The Daily Briefing

News for Health Care Executives

Tumor Site Program Resource Grids

May 23, 2012

The recently updated tumor site program resource grids outline the requirements for developing tumor site programs by disease site organized by the key clinical, operational, and supportive services necessary to drive performance accross the care continuum.

Oncology Roundtable members can download the PDF grids or order unlimited hardcopy posters below.

Preview the Lung Program Resource Grid

 Preview the Lung Program Resource Grid

View the Walkthrough

Silence is golden? Thomas calls out fellow Justices for health law questions

Thomas defends his silent approach to oral arguments

April 09, 2012

Supreme Court Justice Clarence Thomas last week defended his famously silent approach to oral arguments and criticized his fellow justices for speaking too much during the arguments in the case against the federal health reform law.

Thomas has not asked a single question during oral arguments since 2006. No other justice has gone a single year without asking a question.

During a panel discussion at the University of Kentucky, Thomas said the numerous questions from his fellow justices during the health reform oral arguments were not unusual but that they were unproductive. 

Specifically, Thomas explained that he thinks attorneys should be allowed to make their cases without guidance from the top court's justices, saying, “I don’t need to hold your hand, help you cross the street to argue a case. I don’t need to badger you."

Thomas added that the justices "have a lifetime to go back in chambers and to argue with each other." Meanwhile, lawyers "have 30, 40 minutes per side for cases that are important to them and to the country. They should argue. That's part of the process" (Sink, "Blog Briefing Room," The Hill, 4/6; Gerstein, "Josh Gerstein," Politico, 4/6; AP/Washington Post, 4/5). 


MedPAC raises concern about meaningful use attestation

Only 16% of registered hospitals have received payments

April 09, 2012

During a meeting in Washington, D.C., last week several Medicare Payment Advisory Commission (MedPAC) members raised concerns about the small number of eligible professionals and hospitals that have successfully attested to the Medicare portion of the meaningful use program.

Commission members noted that health care provider participation in the meaningful use program is lower than the federal government's previous projections. According to CMS data released at the MedPAC meeting, total incentive payments awarded to eligible professionals for the meaningful use of electronic health records (EHRs) reached $636 million in February, a 57% increase over the previous month, while cumulative payments to hospitals reached $1.4 billion, a 10% increase from the previous month.

The 10% increase in hospital payments in February is down from December 2011 when there was a 50% increase in cumulative incentive payments to hospitals. According to the data:

  • 3,280 hospitals (58% of eligible facilities) have registered for the meaningful use program, and796 hospitals have received payments.
  • 126,321 physicians (25% of eligible professionals) have registered for the program, and 31,650 physicians have received payments.

Some hospital and physician advocates cited high EHR adoption costs and overly burdensome program requirements as reasons for the low adoption rates. MedPAC members indicated an interest in monitoring the meaningful use program to determine if EHR adoption reduces costs and boosts efficiency (AHA News, 4/5; Daly, Modern Healthcare, 4/6 [subscription required]).


NQF endorses 30 new care measures

Measures cover perinatal care, renal care, and resource use

April 09, 2012

The National Quality Forum (NQF) last week endorsed three sets of measures addressing issues related to perinatal care, renal care, and resource use.

Fourteen perinatal care measures
NQF approved 14 quality measures for perinatal care that cover various pregnancy- and childbirth-related issues, including prevention of deep-vein thrombosis in women receiving Cesarean sections and bloodstream infections in newborn infants.  

Commenting on the new measures, Carol Sakala, director of NQF's Perinatal and Reproductive Health Endorsement Maintenance Steering Committee, said that
"[u]se of this measure set for quality improvement and public reporting will help strengthen maternal and newborn health and the value of our considerable investment in maternity care."

Twelve renal care measures
NQF also approved 12 quality measures for renal care that focus on chronic kidney disease, end stage renal disease, and dialysis.

Noting that kidney disease is associated with premature death and increased health costs, Kristine Schonder, co-chair of NQF's Renal Endorsement Maintenance Steering Committee, said the measures will "help improve the quality of care throughout the course of kidney disease and protect renal patients from additional complications, in turn improving their health and well-being."

