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Oklahoma tornado devastates Moore hospital

Monday's devastating tornado in Moore, OK, incapacitated the Moore Medical Center, a small hospital about 10 miles south of Oklahoma City, forcing it to evacuate patients and redirect victims of the massive damage to other health centers.

The second floor of the Moore Medical Center was completely demolished, though Kelly Wells, a spokeswoman for the Norman Regional Health System said the staff did not suffer any injuries.

The Oklahoma hospital is normally equipped to provide 24-hour emergency services, but victims in the area will have to find their way to other medical centers in the area, said Wells.

CNN reported that patients from the Moore Medical Center were being sent to the nearby Norman Regional Hospital and HealthPlex Hospital, and all the patients normally under the purview of Moore were also being told to go there.

In the aftermath of the tornado, 65 patients were being treated at Oklahoma University Medical Center, according to CNN.

The tornado, which was reported to be at least two miles wide during its most destructive moments, decimated about 300 homes in the Moore area.

At last count, at least 51 people in Moore were killed by the tornado, at least 20 of whom were children. At least 145 others have been hospitalized in the Oklahoma City area. Visit Medical Daily for the story.

 

Will workplace wellness screenings under Obamacare improve health?

CVS Caremark was widely criticized in March when word got out that its employees would have to submit to yearly health screenings or pay $50 more a month for insurance. The pharmacy chain isn’t exceptional: The Kaiser Family Foundation reports nearly half of U.S. companies with more than 200 employees have wellness programs that measure workers’ weight, blood pressure, blood sugar, and cholesterol. That number is likely to grow next year, when rules take effect under the Affordable Care Act that give employers more tools to prod workers into healthier behavior. The law will let companies charge employees who don’t meet certain health targets 30 percent more for insurance premiums, up from 20 percent now.

Chronic conditions such as obesity and diabetes account for three-quarters of U.S. health costs; a lot of that money could be saved if Americans took better care of themselves. Giving incentives to quit smoking or lose weight, the reasoning goes, will help companies tame growing medical costs while making workers healthier. It’s not at all clear that it does either—and advocates for patients caution that the programs could be used to make sick people pay more, a practice Obamacare was supposed to prevent.

“If it becomes a tool for shifting healthcare costs … you might undermine the whole idea of workplace wellness,” says Alan Balch, vice president of the Preventive Health Partnership, an alliance of the American Cancer Society, the American Diabetes Association, and the American Heart Association.

The share of U.S. companies that reward workers who participate in wellness programs grew to 61 percent in 2012 from 36 percent in 2009, according to a survey by Towers Watson and the National Business Group on Health. Market researcher IBIS World reports that employers spend $2 billion annually on the programs.

Often employees receive the incentives just for agreeing to a finger prick and blood pressure check, no matter how the tests turn out. Johnson & Johnson’s wellness program lowers premiums for workers who take screenings and follow up with counselors to improve their health. At consumer credit bureau Experian, workers can earn $690 in premium discounts and fitness subsidies for joining the company’s wellness program.

But the Obamacare rules set to take effect next year would allow companies more power to tie the price employees pay for insurance to specific health goals. Workers in such programs would only receive money, or avoid an increase in their insurance costs, if, for example, they keep their cholesterol or weight at certain levels. Those who can’t—because of a disability, or because of a predisposition to high cholesterol or diabetes—must be given a “reasonable alternative” to earn the reward, such as attending a seminar on healthy eating. In a February NBGH survey of 83 U.S. employers, 41 percent favored tying incentives to test results.

The U.S. Equal Employment Opportunity Commission is now examining whether such programs could violate anti-discrimination laws. And California’s legislature is considering a bill that would bar linking financial rewards to a worker’s health status. While some studies suggest $3 or more in savings for every dollar spent on wellness programs, the gains may come from shifting costs to less healthy employees rather than changing behavior, a March analysis in Health Affairs concluded.

Dangling premium reductions as an incentive doesn’t get people to shape up, the authors wrote: “Powerful personal, social, and financial incentives to be healthy, nonsmoking, and thin already exist.” A RAND Corp. study last year found there’s not enough evidence “to definitively assess the impact of workplace wellness on health outcomes and cost.”

