The Daily Briefing

News for Health Care Executives

HealthGrades lists top hospitals for emergency care

Patients admitted to top hospitals had more than 40% lower mortality rate

February 21, 2012

HealthGrades on Tuesday released its annual list of the top U.S. hospitals for emergency medicine, noting wide variation in mortality rates for patients admitted through the ED. 

For its Emergency Medicine in American Hospitals report, HealthGrades analyzed data for more than seven million Medicare patients admitted through the ED between 2008 and 2010.

The study focused on 12 common conditions, including bowel obstruction, chronic obstructive pulmonary disease, diabetic acidosis and coma, gastrointestinal bleed, myocardial infarction, heart failure, pancreatitis, pneumonia, pulmonary embolism, respiratory failure, sepsis, and stroke. Altogether, the 12 conditions represent 21.9% of Medicare admissions, and 82.6% of these are admitted through the ED, according to HealthGrades.

Emergency Medicine Excellence Award recipients
Of the 4,783 short-term acute care hospitals included in the study, 263 hospitals performed in the top 5% and received HealthGrades' "Emergency Medicine Excellence Award." A full list of the top EDs is available on the HealthGrades website.

Overall, HealthGrades found that top hospitals on average had a 41.52% lower risk-adjusted mortality rate compared with other facilities. HealthGrades estimated that an additional 170,856 patients would have survived emergency hospitalization from 2008 to 2010 if all hospitals performed at the level of top-performing facilities.

Top cities for emergency care
In addition, the report identified the 10 U.S. cities with the lowest risk-adjusted mortality rate for patients admitted through the ED from 2008 to 2010. They were:

  • Milwaukee, Wis.;
  • Phoenix-Prescott, Ariz.;
  • Cincinnati, Ohio;
  • West Palm Beach, Fla.;
  • Baltimore, Md.;
  • Traverse City, Mich.;
  • Dayton, Ohio;
  • Cleveland, Ohio;
  • Fargo, N.D.; and
  • Detroit, Mich. (HealthGrades release, 2/21; HealthGrades report, 2/21; HealthGrades methodology, 2/21).

Study: Online patient ratings correlate with better hospital care

Best-rated hospitals had 42% lower MRSA rates

February 21, 2012

Positive online patient ratings are associated with better hospital performance and higher quality of care, according to a recent study in the Archives of Internal Medicine.

For the study, researchers from Imperial College London used a website run by the United Kingdom's National Health Service—called NHS Choices—to examine 10,274 hospital ratings posted between Jan. 1, 2009, and Dec. 31, 2010. They then compared the ratings to patient outcomes at 146 of the hospitals.

Measures of patient outcomes included death rates, readmission rates, and Methicillin-resistant Staphylococcus aureus (MRSA) rates.

Compared with hospitals that received the worst patient ratings, the study found that the best-rated hospitals had:

  • 42% lower MRSA rates;
  • 11% lower readmission rates; and
  • 5% lower death rates.

The study also found that 68% of all patients who rated a hospital said they would recommend the hospital to a friend. According to the study, hospitals that received such positive recommendations were more likely to have lower mortality rates for high-risk conditions and lower readmission rates.

Felix Greaves—a physician and expert from Imperial College London's School of Public Health—said researchers found "the general trend is that where a hospital's overall performance on clinical measures is good, patients seem to rate it highly—and vice versa" (Gale, CMIO, 2/14; Mason, London Telegraph, 2/15; Zorlu, London Guardian, 2/14).

MCAT makeover: New exam tests aspiring docs on psychology and ethics

Updated exam adds two sections, deletes one

February 21, 2012

Representing a "major shift" in thinking on what makes a good doctor, the Association of American Medical Colleges (AAMC) has announced that the Medical College Admission Test (MCAT) starting in 2015 will quiz aspiring physicians on psychology and sociology in addition to the natural sciences.

The current exam features two natural sciences sections that analyze students' knowledge of concepts from biology, organic chemistry, biochemistry, and physics, as well as a reasoning and writing portion.

The updated test will add two new sections. The first—titled "Psychological, Social, and Biological Foundations of Behavior"—will test students' understanding of behavior, cultural differences, and socioeconomic factors. The second—titled "Critical Analysis and Reasoning Skills"—will include questions about social science and humanities concepts, including ethics, philosophy, and cross-cultural studies. In addition, the new test will omit the writing section, which medical school admissions officers said was the least helpful in identifying strong candidates.

