Posts Tagged ‘hospitals’
Tuesday, March 23rd, 2010
That fact that New York City’s public hospitals could lose $1 billion illustrates the difficulty that healthcare systems face in their efforts to stay afloat. New York City Health and Hospitals Corporation has projected a billion dollar loss through June 30, 2011, despite an expected infusion of “hundreds of millions of dollars” in retroactive Medicaid payments.
The Medicaid payout, as well as cost-cutting efforts and improvements to efficiency will help the 12-hospital system achieve an operating gain as of June 30. Operations, however, will “burn through that at a pretty torrid rate,” notes system president Alan Aviles. The growing demand for subsidized and free care during the recession, as well as cuts to Medicaid – which covers approximately two-thirds of the system’s patients – makes balancing the budget problematical.
New York’s public hospitals saw the number of uninsured patients grow by 4,000 in 2009, 36,000 in 2008 and 17,000 in 2007. According to Aviles, the growth among the uninsured is leveling, but his system has limited capacity to accept new patients. The $1 billion doesn’t include approximately $70 million in payment cuts and tax increases contained in the New York state budget for the fiscal year that begins in April. The gloomy forecast assumes a $300 million cut to the system’s disproportionate-share payments, which are financial assistance given to hospitals that serve low-income patients. Aviles is lobbying New York legislators to reinstate these by prioritizing such spending in the public health system’s favor.
“This highlights that as this economic downturn continues, that public hospitals and other safety net systems that serve a great number of Medicaid and uninsured patients are going to be increasingly reliant on disproportionate-share payments to keep their systems afloat and solvent,” Aviles said.
Tags: Alan Aviles, CMS, Governor David Paterson, hospitals, Medicaid, New York, safety net
Posted in Healthcare, Hospital Systems | No Comments »
Tuesday, September 29th, 2009
Price transparency may be one welcome element in healthcare reform legislation. The proposed bipartisan bill written by Senator Max Baucus (D-MT) and his Senate Finance Committee includes a provision that will require hospitals to list standard charges for their services.
As the system currently works, insurance companies enter into agreements with hospitals and physicians to determine how much they will pay for hip replacement surgeries, cataract procedures and MRIs — all long before the patient enters the scene. Hospitals and doctors tend to charge the uninsured significantly higher rates than they do the insured. Medicare sets its own rates, which typically are lower than commercial rates.
“The pricing model is ridiculous,” said Brad Myers, a founder of Pensacola, FL-based NewChoiceHealth, Inc., an online tool that allows consumers to compare healthcare prices. Myers bases his information on estimates gleaned from Medicare data.
The states of Maine and New Hampshire have addressed this partially with online cost comparison websites that are accurate because they are based on insurance claims paid for real procedures. Consumers can use the information posted to shop around or to get the best deal possible. A visit to the Maine website finds that one hospital charges the uninsured $1,326 for a colonoscopy. The insured pay the hospital between $800 and $950 for the same procedure, depending on who carries their coverage. Medicare pays the same hospital just $793.
Tags: colonoscopy, doctor, healthcare reform, hospitals, insurance company, legislation, Medicare, MRIs, surgery
Posted in Economics, Healthcare, Hospital Systems | No Comments »
Wednesday, September 9th, 2009
Hospitals and medical office buildings must undergo a complete rethinking to move them functionally and architecturally from the 1970s to models that make sense for the 21st-century. Wanda Jones, healthcare futurist and president of the New Century Healthcare Institute, believes that we need to reinvent hospital design and construct linear-spine facilities that provide patients with more personalized medicine. This anticipates expansions, contractions, removal and replacement of patient towers by dividing the number of patient beds into two, three or four towers. This way, they can be incrementally changed without interrupting the others and are readily adaptable to specific programs.
In a recent interview for the Alter+Care Podcasts on Healthcare, Wanda Jones discusses the paradigm shift in terms of new technologies that will make obsolete the knowledge base on which healthcare systems, hospitals and physicians have made money up until now. Every surgical specialty will use robotics, and cures for cancer will be based on technology that has arisen out of the human genome project. The New Century Healthcare Institute is a research-and-development and educational foundation devoted to population-based planning and adaptation of the healthcare system to future conditions.
Wanda Jones on Revolution in Hospital and Office Design:
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Tags: Healthcare, healthcare system, hospital design, hospitals, linear-spine facilities, medical education, medical office, Medicare, patients, technology, Wanda Jones
Posted in Healthcare, Hospital Systems, Physician Recruitment | No Comments »
Thursday, July 16th, 2009
Healthcare providers will slash up to $1.7 trillion in costs over the next 10 years by enhancing the care of chronic diseases, reorganizing administrative procedures and eliminating unnecessary treatments.
This is a sneak peak at how healthcare systems, physicians, pharmaceutical companies, insurers, medical device manufacturers and other stakeholders plan to respond to President Barack Obama’s request that the industry find ways to control patient costs. Among the American Medical Association’s (AMA) suggestions are cutting overused – and often unnecessary — procedures, such as Caesarean sections. The savings are crucial to funding the Obama administration’s proposed health system overhaul.
A new White House study states that reforming healthcare will increase the nation’s GDP by two percent in 2020 and eight percent in 2030, cut unemployment and save families an average of $2,600 a year by 2020. Without healthcare reform, the number of uninsured Americans will rise to 72 million by 2040, compared with 46 million today.
Christina Romer, chair of the president’s Council of Economic Advisers, said “The one thing that’s happened relative to the 1990s is the nightmare scenario is getting closer.” Other recommendations include reducing medical errors, using common insurance forms, improving physician performance standards, readmitting fewer patients to hospitals, improving drug development efficiency and expanding in-home care for patients with long-term illnesses.
