals, nursing homes, doctors and state health programs could survive a brief pinch if the Washington debt ceiling deadlock leads the government to stop paying Medicare and Medicaid bills.

But if an impasse were to drag on for more than a few weeks, health care providers could be unable to pay their staffs or even face insolvency, according to health care experts and former government officials.

Even as the Tuesday deadline for a deal between President Barack Obama and Congress approaches, the implications of a worst-case scenario remains speculative.

The Treasury Department hasn’t signaled how it would prioritize which government bills to pay. Few health care providers have made any doomsday plans, but the uncertainty is making many edgy.

“It’s not a matter of planning right now because there’s too much unknown,” says Cheryl Phillips, senior vice president for advocacy for LeadingAge, an association of 5,600 not-for-profit home health agencies, nursing homes and other organizations that work with seniors. She says that many of their members have very limited operating margins, so a stop in payment could quickly be destructive.

There’s no precedent for this kind of fiscal crisis.

There’s no precedent for this kind of fiscal crisis, although Medicare providers have experienced short-term delays in the past when Congress made last-minute changes to Medicare reimbursement rates, says Gail Wilensky, who ran Medicare, the federal health program for the elderly and disabled, under President George H.W. Bush.

“I’m sure it irritated the providers, but it didn’t affect the beneficiaries,” Wilensky says, noting that despite delays that sometimes stretched for several weeks, business continued as usual. “In the short term, there should be little to no effect.”

Others believe financial pain could come rapidly for some. John Reiss, a Philadelphia lawyer who advises hospitals, doctors and medical device makers for the firm Saul Ewing, says his clients are “dumbfounded” by the ongoing deadlock but still assume that there’ll be a deal before it’s too late.

Clients are “dumbfounded” by the ongoing deadlock.

 If not, he says some facilities have enough cash on hand to last for several months, but “there are some hospitals surviving on six or seven days cash on hand and those places are going to be in trouble.”

Stan Rosenstein, a health care consultant and the former director of California’s Medicaid program, known as Medi-Cal, says a prolonged impasse could be “devastating.”

Nursing homes in particular rely on Medicare and Medicaid, the joint state-federal program for the poor, for most of their payments and could rapidly be unable to finance their daily operations, he says.

“California has had a lot of experience in this with its late budgets and it only takes a couple or three weeks for it have a major impact,” says Rosenstein, referring to when the state legislature deadlocked over budgets and the state stopped paying its bills, including for Medi-Cal.

A default could unnerve the capital markets, making it difficult or impossible for providers to borrow to stay afloat.

But the worst case scenario here would be more apocalyptic, he says. That’s because health care providers would lose revenues from Medicare and Medicaid at the same time.

Plus, a debt default could also unnerve the capital markets, making it difficult or impossible for providers to borrow money to stay afloat. And states are having so many financial problems that they’re not in a position to fill in the gaps.

Matt Salo, executive director of the National Association of Medicaid Directors, says that in the “worst-case scenario, Aug. 2 comes around with no deal, Medicaid is not going to shut down.”

But if the bond markets melt down, states could face higher interest rates on money they’ve already borrowed from investors, making it even harder for states to pay their share of Medicaid, which is generally about half, he says. The federal government on average pays about 56 percent of Medicaid costs.

How quickly states feel the pain depends on the schedule Medicaid pays them. Rhode Island receives payments every two weeks, and it was just paid yesterday, says Fred Sneesby, a spokesman for the state’s Department of Human Services. The next scheduled payday is Aug. 12. California, though, is paid every week, Rosenstein says.

“I don’t think there’s any state that has the wherewithal to advance the money,” says Rosenstein, who advises states, insurers and providers for the consulting firm Health Management Associates.

Thomas Scully, who was the administrator for Medicare under President George W. Bush, says if there is a default, the Obama administration’s political decisions will determine how quickly health care payments are shut off. “They’re either going to shut down Medicare and Social Security first or last,” he says. “If they want to provoke a crisis they would quit paying hospitals and doctors and quit sending out Social Security checks.”

Donna Shalala, who was health and human services secretary under President Bill Clinton, says Medicare pays its claims within two weeks, which is faster than many private insurers.

“The health care system is very dependent on Medicare payments, because they come very quickly,” she says. “If they’re not reimbursing, that would create problems for the entire industry – hospitals, doctors, everyone. It is not a happy scene.”

Doug Myers, chief financial officer for Children’s National Medical Center in Washington, D.C., says 55 percent of the hospital’s patients are on Medicaid. He said the hospital would “start feeling the impact” within 30 days of a halt in federal funding.

“Whatever happens to Medicaid, happens to Children’s National,” he says.

Martha Roherty, executive director of the National Association of States United for Aging and Disabilities, says she’s been advising state agencies that advocate for services for the elderly to immediately claim any money they’re entitled to from federal grants. Usually, she says, they do it just once a month or quarterly.

“We have been telling them” to “take it now,” she says. Roherty added that basic services that rely on federal money, such as senior centers and nutrition meals that are delivered to people’s homes, could quickly shutter if the federal government stops paying those bills.

Paul Ginsburg, president of the Center for Studying Health System Change, a Washington think tank, says the health care system is actually in a better position to handle a halt in government payments than many other sectors of the economy.

