New Database Reveals Thousands of Hospital Violation Reports New Database Reveals Thousands of Hospital Violation Reports

Hospital (Photo credit: Ralf Heß)

 

From the March 20, 2013 State Line article

 

Hospitals make mistakes, sometimes deadly mistakes.  A patient may get the wrong medication or even undergo surgery intended for another person.  When errors like these are reported, state and federal officials inspect the hospital in question and file a detailed report.

Now, for the first time, this vital information on the quality and safety of the nation’s hospitals has been made available to the public online.

A new website, www.hospitalinspections.org, includes detailed reports of hospital violations dating back to January 2011, searchable by city, state, name of the hospital and key word.  Previously, these reports were filed with the U.S. Department of Health and Human Services, Centers for Medicare and Medicaid (CMS), and released only through a Freedom of Information Act request, an arduous, time-consuming process.  Even then, the reports were provided in paper format only, making them cumbersome to analyze.

Release of this critical electronic information by CMS is the result of years of advocacy by the Association of Health Care Journalists, with funding from the Ethics and Excellence in Journalism Foundation.  The new database makes full inspection reports for acute care hospitals and rural critical access hospitals instantly available to journalists and consumers interested in the quality of their local hospitals.

The database also reveals national trends in hospital errors. For example, key word searches yield the incidence of certain violations across all hospitals.  A search on the word “abuse,” for example, yields 862 violations at 204 hospitals since 2011. …

 

Related articles

• Series on N.C. hospitals wins national award (charlotteobserver.com)
• Medical execs dispute hospital study (krqe.com)
• Govt. To Publish Data On What Drug & Device Makers Pay To Individual Doctors & Hospitals (consumerist.com)
• Time Magazine Study Reveals Hospitals Hiking up Medical Bills (counselheal.com)

 

What is observation care? Clearing up common misperceptions

From the 4 February 2013 article at KevinMD.com

o treat observation care as simply a loophole that allows hospitals to avoid the Medicare penalties from readmissions — as Brad Wright, an assistant professor of health management and policy at the University of Iowa did earlier this month — is to take a short-sighted approach to a complex health issue.

 

Observation care in fact aims to address several of healthcare’s thorniest challenges head on. In the process, a well-run observation unit can not only help reduce hospital readmission rates, but it can reduce crowding and speed throughput in the ER, save patients an extended first hospital admission (let alone a re-admission), and perhaps most importantly, improve patient outcomes.

To see how, and to clear any misconceptions some like Wright could have about observation care, it might be helpful to do some Q&A.

…

 

Read the entire article here

Related articles

• Can Patient-Centered Care Reduce Hospital Readmissions? (healthblawg.typepad.com)
• The Relationship Between Discharging Patients From the Hospital Too Early and the Likelihood of a 30 Day Readmission: Treat, Street and Repeat. (diseasemanagementcareblog.blogspot.com)
• D. Brad Wright: Penalizing Hospitals for Re-admissions: Will It Work? (huffingtonpost.com)
• Positive nursing environments reduce readmissions (medicalstaffingnetwork.wordpress.com)

 

Feds release nursing home inspections, free of censor’s marks

Reblogged from Public Health--Research & Library News:

From ProPublica:

In response to a Freedom of Information Act request by ProPublica, the government has released unredacted write-ups of problems found during nursing home inspections around the country. We’re making them available today for anyone who wants to download the complete versions.

For several months now, ProPublica has made redacted versions of this same information available in an easily searchable format in our…

Read more… 247 more words

What Does the Dartmouth Atlas Have to Say About the Politics of the ACA?

