New York’s Vassar Brothers Medical Center Plans Expansion

Vassar Brothers Medical Center in Poughkeepsie, N.Y., has proposed a $66 million expansion project that includes the construction of an ambulatory surgery center, according to the Poughkeepsie Journal.

Officials from the hospital announced the plans last year as part of an effort to reduce crowding and improve parking at the hospital, according to the report.

VBMC has proposed a 78,000 square-foot medical complex that would include an ASC as part of the project, according to the report. Other additions include an 850-space parking garage and a cafeteria.

If approved by the board, construction could begin this summer and completed by the end of 2011.

Read the Journal’s report about Vassar Brothers Medical Center.

Illinois Supreme Court Rejects Medical Malpractice Caps

In a setback for physicians and hospitals, the Illinois Supreme Court nullified the state’s medical malpractice law, ruling that a cap on non-economic damages enacted in 2005 by the state legislature is invalid.

“Today’s court decision threatens to undo all that Illinois patients and physicians have gained under the cap, including greater access to health care, lower medical liability rates and increased competition among medical liability insurers,” said J. James Rohack, MD, president of the AMA, in a written statement following the ruling.

The Supreme Court upheld part of a lower court’s 2007 ruling that the state’s medical malpractice law violated the separation of powers clause in the Illinois Constitution by allowing lawmakers to interfere with a judge’s ability to reduce verdicts, according to a report in the Chicago Tribune.

The case, LeBron, a Minor v. Gottlieb Memorial Hospital, involved a malpractice lawsuit filed in 2006 against the hospital by the family of a girl who suffered severe brain damage and other injuries during her delivery there.

The state’s hospital association also spoke out strongly against the ruling, which has been followed closely by the healthcare industry and could play into the national healthcare reform debate this year, according to the Tribune report.

“The hospital community is deeply concerned that this decision will renew the malpractice lawsuit crisis and make it more difficult for Illinoisans to access or afford health care as liability costs for physicians and hospitals are driven to unsustainable levels,” said Illinois Hospital Association President Maryjane A. Wurth, in a written statement.

Read the Illinois Supreme Court’s medical malpractice cap ruling (pdf).

Read the Chicago Tribune’s report on Illinois medical malpractice caps.

CMA Says California HMOs Will Need More Doctors to Meet New Time Limits

New state regulations setting time limits for HMO patients to see doctors may force HMOs to add more physicians to keep appointments on time, according to a release from the California Medical Association.

Under the regulations, HMOs must make sure members have urgent care within 48 hours, see a primary care physician within 10 business days of requesting an appointment and a specialist within 15 days.

“As doctors, our No. 1 priority is our patients,” said CMA President Brennan Cassidy, MD. “We want to be sure that HMOs meet these requirements without forcing doctors to shorten patient visits or meet unrealistic quotas that would comprise the quality of care.”

Read the California Medical Association’s release on patient waiting times.

Wake Forest Medical Center in North Carolina Proposes 8-OR ASC

Wake Forest University Baptist Medical Center in Winston-Salem, N.C., is asking for state permission to build a $38.7 million ASC next to its main campus, according to a report by the Business Journal Serving the Greater Triad Area.

Wake Forest University, which runs a medical school, wants to build an eight-OR facility, adding seven rooms to its total inventory and relocating one existing room to the new center.

The facility would also include two teaching rooms to simulate operating and robotic surgery techniques for medical students.

Read the Business Journal Serving the Greater Triad Area’s report on Wake Forest University Baptist Medical Center.

Massachusetts Report Finds Hospitals’ Negotiating Clout With Insurers Drives Up Costs

Massachusetts hospitals and physician groups with market clout negotiate rates that are twice as high as for other hospitals, and such clout is the main cause of healthcare inflation in the state, according to a release by State Attorney General Martha Coakley.

Ms. Coakley’s office based the findings on a year-long study of the Massachusetts market, finding that about 10 hospitals enjoy reimbursements 10-100 percent higher, for similar work, than reimbursements for the other 55 hospitals in the state.

The office’s report says the 10 favored hospitals had brand-name recognition or few competitors in their markets, but it did not name any provider or insurer, saying its aim was to identify systemic problems and not blame individual organizations.

Based on its findings, the report recommended against establishing global payments covering a patient’s entire medical care for an illness, an approach recommended by a state commission.

The study concluded that higher healthcare costs are basically caused by rising prices, not increased demand for new services. One major insurer reported provider price increases accounted for 80 percent of the growth of medical expenses from 2006-2009.

The report called on the state to:

• Discourage or prohibit contract provisions that perpetuate market disparities;
• Increase transparency and standardization in payment and quality;
• Reform payments to account for market distortions; and
• Encourage development of a “value-based” healthcare market.

Read the Massachusetts Attorney General’s release on health insurance reimbursements.

Former Hospital Executive Charged With Stealing From Donations

The former director of the cardiovascular center at South Shore Hospital in Weymouth, Mass., has been charged with embezzling donations to the hospital’s fundraising program and from other hospital sources, according to a report by the Enterprise News.

Federal prosecutors allege that William S. Burke diverted to a personal bank account charitable contributions from the hospital’s “Dare to Care” fundraising program and medical-supply rebates to the cardiovascular center from 2007-2009.

Hospital employees reported the alleged theft to federal law enforcement officials and Burke left South Shore in Oct. 2009, after more than four years of service.

Read the Enterprise News’ report on South Shore Hospital.

Five-Year Fix for Medicare Doctor Pay Cuts in Works

As lobbying intensifies, momentum is building to provide a five-year reprieve that would block a 21-percent fee cut to physicians who treat Medicare patients. If no legislative action is taken this month, the physician pay cut is set to go into effect in March, according to a report in The Hill.