“Medicare and Medicaid beneficiaries are going to be able to get care for a while, while if a store is selling something and people don’t have money to buy it, that will hit immediately,” he says.

Salo agrees that by the time health providers are in serious trouble, everyone else will be too. “If we go into default for a really long time,” he says, “I’m guessing cash flow in Medicaid is not going to be the biggest of our concerns.”

Kaiser Health News staff writers Julie Appleby, Mary Agnes Carey, Juan E. Gastelum,  Peggy Girshman, Shefali S. Kulkarni and Bara Vaida contributed to this story.

KHN wants to hear from you: Contact Kaiser Health News

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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State cuts back services to help smokers quit, but some help remains

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Washington State's Tobacco Quit Line Web page

Due to budget cuts, Washington State Tobacco Quit Line, which has helped more than 89,000 residents kick the habit over the past six years, will no longer be able to provide services to the general population.

This means they will no longer be able to obtain counseling with a Quit Coach or receive medications, such as nicotine patches, to help them quit.

However, residents of King County (at least until next spring) and some other groups will be able to get help other coverage sources.

Covered groups include:

  • Washington adults insured by Medicaid Fee-For-Service plans
  • Washington adults with coverage for phone-based cessation counseling through their employer or health insurance
  • King County residents – through March 2012

The King County benefit persists because it is funded through an program from Public Health – Seattle & King County and the U.S. Department of Health and Human Services called the Communities Putting Prevention to Work (CPPW) initiative.

The King County benefit includes a call with a Quit Coach for all adult residents.

Other populations in King County have additional benefits; these populations include:

  • Pregnant adults
  • Uninsured adults
  • Adults covered by non fee-for-service Medicaiddults referred Veteran’s Administration
  • Adults covered by Indian Health Services.

To learn more:

  • If you have questions about coverage, call 1-800-QUIT-NOW
  • Washington residents needing counseling in Chinese, Korean or Vietnamese can get help from the Asian Pacific Islander Coalition Against Tobacco Quitline.

Asian Language phone contacts:

  • Chinese (Cantonese/Mandarin): 800-838-8917
  • Korean: 800-556-5564
  • Vietnamese: 800-778-8440
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Nation’s healthcare bill to nearly double by 2020

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By Phil Galewitz

The federal health law, which will expand coverage to 30 million currently uninsured Americans, will have little effect on the nation’s rising health spending in the next decade, a government report said today.

The report by the Medicare Office of the Actuary estimated that health spending will grow by an average of 5.8 percent a year through 2020, compared to 5.7 percent without the health overhaul.

With that growth,  the nation is expected to spend $4.6 trillion on health care in 2020, nearly double the $2.6 trillion spent last year.

Health law critics said the report confirmed their concerns. “Most of us understood the health reform law was about expanding coverage not cutting costs,” said Joseph Antos, a health policy expert at the conservative-leaning American Enterprise Institute.

But White House Deputy Chief of Staff Nancy-Ann DeParle said the report showed Americans were getting a good deal. “The bottom line from the report is clear: more Americans will get coverage and save money and health expenditure growth will remain virtually the same,” she said on the White House blog.

DeParle, who helped lead the White House efforts on the overhaul, said several delivery system reforms being tested under the health law will work to lower spending.

“We know these new provisions will save money for the health care system, even if today’s report doesn’t credit these strategies with reducing costs,” she said.

She pointed to new programs that administration officials have said they hope to implement changing the way Medicare and Medicaid pay doctors and hospitals.

National health spending in 2010 grew at its slowest rate ever recorded – 3.9 percent – as a result of more Americans forgoing treatment because they had lost their jobs and their health coverage, said the report, which is being published online today by the journal Health Affairs. In 2009, health spending grew by 4 percent.

The report estimates that spending on health will accelerate this year because the economy is expected to improve and people would have more disposable income to spend on medical care.

In 2014, when the major coverage expansions of the health law begin to take effect, national health spending is expected to grow 8.3 percent, according to the new analysis.

But spending growth should return to its 6 percent historical average from 2015 to 2020 as some employers drop coverage and the so called “Cadillac tax” on high-cost insurance plans takes effect in 2018.

“The effect is likely to be a slowdown in the growth of health services, health insurance premiums and health spending overall,” the study said.

Meredith Rosenthal, a health economist at Harvard School of Public Health, said it is difficult to predict what impact the health law will have on slowing national health spending.

“Many of the components of the law that are intended to control costs are still in draft form,” she said citing experiments such as accountable care organizations and bundled payments that change how Medicare pays providers.

The number of Americans with employer-sponsored insurance will grow from 163 million last year to 170 million in 2014, the report estimated.

But by 2020 that number is expected to drop to 168 million as a result of two factors: Baby Boomers joining Medicare and employers dropping health coverage for workers. Most of those workers would turn to new state insurance exchanges – or marketplaces –or Medicaid, the federal-state health program for low-income and disabled people.

The issue over how many employers would stop offering coverage has been a political flash point since the health law was approved in March 2010. Democrats maintain most employers would continue to provide coverage, but Republicans and other critics predict many companies would drop it because their workers will be able to go to new health exchanges. Starting in 2014, the health law requires all employers with 50 or more workers to provide coverage or pay a fine.

The Congressional Budget Office — the neutral scorekeeper — estimates that, by the end of the decade, 3 million fewer people will get health insurance from their employer. That’s slightly more than the Office of Actuary prediction.