From the 27 December 2012 article at The Health Care Blog by Anubhav Kaul, MD, Peter Bhandari, and Thom Walsh, PhD

…The Dartmouth Atlas Project is an online database which collects Medicare spending and utilization data from around the country. Information gathered from the database has shown immense variation in the way medical resources are utilized by even similar regions, communities, and health care organization. Evidence has repeatedly shown that, from a population perspective, areas that spend more on medical care do not consistently benefit from increased quality of care or patient wellbeing. Variation in the type of care delivered can be attributed to diverse incidence and prevalence of disease severity or the type of care a well- informed patient chooses. Variation in health care delivery is thus omnipresent and expected, because every patient is unique and medical innovation presents a growing number of care options to choose from….

[The interactive map may be found here]

…

The top ten Republican states have higher Medicare spending than the top ten Democratic states. The rate of hospitalization and surgical procedures are also higher for Republican states. If we investigate a procedure like percutaneous coronary interventions (PCI), the Republican states are performing more PCI procedures with equal mortality benefit compared to Democratic states. The evidence of variation in cost and utilization is a strong indication of inconsistency and inefficiency in the care delivery process. Are the Republican states providing better care by providing more care? We cannot find evidence of for such an assertion. Nor do we find evidence of harm occurring from a lack of utilization to individuals residing in democratic states. Six of the ten Republican states sued the federal government over the individual mandate and Medicaid expansion earlier this year (Utah, Alabama, Louisiana, Texas, Georgia, and Nebraska), compared to only one democratic majority state (Maine). Yet the Republican states have a higher average of uninsured people, thus inhibiting a greater percentage of their citizens from accessing preventive healthcare….

Read the entire article here

Related articles

• Care at the End of Life (nytimes.com)
• 4 Secrets Republicans Are Keeping About Medicare to Convince Us That $600 Billion in Cuts Are Necessary | Alternet (mbcalyn.com)
• Report: Variations in quality of care a ‘hidden’ curriculum for new doctors at teaching hospitals (boston.com)
• Frequency of seniors’ surgeries varies by geography (miamiherald.com)
• Medicare patients’ elective surgeries linked to where they live (reporternews.com)

November is Long-Term Care Awareness Month

English: Nursing and Residential Care Home, Withington This is Clyde Court, on Lapwing Lane. (Photo credit: Wikipedia)

 

From a recent USA.gov email

 

When planning ahead in these uncertain financial times, it’s important to think about long-term care for yourself and your loved ones. Long-term care (LTC) is a range of services and supports you may need to meet your health or personal needs over a long period of time. These services might include emergency response systems, senior centers, assisted living, nursing homes, transportation services, and many more.

Most long-term care assists people with activities of daily living like dressing, bathing and using the bathroom. Other common long-term care services include helping with housework, cooking, shopping, or even managing money. Long-term care can be provided at home, in the community, in assisted living or in nursing homes. And it’s not just for seniors—if you have a significant health challenge, you may need long-term care at any age.

While there are a variety of ways to pay for long-term care, it is important to think ahead about how you will fund the care you may need. Generally, Medicare doesn’t pay for long-term care, but only for a medically necessary skilled nursing facility or home health care. Long-term care insurance may be an option to help you and your family prepare ahead of time for the potential need for long-term care. There are a variety of plans available that vary in cost depending on what services you want covered and the age you begin coverage. Before you choose a plan you should take into account where and what kind of care you might need.

Be sure to take some time this month to check out your options and plan ahead, so you can rest assured that you and your family get the care you need. And if you’re a caregiver now for a family member with health challenges, find more resources and support from USA.gov.

 

Related resources

 

• National Clearinghouse for Long Term Care Information 
• Guide to Long Term Care Insurance (USA.gov)
• Caregiver’s Resources (USA.gov)

 

Related articles

• Retirement: The pros and cons of long-term-care insurance (pattidudek.typepad.com)
• Elderly deserve respect, compassion (pantagraph.com)
• Long Term Care Costs Continue To Spike (aarp.org)
• Five Avoidable Caregiver Mistakes (aarp.org)
• Official puts long-term care in focus (newsherald.com)

 

[Reblog] Rising Medicare Part D Drug Premiums & How to Compare Plans

From the 10 October 2013 article at As Our Parents Age

 

Check out this interactive plan finder.

