hospitals

RECENT POSTS

May 17, 2012 | 10:07 AM | By

Patrick: Use Anti-Trust Laws To Fix High Hospital Prices

WBUR’s Martha Bebinger reports:

I’ve been waiting to hear from Governor Patrick on one of the most controversial health care cost control issues on Beacon Hill: what to do about hospitals that charge three, four or five times more for an MRI (and hundreds of other services) with little or no difference in quality.

Two reports from Attorney General Martha Coakley and at least two from the Governor’s administration (the latest here) say that inflated prices based on the market clout of major teaching hospitals are a major factor driving health care costs in Massachusetts.

Governor Deval Patrick addresses members of the Greater Boston Chamber of Commerce Photo courtesy of the Chamber

Now we have some insight into the Governor’s position on this dicey problem. During a Greater Boston Chamber of Commerce breakfast Tuesday, the Governor was asked whether he wants a provision in the final health care costs bills from the House and Senate that would deal with what’s often called “price disparities” among hospitals? The Governor framed the problem as one of “market clout” and said dealing with the market clout of top Boston hospitals is in the hands of AG Coakley.

The AG, said Patrick, “has tools today to address these imbalances and we have to look to her office to use those tools.”

I called Patrick’s office to clarify. What “tools?” An aide says the Governor was referring, loosely, to the AG’s ability to file anti-trust charges against hospitals. Continue reading →

FILED UNDER: Medicine/Science, Money, Politics, cost, deval patrick, health reform 2012, hospitals, Martha Coakley, reform 2012
May 4, 2012 | 2:34 PM | By

A New Approach To Cutting MA’s Health Costs: Throw Spaghetti

(401k/flickr)

By Rachel Zimmerman and Carey Goldberg

When Massachusetts passed sweeping health insurance reform in 2006, a crucial piece was missing from the landmark legislation: how to control rising medical costs.

Today, state lawmakers unveiled an ambitious new proposal to do just that, including new ways to pay doctors and hospitals, a specific cap on health-care spending tethered to economic growth and a tax on the state’s most expensive hospitals if they can’t justify their prices.

MIT economics professor Jonathan Gruber, an architect of the state’s 2006 health law and an advisor to President Barack Obama on the national Affordable Care Act calls the new House proposal “aggressive, broad and visionary.”

“This is an incredibly hard problem,” said Gruber, speaking on WBUR’s Radio Boston today. “What I like about this…is that it’s really taking the spaghetti approach to cost control; let’s throw a bunch of things against the wall and see what sticks. They’re doing a bunch of different things all of which might work.”

So, what does it mean for patients?

Rep. Steve Walsh, the House chair of the joint Committee on Health Care Financing, said the plan would save $160 billion over 15 years. As far as savings for patients, Walsh said: “The first thing I’d tell [a patient] is five years from now, her family plan is going to be $2,000 cheaper than it is today.” Walsh said businesses would also find their health costs cut significantly.

House Speaker Robert DeLeo added: “With this bill, I think everyone’s gotten a little something they want and everyone’s gotten a little something they don’t want. So that’s what this legislation is all about, but at the end of the day, most importantly what it’s going to provide is some real health care cost containment. That’s what the bill is all about.”

One of the greatest challenges, he said, was to contain costs while not undermining a key industry in the state, with 1 in 7 jobs here linked to health care. Clearly some folks will be disappointed that the plan didn’t go far enough. Gov. Deval Patrick introduced legislation in February 2011 that would have allowed greater government oversight of contracts between insurers and health care providers and moved more medical groups into global payment systems that put doctors and medical groups on a budget.

But DeLeo also made the point that once again, the state is in the forefront of health reform. “I look at this as Massachusetts being a leader once again in terms of what’s going on in the health care field in the country.”

Here are some details of the House bill, officially the Health Care Quality Improvement and Cost Reduction Act of 2012, presented today by lawmakers. The state Senate is expected to introduce its own version of the plan next week.

1. Oversight: A new, quasi-governmental agency called the Division of Health Care Cost and Quality would oversee the transition to the new payment and delivery system with a board including consumer, government and industry representatives.

2. Cost-Cutting: To curb the increase in medical spending, the plan establishes a cap for health-care spending linked to the local economy, the Gross State Product, minus one-half a percent.