The study authors stressed their projections could vary depending on many factors, including the overall state of the economy and how quickly people sign up for new coverage.

“These projections are definitely uncertain and that increases as we move along in the projection period,” said Sean Keehan, a study author and an economist in the Office of the Actuary.

The Medicare actuaries acknowledged that they were off on one of their estimates last year. At that time, they predicted that national spending in 2009 would grow by 5.8 percent, instead of the 4 percent growth that the report said actually occurred.

Keehan said one of the factors helping push that prediction off the mark was that fewer people than expected joined COBRA plans after losing their jobs and that resulted in fewer people with health coverage and less spending.

The office also predicted last year about 375,000 people would sign up for new Pre-existing Condition Insurance Plans by 2013. But since the plans began a year ago under the health law, only about 20,000 people have signed up.

CMS Chief Actuary Rick Foster attributed the lack of public awareness of the new insurance pools for the less-than-anticipated participation. He said his office took into account the low participation rates in making estimates for enrollment in Medicaid and insurance exchanges starting in 2014.

The report estimated about 13.9 million people would enroll in new state-based insurance exchanges in 2014 and the number of uninsured would drop by nearly 20 million in that year. Given how many millions of eligible people don’t sign up today for Medicaid, that prediction is highly speculative, said Steven Findlay, an analyst at Consumers Union.

KhN wants to hear from you: Contact Kaiser Health News

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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A black crow

West Nile virus trackers ask public to report bird deaths

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King County health officials are asking the public to help track the spread of West Nile virus by reporting dead crows, ravens, jays and magpies.A black crow

These birds are particularly vulnerable to the mosquito-borne virus and their deaths can be a sign that West Nile carrying mosquitos are in the area.

Over the next three months, dead birds reported will be collected for laboratory testing for West Nile virus if they are deemed suitable candidates for testing, health officials said.

To be tested, the bird must be a crow, raven, jay, or magpie, dead for less than 24 hours, and have no visible trauma or decay.

West Nile virus was not detected in King County last year, but it was present in previous years, health officials said.

West Nile virus is a mosquito-borne virus that is spread to humans through the bite of an infected mosquito. A mosquito becomes infected by biting an infected bird that carries the virus.

Photo: Cynthia Goldsmith - CDC

West Nile virus is not spread by person-to-person contact, nor is it transmitted directly from birds or other animals to people. Mosquito season, when West Nile virus is of most concern, runs from spring through late fall.

Most people infected with the virus have no or only mild symptoms, but the infection can be severe, even fatal, with virus attacking the brain and spinal cord. People over 50 years are the most vulnerable to serious infection.

Last year, more than 1,000 cases of West Nile virus infections were reported nationwide, of whom 57 died.

Horses are also susceptible to West Nile virus infection, which can result in severe disease or death, health officials said, and horse owners should contact their veterinarian because a vaccine is available for horses.

To report a dead crow, raven, jay, or magpie to public health officials call 206-205-4394 or report the bird online.

How to prevent infection

Protect yourself from mosquitoes by eliminating their breeding habitat:

The mosquito most responsible for West Nile virus in our area is the northern house mosquito Culex pipiens, which prefers to lay eggs in standing water common around most houses. Even small amounts of water, such as in plant saucers or a clogged gutter, can produce many mosquitoes. Remove this habitat to reduce the number of mosquitoes near your home:

  • Tip out containers that collect water, including barrels, buckets, wheelbarrows, bottles, wading pools, birdbaths, animal troughs and plant saucers
  • Dump water off of tarps and plastic sheeting and get rid of used tires
  • Clean garden ponds, circulate water in fountains and cover rain barrels with mosquito screens
  • Clean leaf-clogged gutters and repair leaky outdoor faucets
  • Repair ripped windows and door screens and make sure they fit tight so adult mosquitoes can’t get into your home
  • Help elderly neighbors with these actions

To learn more:

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Sign for an emergency room.

New ER programs focus on quality-of-life

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Sign for an emergency room.

By Michelle Andrews

In the controlled chaos of an hospital emergency department, ensuring that patients are pain-free and can make informed choices about their care often takes a back seat to assessing and stabilizing them and moving them through the system as fast as possible.

But now some experts say that providing palliative care – which focuses on patients’ quality-of-life issues – can and should be a priority in emergency departments, and they’re putting together a program to help hospitals better address those issues.

“A decade ago, we thought of the emergency department as a way station,” says Tammie Quest, an associate professor of emergency medicine at Emory University School of Medicine who is also board-certified in hospice and palliative medicine. “Now we’re recognizing what can be done to identify patient needs there, and help to initiate what can be done in the hospital or once the patient leaves the hospital.”

Under the sponsorship of the Center to Advance Palliative Care, an advocacy organization, Quest is heading up the development of a program that will provide hospitals with online tools and guidelines, identify best practices and link doctors and others with experts to help integrate palliative care into their emergency departments.

Many of the patients who come to the emergency department are suffering from flare-ups of serious illnesses or have suffered a grievous injury and are faced with unexpected decisions that can be life-altering. These are exactly the types of patients palliative care aims to help, say experts.

With training, emergency department staff members can enhance their skills in pain and symptom management, a challenge in patients with complex medical problems, says Quest.