According to MedPage Today, the updates are the first major changes to the test since 1991. The new exam was developed over a three-year period by a 21-member advisory panel, which received input from medical school professors, administrators, residents, and students.

"Bedside manner is a complex mix of understanding people, where they come from, and why they behave the way they do, and we think this shift in emphasis [of the test] will actually help us round out that dimension of a good doctor," says Darrell Kirch, president and CEO of AAMC (AAMC release, 2/16; AHA News, 2/16; Healy, "Booster Shots," Los Angeles Times, 2/16; Walker, MedPage Today, 2/16).

New report: How hospitals are realizing benefits of EMR

February 21, 2012

A new report, jointly authored by the Advisory Board Company and HIMSS Analytics, surveys CIOs on their tactics to implement and realize benefits from EMR.

The report draws on interviews with 33 CIOs of hospitals with advanced EMR systems.

The survey results indicate that the promise of improved quality and effectiveness is the dominant driver for the organizations to adopt EMRs.

Hospitals with advanced EMR systems report achieving a wide range of EMR adoption benefits, including clinical quality enhancement, patient safety improvement, and operational efficiencies. While deploying a number of benefit realization strategies, hospitals with defined explicit benefit targets are more likely to realize those benefits.

Read the full report.

S&P: Providers see revenue bump in 2011

Medicare, commercial revenue both increase last year

February 21, 2012

Health care providers' Medicare and commercial insurance revenue increased by 5.28% in 2011, according to Standard & Poor's Healthcare Economic Indices.

S&P reports that providers' commercial insurance revenue increased by 7.11%, while providers' Medicare revenue—excluding Medicare Advantage—increased by 2.51%.

Meanwhile, hospital Medicare revenue increased by 1.5% and hospital commercial revenue rose by 7.95%. S&P also reports that professional-service Medicare and commercial revenue grew by 3.72% and 6.09%, respectively.

According to David Blitzer, chair of the Index Committee at S&P Indices, since the summer of 2011, growth rates have started to accelerate "most notably for hospital costs and those covered by commercial insurance plans." He adds, "We appear to be entering 2012 witnessing a renewed acceleration in health care costs" (S&P release, 2/16; Evans, Modern Healthcare, 2/16 [subscription required]).

Sebelius: Hospital EHR adoption nearly doubled over two years

About $3.12B in MU incentive payments already have been distributed

February 21, 2012

HHS Secretary Kathleen Sebelius on Friday announced that the number of hospitals using electronic health records (EHRs) has more than doubled in the last two years.

Sebelius delivered her announcement after touring the Health Science Institute at Metropolitan Community College-Penn Valley in Kansas City, Missouri. In 2010, the institute opened a "virtual hospital" to help train students studying health care and health IT.

An HHS release cites information from a new American Hospital Association survey finding that the percentage of U.S. hospitals that have adopted EHRs increased from 16% in 2009 to 35% in 2011. The survey also found that about 85% of hospitals now plan to seek incentive payments through the meaningful use program.

The release also states that new CMS data show that $3.12 billion in incentive payments have been distributed to physicians, hospitals, and other health care providers through the meaningful use program.

In addition, the release notes that projections from the Bureau of Labor Statistics estimate that the number of health IT jobs nationwide is expected to increase by 20% between 2008 and 2018 (HHS release, 2/17; Stafford, Kansas City Star, 2/17).

Weekly review

Key articles from Feb. 21-Feb. 24

February 27, 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.

HealthGrades lists top hospitals for emergency care (Feb. 21)

HealthGrades on Tuesday released its annual list of the top U.S. hospitals for emergency medicine, noting wide variation in mortality rates for patients admitted through the ED.  

Which hospitals are most likely to meet Stage 1 meaningful use? (Feb. 22)

Hospitals nationwide are striving to achieve Stage 1 meaningful use for electronic health records—but which ones are the most likely to succeed? New data from HIMSS Analytics reveal which hospitals are ahead of the pack. 

How hospitals accommodate Catholic, secular care  (Feb. 22)

The New York Times this week examined the increasing trend of Catholic-secular hospital mergers, highlighting how organizations have changed strategies to accommodate both types of facilities. 