Take a few minutes to read As Medicare Drug Premiums Soar It’s Time to Shop Around, another informative article about prescription drug plan open season.

[Flahiff's note...
If you do not have ready access to a computer or find computers challenging, try these resources for assistance in comparing plans

• Local Area Office on Aging (may have a slightly different name in your area)
  As a volunteer at our area office, this is our top priority during open enrollment...which ends December 7th
• Local United Way for referral to agencies in your area (211 for most localities)
• Local public library for referral to agencies in your area (ask for a  reference librarian)]

This October 2, 2012 Reuters article by Mark Miller goes into considerable detail about the rising premiums and explains what steps Medicare beneficiaries can take to shop around.

Best Quote from the Article: Premiums for many popular Medicare prescription drug plans will soar next year – but seniors don’t have to take the rate hikes lying down.

It goes hand-in-hand with the other article I reviewed in my September 30, 2012 blog post, Medicare Prescription Drug Plan: 2013 Info.

Medicare beneficiaries and their adult children can use these two articles, together with the Plan Finder at Medicare.gov. At the top right on  the page is a button that takes visitors to an online demonstration of the Plan Finder.

Related articles

• Evaluating Medicare plans (miamiherald.com)
• Q&A: Medicare open enrollment too often overlooked (mcclatchydc.com)
• Report: Premium hikes for top Medicare drug plans (cnsnews.com)
• By the Numbers: Medicare Costs for Seniors to Rise Under President’s Plan (heritage.org)
• Report: Premium hikes for top Medicare drug plans (kansascity.com)
• Time for a Medicare switcheroo? (bankrate.com)
• Do you know Medicare Plans and what is best for you? (getlifebenefits.wordpress.com)
• Medicare Part D and Medicare Advantage Changes for 2013 (extendhealth.wordpress.com)
• Medicare Part C, Medicare Part C Coverage, Medicare Part C Enrollment and resources to help consumers understand… (getlifebenefits.wordpress.com)
• So What Does Medicare Cover? (kcet.org)

Top Ten Myths of Medicare

 

From the Full Text Report abstract

Top Ten Myths of Medicare

August 26, 2012

Top Ten Myths of Medicare
Source: Social Science Research Network

In the context of changing demographics, the increasing cost of health care services, and continuing federal budgetary pressures, Medicare has become one of the most controversial federal programs. To facilitate an informed debate about the future of this important public initiative, this article examines and debunks the following ten myths surrounding Medicare: (1) there is one Medicare program, (2) Medicare is going bankrupt, (3) Medicare is government health care, (4) Medicare covers all medical cost for its beneficiaries, (5) Medicare pays for long-term care expenses, (6) the program is immune to budgetary reduction, (7) it wastes much of its money on futile care, (8) Medicare is less efficient than private health insurance, (9) Medicare is not means-tested, and (10) increased longevity will sink Medicare.

 

Related articles

• Kaplan: The Top Ten Myths of Medicare (lawprofessors.typepad.com)
• Kaplan: The Top Ten Myths of Medicare (taxprof.typepad.com)
• Medicare Cuts: Will they affect you? (medicaresupplementshop.com)
• Article on the Myths Surrounding Medicare (lawprofessors.typepad.com)
• What do I do if my Medicare HMO goes out of business? (insurance.com)
• The almost-definitive guide to the Medicare debate (dailykos.com)

 

[on the Affordable Care Act] HealthNewsReviews.org Guest post: Bewitched, bothered and bewildered

 

Reblog from 7 August 2012 article at HealthNewsReview.org

The following is a guest post submitted by Harold DeMonaco, MS, one of our expert story reviewers for HealthNewsReview.org.  The opinions stated are his.

——————————————————————————————

I, like many, read the internet version of my local newspaper.  And in doing so, I am provided with an opportunity to view the comments of my fellow residents on topics of importance.  My local newspaper is a bit right leaning and as a result, the vox populi is as well.

