Hospitals & Providers

Insist that the expected value of improvements in information quality is expressed in dollar figures

Federally qualified health centers need $248 million to meet plan targets, much more than the proposed $100 million in the appropriations bill

After New York State Attorney General Cuomo's industry-wide investigation of allegations that insurers saddle consumers with too much out-of-pocket costs, UnitedHealth says it will develop a new, independent database. Consultants say this is emblematic of a more persistent problem: the relationship among payers, patients, and providers.

MCO execs should be looking at payment changes that are win-win for the payer, consumer

ASCs are gaining in popularity due to their convenience, but acute-care hospitals are losing patients and profits.

Critical information doesn't follow an elderly patient from one point of care to the next. CMS is looking at the issues via a pilot project will examine readmission rates of elderly patients to hospitals, especially within 30 days, from the same diagnosis.

Some plans are responding to disruptive innovations with innovative delivery strategies

Regardless of gains made by medications to control some lipids, triglycerides, like obesity and diabetes, are on the rise, according to WellPoint's HealthCore. LDL levels alone aren't enough to knock out heart disease.

Because of their physical size, obese patients often cannot use standard wheelchairs, waiting-room armchairs, blood pressure cuffs, hospital beds and gowns, or M.R.I. and CAT scan machines.

Payers miss opportunities to reduce costs during times of transition between levels of care for hospitalized patients

Some green goals are consistent with functional requirements of the healthcare facility, but others may require trade-offs, including possible compromises on the project budget and schedule

Insurers follow updated CMS rules regarding financial responsibility for egregious medical mistakes, do not pay list and never events

Hospital medicine groups yield cost savings of approximately 13% while delivering high quality care and patient satisfaction, irrespective of the business model.

There is more focus on linking payment with quality, whether as pay for performance, value-based purchasing or restructured employee benefits packages that modify out-of-pocket expenses based on quality of providers, according to experts.

Each year, nonprofits must review their rate strategies in the context of maintaining financial viability. To achieve sustainability goals, some must raise rates to cover costs of patient care, for example.

While legislators and healthcare stakeholders across the country wrangle over the problem of the nation's 46.5 million uninsured, a grassroots movement called Project Access is having an impact on the health of thousands of uninsured Americans.

The intensive care unit (ICU) is, in many ways, the most significant section of a hospital, because it is where life-threatening issues occur almost daily. The ICU is the one area where most hospitals don't employ specialists-board-certified intensivists with expertise and training in critical care medicine.

A few hospital systems already are improving work process by implementing Lean and Six-Sigma management principles. Implementing Lean Sigma (a complementary combination of Lean and Six-Sigma) in a hospital setting is not about fixing problem employees who fail to improve their work. It's about fixing the broken systems and processes that hinder medical professionals from doing what they do best.

In a consumer-driven healthcare marketplace where Americans are taking a closer look at healthcare options and are comparing quality, price, and access between the United States and overseas, many are finding it pays to take that trip abroad.

Healthcare executives have seen a significant increase in efforts by unions to organize nurses in the last few years. The national rate of unionized nurses currently exceeds 23%; in 1998, that number was less than 17%. In contrast, the national rate of unionized workers is just 12%.

Technology has been a part of the hospital landscape for decades, and hospitals have now begun to implement digital technology to improve communications between physician and nurses, lessen the likelihood of medication errors, and improve the quality of care, leading to better patient outcomes. Some are investing as much as 25% of their budgets to become digital.

George Clooney's challenges make for good TV. While the former star of "ER" struggles with fictional patients, much of the drama in today's emergency department (ED) centers around the problems of overcrowding, increased utilization and increased wait times.

Realizing economic benefits of eHealth information sharing, forward thinking payers began working years ago to sponsor multi-payer web communications platforms that allow providers to communicate with many sponsors from one access point.

The need for healthcare workers is quickly outpacing an ever-shrinking candidate pool. As one response to the labor crisis, healthcare organizations need an effective way to communicate the full value of the benefits they provide to employees.

Sometimes in our technology-driven environment, we get into a fixed routine of the current standard of care for our patients. What would we see or hear if we saw our practice or facility through the eyes and ears of our patients?

More than 650 hospitals have pledged to adopt the Leapfrog Group's policy on "never events"-rare medical errors that should never happen to a patient.

When Newt Gingrich recently suggested that in the future, consumer healthcare is going to look more like Travelocity and that consumers are going to go where the best care is and shop for the best price for drugs and services, Jonathan Edelheit, president of the Medical Tourism Assn., couldn't have agreed more.

The healthcare industry has yet to use evidence-based medicine (EBM) to its fullest potential, despite studies suggesting the need for it. Wide variation in medical practice and resulting clinical outcomes is indicative of the not-yet completed journey toward implementing evidence-based medicine.

Physicians' first-hand experience has no substitute, and Dr. William Cromie has maintained CDPHP's vision of including physicians in the governance of this health plan. Often, the plan and the physicians are faced with tough choices and collective compromises.

Physician peer interaction is only a click away thanks to online networking sites.