Hospital Care At Home

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She went to the ED, was diagnosed with pneumonia and needed hospitalization, but the doctor proposed something that made her nervous: Instead of being admitted to the hospital, she could go back home and let the hospital come to her!

As a “hospital-at-home” patient, she would get home visits from doctors and nurses who would come twice a day and perform any needed tests or bloodwork.

A slowly growing number of hospitals are encouraging selected ED patients who are acutely ill, but stable and don’t need intensive, round-the-clock care, to opt for hospital-level care at home.

“hospital-at-home” patient… “I’d do it again in a heartbeat”


source: “shots HEALTH NEWS FROM NPR”



How the ACA changed American incomes

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The Affordable Care Act’s tax increases were concentrated among the wealthiest 1% of Americans, while its benefits were spread broadly among the poorest 40%, according to new data from the Congressional Budget Office. The CBO examined how the law affected household incomes in 2014, the first year many of its key provisions took effect.
At least as far as this analysis goes, the ACA helped more people than it hurt. Whether you want to call it “redistributing wealth” or “reducing income inequality,” the ACA achieved it. Or, in CBO’s words, the law “made household income more evenly distributed.”

Electronic Health Records Were Supposed to Cut Medical Costs. They Haven’t!

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Despite the promise that electronic health records would cut billing costs, savings have yet to materialize, according to a major new study by researchers at Harvard Business School and Duke University.

The study, published in the February 20 issue of the Journal of the American Medical Association, looked at five types of visits: primary care visits, ER visits resulting in a patient discharge, general medicine hospital stays, outpatient surgical procedures, and inpatient surgeries.

Findings included:

– A primary care visit necessitated 13 minutes in billing and insurance-related activities, costing $20. The time and cost ramped up to 100 minutes and $215 for an inpatient surgery.
– Just the physicians’ portion of the time and cost spent on billing amounted to 3 minutes and about $6 for a primary care visit, up to 15 minutes and $51 for surgery.
– Physicians, who cost between $3 and $8 per minute, are doing administrative tasks that ascribe costing 50 cents a minute could do better, Kaplan says.

Hospitals offer big bonuses, free housing and tuition to recruit nurses

Posted by | Health News, Hospital Finance, Nursing, Nursing Staff | No Comments

Hospitals and other medical facilities are getting so desperate to recruit and retain nurses they’re offering all sorts of pricey perks and incentives.

“Five-figure signing bonuses, free housing, college tuition for employees and their children!”

“These are some of the grandiose examples we’ve heard from our members,” said Seun Ross, director of nursing practice and work environment at the American Nurses Association. “Who knows what employers will come up with next?”

America is undergoing a massive nursing shortage. Not only are experienced nurses retiring at a rapid clip, but there aren’t enough new nursing graduates to replenish the workforce, said Ross.

The nation’s aging population is exacerbating the problem. The American Nurses Association estimates the U.S. will need to produce more than one million new registered nurses by 2022 to fulfill the country’s health care needs.

The Healthcare Gap Between Red and Blue America

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The most immediate effect of the recent steps taken by Donald Trump and congressional Republicans to unravel the Affordable Care Act will be to create an even deeper gulf between red and blue states in the availability and quality of health insurance. An array of blue states are exploring ways not only to blunt Trump’s moves but also to reach beyond the ACA with new mechanisms to expand coverage.

Amid the shift to ambulatory care, Micro-hospitals are gaining favor with health systems

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Across the country, more health systems are developing micro-hospitals, which have fewer inpatient beds to make room for lower-acuity patients, observation, and short stays. The cheaper acute-care delivery models can also broaden referral networks and often complement an array of ambulatory services.

While health systems create additional access points, they can also financially benefit by charging facility fees for these outpatient services, which help pay for the hospital’s overhead costs.

The hospital systems buying physician practices say vertical integration will facilitate care coordination and lower costs… Where’s the evidence?

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Contrary to physicians claims caught up in the consolidation wave, hospital administrators continue to grant most specialties pay hikes that outpace inflation by a healthy margin.

Modern Healthcare’s Physician Compensation Database, which tracks average salaries based on a survey of a dozen compensation consulting firms and organizations, shows the average pay for 22 specialties, including the relatively low-paying fields of family practice, pediatrics, and internal medicine, rose 10.8% between 2012 and 2017. Average physician pay now stands at $386,000 a year, up 10.9% from $348,000 in 2012.

In percentage terms, that pay hike is 4 percentage points more than the national inflation rate over the same period. In other words, despite consolidation, doctors in recent years have consistently pulled down steady, inflation-adjusted pay increases—something that has eluded most American workers.

HCCI 2016 Healthcare Cost and Utilization Report

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The 2016 Health Care Cost and Utilization Report show that spending per privately insured person grew by 4.6 percent, faster than in previous years. Price increases were the primary driver.

Key Findings from this Report

  • Total spending per person is now growing at faster rates than prior years, with 4.6% growth in 2016 compared to. 4.1% growth in 2015, which followed 2 years of sub-3% growth from 2012 to 2014.
  • Spending growth in each year from 2012 to 2016 was almost entirely due to price increases. We saw particularly large increases in spending and price for administered drugs, emergency room (ER) visits, and surgical hospital admissions.
  • Utilization of most health care services remained unchanged or declined, both year-over-year and over the 2012-2016 period.
  • Consumer out-of-pocket (OOP) spending per person increased but grew more slowly than total spending. This difference in growth led to a decline in OOP spending as a share of total spending.

The report covers the period 2012 through 2016 and includes claims data from four national insurance companies: Aetna, Humana, Kaiser Permanente, and UnitedHealthcare.

Preventive Care Saves Money? Not Really!

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The idea that spending more on preventive care will reduce overall health care spending is widely believed and often promoted as a reason to support reform. It’s thought that too many people with chronic illnesses wait until they are truly ill before seeking care, often in emergency rooms, where it costs more. It should follow then that treating diseases earlier, or screening for them before they become more serious, would wind up saving money in the long run.

Unfortunately, almost none of this is true!

Health care’s ‘upstream’ conundrum

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When it comes to the long-term health of the country, findings now show the big problem might not be health care at all—it might be everything else. Can researchers get politicians to pay attention?

It’s easy to think of “health” as just another category of social-service spending. But a great deal of modern research suggests that it might be more accurate to think of it as the payoff of all the other services put together. Elizabeth Bradley, president of Vassar College and a former Yale researcher widely seen as the world’s foremost expert in the relationship between social services and health, has documented how the ratio of a country’s social-service spending to health care spending is highly correlated with health outcomes around the world. “The right question for our political agenda is, ‘What’s going to give us the most bang for the buck in health outcomes?'” says Bradley. “What our work has shown is that the answer is spending on social services.”