Archive for the ‘Hospital Systems’ Category
Monday, July 12th, 2010
Medical schools and teaching hospitals that educate primary-care physicians and allied professionals can apply for $250 million in new grants through the Prevention and Public Health Fund. According to Health and Human Services (HSS) Secretary Kathleen Sebelius, the grants are 50 percent of a $500 million fund created by healthcare reform legislation. The doctor deficit goes back to the 1980s and 1990s when medical schools capped their enrollments at 16,000 students per year because they believed that managed care would create a physician glut.
With the nation facing a shortage of 66,000 primary-care physicians just 10 years from now, including 7,000 in underserved urban and rural areas, according to HHS, the new funding is welcome news and represents a starting point to resolve the physician shortage. The money will train approximately 1,700 new primary-care physicians, physician assistants and nurse practitioners through 2015. Representative Lois Capps (D-CA) describes the new healthcare bill as a jobs bill because it provides funding to train new healthcare professionals.
The lion’s share of the grants — $168 million - will benefit physicians and be awarded to 105 eligible teaching hospitals and university medical schools. An additional $32 million will fund 40 programs that train physician assistants. Another $30 million will fund nurse practitioner training.
Although the 1,700 primary-care physicians this grant money will train is a drop in the bucket - considering that approximately 250,000 active physicians are expected to retire between now and 2020 - it represents a step in the right direction.
Tags: Department of Health and Human Services, Kathleen Sebelius, Lois Capps, nurse practitioners, physician assistants, primary-care physician
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Thursday, July 8th, 2010
With the narrow 219 - 212 passage of healthcare reform legislation by the House of Representatives, its positive impact on commercial real estate is becoming clear. Jeffrey H. Cooper, an international investment banker who specializes in healthcare facilities with Savills, believes that the potential exists to develop more than 60 million SF of new medical office buildings.
Cooper believes that passage of the healthcare reform bill will impact four areas:
- With 30 million new insured Americans seeking healthcare, the need for medical facilities to serve them will expand.
- By using the standard multiplier that calculates that each new outpatient requires 1.9 SF of medical office space, 30 million newly insured individuals will require that approximately 57 million SF be constructed.
- As reimbursements for inpatient treatment are reduced, there will be a simultaneous need for the development of new ambulatory treatment facilities and medical office buildings.
- As the demand for new capital projects grows, hospitals will seek out third-party financing and ownership. This is particularly true in cases where tax-exempt bond financing is not available.
With more than 30 years of real estate investment banking experience, Cooper is likely on the right track here.
Tags: commercial real estate, healthcare reform legislation, House of Representatives, Jeffrey Cooper, medical office buidlings, President Barack Obama, primary care, Savills
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Wednesday, July 7th, 2010
Although between 5.8 and seven million Americans may qualify for healthcare coverage through the temporary high-risk pool program created as part of healthcare reform, the $5 billion set aside for use between now and 2014 may cover only 200,000 patients annually.
The high-risk pool, created by the 2010 Patient Protection and Affordable Care Act, provides subsidized coverage to uninsured individuals with pre-existing medical conditions. One portion of the law provides income-based subsidies so healthcare coverage is more affordable and accessible. Because most of the provisions do not become effective until January of 2014, however, the limited funding means available dollars will have to be stretched as far as possible, said Paul B. Ginsburg, Ph.D., NICHR director of research. The National Institute for Health Care Reform (NIHCR) has identified key policy considerations in its Health Coverage for the High-Risk Uninsured: Policy Options for Design of the Temporary High-Risk Pool policy analysis.
According to Kaiser Health News, many people with medical conditions may be unable to obtain coverage. “That fear — along with partisan considerations — prompted officials in 20 states to decline to establish their own federally financed pools, opting to leave the task to Washington. Officials in those states, predominantly Republicans, worry that they would face intense pressure to pick up the burden if the money runs out.”
Tags: healthcare reform, high-risk pools, Kaiser Health News, Patient Protection and Affordable Care Act, Republicans
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Tuesday, June 29th, 2010
President Barack Obama is expanding payment recapture audits as a means of fighting waste and abuse in government programs such as Medicare and Medicaid. The presidential memorandum will direct federal agencies to “expand and intensify” the use of audits, such as those performed by recovery audit contractors and Medicaid integrity contractors. The initiative will extend the scope of such audits beyond fee-for-service payments into other government contracts. The president also will support bipartisan legislation to expand the authority of government agencies to direct recaptured funds toward audits.
The announcement follows an executive order issued by President Obama in November, 2009, that directed the government to aggressively control improper payments, which were said to equal $98 billion. Fully $54 billion of that was attributed to Medicare and Medicaid and reflect an estimate of payments made in error, duplicate billing and even fraud.