Many of those who post thoughts on current events do so with great fervor and some with great frequency.  The tone and tenor of the “discussions” can vary but were at their most vitriolic when writers could use pseudonyms.  Many of the most vocal appear to have departed when a requirement was made to self identify posts to the site.  Several continue to provide the rest of us with the fruits of their years and breadth of experience as well as their keen intellect.

Given the right leanings of the newspaper and the most vocal of the vox populi, it is not surprising that the Affordable Care Act (presumably a four letter word for many) is viewed in a somewhat negative fashion.  This is somewhat surprising since presumably the writers are either the beneficiaries of then Governor Romney’s surprising insight into healthcare or to the workings of President Johnson’s Great Society and Medicare.  Massachusetts has managed to insure just about every citizen in the state and has now enacted legislation to better control health care costs.  While there is work to be done to develop an ideal healthcare delivery system in Massachusetts and control costs, near universal access has been accomplished.

Why then do people object so strenuously to Obamacare?  Is it their fear of government control?  If so, the objectors should rightfully refuse Medicare, a pay as you go, government run insurance program managed by the Centers for Medicare and Medicaid.  I suspect that the underlying reason is really rooted in economics.  In essence, it is a zero sum game. If you win something, I must lose something.

The Blue Cross Foundation of Massachusetts periodically publishes updates on the Massachusetts experiment.  Here are the latest findings:

• 439,000 more Massachusetts residents have health insurance coverage than did before reform.
• Massachusetts has the highest rate of insurance in the country with 98.1 percent of residents insured.
• There has been no evidence of subsidized coverage “crowding out” employer-sponsored insurance, and employer offer rates have grown from 70 percent to 77 percent since implementation of reform.
• Public support for Massachusetts health reform has remained strong with two out of three adults supporting reform.
• Most employers believe health reform has been good for Massachusetts and 88 percent of Massachusetts physicians believe reform improved, or did not affect, care or quality of care.
• The cost of health care and the annual rate of increase in health care spending remains a challenge.  With no intervention, per capita health care spending in Massachusetts is projected to nearly double by 2020.

Given the intensity of the debate around Obamacare, I would have assumed that more news stories would provide readers with more information about the Massachusetts experience.  More often than not however, readers are provided with partisan arguments for and against the Affordable Care Act.  While there is a good deal of noise, there often is little in the way of real information.

 

 

The following is a guest post submitted by Harold DeMonaco, MS, one of our expert story reviewers for HealthNewsReview.org.  The opinions stated are his.

——————————————————————————————

I, like many, read the internet version of my local newspaper.  And in doing so, I am provided with an opportunity to view the comments of my fellow residents on topics of importance.  My local newspaper is a bit right leaning and as a result, the vox populi is as well.

Many of those who post thoughts on current events do so with great fervor and some with great frequency.  The tone and tenor of the “discussions” can vary but were at their most vitriolic when writers could use pseudonyms.  Many of the most vocal appear to have departed when a requirement was made to self identify posts to the site.  Several continue to provide the rest of us with the fruits of their years and breadth of experience as well as their keen intellect.

Given the right leanings of the newspaper and the most vocal of the vox populi, it is not surprising that the Affordable Care Act (presumably a four letter word for many) is viewed in a somewhat negative fashion.  This is somewhat surprising since presumably the writers are either the beneficiaries of then Governor Romney’s surprising insight into healthcare or to the workings of President Johnson’s Great Society and Medicare.  Massachusetts has managed to insure just about every citizen in the state and has now enacted legislation to better control health care costs.  While there is work to be done to develop an ideal healthcare delivery system in Massachusetts and control costs, near universal access has been accomplished.

Why then do people object so strenuously to Obamacare?  Is it their fear of government control?  If so, the objectors should rightfully refuse Medicare, a pay as you go, government run insurance program managed by the Centers for Medicare and Medicaid.  I suspect that the underlying reason is really rooted in economics.  In essence, it is a zero sum game. If you win something, I must lose something.