The rise of wellness programs has been accompanied by a proliferation of medical tests. Public health guidelines recommend cholesterol screening for healthy adults once every five years and screening for diabetes only in people with high blood pressure, absent other symptoms. Wellness screenings typically test for both annually.

Bruce Elliott, manager of compensation and benefits at the Society for Human Resource Management, a trade group representing HR professionals, says critics need to give wellness programs a few years to prove their effectiveness: “It’s an investment, and it’s an investment that does take some time.” Helping employees quit cigarettes or lose weight will translate to lower medical costs over three to five years, he says.

There are a few simple fixes that have been shown to improve health and save costs, says Jeffrey Harris, director of the Health Promotion Research Center at the University of Washington. Aiding smokers who show a desire to quit can quickly pay off. Workers who aren’t stepping out a couple times an hour for a cigarette are more productive. And offering free in-office flu vaccines translates into fewer sick days.

Beyond that, the advantages get murkier. Tom Emerick, former vice president for benefit design at Wal-Mart Stores, says when he started out in 1980 companies were just beginning to offer money to employees who quit smoking or lost weight. Many employers ultimately discarded the programs because they didn’t work. Now an independent benefits consultant, he’s writing a book with Lewis that’s critical of wellness programs. He advises clients to forget about health screenings. The best thing they can do for their employees’ health, he tells them, is to reduce their stress by making their work more rewarding and fulfilling.

The bottom line: Companies spend $2 billion annually on wellness programs that haven't been proven to reduce costs or make people healthier. Visit Business Week for the article.

 

All sterile drug products made and distributed by NuVision Pharmacy Dallas Facility: Recall - lack of sterility assurance

FDA is alerting healthcare providers of concerns about a lack of sterility assurance of all sterile drug products made and distributed by NuVision Pharmacy of Dallas, TX. The FDA is basing this expanded alert on a recent inspection of the NuVision Dallas facility, during which FDA investigators observed poor sterile production practices that raise concerns about a lack of sterility assurance of the company’s sterile drug products. The agency is not aware of any additional adverse event reports associated with other sterile products from NuVision.

In April 2013, NuVision recalled Methylcobalamin injection and lyophilized injection products due to a lack of sterility assurance and concerns associatedwith the quality control processes identified during the FDA inspection. The FDA received adverse event reports of fever, flu-like symptoms, and soreness at the injection site associated with the Methylcobalamin injection product that was previously recalled.

For all sterile products from NuVision, the FDA recommends that healthcare providers and other healthcare professionals, including hospital staff, immediately check their medical supplies for NuVision sterile products, quarantine those products, and not administer them to patients. Patients who were administered any sterile drug products produced and distributed by NuVision and who have concerns should contact their healthcare provider. Read the MedWatch safety alert, including a link to the FDA Press Release.

 

GHX kicks off 13Th Annual Healthcare Supply Chain Summit

GHX kicked off the thirteenth annual Healthcare Supply Chain Summit Monday at the Red Rock Resort & Spa in Las Vegas. Bringing together nearly 600 healthcare professionals from hospitals, suppliers, distributors and GPOs, the Summit has become the world’s largest and most well-respected healthcare supply chain event. This year’s conference is dedicated to the idea of “We Are Change”– promoting collaboration, transparency, technology adoption and forward thinking to change the healthcare status quo, reduce costs and improve patient care.

Complementing the theme of “We Are Change,” many of the Summit’s sessions will focus on the most pressing healthcare trends in the industry, including:

·         Accountable Care through the Supply Chain: The healthcare industry is undergoing massive change as it moves toward a system that pays for value, not volume. The post-reform era requires informed leaders who understand how to turn their businesses into accountable supply chain organizations.

·         Becoming Change Leaders: Leading change within an organization is not a simple task, but elevating supply chain management to a strategic enterprise initiative is critical to succeed in the new age of healthcare.

·         Taking Costs Out of Healthcare: Increasingly, the healthcare supply chain is being looked at to contribute value by maximizing those activities that work and, most importantly, changing those that just add costs.