3. Leveling The Field: The state could impose a 10 percent “luxury tax” on pricey hospitals that charge more than 20 percent of the state median price for a given service without being able to justify that higher price. (Two earlier reports by Attorney General Martha Coakley found that certain hospitals exploited their market clout and charged higher prices without offering better quality care.) Hospitals would pay this penalty into a “distressed hospital” fund for institutions that serve a high proportion of poor and vulnerable patients. Continue reading →

FILED UNDER: Medicine/Science, Personal Health, Politics, cost, hospitals, mass. health reform, payments reform, reform 2012
April 26, 2012 | 7:34 AM | By

Health Payment Reform Can Bring Big Savings For Employers, Report Finds

Projected impact of growth scenarios on total employer savings on employer-sponsored health insurance. From "Benefits of Slower Health Care Cost Growth for Massachusetts Employees and Employers" by Jonathan Gruber and Ian Perry. (Courtesy)

Projected impact of growth scenarios on total employer savings on employer-sponsored health insurance. From "Benefits of Slower Health Care Cost Growth for Massachusetts Employees and Employers" by Jonathan Gruber and Ian Perry. (Courtesy)

WBUR’s Martha Bebinger reports that under new health payment reform (read cost-containment) plans currently underway in the state legislature, employers could save between $8 and $35 billion over nine years, according to a new analysis by MIT economist Jonathan Gruber.

That translates into direct financial benefits for workers, writes Bebinger:

Gruber says there’s a direct trade off between health care costs and wages. When premiums go up, wages don’t rise as quickly.

“What we’re saying here, by that same logic, is if we can control health care costs workers get more,” Gruber said.

In what Gruber calls a modest proposal, health care costs would increase 5 percent per year, just one point less than the expected 6 percent increase. The savings for employers would be $8 billion over nine years.

Under a more aggressive approach, health care costs would still rise, but only 2 percent per year. Employers would save almost $35 billion or about $1,000 per worker, per year. Continue reading →

FILED UNDER: Insurance, Money, Politics, cost, hospitals, insurance, payment reform
April 25, 2012 | 2:45 PM | By

Report: Electronic Medical Records Uptake ‘Encouraging’ But Digital Divide Remains

Even though the majority of doctor’s offices across the nation have adopted electronic medical records for patients, a clear divide remains between large urban teaching hospitals and their smaller, rural counterparts, according to a new Robert Wood Johnson report.

The report, released today, found that adoption of electronic health records reached 57% last year, a 17% jump from 2002.

Still, researchers note that while the increases in adoption are “encouraging” there are signs of trouble:

The gap in EHR adoption rates based on hospital size, teaching status, and location has become larger, indicating that hospitals with certain characteristics continue to adopt HIT at a faster rate than others. Adoption among large hospitals, for example, increased by 17.3 percentage points, as compared to 10.1 percentage points among smaller hospitals, widening the gap in adoption from 15.0 percentage points in 2010 to 22.8 percentage points in 2011. Similar differences were found based on teaching status and location.

But, as one of our guest bloggers recently noted, the digital divide doesn’t end with the the urban/rural, academic/non- academic split. There is also the great human/pet divide. Professional patient advocate Ken Farbstein writes here about his dog Jackson’s handy EMR printout, something he, as a human patient, still does not have access to.

The Robert Wood Johnson report also offers a state-by-state comparison on the top EMR adopters:

Minnesota (60.9%), Wisconsin (59.9%), and North Dakota (57.9%) had the highest rates of adoption, while Louisiana (15.9%), New Jersey (16.3%), and South Carolina (19.5%) are at the low end of the scale.

Massachusetts was in the higher-end range at 43.6%.

FILED UNDER: Medicine/Science, Personal Health, electronic medical records, hospitals, technology
April 4, 2012 | 11:28 AM | By

Hospitals Launch Drive To Help Environment, Lower Costs

(sneeu/flickr)

“Ditch Fast Food, Turn Down The Lights,” is the takeaway of this Kaiser Health News story about a new national initiative by hospitals (including Boston-based Partners HealthCare) to be more enviromentally friendly — while also saving money:

The Healthier Hospitals Initiative challenges hospitals to reduce energy use and waste, purchase environmentally friendlier products and serve healthier foods. The effort is as much about reducing health risks and environmental damage, as it is about lowering costs, officials said.

