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"BOB WACHTER: The U.S. health-care system is often criticized for its failure to innovate. With our costs far higher than those of any other developed country and our outcomes, on average, no better, such critiques are not unfounded.
However, over the past 20 years, a new specialty has developed that represents a substantial innovation. The story of this specialty–hospitalists–illustrates our great potential for innovation. As we consider all sorts of new innovations, from tele-visits, to precision medicine, to new delivery models such as accountable care organizations, it’s a story worth telling. The traditional model for hospital care in the U.S. was one in which a patient’s primary-care physician was expected to remain in charge of her care in the hospital. While this model seems to have much to recommend it–after all, who wouldn’t want to be cared for by their regular doctor when they’re really sick–in reality, it didn’t work very well. Primary-care physicians are extraordinarily busy in the office, so hospital patients often languished, or were cared for haphazardly by multiple specialists, with no one there to serve as the orchestra conductor. And it became increasingly difficult for primary-care physicians to keep up with new advances in both office practice and hospital medicine. As hospital care became faster paced and more expensive, the downsides of the traditional model became ever more evident. About 20 years ago, a new specialist emerged, which a colleague and I dubbed a “hospitalist” in an article in the New England Journal of Medicine. Hospitalists are generalist physicians who take on the role of managing a patient’s hospital care, returning the patient to his or her primary-care physician at the time of discharge." Read more at WSJ "When it comes to health care costs, it’s clear: Where you live matters. And in California, the gap is especially sharp between the north and south.
Take, for instance, common procedures like a cesarean section or a total knee replacement. The total average price tag for a typical C-section in the four-county Sacramento area is $28,828; in east Los Angeles County, it’s $17,567, according to a health care comparison tool unveiled last week by state officials and Consumer Reports magazine. And that knee replacement? It’s about $42,488 in the Sacramento Valley but drops to $27,276 in east Los Angeles County." Read more at Sacramento Bee "Los Angeles prosecutors say a doctor was the ringleader in one of the state's biggest health fraud schemes that included unnecessary surgery by an untrained assistant that scarred patients for life.
Indictments unsealed Tuesday say a doctor and 14 associates bilked insurance companies out of $150 million in the scheme. District Attorney Jackie Lacey says Dr. Munir Uwaydah was arrested in Germany on the 57-count indictment. Eleven of his co-defendants appeared briefly in Los Angeles Superior Court and had not guilty pleas entered on their behalf. They were held on bail as high as $21.5 million." Read more at KPCC "For the last four years, Medicare has wielded a big stick: It has fined hospitals if too many of their patients returned to any hospital within weeks of being released.
But many safety-net hospitals, including academic teaching hospitals, say this is unfair because they take care of sicker, poorer patients. Now data released Monday shows they may be right. Researchers at Harvard Medical School found that hospitals are being penalized to a large extent based on the patients they serve. The researchers found that nearly two dozen variables, such as patients’ education, income and ability to bathe, dress and feed themselves, explain nearly half of the difference in readmission rates between the best- and worst-performing hospitals." Read more at The Washington Post "U.S. Surgeon General Vivek Murthy will call Wednesday for a national campaign centered on walking, an effort he said is intended to combat chronic disease and obesity, and to surmount obstacles that stand in the way of simply taking a walk.
Murthy said the government will partner with schools, nonprofit organizations and the private sector to promote walking at home, at school and in the workplace. His “call to action” seeks to make walking a national priority, promote development of communities where it is safe and easy to walk, develop walking programs, and conduct research on walking." Read more at The Washington Post "Medical giant Cedars-Sinai Health System said Tuesday it has acquired nearby Marina Del Rey Hospital, adding to a flurry of similar healthcare deals. Cedars-Sinai said it has purchased the 145-bed hospital and its neighboring medical office building. The price wasn't disclosed.
Marina Del Rey Hospital will operate as an affiliate of Cedars-Sinai and continue to provide its existing services, including a 24-hour emergency room. All 660 hospital employees will remain in place, according to Cedars-Sinai. Marina Del Rey Hospital was owned by a partnership led by Westridge Capital, a private investment firm based in Los Angeles. The deal fits in with Cedars-Sinai's ongoing efforts to expand and make care more convenient to patients in the community. It's also part of a larger consolidation trend among U.S. hospitals and, more recently, big health insurers." Read more at LA Times "California public health officials have released a report highlighting how demographic disparities across the state affect physical and mental health, Payers & Providers reports.
Details of Report The 96-page report was released by the California Department of Public Health's Office of Health Equity. Overall, OHE Deputy Director Jahmal Miller said the report demonstrates how health outcomes are affected by:
Read more at California Healthline |
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March 2016
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