The Blue Cross Foundation of Massachusetts periodically publishes updates on the Massachusetts experiment.  Here are the latest findings:

• 439,000 more Massachusetts residents have health insurance coverage than did before reform.
• Massachusetts has the highest rate of insurance in the country with 98.1 percent of residents insured.
• There has been no evidence of subsidized coverage “crowding out” employer-sponsored insurance, and employer offer rates have grown from 70 percent to 77 percent since implementation of reform.
• Public support for Massachusetts health reform has remained strong with two out of three adults supporting reform.
• Most employers believe health reform has been good for Massachusetts and 88 percent of Massachusetts physicians believe reform improved, or did not affect, care or quality of care.
• The cost of health care and the annual rate of increase in health care spending remains a challenge.  With no intervention, per capita health care spending in Massachusetts is projected to nearly double by 2020.

Given the intensity of the debate around Obamacare, I would have assumed that more news stories would provide readers with more information about the Massachusetts experience.  More often than not however, readers are provided with partisan arguments for and against the Affordable Care Act.  While there is a good deal of noise, there often is little in the way of real information.

 

 

 

Related articles

• The 716 Billion Dollar Lie (boomantribune.com)
• GOP budget plan’s real target: Medicare (salon.com)
• Robert Reich: Whose Plan Destroys Medicare — Obama’s or Romney-Ryan’s? (huffingtonpost.com)
• Romney struggles to get square with Ryan’s Medicare plan (firstread.nbcnews.com)
• Medicare reform: Obama vs. Ryan vs. Romney (totalbuzz.ocregister.com)
• Romney struggles to square with Ryan’s Medicare plan (firstread.nbcnews.com)
• Schreibman and Gibson fence over Medicare (timesunion.com)
• Obama’s Medicare Reforms Expanded Benefits For Seniors (tpmdc.talkingpointsmemo.com)
• The Difference Between Obama And Ryan’s Medicare Cuts (tpmdc.talkingpointsmemo.com)
• Federal Court Dismisses Challenge to Affordable Care Act’s Contraception Requirement (pattidudek.typepad.com)

 

The Most Powerful Health Care Group You’ve Never Heard Of

 

By BRIAN KLEPPER AND PAUL FISCHER in their 9 August 2012 post at The Health Care Blog

Excessive health care spending is overwhelming America’s economy, but the subtler truth is that this excess has been largely facilitated by subjugating primary care. A wealth of evidence shows that empowered primary care results in better outcomes at lower cost. Other developed nations have heeded this truth. But US payment policy has undervalued primary care while favoring specialists. The result has been spotty health quality, with costs that are double those in other industrialized countries. How did this happen, and what can we do about it.

American primary care physicians make about half what the average specialist takes home, so only the most idealistic medical students now choose primary care. Over a 30 year career, the average specialist will earn about $3.5 million more. Orthopedic surgeons will make $10 million more. Despite this pay difference, the volume, complexity and risk of primary care work has increased over time. Primary care office visits have, on average, shrunk from 20 minutes to 10 or less, and the next patient could have any disease, presenting in any way.

By contrast, specialists’ work most often has a narrower, repetitive focus, but with richer financial rewards. Ophthalmologists may line up 25 cataract operations at a time, earning 12.5 times a primary care doctor’s hourly rate for what may be less challenging or risky work.

 

These differences in physician worth and payment didn’t just happen. Instead, they have been driven by a 31 doctor – 26 specialists and 5 primary care physicians – American Medical Association panel, the Relative Value Scale Update Committee (RUC), which for 20 years has been Medicare’s sole advisor on the value of physician services. The Centers for Medicare and Medicaid Services (CMS), the federal agency overseeing the program, has historically accepted nearly 90 percent of the RUC’s recommendations with no further due diligence. So the RUC has huge financial impact throughout health care, not only for Medicare but for many commercial health plans that follow Medicare’s lead on payment…

…

t is clear that it will be impossible to get American health care under control unless we can recapture regulation and reconfigure it to act in the common rather than the special interest. Until that is accomplished, America’s and our children’s diminishing prospects will be directly tied to our failure to stop the health industry’s rapaciousness.

