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Health Management Technology News
  June 10, 2014
In this issue:
 
 Shifts in charity healthcare

 Sen. Schumer launches fight to give vets better access to healthcare

 Healthcare: Who is my customer?

 Administration overhauls federal healthcare website

 Healthcare interpreters becoming vital part of medical team

 24 hospital and health system executive moves

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Shifts in charity healthcare

Healthcare reform was supposed to relieve the financial strain on hospitals that have provided a lot of free charity care to poor and uninsured patients. The reform law, known as the Affordable Care Act, was expected to insure most of those patients either through expanded state Medicaid programs for the poor or through subsidized private insurance for middle-income patients, thereby funneling new revenues to hospitals that had previously absorbed the costs of uncompensated care.

In return for the new income streams, hospitals that treat large numbers of the poor and get special subsidies to defray the cost would have those subsidies reduced on the theory that they would no longer need as much help.

But after the Supreme Court ruled that the reform law could not force states to expand their Medicaid programs, 20 or more states declined to do so. That failure has hurt some big urban hospitals, because their charity care burden remains essentially the same even as their federal aid has been cut. Even in California, which has expanded its Medicaid program, public hospitals that serve the poorest patients could face a big funding shortfall in future years, according to a study just published by researchers at the University of California at Los Angeles.

A recent report in The Times by Abby Goodnough found that some hospital systems have started tightening the requirements for charity care in efforts to push uninsured people into signing up for subsidized health plans on the insurance exchanges created by the reform law. In St. Louis, for example, Barnes-Jewish Hospital has started charging co-payments to uninsured patients no matter how poor they are. Those at or below the poverty level ($11,670 for an individual) are charged $100 for emergency care and $50 for an office visit.

Read the full article from The New York Times
here
 

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Sen. Schumer launches fight to give vets better access to healthcare

Senator Charles Schumer has launched a fight to pass bipartisan legislation that would give veterans better access to health care.

Long delays and cover-ups at the VA hospital in Phoenix are a red flag, Schumer said. He told a group of reporters that included 1010 WINS’ Roger Stern, that action is important for the 350,000 vets living in the New York area.

“Even if here in New York we have a fraction of the problems that they had in Phoenix, we should act,” Sen. Schumer said.

The Senate bill would allow the VA to fire poor administrators, hire more doctors and nurses, and open additional facilities.

Read the full article form ABC New York here  

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Healthcare: Who is my customer?

Shopper. Consumer. Retailer. The roles are well-defined. In the consumer value chain, it is clear. The role of the customer is clear. Companies realize that the person that uses the product is the consumer, the person that buys the product is the shopper and the company that sells the product is the retailer. For the operations teams in the consumer value network, the focus is delivering value to maximize the experience for the shopper. They work with the retailer to improve this customer experience while maximizing the value for the retailer. This includes having the correct product at the shelf when the shopper wants to buy it while ensuring product quality at the point of delivery. They are now in their third decade of refining the processes.

In healthcare, it is different. In the delivery of supply chain excellence it is critical to know the expectations of the customer, but what if the customer is not clear? The role of the customer is not so clear in healthcare. Suppliers, both pharmaceutical and medical device companies, are confused. Who should the supplier serve? Is it the physician? The hospital? The patient? The insurer? The Group Buying Organization (GPO)?

In this value network, each party has a slightly different focus, and the payment systems is more bi-furcated than other value networks (split payments to multiple parties). As a result, it is hard for the industries within the network to align on clear metrics that define customer-centric excellence.

Read the full article from Forbes here  

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Administration overhauls federal healthcare website

The Obama administration is revamping HealthCare.gov and scrapping significant parts of the federal health-insurance marketplace in an effort to avoid the problems that plagued the site's launch last fall, according to presentations to health insurers and interviews with government officials and contractors.

