Health Care Thoughts: Hospitals Rising
by Tom aka Rusty Rustbelt
Health Care Thoughts: Hospitals Rising
One of the key operational themes of PPACA (Obamacare) is integration. Almost all models of integration have a hospitals or hospital networks as the hub. Some networks are already highly integrated, others are headed in that direction. (There was a big push for integration at the time of the Clinton-care proposals, some of the integration stuck and some of it unwound as a result of operational disasters.)
This gives hospitals and hospital networks an immense amount of new power, whether it is used for good or ill is yet to be seen (I have often encountered a “not-for-profits give better care and are more ethical” theme, but as NFP merge into networks with billions of dollars this does not appear to me to be correct).
In regions with competing networks there are stampedes for “market share,” with a great deal of money often thrown into new facilities and new services. There are also bidding wars for employed physicians and battles for favorable affiliations with practice groups.
This also creates a “talent war” for quick and nimble executives, and I fear the ascendency of “slick-and-useless” MBAs in the hospital industry.
This is a little “inside baseball” but beyond politicals, law and economics there are details with consequences.
Aetna buys Coventry (http://www.coventryhealthcare.com/)
CNBC is interpreting this as a bet that Obama will be reelected, FWIW.
STR, I find this chilling but why would CNBC come up with that explanation?
Apparently because they believe it to be true.
CNBC interviewed the Aetna CEO, very interesting, I will try to find link.
Now a counter theory that Aetna expects Romney to win.
The CEO should know:
In RI there are 2 hospital networks, Lifespan and Care New England. Out of 13 hospitals, these 2 networks cover 8.
In Woonsocket, Landmark has been struggling for years. They seem to find a buyer, but then something always happpens at the state level such that the deal fall through. I’m convinced the big guy RI Hosp/Lifespan has been trying to shut it down as a competitor. As a matter of need in the area, I don’t see how that is practical. The latest is that BCBS is not willing to pay a rate that will allow the hospital to survive which has put a crimp in the latest deal for the Catholic Church hospital system to buy it.
And lets not mention monopoly threats, intimidation, lies, and corruption.
Incompetent service, take it or die.
Bad pay, to bad, you tick us off you out of business.
You dress it up in pretty ribbons. A “bidding war” for doctors.
Don’t you mean PRICE FIXING AGREEMENT to only pay doctors so much?
Though I don’t have the hard numbers to prove it, I can personally attest to the fact that because ACA has mandated that patient satisfaction scores be tied to Medicare and Medicaid reimbursement, hospitals are spending an enormously amounts of precious healthcare dollars paying outside consultants to advise them on how to boost patient satisfaction scores. This has resulted in hospitals hiring a large army of full-time and fully benefited RNs, along with a very top heavy management team, to call up newly discharged patients and ask them what they liked and disliked about their hospital stay. They are doing this not because they are looking for better ways to satisfy their patients. Nor are they doing this to improve patient outcome or reduce hospital readmission rates. They are doing this because outside consultants like the Studer Group claim that by simply having RNs call up newly discharged patients at home to inquire about their recent hospital stay, these patients are more likely to give the hospital a higher satisfaction score than they otherwise would. Is this total nonsense, or what!
It’s hard for me to believe that hospital administrators are falling for this Studer-ized nonsense given that there is plenty of data out there proving that high patient satisfactions scores are strongly correlated with higher readmission rates, more costly hospital stays, and higher patient mortality rates. As emergency physician ‘WhiteCoat’ aptly puts it, “High satisfaction with a health care facility means that you’re more likely to be admitted, you’re more likely to pay more for your care, and you’re more likely to be discharged in a body bag”:
What I find particularly troubling about this, at least from a patient confidentiality standpoint, is that this information from newly discharged patients is being emailed to all doctors and nurses who work or had worked on the unit where the patient was staying, providing them with their medical record and room number. I don’t know about you, but I certainly wouldn’t want my medical record and the hospital room number I was staying in posted on hundreds of emails throughout the hospital! Then again, I’d refuse to talk to any stranger who calls me at home asking about my hospital stay. Now if either a doctor or nurse who had cared for me called me up to ask how I was doing and to answer any questions I had with regards to my discharged medicines and follow-up visits, I would be happy to speak with them.
This emphasis of patient satisfaction scores has caused hospitals to waste precious healthcare dollars on providing wildly frivolous things like free 30 minute massages for patients and dishing out five-star meals to them. Now it is causing them to waste precious healthcare dollars on creating an entirely new nursing department whose only job it is to find out what patients liked and disliked about their hospital stay. Needless to say, this can only lead to higher healthcare costs — and higher healthcare costs that play no role whatsoever in improving patient outcome or reducing hospital stay.
How many $billions has been paid out over the last few decades fro flawed care resulting in the deaths of hundreds and those doctors have been allowed to continue practice without the hospital or medical associations taking action to clean-up their acts? And what the population gets in response are proposals to cap claims against doctors when the limits are already capped between $250,000 -$500,000 with the exception of physical needs.
It did not have to get this way if costs were controlled by the healthcare industry; but, they were not. It did not have to get this way if doctors and hospitals policed their own (the same as Wall Street should); but, they do not.
This is from 2007; but, it is still a good and relevant read. http://www.citizen.org/documents/NPDB%20Report_Final.pdf “The Great Malpractice Hoax. This is why CMS and the ACA are clamping down. The care, the services for fees, were not producing the results which were overpaid for in the first place.