More From This Series: Insuring Your Health

They can also improve their communication skills so that they are more empathetic when giving bad news to a patient or relative whom they may have just met, for example, or can help patients quickly develop a plan for care that meets their needs.

Another key to success is incorporating systemic changes, such as checklists, that make discussing patients’ wishes – Do they want to be put on a ventilator, if necessary, or be admitted to intensive care? Have they completed end-of-life planning documents? – as routine as checking a patient’s airway, breathing and circulation.

“These discussions just aren’t happening” right now, says David Weissman, an oncologist and professor emeritus at the Medical College of Wisconsin in Milwaukee, who is consulting on the project. Weissman estimates that fewer than 50 emergency departments are focused on incorporating palliative-care principles.

Palliative care grew out of the hospice movement, which emerged in the 1970s. Today, patients with fewer than six months to live have access to a wide array of supportive services to manage their pain and other symptoms and provide counseling and decision-making help for themselves and family members.

But clinicians and patient advocates have come to realize that other patients – who weren’t dying but had serious, chronic or life-limiting illnesses – also needed help managing their pain, coordinating their medical care, assessing their options and addressing their fears, as did their families. That launched the palliative-care movement.

Sixty-three percent of hospitals with more than 50 beds have palliative-care programs in place, up from just 30 percent a decade ago, according to the Center to Advance Palliative Care. In addition to improving patients’ quality of life, palliative care makes sound financial sense: A 2008 study published in the Archives of Internal Medicine found that patients who received palliative-care services cost hospitals between $1,696 and $4,908 less per admission.

Starting in September, the Joint Commission, an organization that sets hospital standards and monitors their performance, will begin offering voluntary certification for hospital inpatient palliative-care programs. This may improve insurance coverage of the programs, the cost of which is currently borne by hospitals to a large extent.

Typically, palliative care at hospitals is provided by a specially trained team, often consisting of a doctor, nurse, social worker and chaplain. Rather than try to shoehorn palliative-care teams into the emergency department, however, the new program aims to educate staff and change systems throughout the emergency department, says Quest. The hospital’s specialized palliative-care teams would be called in for only the toughest cases.

Garrett Chan was working in the emergency department at Stanford Hospital & Clinics in Palo Alto, Calif., one afternoon when an elderly woman was brought in. It was her 91st birthday, and she had blacked out at her birthday party and taken a fall, fracturing her back.

Chan, a nurse who has a supervisory role in the department and has been incorporating palliative-care principles there, could tell that the woman was upset that she was missing her party. “I knew it was having a negative effect on her health,” says Chan. He called the dietary department of the hospital, which decorated a cake with a “Happy Birthday” message.

The cake put a smile on her face, says Chan, at a time when she was dealing with pain and discomfort and facing uncertainty about what had caused her to black out. “It’s some of these small interventions,” says Chan, “that you might not think are significant, but they have a big effect on psychological and emotional well-being.”

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This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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Parents’ military deployments take emotional toll on teens — UW study

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By Glenda Fauntleroy, Contributing Writer
Health Behavior News Service

When military deployments call for their parents to serve abroad, adolescents have a tough time adjusting, and a new study shows their moods often lead to risky behavior.

The wars waging in Iraq and Afghanistan for most of the past decade have significantly influenced the mental health of many children of U.S. servicemen and women.

The study, which appears online and in the September issue of the American Journal of Public Health, used data from 10,606 adolescents who took part in the 2008 Washington State Healthy Youth Survey collected in public schools in the 8th, 10th and 12th grades.

The survey measured the teens’ well-being and asked them to rate their quality of life through statements such as, “I feel I am getting along with my parents or guardians” and, “I feel good about myself.”

Among these teens, the study found differences between boys and girls, and according to age.

KEY POINTS:

  • Having a deployed parent can harm teens’ mental health and quality of life.
  • Teens with a deployed parent are more likely to be depressed or have thoughts of suicide than teens of civilian parents.
  • High schoolers with a deployed parent are more likely to binge drink and use drugs than their peers of civilian parents.

“Adolescent boys with military parents are experiencing more adverse effects on well-being compared to their female peers,” said lead author Sarah Reed, of the Department of Health Services and the Maternal and Child Health Program at the University of Washington in Seattle.

“It’s time to focus more on the children who are left behind.”

When compared to teens of civilian parents, 8th-grade girls of deployed parents had higher odds of reporting thoughts of suicide. Eighth-grade boys had higher thoughts of suicide and low quality of life. Likewise, in the 10th and 12th grades, adolescent boys with deployed parents had higher odds of depression, low quality of life and thoughts of suicide.

Military teens also were engaging more in risky habits. In the 10th and 12th grades, 33 percent of teen boys with deployed parents reported binge drinking in the past two weeks compared with 23 percent of the male teens with civilian parents. Thirty-seven percent of male military teens also reported drug use — again higher than the 22 percent of their civilian peers.

Reed said her team is hopeful the study brings more attention to the needs of military families.

“It’s time to focus more on the children who are left behind,” she said. “All service members and their families, including active duty, National Guard, reserves and veterans, deserve the support necessary to recover and heal from war.”

Jeanie Alter, project manager in the Indiana Prevention Resource Center at Indiana University in Bloomington, said the study was timely because the federal government is focusing efforts on integrating substance abuse and mental health toward enlistees and their families.