Tags: AMA, American Medical Association, Caesarean section, Christina Romer, chronic diseases, Economic Advisers, GDP, healthcare industry, healthcare providers, healthcare reform, Healthcare systems, hospitals, in-home care, insurers, long-term illness, medical device manufacturers, patient costs, patients, pharmaceutical companies, physicians, President Barack Obama, reforming healthcare, treatment, uninsured Americans, White House
Posted in Economics, Healthcare, Hospital Systems | No Comments »
Friday, April 17th, 2009
With 78 million baby boomers marching towards retirement, the U.S. population is older and less healthy as cases of obesity, diabetes and other chronic diseases increase, says Donna F. Jarmusz, Alter+Care Senior Vice President, in a recent interview for the Inspire blog. These same consumers dislike inconvenient, institutional healthcare delivery systems, are demanding and have high expectations. We have a drive-through mindset and enjoy everyday consumer experiences– buying a cup of coffee, drive-up banking, picking up dry cleaning. We hardly think about them because they’re all convenient and accessible.
Consumers are looking for a similar consumer focus in their healthcare services. They are also looking to healthcare providers for preventative health resources to achieve healthier lifestyles.
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Donna Jarmusz on the Healthcare Village:
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Tags: Ambulatory surgery center, ambulatory-care facilities, baby boomers, Cardiac rehab, chronic diseases, consumers, credit, diabetes, diease management, GI centers, Healthcare referrals, Healthcare Village, Hospital capital, hospitals, institutional healthcare, Liability insurance, obesity, Office of the Inspector General, OIG, Oncology, Outpatient services, physicians, Radiology, reimbursements, Retail healthcare, retirement, Revenue-sharing partnerships, wellness center, Wellness Centers
Posted in Healthcare, Healthcare Village, Wellness Centers | 1 Comment »
Tuesday, April 7th, 2009
If Benjamin Braddock graduated from
college today, the clueless Mr. Robinson would likely tell him to go into healthcare – not plastics — as he advised the befuddled young man in the classic 1967 movie “The Graduate”.
Although the economy is shedding jobs at an alarming rate, the healthcare industry added 371,600 jobs during 2008. That momentum has not slowed, despite the fiscal crisis and recession. While the economy lost 1.9 million jobs during the fourth quarter of 2008, healthcare added 93,200 jobs. Hospitals hired 11,900 new workers in December, bringing the nation’s total hospital workforce up to approximately 4.71 million. Physicians’ offices hired 5,600 more staff, bringing that workforce up to nearly 2.3 million employees.
Ambulatory-care centers saw 1,100 jobs vanish during December, a 0.2 percent loss. Still, that fast-growing sector grew to 521,700 jobs during all of 2008, a 1.7 percent increase compared with the previous year.
“The only major private industry sector that continued to add a significant number of jobs was healthcare”, notes Keith Hall, commissioner of the Bureau of Labor Statistics.
According to a new Ernst & Young study on business risk, the global war for talent will be top of the mind for CEOs. Nowhere will this be more evident than in healthcare. There remains a chronic shortage of surgeons and family-practice doctors. Part of this is because U.S. medical schools held enrollment to 16,000 students a year from 1980 to 2005, fearing a glut of doctors under managed care. Perhaps the hiring by hospitals is a correction to 25 years of no-growth within certain specialties and the continuing dearth of nurses.
Tags: ambulatory-care centers, Benjamin Braddock, business risk, chronic shortage, economy, family-practice doctors, fiscal crisis, Healthcare, healthcare industry, hospitals, jobs, no-growth, nurses, physicians, recession, surgeons, US medical schools
Posted in Healthcare | No Comments »
Monday, April 6th, 2009
The recession has put the health care industry’s importance to our economy in sharp relief. It accounted for 17 percent of GDP and added 371,600 jobs last year. Even when the economy lost 651,000 jobs during February, healthcare added 27,000 new positions.
In terms of the construction of new facilities during 2009, healthcare development is expected to fall by five or eight percent. Yet, the drivers that historically have made the healthcare market so strong – obsolescence, new technologies and demographics – are still very much in place.
The collapse of the $330 billion auction rate securities market which let healthcare systems borrow money long term while paying short-term interest rates – cut off a principal source of capital for new development. Hospitals have investment portfolios tied to Wall Street, another source of capital that is being cut off. Endowments are drying up as even the most dependable philanthropists see their fortunes shrink. Access to long-term debt vehicles, such as variable-rate demand bonds backed by letters of credit, is available only to healthcare systems that are A-rated or even better. Even when a provider has superior credit, interest rates to borrow money may be as high as six to 6.5 percent. For some hospitals and healthcare providers, the cost of credit – if they can get it – is too expensive.
To fill the gap, healthcare providers are considering private sources that have the capital necessary to finance projects. The upside of private capital is that it can be committed over the long term to help hospitals and providers fulfill their strategic expansion plans without the same balance sheet implications – something hospitals are focused on in order to maintain a good standing with the ratings agencies.
In a 0 percent federal rate environment when 30-year fixed-rate mortgages have come down to 5.29 percent, capital is competitive with traditional hospital financing, compared with other cycles.
Tags: auction rate securities market, balance sheet, credit, economy, GDP, health care industry, Healthcare, healthcare development, hospitals, interest rates, jobs, mortgages, new technologies, ong-term debt vehicles, philanthropists, private sources, recession, traditional hospital financing, variable-rate demand bonds, Wall Street
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