Related articles

• A Call For a New Primary Care Society (thehealthcareblog.com)
• Will Anyone Listen When Former CMS Chiefs Call For More Objective Physician Payment? (thehealthcareblog.com)
• How can primary care be a policy leader? (kevinmd.com)
• CMS Proposes Payment Increases (!) for Family Physicians and Other Primary Care Practitioners (managemypractice.com)
• Does More Primary Care Increase Healthcare Costs Instead of Lowering Them? (freakonomics.com)
• Health Affairs Study: One-Third of Doctors Won’t Accept New Medicaid Patients (forbes.com)

 

More than 16 million people with Medicare get free preventive services in 2012 Affordable Care Act made many preventive services no cost to beneficiaries (with link to a planning guide)

Affordable Care Act made many preventive services no cost to beneficiaries

From the 20 July 2012 article at the US Dept of Health and Human Services

The Affordable Care Act – the new health care law – helped over 16 million people with original Medicare get at least one preventive service at no cost to them during the first six months of 2012, Health and Human Services (HHS) Secretary Kathleen Sebelius announced today.  This includes 1.35 million who have taken advantage of the Annual Wellness Visit provided by the Affordable Care Act.  In 2011, 32.5 million people in Medicare received one or more preventive benefits free of charge.

“Millions of Americans are getting cancer screenings, mammograms and other preventive services for free thanks to the health care law,” said Secretary Sebelius.  “These new benefits, made possible through the health care law, are helping people stay healthy by giving them the tools they need to prevent health problems before they happen.”

Prior to 2011, people with Medicare faced cost-sharing for many preventive benefits such as cancer screenings.  Through the Affordable Care Act, preventive benefits are offered free of charge to beneficiaries, with no deductible or co-pay, so that cost is no longer a barrier for seniors who want to stay healthy and treat problems early.

The law also added an important new service for people with Medicare — an Annual Wellness Visit with the doctor of their choice— at no cost to beneficiaries.

For more information on Medicare-covered preventive services, please visit: 
http://www.healthcare.gov/law/features/65-older/medicare-preventive-services/index.html

To learn what screenings, vaccinations and other preventive services doctors recommend for you and those you care about, please visit the myhealthfinder tool at www.healthfinder.gov.

Related articles

• Half on Medicare in AZ use free preventive care (Rim Country Gazette)
• Pennsylvania seniors with Medicare receive free screenings (Times-Tribune)
• Michigan seniors strive to stay healthy (TheDailyReporter)

• Ask Medicare Helps Caregivers Plan for the Future (Center for Medicare and Medicaid Services)

  Baltimore, MD, June 28, 2012 /PRNewswire/ — Now is an ideal time for caregivers to get organized, manage personal finances and plan for the future. Effective long-term planning can help bring peace of mind and is particularly important for the nation’s growing number of caregivers who must manage their own affairs while attending to the health and well-being of another. Nearly 66 million U.S. residents¹ provide care for a chronically ill, disabled or aging family member or friend. This can involve:

  • Setting up doctor appointments for the many free, preventive services available to Medicare beneficiaries,
  • Reviewing drug plan coverage,
  • Planning for changes in in-home care needs, or
  • Preparing for a transition from the home to an assisted living or nursing home facility.

  The Centers for Medicare and Medicaid Services initiative, Ask Medicare, can help caregivers plan by offering a wealth of consumer-focused information, including personal stories from other caregivers on overcoming common challenges, a free e-newsletter, and decision-making tools addressing a range of health care issues. The “How Can you Plan for the Future?” checklist provides planning ideas.