Four health care resource use measures
In addition, NQF approved four measures pertaining to health care resource uses and costs.

The measures focus on treatment costs associated with asthma, chronic obstructive pulmonary disease, pneumonia, and joint replacements. According to a news release, the measures are intended to generate critical data on resource use to help officials create a less wasteful, more efficient health system (McKinney, Modern Healthcare, 4/3 [subscription required]; Miliard, Healthcare Finance News, 4/4; NQF release [1], 4/2; NQF release [2], 4/2; NQF release [3], 4/2).


Soaring painkiller sales fuel wave of pharmacy robberies

Increase attributed to aging population, willingness to prescribe pain drugs

April 09, 2012

Sales of two of the most popular prescription painkillers in the United States—oxycodone and hydrocodone—have soared over the last decade, contributing to a surge in overdoses and armed pharmacy robberies, according to an analysis by the Associated Press.

According to Drug Enforcement Agency (DEA) data, U.S. pharmacies, hospitals, and health providers in 2010 received and dispensed the equivalent of 42 tons of pure hydrocodone, the key ingredient in Vicodin, Norco, and Lortab. They also received the equivalent of 69 tons of pure oxycodone, the key ingredient in OxyContin, Percocet, and Percodan.

Gregory Bunt, medical director at Daytop Village drug treatment clinics, said the increase is due in part to the aging U.S. population and greater willingness to prescribe pain medications. In addition, he notes that individuals with substance use disorders who go "doctor shopping" contributed to the higher sales.

The increased access to painkillers has had several negative consequences. For example, DEA data show an increase in armed robberies at pharmacies across the country as drug misusers and dealers seek narcotic painkillers.

Meanwhile, many states—such as Florida, Nevada, and Utah—have seen an increase in overdose deaths. CDC data show that opioid pain relievers in 2008 contributed to 14,800 overdose deaths.

Responding to the trend, DEA has begun cracking down on pharmacists who heavily distribute painkillers. Meanwhile, 40 states now operate drug monitoring programs to track misuse of painkillers, up from 20 states in 2006 (Hawley, AP/U-T San Diego, 4/4).


New treatments save older pets—but at what cost?

Some pet owners worry about the wisdom of major medical procedures

April 09, 2012

The New York Times examined how major, if costly advances in veterinary care are keeping older pets alive, profiling one man who paid about $25,000 to save his 10-year-old dog from lymphoma.

According to the Times, innovations in imaging technology, pharmaceutical treatments, surgical techniques, and holistic medicine now allow veterinarians to treat many once-incurable animal ailments, such as cancers, urinary-tract disorders, kidney conditions, joint problems, and dementia.

"We went from 1950s technology to state of the art in a very short time," notes Lisa Forrest, an oncology professor at the University of Wisconsin (UW) School of Veterinary Medicine, which now uses cutting-edge TomoTherapy—a linear accelerator on a helical device—to deliver multi-angle radiation to animals.

The innovations have driven increased demand for life-extending veterinary procedures. For example, the Animal Medical Center in Manhattan performed 630 stent procedures on dogs and cats last year, up from 34 stent procedures in 2005.

Costs of animal care
>However, veterinary treatments can carry a hefty price tag. For instance, a full radiation program at UW costs about $6,000. Altogether, U.S. pet owners spent $13.4 billion last year on animal medical care, up from $9.2 billion in 2006.

According to the American Animal Hospital Association, less than 3% of U.S. residents have pet insurance—but even those who do buy a pet insurance policy generally pay for most major procedures out of pocket.

Because many treatments can only extend a pet's life for a short time, some pet owners worry about the wisdom and value of major treatment procedures, the Times reports. One owner who spent $10,000 to treat his 12-year-old poodle for a brain tumor said he "did not hesitate to do it, but in the future, I'm not sure we can handle a bill like that" (Grimes, Times, 4/5). 


Weekly review

Key articles from April 2-April 6

April 09, 2012

Missed a day of the Daily Briefing? Here's a quick round-up of top stories and research highlights from last week’s issues.