·         Creating Better Trading Partner Relationships: Trust, transparency and collaboration are relatively new concepts when it comes to trading-partner relationships, but healthcare providers and suppliers need to transform and strengthen their relationships in the changing market

·         The UDI Rule is Here to Stay: The Food & Drug Administration’s Unique Device Identification (UDI) regulation is creating major changes, not just for suppliers, but organizations throughout healthcare. Jay Crowley from the FDA and David Brooks from Covidien will offer attendees information they need to understand about UDI, timing of regulation rollouts and what they can to do to make sure they are ready. Craig Karagitz of Terumo Cardiovascular Systems will also discuss his company’s journey of successfully completing four test data loads into the GDSN in preparation for UDI.

·         The Dawn of the Implantable Device Supply Chain (IDSC): The IDSC spans 15 processes from initial case scheduling, through to the operation and final payment. It’s a manual, error-ridden process that costs the industry $5 billion a year in waste. But with new technologies and more collaboration between trading partners, the IDSC is changing – becoming more automated, transparent and reducing those processes from 15 to four.

The entire GHX Healthcare Supply Chain Summit agenda can be viewed here. Follow the conference action in real-time by visiting the Healthcare Hub blog or following #GHX on Twitter.

 

Premature babies get boost from live music

CHICAGO — As the guitarist strums and softly sings a lullaby in Spanish, tiny Augustin Morales stops squirming in his hospital crib and closes his eyes. This is therapy in a newborn intensive care unit, and research suggests that music may help those born way too soon adapt to life outside the womb.

Some tiny preemies are too small and fragile to be held and comforted by human touch, and many are often fussy and show other signs of stress. Other common complications include immature lungs, eye disease, problems with sucking, and sleeping and alertness difficulties.

Recent studies and anecdotal reports suggest the vibrations and soothing rhythms of music, especially performed live in the hospital, might benefit preemies and other sick babies.

Many insurers won’t pay for music therapy because of doubts that it results in any lasting medical improvement. Some doctors say the music works best at relieving babies’ stress and helping parents bond with infants too sick to go home.

But amid beeping monitors, IV poles and plastic breathing tubes in infants’ rooms at Chicago’s Ann & Robert H. Lurie Children’s Hospital, music therapist Elizabeth Klinger provides a soothing contrast that even the tiniest babies seem to notice

“What music therapy can uniquely provide is that passive listening experience that just encourages relaxation for the patient, encourages participation by the family,” Klinger said after a recent session in Augustin’s hospital room.

The baby’s parents, Lucy Morales and Alejandro Moran, stood at the crib and whispered lovingly to their son as Klinger played traditional lullabies, singing in Spanish and English. “The music relaxes him, it makes him feel more calm” and helps him sleep better too, Lucy Morales said. “Sometimes it makes us cry.”

Some families request rock music or other high-tempo songs, but Klinger always slows the beat to make it easier on tender ears.

“A lot of times families become afraid of interacting with their children because they are so sick and so frail, and music provides them something that they can still do,” Klinger said, who works full time as a music therapist but her services are provided for free.

Music therapists say live performances in hospitals are better than recorded music because patients can feel the music vibrations and also benefit from seeing the musicians.

More than two dozen U.S. hospitals offer music therapy in their newborn intensive care units and its popularity is growing, said Joanne Loewy, a music therapist who directs a music and medicine program at Beth Israel Medical Center in New York.

Preemies’ music therapy was even featured on a recent episode of the hit TV show “American Idol,” when show finalist Kree Harrison watched a therapist working with a tiny baby at Children’s Hospital Los Angeles.

Dr. Natalia Henner, a newborn specialist at Lurie hospital, said studies in nursing journals show music therapy for preemies “does help with promoting growth. And there’s some good literature ... saying that the time to discharge is a little bit shorter in babies who’ve been exposed to more music therapy.” She said it “definitely facilitates bonding” between parents of preemies and other babies too sick to go home.