“With nearly 15,000 National Guard members, Indiana has the fourth largest National Guard in the nation and about three-fourths of the members have been deployed at some point in their career,” Alter said. “We know they suffer from substance abuse at greater rates, thus putting their families at risk.”

Health Behavior News Service is part of the Center for Advancing Health

The Health Behavior News Service disseminates news stories on the latest findings from peer-reviewed research journals. HBNS covers both new studies and systematic reviews of studies on (1) the effects of behavior on health, (2) health disparities data and (3) patient engagement research. The goal of HBNS stories is to present the facts for readers to understand and use for themselves to make informed choices about health and health care.

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Tularemia - CDC/ Courtesy of Larry Stauffer, Oregon State Public Health Laboratory

King County monitor detects tularemia bacteria in the air — but no health threat seen

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Tularemia - CDC/ Courtesy of Larry Stauffer, Oregon State Public Health Laboratory

A monitor set up to detect a terrorist attack with bioweapons detected the bacteria tularemia in the air in King County on Monday, but health officials say the levels of the pathogen, which is also naturally occurring, were too low to pose a threat to human health, Washington State Department of Health officials said Tuesday.

Follow up testing conducted on Monday evening from the same station found no sign of the bacteria, health officials said in an advisory issued today.

The findings suggest that the bacteria were from natural sources, officials said.

Since the air monitoring system was established nationally in 2003, similar positive test results due to naturally-occurring bacteria have been common in other areas of the country, officials said.

“The bacteria, Francisella tularensis, are found throughout Washington, commonly carried by rabbits, squirrels, and other rodents. People rarely are infected with tularemia; only two cases have been identified in Washington this year,” officials said. “Typically, Washington sees between one and 10 human cases per year.”

The monitors are part of BioWatch, a federal bio-surveillance program, that routinely collects air samples and tests them for trace amounts of biologic material that could be due to either an intentional attack or a natural occurrence.

This is the first time that a sample from the Puget Sound area has tested positive.

There are several monitors located throughout the Puget Sound area in King, Pierce, and Snohomish counties. Locations of the monitors are withheld for security purposes.

Health officials maintained that the alert shows that the monitoring system works, detecting the bacteria even though levels were low and triggering a planned public health and law enforcement response.

To learn more:

  • Visit the Department of Homeland Securities BioWatch website.
  • Visit the CDC’s webpage on tularemia.
  • Read the Washington State Department of Health’s tularemia fact sheet, with is available in English, Chinese, Korean, Russian, Spanish and Vietnamese.
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Get your child vaccinated now to beat back to school rush, say health officials

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To beat the back to school rush, parents should get their children vaccinated now, Washington State Health Officials warn.

Although children can be exempted from the school vaccination requirements for medical, religious or personal reasons, obtaining a certificate of exemption has become more difficult under a new law that went into effect July 22nd.

In the past, a parent or guardian could obtain a certificate allowing a child to enter school without the required vaccinations simply by signing a form.

Under the new law, parents must get information from their health care provider about immunizations. The health care provider must then sign a Certificate of Exemption form for most types of exemptions.

But health officials warn that vaccination are advisable especially after recent outbreaks of vaccine-preventable diseases such as whooping cough and measles.

All recommended vaccines for children under 19 are provided at no-cost through Washington’s Childhood Vaccine Program, Department of Health officials note.

Health care providers may charge an office visit or administration fee, but this can also be waived for those who cannot pay.

To learn more:

  • Or call the Family Health Hotline at 1-800-322-2588.
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FDA proposes guidelines for health ‘Apps’

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Want to know how a medication might affect your breast milk? Got a question about a disability, aging, mental health?

There’s an app for all that—and a whole lot more.

The variety and availability of smartphone applications—or apps—have exploded in recent years as multi-tasking consumers increasingly use their phones to keep up with the latest on news, finance, and health.

Apple says its iPhone App Store has more than 350,000 apps, and Android, BlackBerry, Windows, and other smartphones account for tens of thousands more. With so many apps on the market, it’s no wonder the number of health care related apps has also spiraled.

The Food and Drug Administration (FDA) is now proposing guidelines that outline the small number of mobile apps the agency plans to oversee—medical apps that could present a risk to patients if the apps don’t work as intended.  The proposed guidelines were posted on the Federal Register website Thursday.

Consumers may weigh-in on the guidelines during a public comment period that ends Oct. 19

FDA policy advisor Bakul Patel says some of the new mobile apps are designed to help consumers manage their own health and wellness—like the National Institutes of Health’s LactMed app, which gives nursing mothers information about the effects of medicines on breast milk and nursing infants.

Other apps are aimed at helping health care providers improve and facilitate patient care—like the Radiation Emergency Medical Management (REMM) app, which gives health care providers guidance on diagnosing and treating radiation injuries. There are even apps to aid diagnosis of rashes and heart irregularities.

FDA has already cleared a handful of mobile medical apps used by health care professionals, such as a smartphone-based ultrasound and an application for iPhones and iPads that allows doctors to view medical images and X-rays.

“There are advantages to using medical apps, but consumers and health care professionals should have a balanced awareness of the benefits and risks,” Patel says.

Apps can give consumers valuable health information in seconds and are opening innovative ways for technology to improve health care, Patel says. However, the small group of mobile medical apps FDA proposes to oversee present a potential risk—these apps may impact how a currently regulated medical device (such as an ultrasound) performs, he adds.