Aimed at the political middle and designed to rally support for healthcare reform, the proposal would employ private auditors whose sophisticated computer systems can scan Medicare and Medicaid billing records for patterns of false claims. The auditors would get to keep some of the dollars recovered. According to the White House, a Medicare pilot program recovered approximately $900 million for taxpayer between 2005 and 2008.
Tags: fraud, Medicaid, Medicare, President Barack Obama, recovery audit contractors
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Monday, June 28th, 2010
President Barack Obama has called on Congress to enact a patch on Medicare payments to physicians and declared his commitment to achieving a long-term solution. “For years, I have said that a system where doctors are left to wonder if they’ll get fairly reimbursed makes absolutely no sense,” the President said. “And I’m committed to permanently reforming this Medicare formula in a way that balances fiscal responsibility with the responsibility we have to doctors and seniors.” The President’s statement came after legislation that would give physicians 18 months of pay raises stalled in the Senate. Instead, a 21 percent pay cut will go into effect unless the Senate acts to prevent that.
According to an American Medical Association survey, approximately 20 percent of physicians have said they are limiting the number of Medicare patients they treat because of the reimbursement levels. In his speech, President Obama took to task Congressional Republicans who have stalled the legislation. A significant number of Republicans - and some Democrats - are unhappy with the price tag on the “physician fix”, which would cost approximately $22 billion over 18 months. A 10-year fix would cost in the neighborhood of $200 billion.
The American Osteopathic Association, American College of Physicians and the American Academy of Family Physicians are on record as supporting the amendment, even though it doesn’t completely restructure the way physicians are reimbursed by Medicare.
Tags: American Academy of Family Physicians, American College of Physicians, American Medical Association, American Osteopathic Association, Congress, Democrats, Medicare, Medicare patch, Physician fix, President Barack Obama, Republicans, Senate, senior citizens
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Thursday, June 24th, 2010
Starting in September, the approximately five million Americans under the age of 19 who have pre-existing medical conditions cannot be denied health insurance coverage. The healthcare reform law also gives these patients expanded physician choices because many previously had to rely on government programs such as Medicaid. Children account for approximately nine percent of the 57.2 million Americans under the age of 65 who have pre-existing conditions.
Although Congress wanted to implement this section of the bill immediately instead of waiting until September 23, some private insurers are showing signs of stepping up to the plate and providing coverage as soon as the Obama administration issues regulations on final implementation. According to Illinois Insurance Director Michael McRaith, “It would not surprise me if insurers would undertake this earlier.”
Although there were some concerns that insurers might try to deny coverage to children with pre-existing conditions or set rates too high, Secretary of Health and Human Services Kathleen Sebelius sent a letter to Karen Ignani, CEO of America’s Health Insurance Plans directing the trade organization to comply with the new law. “To ensure there is no ambiguity on this point, I am preparing to issue regulations in the weeks ahead ensuring that the term ‘pre-existing condition exclusion’ applies to both a child’s access to a plan or to his or her benefits once he or she is in the plan,” Sebelius wrote.
“This is a confidence builder in what healthcare reform does,” said Ron Pollack, executive director of Families USA, a consumer health advocacy group that backed expanding healthcare coverage. “It’s a popular group to reach out to…and it’s not going to have as big of an impact on costs as, say, somebody between the ages of 56 and 64 who has multiple chronic conditions.”
Tags: America's Health Insurance Plans, Congress, Deparment of Health and Human Services, Families USA, healthcare reform, Karen Ignani, Kathleen Sebelius, Medicaid, Obama administration, pre-existing medical conditions
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Tuesday, June 22nd, 2010
Former President Bill Clinton warned the healthcare insurance industry that they need to move towards being an “in the future business” rather than holding on to obsolete, unsound business models. In a recent keynote speech to America’s Health Insurance Plans’ annual conference, Clinton told the insurers’ trade group that he respected their support for healthcare reform. He cautioned, however, that there is still work to be done.
“We now have to go after the cost in a way that improves the quality,” Clinton said. “You did your part but it’s all gong to be for nothing unless we bring down the cost of healthcare.” Clinton called on Congress to enact an amendment to the new healthcare law that specifically establishes a bipartisan commission whose goal is to determine the best practices in healthcare. Clinton suggested that the panel be patterned after the National Commission on Fiscal Responsibility and Reform, which President Barack Obama created in February. Its goal would be to devise solutions that rein in costs and improve the quality of care. According to Clinton, the commission would ideally meet between its creation and 2014, when most of the reforms become effective.
“I don’t really care who’s at fault,” Clinton concluded. “We need to figure out how to fix this healthcare thing.”