The Senate recently passed pay-as-you-go legislation requiring Congress to offset new spending or tax cuts with corresponding spending cuts or tax increases, and the House passed a similar bill last year and is expected to take up a new version next week, The Hill reported. The Senate bill includes an exemption from pay-as-you-go for the physician payment fix. Specifically, it would allow Congress to spend up to $82 billion for physician payments without having to find offsetting savings or revenue sources. This amount would be enough to lock in fees at their current rates for five years.

The American Medical Association and other physician groups — joined by AARP — have been lobbying for a more expensive overhaul to the Medicare physician payment system, known as the sustainable growth rate formula, or SGR. Passing a permanent fix could cost $200 billion, according to a Feb. 2 report in Politico. Finding such a solution tops the AMA’s healthcare reform agenda.

Read The Hill’s report on physician fee cuts.

Intrapreneurship

I was in a meeting recently and a discussion was proposed as to whom should be the owner of an idea originated inside a hospital. The employee, the institution, both?

It is clear to me that when a physician is hired to do research, the output of this research should belong to the hospital, and the hospital should acknowledge his/her contribution by giving away part of the benefits obtained from it. In this case, the new idea would probably have been unthinkable outside the premises of the hospital, without its infrastructure and assets, so it makes sense.

But what happens if an employee has an idea, let’s say, related to his/her field of experience but not necessarily linked to research? Let’s take this example, if an OR Nurse perceives a need and thinks about a solution to this need while in the operating room, let’s say a new medical device, should the idea belong to the hospital? Well, yes, the idea came to them because they were working at the hospital, but can the hospital claim any ownership over it?

Who is the owner of the idea, then? It may seem a futile discussion, but to me it represents the most important barrier to innovation in our healthcare systems, so it is far from trivial. Sometimes employees don’t engage in innovation because they perceive the ownership issue as unfair. If we want to foster innovation in healthcare, this question needs to have a clear answer. At the end of the day, it all goes down to how the hospital sees healthcare professionals: Do employees work for the hospital, or do they work at the hospital?

Are hospitals really willing to encourage innovation and intrapreneurship inside their premises? Are hospitals willing to create a culture of reward for those entrepreneurs? There is a lot to be gained here: if the hospital succeeds in fostering innovation, it can create a great environment to attract talent, lead, and generate economic value and social impact.

People do respond to incentives. That’s something I learned very early when dealing with innovators and entrepreneurs. Innovation should not trigger a war between the healthcare facility and the employee. It should always be a win-win scenario where both parties can create a lot of value if they cooperate. So, in my opinion this is not about claiming ownership, but about both parties acknowledging how far can they go and how better they will be if they work together, and share the ownership. That’s the answer that makes sense to me.

 

W.Va. Optometrists Next to Request Removal of Practice Limits

Optometrists in West Virginia are hoping new bill is the state legislature will allow them to expand the scope of their practices, but ophthalmologists and other physician groups are arguing against the bills, according to a report inThe Charleston Gazette.

Currently, optometrists in West Virginia can perform eye exams and prescribe glasses and contact lens. They are prohibited from performing surgery, giving injections or ordering lab tests, according to the report.

If the bills pass, optometrists would be allowed to perform surgery involving lasers and scalpels and to give injections around the eyes. The bills would also expand the state’s Board of Optometry authority, which could expand optometrists’ ability to prescribe medications.

Ophthalmologists say that approval of such a bill could pose a patient-safety risk, as only ophthalmologists have the medical training to understand how certain drugs interact, according to the report. Additionally, ophthalmologists worry that some optometrists have only had weekend training in certain procedures that require more in-depth study.

Optometrists say that the bills would expand coverage to patients in rural areas, who currently have to drive hours to see an ophthalmologist.

Florida recently proposed a similar law that would allow optometrists to prescribe certain eye medications in oral form, which has been met with similar opposition.

Read the Gazette’s report on optometrists’ scope of practice.

Healthcare Spending Reaches 17.3% of GNP, Largest 1-Year Rise Ever Recorded

Independent actuaries working for the CMS reported that the healthcare sector’s share of the economy grew by 1.1 percent in 2009, the largest one-year increase ever reported, according to a report in Health Affairs.

The healthcare sector’s rising share of the economy, magnified by a contraction in other sectors, reached 17.3 percent of the gross domestic product and is expected to reach 19.3 percent of GDP by the end of the decade.

Looking at another measure, healthcare spending growth, 2009 was not a record year. Healthcare spending grew by 5.7 percent to $2.5 trillion last year, higher than the 4.4 percent it logged in 2008 but lower than the 6 percent reported in 2007. This year, the actuaries expect healthcare spending growth to slow to 3.9 percent.

Factors for the 2009 increase included increased spending on Medicaid, which rose 10 percent in 2009, increased spending on COBRA health insurance for the newly jobless, a large number of baby-boomers entering Medicare and treatments for H1N1 patients.

Government healthcare spending in 2009 rose by 8.7 percent to $1.2 trillion, or nearly half of total national healthcare spending. By 2012, the government’s share of healthcare spending will exceed half, compared with one quarter 50 years ago, before Medicare and Medicaid were created.

Private-sector healthcare spending did not grow as fast as government spending and is expected to increase by 2.8 percent in 2010, a slow-down caused by continuing loss of health coverage due to unemployment and the expiration of the COBRA created by the stimulus bill.

The Los Angeles Times quoted analysts who were dismayed by the healthcare sectors’s increases.

Stuart Butler, an analyst at the Heritage Foundation, said the figures show that more aggressive cost controls are needed. “The only way to do this is to simply spend less,” he said.

Len Nichols, health policy director at the New America Foundation, added: “If you believe that much medical care is unnecessary, as I do, then it is criminal that we are spending so much.”

Read Health Affairs‘ report on healthcare spending.

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