FDA is proposing to oversee mobile medical apps that:

  • Are used as an accessory to an FDA-regulated medical device. For example, an app could enable a health care professional to view medical images on an iPad and make a diagnosis;
  • Transform a mobile platform into a regulated medical device. For example, an app that turns a smartphone into an electrocardiography, or ECG, machine to detect abnormal heart rhythms or determine if a patient is experiencing a heart attack.

If you want to provide input on FDA’s proposal, you can submit your comment online athttp://www.regulations.gov/ or in writing to: Division of Dockets Management (HFA-305), Food and Drug Administration, 5630 Fishers Lane, Rm. 1061, Rockville, MD  20852.

“We want to hear from as many consumers, advocacy groups, health care professionals, and software creators and distributors as possible to help us finalize the proposed guidelines,” Patel says.

This article appears on FDA’s Consumer Updates page, which features the latest on all FDA-regulated products.

Posted July 19, 2011

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History shows Medicare can be cut while sparing beneficiaries

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By Julie Rovner, NPR News
This story comes from our partner NPR‘s Shots blog.

Lately you’d think President Obama was threatening to push Granny off the cliff.

That’s pretty much been the reaction of liberal Democrats to even the hint that the president might consider reductions in spending for Medicare as part of a deal to raise the nation’s debt ceiling.

Photo of Vierdrie

“Any cuts to Social Security, Medicare and Medicaid should be taken off the table,” the Congressional Progressive Caucus wrote in a letter to the president. “These cuts would hurt households and damage the country’s economic recovery as well.”

But most of the outrage assumes — incorrectly — that any cuts would necessarily be aimed directly at Medicare patients. History suggests otherwise.

Because Medicare is such a huge budget target, “we’ve had a series of cuts, year after year, decade after decade,” says Joe Antos, a health economist with the conservative American Enterprise Institute.

How big a target is Medicare exactly? This year the Congressional Budget Office figures the program for the elderly and disabled will spend $562.8 billion.

Even with all the cuts to Medicare over the years, Antos says, “We’ve hardly ever directly touched beneficiaries.”

In fact, says Antos, who spent years estimating savings for some of those budget cuts at CBO, “the whole political history of (cutting) Medicare has been focused not on beneficiaries, it’s been focused on health care providers,” such as doctors, hospitals and nursing homes.

And in many of those cases, he says, beneficiaries have often not even felt the reductions in payments.

One example was the 1983 shift in the way Medicare pays hospitals from simply paying each bill to a prospective payment system, that paid a set amount per diagnosis. That encouraged hospitals to become more efficient.

“We saved an enormous amount of money by moving to that system, and in the process, we changed the way hospital service is delivered to people, for the better, I think” Antos says. “That was, I think a win for everybody.”

How many of those cuts directly increase costs or reduce access for beneficiaries? Zero.

Now it’s true that most of the cuts have been reductions in scheduled increases, which served to restrain growth of Medicare’s budget some.

And it’s also the case that patients have been touched by Medicare payment changes, and could be again in the future. Higher-income beneficiaries now pay higher premiums for Medicare outpatient coverage as a result of the 2003 Medicare prescription drug law. And the budget plan passed by the House in April would shift considerable cost from the government to seniors on the program.

But Antos says beneficiaries are always last in line when it comes to making cuts in Medicare spending. “In terms of direct cuts to beneficiaries or benefits, that is a highly unpopular thing for a politician to do,” he says.

Just ask all the Democrats who lost their seats last year after getting pummeled by Republicans who complained about the $500 billion in Medicare reductions in the Affordable Care Act, the federal law overhauling the health care system.

How many of those cuts directly increase costs or reduce access for beneficiaries? Zero.

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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Seattle ranked sixth most walkable U.S. city

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Seattle has been ranked the sixth most walkable city by Walk Score, a Seattle-based company that creates walkability scores for house sales listings.

Green: more walkable. Red: less walkable. Click to view your neighborhood rankings

The score is based on the walking distance to grocery stores, restaurants, schools, parks, public transit, and other amenities. The company ranks cities and neighborhoods on a scale of 0-100, with locations receiving a score of 90-100 deemed a “Walkers’ Paradise.”

This year, the company named New York America’s most walkable city.

Top Ten Most Walkable Cities:

  1. New York
  2. San Francisco
  3. Boston
  4. Chicago
  5. Philadelphia
  6. Seattle
  7. Washington, D.C.
  8. Miami
  9. Minneapolis
  10. Oakland

The top-ranked Seattle neighborhoods, with scores ranging from 98 to 91, were Denny Triangle, South Lake Union, Bell, Cascade, Ballard, First Hill, Downtown, University District, Waterfront and Capitol Hill.

Lowest ranked were Blue Ridge, Sand Point, Arbor Heights, North Beach and Rainier View, which was ranked the lowest at 22.

To learn more:

  • You can find your city’s Walk Score, find the Walk Score of their own address, and vote for the city they think is most walkable at www.walkscore.com.
Local resources:
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Sunday View: Cost control in cancer care — It’s not just about the money.

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Portrait of Harold PollackBy Harold Pollock

Health reform raises central ideological questions about the size and scope of government, about progressive taxation, about the individual mandate and more.