Tags: America's Health Insurance Plans, best practices, Bill Clinton, Congress, healthcare reform, insurance companies, National Commission on Fiscal Responsibility and Reform, President Barack Obama, The Big Dog
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Monday, June 21st, 2010
At a time when primary-care physicians are in short supply, many hospitals are offering bigger paychecks and incentives to specialist nurses such as certified nurse anesthetists (CRNAs), nurses who administer anesthesia to patients during surgical procedures. A study conducted by Merritt Hawkins & Associates, a physician recruiting firm, found that primary-care physicians were offered an average base salary of $173,000 last year compared with the $189,000 average for CRNAs.
“It’s the fourth year in a row that CRNAs were recruited at a higher pay than a family doctor,” said Kurt Mosley, a staffing expert with Merritt Hawkins. As the number of surgeries has grown in recent years, creating demand for anesthesiologists and anesthetists, CRNA salaries have trended higher. Mosley notes that the income disparity is not going to encourage medical students to pick primary practice, at a time when the nation is facing a shortage of approximately 60,000 physicians in that specialty.
“The demand for primary-care doctors will increase twofold when health reform happens and millions of more Americans have access to healthcare,” Mosley said. “Who is going to triage these patients? It’s not the neurologist or the pulmonologist. It has to be the primary-care doctor.”
The American Association of Nurse Anesthetists (AANA) argues that its members are receiving the compensation they deserve. “From our perspective, we are fairly compensated for the level of responsibility that we shoulder,” said Lisa Thiemann, the AANA’s senior director of professional services and a CRNA for 14 years. “We are at the head of the patient’s bed. We deliver anesthesia and we keep the patient safe. Once nurses and physicians arrive at anesthesia training, we use the same textbooks and the same cases. We all deliver anesthesia the same way.”
Tags: American Association of Nurse Anesthetists, anesthesiologists, anesthetistsanesthesia, certified nurse anesthetists, CRNAs, family-practice doctors, Medicare, Merritt Hawkins & Associates, private insurance, triage
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Wednesday, June 16th, 2010
Approximately 38 percent of companies have employees for whom healthcare insurance coverage would be deemed “unaffordable”, according to a study by the New York-based pro-business benefit consultant Mercer L.L.C. According to the healthcare reform bill that phases in between now and 2014, employers are subject to penalties if premiums paid by their full-time employees are more than 9.5 percent of household income. The yearly penalty for too-expensive coverage is $3,000 for each full-time employee who takes government assistance to buy coverage in a state insurance exchange.
“Lawmakers did not take into account that employers don’t have access to information on employee household income,” said Tracy Watts, a Mercer partner. “Employers question how they are going to get that information and what other administrative challenges might come along with this new requirement. For example, what happens if an employee’s total family income changes during the course of a plan year?”
Another Mercer finding is that 51 percent of employers with more than 500 workers offer coverage to part-time employees who work 30 hours a week or more. The rest either do not offer coverage to part-timers, or require that they work 30 hours to be eligible. “This rule will require employers with a lot of part-time employees to make some hard choices,” according to Watts. “If they don’t offer coverage to part-timers, can they afford to start, or to raise the minimum hours required for coverage?”
Tags: benefit consultant, healthcare insurance, healthcare insurance premiums, healthcare reform, HMOs, Mercer
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Tuesday, June 15th, 2010
At one of the initial meetings of the Kid’s Advisory Board of Children’s Memorial Hospital, 17-year-old Kendall Ciesemier told the architects designing the $915 million hospital in Chicago’s Streeterville neighborhood that they needed to add something to the plan. It was essential there be an outdoor space, a place where patients could escape the hospital. The architects resisted, telling Kendall that it would be difficult to design a space that could withstand the extremes of heat and cold. No, she persisted, “we have to have windows open and sun beating down.”
Kendall is one of a dozen teenagers on the board, all of whom have spent time in hospitals and are dealing with life-threatening conditions or are chronically ill. Kendall, who suffers from biliary atresia, was adamant about the space because, at age 11, she spent a summer in the hospital following two liver transplants. “When I was well enough, my dad would sneak me down to the hospital courtyard at night,” she said. “It was so peaceful and calming to be outside.”
The hospital’s planning team was sympathetic. They added two outside “pocket gardens” at either end of the 5,000-square-foot enclosed Crown garden that juts out 11 stories above Superior Street. “I was so impressed that my small idea turned into an enormous aspect of the hospital,” Ciesemier said. “They took me seriously. That was awesome.”
The former Children’s Memorial, officially the Ann & Robert H. Lurie Children’s Hospital of Chicago, is scheduled for completion in summer 2012. “These children have a unique view as to what ‘works’ and what doesn’t as it relates to the environment, food, therapy and other matters,” Ann Lurie noted.
Tags: Ann Lurie, Childrens Memorial Hospital, Kid Advisory Board, landscape architecture, pediatric hospitals, Streeterville
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