Cleveland Clinic, North Shore-LIJ partner to advance innovation (Feb. 23)

Cleveland Clinic Innovations is collaborating with North Shore-Long Island Jewish Health System for its second innovation partnership, a move that CCI officials say could foreshadow a "national innovation alliance." 

CMS releases meaningful use Stage 2 proposed rule (Feb. 23)

The notice of proposed rulemaking on Stage 2 of meaningful use was released on Feb. 23, opening up a window into the next chapter of CMS's EHR incentive program.

Study names top 25 hospital websites (Feb. 24)

A recent study in the Journal of Healthcare Management names the nation's top 25 hospital websites, but notes that many hospital pages still miss the mark and could be improved.

Study: MRIs may detect autism as early as six months of age

Finding could help physicians implement early interventions in high-risk children

February 21, 2012

Researchers have observed brain development discrepancies in autistic children as young as six months old, a finding that could allow physicians to identify high-risk children months before parents usually notice symptoms.

In a study published in the American Journal of Psychiatry, University of North Carolina-Chapel Hill researchers conducted MRI brain scans on 92 infants considered at a higher risk of developing autism because they had an older, autistic sibling. They conducted the scans at six months, one year, and two years of age.

According to the findings, 28 of the children in the study developed autism. Based on the MRI scans, the researchers found that those children demonstrated key differences in brain pathway development. At six months, the children with autism exhibited more development than children without autism. Specifically, they had increased anxonal diameter, myelination, and fiber density in some areas of the brain. However, by 24 months, the autistic children's brain development had fallen behind that of their non-autistic peers. 

Most parents of autistic children begin to identify symptoms between ages one and two, and most children are not officially diagnosed until age five. According to the study's authors, the findings may help identify infants at a high risk of developing autism early, which "offers the possibility of implementing interventions that could reduce or even prevent the manifestation of the full syndrome" (Szabo, USA Today, 2/17; Walsh, MedPage Today, 2/17).

Daily roundup: Feb. 21, 2012

Bite-sized hospital and health industry news

February 21, 2012

  • Alabama: State officials last week announced plans to close four of Alabama's six mental health hospitals in an effort to slash costs and change care delivery. The Alabama Department of Mental Health will close the hospitals by May 2013, leaving one facility open for criminal suspects and one for geriatric patients. The remaining patients will be relocated to group homes or community centers (Brown, New York Times, 2/17).
  • California: The Joint Commission has given a gold seal of approval to Community Hospital in Salinas for providing advanced inpatient diabetes care. The recognition comes after the health care accreditation organization visited the hospital in December 2011 to conduct an on-site survey of the hospital's compliance with diabetes care standards. Community Hospital is one of six hospitals in California and one of 41 nationwide to receive the designation (Flores, HealthyCal, 2/14).
  • Illinois: The Illinois Breast and Cervical Cancer Program—established to provide women's health services to the uninsured or those whose insurance excludes screening services—has placed about 400 women each month on a waiting list for mammogram appointments because of a funding shortfall. Shannon Lightner, deputy director of the Office of Women's Health at the Illinois Department of Public Health, says women who show breast cancer symptoms or have had abnormal mammograms will still have access to the screenings (Shelton, Chicago Tribune, 2/17).
  • Michigan: Since opening in March 2009, Henry Ford West Bloomfield Hospital has attracted so much business that officials are considering expanding the facility by 109 patient rooms. The $175 million project also would expand the ED and add new ORs and labor and delivery suites. Henry Ford Health System's board is expected to reach a decision on the expansion later this year (Burden, The Detroit News, 2/17).

Introducing the Crimson/QuadraMed Core Measures Collaboration

February 21, 2012

The Advisory Board Company is collaborating with QuadraMed, an industry-leading core measures vendor, to provide abstraction and reporting services to Crimson members.

Learn more.

Medicare spending increasing faster for obese beneficiaries

Each obese beneficiary adds an additional $149 annually to Medicare's already increasing tab, according to a recent study in the Archives of Internal Medicine.

For the study, researchers at the University of Maryland School of Medicine analyzed survey data on nearly 30,000 Medicare beneficiaries from 1997 to 2006, and found that during that time the percentage of obese beneficiaries increased from 21% to 29%.

The study found that Medicare costs increased by $122 annually for normal-weight individuals, while costs increased by $230 among overweight beneficiaries, and $271 for obese beneficiaries (Grens, Reuters, 2/16).