Magazine names the world's 25 most beautiful hospitals (April 2)
HealthExecNews recently released its list of the 25 most beautiful hospitals in the world, highlighting facilities across four continents and 11 countries.

RWJF: The healthiest counties in each state (April 3)
A new interactive map identifies the healthiest and least healthy counties in each state, drawing on the Robert Wood Johnson Foundation and the University of Wisconsin's Population Health Institute's third annual county-by-county analysis of public health.

What not to do: Nine doc groups ID 45 'unnecessary' procedures (April 4)
In a rare, coordinated effort to reduce medical waste, nine physician specialty organizations each have identified five tests and procedures in their respective fields that may be unnecessary or overused.

Two pieces of advice for LOS reduction (April 5)
Hospital leaders across the nation typically have their length of stay statistics committed to memory. It's an important metric—and one worth remembering—but these two suggestions can help guide your improvement efforts.

FTC orders Ohio hospitals to undo merger (April 4)
The Federal Trade Commission has ordered two Ohio hospitals to dissolve their merger, a decision that could have broad implications for hospital deals nationwide, the New York Times reports.

Simple checklist slashes readmissions for HF patients (April 3)
Using a simple checklist helped health care providers decrease the percentage of heart failure patients readmitted to the hospital within 30 days from 20% to 2%, a recent study found.


Daily roundup: April 9, 2012

Bite-sized hospital and health industry news

April 09, 2012

  • California: Aetna will proceed with an insurance premium rate hike that took effect April 1, despite criticism from California's insurance commissioner and several state consumer groups that the increase is excessive. Insurance Commissioner David Jones (D) says it is the first time a California insurer has continued to implement a rate hike that was deemed excessive by the insurance department (Buck, Sacramento Bee, 4/6; Lifsher, Los Angeles Times, 4/6).
  • Massachusetts: Attorney General Martha Coakley (D) has drafted a proposal to more tightly regulate hospital and physician prices. Under the proposal, providers and insurers would be required to offer detailed pricing information to patients prior to a procedure. The proposal also would grant the state Division of Insurance and Department of Public Health authority to limit prices and market power (Kowalcyzk, Boston Globe, 4/6).

                 A deeper look: Mass. weighs more oversight of hospital prices

  • New Hampshire: Dartmouth College last week renamed Dartmouth Medical School after the late Theodor Geisel, a 1925 Dartmouth graduate better known as Dr. Seuss, and his wife Audrey in recognition of their philanthropic contributions to the school. According to a news release, the school now will be known as Geisel School of Medicine at Dartmouth (Pierce, New Hampshire Union Leader, 4/5).
  • Texas: A new study by Texas State University-San Marcos' department of health information management found that Texas will need 6,500 more health IT workers than previously estimated. According to the study, the state will need 10,000 more health IT workers by 2013, while previous estimates said the state would need 3,500 additional health IT workers between 2010 and 2015 (Austin Business Journal, 4/4). 


How do you measure accountability of physician marketing?

April 09, 2012

Join Crimson Market Advantage on April 11 for a complimentary webconference on tracking revenue and impact of physician marketing efforts.

Learn more.


Report: Preventive procedure costs vary by as much as 700%

The cost of certain preventive examinations can vary by as much as 700% and could increase health insurance premiums if employees do not pay attention to such price variations, according to a new report.

The report—from Change Healthcare—examined the costs of preventive procedures for 15,000 individuals and found wide variations in the cost of preventive procedures. For example, the report found that the cost a colonoscopy can be between $786 and $1,819.

According to USA Today, the cost of preventive tests can vary depending on if:

  • the test is performed in a hospital, a physician's office, or an ambulatory clinic;
  • the provider is located in a rural or urban area; or
  • the clinic specializes in the procedure.

Doug Ghertner, president of Change Healthcare, said the report shows that there can be a direct correlation between a consumer's provider choice and premium increases.

To prevent large premium increases, Ghertner recommended that businesses make the cost of preventive procedures available to employees and provide incentives for workers to choose less-costly care (Kennedy, USA Today, 4/5).