Organizers, who hope to have 2,000 hospitals participating by 2014, did not list specific goals such as units of energy saved, waste reduced or unhealthy food discarded in a press briefing Tuesday…

Kathy Gerwig, a vice president at Oakland, Calif.-based Kaiser Permanente (which is not affiliated with Kaiser Health News), said her company weighs environmental impact in buying intravenous bags, as well as computers.

It is also offering healthier food to patients and staff. Dozens of hospitals, including more than 25 children’s hospitals, now offer food from fast food restaurants, she said, adding, “That needs to change.”

Partners Healthcare, which runs Massachusetts General Hospital among other facilities, has reduced energy consumption by 9 percent in the past 18 months by turning down the heat and lowering air conditioner use, said John Messervy, director of capital and facility planning. The move is part of an effort to reduce energy use by 25 percent by 2014. Continue reading →

FILED UNDER: Medicine/Science, Money, environment, hospitals
January 5, 2012 | 9:51 AM | By

A Deeper Dive Into The New Medicaid Waiver

For a deeper (albeit opinionated) look at the new $26.7 billion Medicaid waiver agreement between Massachusetts and the federal government announced last month, here’s Joshua Archambault, director of health care policy at the Pioneer Insititute, blogging about how the new federal dollars may or may not push reform forward equitably.

In an email to me, Archambault writes: “I think the take away from the waiver is that CMS and the Commonwealth are trying to bribe BMC and CHA (along with 5 other hospitals) towards reform. Yet, the reforms are unproven and not fully defined yet. The special payment structure in the waiver, doubles down on past strategies to “ease” the transition by means of more taxpayer money. One is left wondering how other community and safety net hospitals, not named in the waiver, will make the transition towards payment reform if the waiver is built on the assumption that hundreds of millions of additional dollars is required to do so?”

Here’s a bit of his post:

At first glance at the new waiver, it does appear that the state squeezed substantial sums out of the federal government, but where that money ends up is the critical question. The media largely reprinted the press release, and completely ignored the historical context of the waiver, as well as the most basic breakdown of funding distribution. Below are a few takeaways from the waiver, and an outline for why ongoing issues with safety net hospitals in Massachusetts will potentially explode under the federal Affordable Care Act (ACA). Continue reading →

FILED UNDER: Insurance, Money, Politics, health reform, hospitals, medicaid
November 10, 2011 | 3:01 PM | By

Report: Pricier Hospitals Should Prove They’re Worth It

What if more expensive hospitals had to prove they're worth the money?

Some radical ideas on hospital pricing, as reported by WBUR’s Martha Bebinger:

Hospitals in Massachusetts that want to charge more than the median market price for services would have to prove the quality of that service justifies a higher price. That’s part of recommendation #6 from the report by the Special Commission on Provider Price Reform.

This key recommendation comes closest to the commission’s mandate: To address the wide gap between what high and low cost hospitals are paid for the same service.

Specifically, the commission proposes creating a panel of experts whose members would review a hospital’s request to charge more, based on the quality of their service.

Jay Gonzales, Secretary for Administration and Finance in the Patrick Administration and the commission chairman, says creating this panel is “a step government is taking to make sure that if you’re paying higher prices you’re getting something for it, you’re getting better value, or better services.” Continue reading →

FILED UNDER: Medicine/Science, Money, cost, hospitals
November 10, 2011 | 9:52 AM | By

Local Hospitals Fear Super Committee Cuts

Lynn Nicholas, President of the Mass. Hospital Association, whose members are fretting about looming cuts to Medicare

WBUR’s Martha Bebinger reports that Massachusetts hospitals, some of the state’s largest employers, are preparing for the worst as the federal deficit super committee looks to make cuts in Medicare. The local hospitals say the cuts could hurt doctor training programs, among others.

The Massachusetts Hospital Association is out with a new analysis that shows that one year cuts in the program could reach hundreds of millions of dollars. Over 10 years, that number could reach into the billions.

Bebinger spoke with Bob Oakes this morning on the topic, and their conversation is here:

Bob: All the possible cuts we’re talking about this morning would be in Medicare, the federal health care program for the elderly. Why are hospitals so dependent on Medicare?