It’s easy to forget that cost control will be a huge challenge, no matter how these ideological matters are resolved, indeed under any health system.

Finding the right combination of humanity and restraint will be particularly hard in addressing life-threatening or life-ending illness.

Economic incentives, American culture, a changing doctor-patient relationship and fundamental uncertainties at the boundaries of clinical care conspire against our efforts to provide more humane, more financially prudent care.

The necessity and the difficulty of these tasks were underscored by a beautiful New England Journal of Medicine essay, Bending the Cost Curve in Cancer Care, by Thomas Smith and Bruce Hillner.

Their essay received favorable attention from health policy journalists. Yet because it didn’t push the usual partisan buttons, it didn’t receive much wider attention.

That’s too bad, because Smith and Hillner raise many issues that apply beyond the realm of advanced cancer care. For instance, they offer a brave model of skilled providers identifying specific opportunities to reduce costs within their own specialties.

They also present suggestions to address the burdens imposed by cancer overtreatment and undertreatment on patients and society as a whole.

Their first, deceptively simple recommendation is to target cancer testing and imaging to situations of proven benefit. Measured at the population level, the survival benefits of such imaging — routine mammography screening for asymptomatic young women or early lung cancer screening, for example — are often minimal or unproven.

Such imaging is also quite costly. The annual direct costs run into the billions of dollars. Indirect costs include patient anxiety and follow-up treatments that can be expensive and intrusive.

And, at the other end of the life spectrum, physicians are performing annual mammograms in patients who have quite limited life expectancy.

Doctor inspects mammogram. Photo by Bill Branson/NCI

Providers also implement follow-up scans searching for relapse, such as frequent PET-CT scans, that are not supported by guidelines or by clinical trial evidence.

In part, these problems reflect powerful incentives on providers, device manufacturers, and others which promote aggressive care. The problems go deeper, too.

Dr. Vivek Murthy, president of Doctors for America, e-mails that physicians spend less time with patients (not always for reasons of their own choosing) and are less likely to have important discussions with patients and families about priorities or tradeoffs in care.

It takes less time to consent to an intervention or to prescribe a medication than it does to persuade a patient that an intervention or procedure is unwise.

Murthy notes that one cumulative effective of millions of missed conversations is to reinforce the intervention mindset among patients.

So, alongside efforts to alter physician incentives, medical schools and health care settings must equip physicians with the knowledge, the interpersonal skills and other supports to conduct these important conversations well.

Another problem may be even more challenging. We, the public, display a strong bias toward the most aggressive and costly care, often at the expense of other things. The proliferation of $100 million proton beam cancer facilities, even as basic cancer prevention efforts go unfunded, exemplify the imbalance in urgency and priorities. Continued Medicare reimbursements for costly yet dubious medications such as Avastin for breast cancer raise inevitable questions of cost-effectiveness.

A randomized trial found that metastatic non-small-cell lung cancer patients assigned to early palliative care lived almost three months longer, on average, than their counterparts receiving usual care.

Whatever your ideological perspective, Medicare should not and cannot provide a blank check to the supply-side of the medical economy, especially in a political and regulatory context in which private payers are under strong pressure to follow suit.

Smith and Hillner’s essay also raises sensitive issues regarding overly aggressive chemotherapy for patients who face fatal metastatic cancers. Given anxieties captured in the crystalline phrase “death panel,” I would not commence a national cost-control discussion within the frightening and divisive arena of end-of-life care.

On the merits, though, Smith and Hillner cite much evidence that both patients and American society would benefit from less toxic and less aggressive care. When further chemotherapy is unlikely to be successful, they suggest that symptom-directed palliative care provides a better treatment course.

 We, the general public, must alter our own mindset to improve the quality of care. 

Ironically, the inclusion of palliative care elements within standard care may also prolong life. As Atul Gawande noted in the New Yorker, a randomized trial found that metastatic non-small-cell lung cancer patients assigned to early palliative care lived almost three months longer, on average, than their counterparts receiving usual care.

The earlier palliative care group experienced higher quality of life, was less likely to display depressive symptoms and was more likely to be spared toxic side-effects of futile therapies. Some imperfectly understood combination of these benefits prolonged survival through provision of more cost-effective, less-punishing care.

Here again, we, the general public, must alter our own mindset to improve the quality of care. Metastatic lung cancer may be the most straightforward case. The majority of patients with this condition die within one year. Inclusion of palliative care and the turn away from further futile therapy are thus most compelling.

Even here, though, many families hesitate to embrace palliative care because they regard loss of hope as the entry ticket. A definitive bleak diagnosis should not be required to receive services commonly associated with palliative care. All patients require effective pain management. All patients require open communication about prognosis and, often, advance care directives.

Such discussions aren’t easy, especially when families don’t fully trust the care team. Years ago, my father-in-law was diagnosed with advanced lung cancer. At one point, his doctors discussed the possibility of a punishing thoracic surgery. They were unenthusiastic.

Yet our family wasn’t really ready to give up on the prospect of substantially life-prolonging care. Moreover, we weren’t very confident in his doctors. They had done a pretty poor job in the early stages of his care. They lacked the authority to say: “There’s nothing more we can do.”

Fortunately, one of my own physician colleagues mapped the options with me. He explained that surgery was unlikely to prolong my father-in-law’s life and the most likely outcome was that he would spend his few remaining months in recovery from a painful and failed surgery. A different path was chosen. He died soon after, at home, under dignified and humane circumstances in the care of his family and a local hospice.

