Volume VI, Issue 9

March 4,  2019
Medicare Trims Payments To 800 Hospitals, Citing Patient Safety Incidents   
Jordan Rau reports for Kaiser Health News on 3/1/19:

Eight hundred hospitals will be paid less by Medicare this year because of high rates of infections and patient injuries, federal records show. The penalties pit hospitals against one another in a race to prevent the most infections, blood clots, cases of sepsis, bedsores, hip fractures and other complications. Each year, the quarter of general hospitals with the highest rates are punished, even if their records have improved from the previous year. The number is the highest since the federal government five years ago launched the Hospital Acquired Conditions (HAC) Reduction Program, created by the Affordable Care Act.

The threat of losing money elevates the issue in many hospitals to the attention of directors and owners, according to Missy Danforth, VP of Healthcare Ratings at the Leapfrog Group, a nonprofit devoted to patient safety.

"The fact that everyone's talking about it, from front-line nurses to boards of directors, is positioning patient safety where it should be, which is at the forefront of everyone's minds," Danforth said.
Study: Physician Make their Hospitals $2.4M Yearly
Les Masterson reports for Healthcare Dive on 2/26/19:

Physicians generated on average nearly $2.4 million in revenue annually on behalf of affiliated hospitals in 2018, according to a new study by Merritt Hawkins, a unit of medical staffing company AMN Healthcare. That's a 52% increase from the $1.5 million in revenue in 2016. Cardiovascular surgeons generated the most on average for hospitals ($3.7 million). They were followed by invasive cardiologists ($3.5 million), neurosurgeons ($3.4 million) and orthopedic surgeons ($3.3 million). General internists ($2.7 million) and family physicians ($2.1 million) also made millions for affiliated hospitals.
The Merritt Hawkins' 2019 Physician Inpatient/Outpatient Revenue Survey found that physicians are still driving revenue despite payers increasingly moving to value-based payments, according to Mr. Masterson. The report suggested that aging patients are more than making up for the payment models changes that can put physician and hospital reimbursements at risk. 
Safety of Overlapping Surgeries
It is common in U.S. teaching hospitals to move on to the next surgery before the first is completed. Investigators at Harvard Medical School and Stanford University examined the safety of overlapping surgeries and published their findings on Feb. 26 in JAMA.
According the Harvard/Stanford research, this practice is generally safe. However, there were two important exceptions. Patients deemed high risk-those with a relatively high predicted probability of complications from surgery, due to age and preexisting medical conditions-as well as patients undergoing coronary artery bypass experienced higher mortality and complication rates during overlapping surgeries.



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