But the makeover—and the tight timeline to accomplish it—are raising concerns that consumers could face another rocky rollout this fall when they return to the site to choose health plans. Some key back-end functions, including a system to automate payments to insurers, are running behind schedule, according to a presentation federal officials made to health insurers.

Adding to the pressure, HealthCare.gov is still in the midst of transitioning to new government contractors to manage basic functions.

Among the changes in the new version of HealthCare.gov: a revamp of the site's consumer-facing portion including the application for coverage most people will use, as well as the comparison tool that lets them shop for plans, according to slides from a May 20 meeting for insurers held by the Centers for Medicare and Medicaid Services, which oversees HealthCare.gov.

The government is turning to cloud computing from Amazon.com Inc.'s Web Services unit to host many of these functions.

Read the full article from The Wall Street Journal
here
 

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Healthcare interpreters becoming vital part of medical team

As Dr. Deb McLeish prepared to inject Botox into the arms and legs of 10-year-old Jossi Cabello to relieve stiffness from cerebral palsy, McLeish had to make sure Jossi’s mother understood the risks. Guadalupe Cabello speaks Spanish, so McLeish relied on an interpreter, Guadalupe Mangin.

McLeish told Cabello that Botox is related to the toxin that causes botulism, which can result in paralysis. Mangin repeated the words in Spanish.

But when Botox is injected into muscles, it stays in the nerves and doesn’t go into the bloodstream, McLeish said, pausing as Mangin relayed the message.

“That’s why we can use it as a therapy,” McLeish said, Mangin echoing her again.

Cabello consented to the treatment.

Mangin, who works for UW Health, isn’t just bilingual. She’s trained and certified as a health care interpreter, a job that is becoming more standardized as health care organizations treat an increasingly diverse spectrum of patients.

Read the full article from Wisconsin State Journal
here
 

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24 hospital and health system executive moves

The following hospital and health system executive moves were reported in the past week, beginning with the most recent.

1. Ronald Swinfard, MD, president and CEO of Allentown, Pa.-based Lehigh Valley Health Network, announced plans to retire, effective July 1.

2. Chase County Community Hospital in Imperial, Neb., selected Steve Lewis as CEO, effective July 14, according to a report by The Imperial Republican.

3. John Sernulka, CEO of Carroll Hospital Center in Westminster, Md., announced plans to retire, effective July 1.

4. Bakersfield (Calif.) Heart Hospital selected David Veillette as president and CEO, effective June 9.

5. Chicago-based Sinai Health System appointed Karen Teitelbaum as president and CEO, effective July 1, according to the health system.

6. Richmond-based HCA Virginia has selected David Donaldson as COO of Henrico Doctors' Hospital in Richmond, according to a Richmond Times-Dispatch report.

7. Gordon Hospital in Calhoun, Ga., appointed Brandon Nudd COO, according to a WRGA report.

8. Doug Arnold, CEO of Helen Keller Hospital in Sheffield, Ala., announced plans to retire, effective Oct. 1.

9. Englewood, Colo.-based Catholic Health Initiatives appointed Michael Covert CEO of CHI St. Luke's Health Houston market and senior vice president of operations for the health system.

10. Bayonne, N.J.-based CarePoint Health System appointed Gary Bryant CFO, effective immediately, according to a Fort Mills Times report.

11. Jim Woodward, president and CEO of Madison, Wis.-based Meriter-UnityPoint Health, is stepping down from his position to become CEO of Manchester, N.H.-based Elliot Health System.

12. Kalamazoo, Mich.-based Borgess Health President and CEO Paul Spaude will retire in September, according to a Mlive report.

Read the full article from Becker’s Hospital Review here  

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What you need to know about ICD-10

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Industry News

AMA adopts policy to define team-based medical healthcare

Kentucky physician named AMA President-elect

HHS: $300 Million in Affordable Care Act funds to expand services

HHS releases new data and tools to increase transparency on hospital utilization

AHIMA survey: Two-thirds of healthcare lack information governance strategy


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