Martha: It pays doctors to care for many of their sickest patients, the elderly and disabled and several proposals would affect how much or the way doctors are paid. But the biggest worry right now Bob is possible cuts to graduate medical education. Medicare pays part of the cost of training doctors, that’s salaries and equipment and services. And if the super committee reduced medicare spending here, the Massachusetts Hospital Association say members would lose between $100 and $300 million a year or one to $3.2 billion over ten years.

Bob: There are about 5,000 doctors in training in Massachusetts at any given time. How many men and women would this affect?

Martha: We don’t have exact numbers, but one estimate says hospitals would have to eliminate several hundred student or resident slots. Continue reading →

FILED UNDER: Insurance, Money, Politics, hospitals, medical training, medicare
October 4, 2011 | 11:11 AM | By

Ralph De La Torre’s ‘Moxie’ And The Quest For Revamped Health Care

No one asked, but if I were Ralph de la Torre, I’d give my PR people a generous bonus and an extra day off.

This profile of de la Torre, chairman and CEO of Boston-based Steward Health Care System LLC, in The Deal magazine is the kind of story executives dream about. It’s called: “How Ralph de la Torre plans to save healthcare and make a fortune for Cerberus.”

Here’s a taste:

Ralph de la Torre, 45, rocketed to the top of American medicine in 2004 when he became chief of cardiac surgery at Harvard University’s Beth Israel Deaconess Medical Center and, three years later, founded the hospital’s CardioVascular Institute. He then made a dramatic career change, giving up his medical license to run a group of Catholic hospitals outside Boston that were lurching toward bankruptcy. Two years later he persuaded New York-based private equity giant Cerberus Capital Management LP to buy the group. Now he’s on the hunt for other troubled community hospitals.

In fact, the surgeon-turned-administrator-turned-investor now believes he can transform healthcare in America, too, as he wrote President Obama in 2009, not simply “tweak elements of the system” but “overhaul the entire model.” And he plans to do it by using private equity money…De la Torre has never exactly been short on moxie.


(Here’s de la Torre speaking at an Associated Industries of Massachusetts forum in September on the launch of Steward’s new health plan.)
Continue reading →

FILED UNDER: Insurance, Money, Politics, hospitals, Ralph de la Torre, Steward Health Care Systems
September 22, 2011 | 5:10 PM | By

Twenty-Four Hospitals Face Financial Penalties For Preventable Readmissions

Hospitals face cuts in Medicaid payments for higher-than-average patient readmissions

Twenty-four hospitals across the state are facing financial penalties because their so-called “potentially preventable readmissions rates,” are too high, according to MassHealth administrators.

The penalties, slated to take effect Oct. 1, are part of the new, 2012 rate contracts between the state and the 65 hospitals who care for MassHealth patients. Hospitals deemed by the state to have too many re-admitted patients will be hit with a 2.2 percent reduction in their standard payment amount per discharge, or SPAD.

Here’s the list (from the state) of hospitals facing the financial penalty:

–BETH ISRAEL DEACONESS HOSPITAL — NEEDHAM
–NASHOBA VALLEY MEDICAL CENTER
–NOBLE HOSPITAL
–MILTON MEDICAL CENTER
–MARLBOROUGH HOSPITAL
–NORTH ADAMS REGIONAL HOSPITAL
–HEYWOOD HOSPITAL
–ANNA JAQUES HOSPITAL
–STURDY MEMORIAL HOSPITAL
–QUINCY MEDICAL CENTER
–MORTON HOSPITAL INC
–ST ANNES HOSPITAL
–CARITAS NORWOOD HOSPITAL
–SAINT VINCENT HOSPITAL
–ST ELIZABETH HOSPITAL
–SOUTH SHORE HOSPITAL
–CARITAS GOOD SAMARITAN MEDICAL
–METROWEST MEDICAL CENTER
–BROCKTON_HOSPITAL
–CAMBRIDGE HEALTH ALLIANCE
–SOUTHCOAST TOBEY HOSPITAL
–TUFTS NEW ENGLAND MEDICAL
–BRIGHAM & WOMEN’S HOSPITAL
–BOSTON MEDICAL CENTER Continue reading →

FILED UNDER: Insurance, Medicine/Science, Money, hospitals, MHA, readmissions