We all must face these issues to control costs, and for other reasons, too. We can treat our loved ones, and ultimately ourselves, more effectively, more efficiently, and more decently than we often do.


This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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Hospitals look for Disney magic

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Picture of the Disney Castle

By Sreejith K via Flickr

By Phil Galewitz

Barton Memorial Hospital in South Lake Tahoe, Calif., sent its 900 employees back to school in June to learn how to provide better service.

Their instructor: The Walt Disney Co.

“Disney understands guest services,” said Kathy Cocking, Barton’s vice president of operations. “And we’re not as good as we want to be.”

In classes at the hospital, two Disney consultants taught employees how to think more creatively, improve their attitudes toward their jobs and stressed that patients want not just good clinical care, but personal attention, too.

Barton is one of a growing number of hospitals seeking help from the entertainment giant whose theme parks and resorts are famed for meticulous landscaping and rigid employee service standards.

Since October at least 25 hospitals have signed on for multi-year consulting agreements that can include visits to Disney World to observe customer service operations as well as employee training sessions at the hospitals, said spokeswoman Stacey Thomson.

Disney officials attribute the increase in health consulting business to a provision in the new federal health law that requires Medicare payments to hospitals in 2012 reflect patient satisfaction ratings.

Medicare has been publishing patient satisfaction scores on its Hospital Compare website since 2008. Starting in October 2012, Medicare will begin withholding 1 percent of its payments to hospitals. That money — $850 million in the first year — will go into a pool to be doled out as bonuses to hospitals that score above average on several measures, including patient satisfaction.

“Everyone understands these scores will impact our livelihood and our future,” Cocking said. “That’s why we had Disney come here.”

In response to advice from Disney, Barton has revamped its employees’ dress code, improved its landscaping and changed its hiring to focus on applicant’s attitudes, she said.

While Disney has provided consulting services to hospitals and other industries for more than 20 years, it’s using the Medicare payment changes to attract new business. This month, the company launched a new management consulting program that specifically targets customer service for hospitals, based on lessons Disney has learned from working with hospitals.

This includes helping hospitals understand that good service must include not only the work of doctors and nurses, but of all employees, including receptionists and parking attendants.

“Disney taught us that service is a culture and a way of life and not some fad of the month.”

“What we understand very well is the guest experience and that translates well to patients’ experience,” said Patrick Jordan, one of Disney’s two consultants with clinical health experience. Jordan was a speech therapist and vice president for a chain of long-term-care facilities.

He has advised hospitals to redesign employee name tags so they are easy to read and to develop new uniforms to make it easier to identify people’s jobs. He has also suggested rotating people through jobs so they are fresher in their duties.

And he has helped hospitals recreate Disney’s system of having “on stage” and “off-stage” areas so employees know when they are in public or in patient care areas where they need to be especially sharp and focused.

Some health organizations have been criticized for paying thousands of taxpayer dollars to learn management skills from a company known for Cinderella’s Castle and Space Mountain.

The Erie St. Clair Local Health Integration Network, a health planning agency in Ontario, Canada, cancelled a plan last year to pay two Disney consultants $9,500 to give a keynote address at their conference after an Ontario lawmaker said it was an inappropriate use of taxpayer funds.

The University of Iowa Hospitals & Clinics came under fire from state lawmakers in 2009 after it proposed sending 35 of its executives to Disney World at a cost of $130,000. The hospital killed the idea, and instead brought Disney consultants to the hospital so it could reach more of its 2,000 employees. So far, the hospital has paid Disney about $200,000.

“Disney taught us that service is a culture and a way of life and not some fad of the month,” said Gordon Williams, Iowa’s chief of operations.

Paul Duncan, the chair of University of Florida’s health policy department, said such efforts are a logical step for hospitals. But “we do need to remember that Disney is a lot more expensive that Billy’s Air Boat rides or the equivalent … ,” he said. “There really are costs associated with higher levels of service and those costs have to be covered somehow. Will it simply be higher prices?”

Disney’s consulting fees vary from $1,299 for a three-and-a-half-day training program for one person at Disney World (does not include lodging and meals), to $5,000 for a keynote speaker visiting a hospital to hundreds of thousands of dollars for a multi-year consulting arrangement, Thomson said.

Fred Lee, a former Disney health consultant and hospital administrator who in 2005 wrote a book called “If Disney Ran Your Hospital,”  said he’s not surprised to see Disney targeting hospitals. “They are shrewdly capitalizing on the fear and concerns of hospital executives who may lose millions of dollars if their patient satisfaction scores are not at the top of the pack.”

Thomson said the company is not trying to capitalize on the new federal law. “We’re responding to an uptick in demand from hospitals that recognize the need to improve the way they approach patient care,” she said.

Grant Regional Health Center in rural southwestern Wisconsin starting working with Disney in 2002 when it was struggling to recruit doctors, retain workers and improve its image. CEO Nicole Clapp said Disney helped the hospital improve employees’ attitudes toward patients. “We were taking our customers for granted,” she said. “We were treating the gallbladder in room 102 and forgot that’s Mrs. Smith with a pet at home.”

PHOTO by Sreejith K via Flicker (Creative Commons License)  

This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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