Loewy led a study published last month in the journal Pediatrics, involving 11 U.S. hospitals. Therapists in the study played special small drums to mimic womb sounds and timed the rhythm to match the infants’ heartbeats. The music appeared to slow the infants’ heartbeats, calm their breathing, and improve sucking and sleeping, Loewy said.

Soozie Cotter-Schaufele, a music therapist at Advocate Children’s Hospital-Park Ridge near Chicago, says soothing rhythmic sounds of music can mimic womb sounds and provide a comforting environment for preemies. She sings and plays a small harp or guitar, and says the sounds help calm tiny babies while they’re undergoing painful medical procedures. (Associated Press) Visit the Washington Post for the article.

 

New Jersey hospital has highest billing rates in the nation

BAYONNE, NJ — The most expensive hospital in America is not set amid the swaying palm trees of Beverly Hills or the luxury townhouses of New York’s Upper East Side. It is in a faded blue-collar town 11 miles from Midtown Manhattan.

Based on the bills it submits to Medicare, the Bayonne Medical Center charged the highest amounts in the country for nearly one-quarter of the most common hospital treatments, according to a New York Times analysis of 2011 data, the most recent available. No other hospital was at the top of the price list more often.

Bayonne Medical typically charged $99,689 for treating each case of chronic lung disease, 5.5 times as much as other hospitals and 17.5 times as much as Medicare paid in reimbursement. The hospital also charged on average of $120,040 to treat transient ischemia, a type of small stroke that has no lasting effect. That was 5.6 times the national average and 23.6 times what Medicare paid.

For those prices, the quality of care at Bayonne Medical is no better, or worse, than that at most other New Jersey hospitals. In a 2011 state hospital quality report, Bayonne Medical scored only in the top 50 percent. But profits at the hospital, which was bankrupt in 2007, have soared in recent years, in part because it has found a way to turn some of those high billings into payments.

The increasingly contentious issue of hospital charges drew renewed attention last week when the federal government released Medicare data showing that facilities nationwide submitted widely divergent bills for the same treatments.

And while the unassuming, six-story brick hospital here holds a notable place in those rankings, others stand out as well. The midsize Crozer-Chester Medical Center in Upland, PA, was the top biller in the country for urinary tract infections.

One prestigious Manhattan hospital, NYU Langone Medical Center, charged twice as much as the equally high-end New York-Presbyterian to implant a cardiac pacemaker. But Medicare considers the two New York hospitals so similar it pays them both about $20,000 for the procedure.

The hospital industry is quick to say that the charges are irrelevant because virtually no one, private insurers, Medicare or even the uninsured, pays anywhere near those amounts. Medicare sets standard rates for treatments and insurers negotiate with hospitals. But experts add that the charges reflect decades of maneuvering by hospitals to gain an edge over insurers and provide themselves with tax advantages.

Until a recent ruling by the Internal Revenue Service, for instance, a hospital could use the higher prices when calculating the amount of charity care it was providing, said Gerard Anderson, director of the Center for Hospital Finance and Management at Johns Hopkins. “There is a method to the madness, though it is still madness,” Anderson said.

A close look at the finances of Bayonne Medical Center sheds light on how hospital pricing at the extremes may financially benefit an institution. The practices at Bayonne Medical also highlight a new financial strategy used by a small number of hospitals to increase their profits by “going out of network”, severing ties, and hence contractual agreements that limit reimbursement rates, with large private insurers.

Neither officials nor owners of Bayonne Medical responded to multiple calls and e-mail requests for interviews. Because the company is privately held, it does not have to release financial data. Bayonne Medical, which was founded in 1888, was losing nearly $1.5 million a month before it filed for bankruptcy in 2007. By 2011, under new ownership and a new financial model, its patient revenue had nearly tripled and its operating income had reached $9.3 million, according to the American Hospital Directory. The hospital’s turnabout started in 2008 when it was acquired out of bankruptcy by a consortium of buyers in a deal valued at about $41 million.

First, they converted Bayonne Medical from a nonprofit to a for-profit hospital at a time when such hospitals were a rarity in New Jersey. Next, they moved to sever existing contracts with large private insurers, essentially making Bayonne Medical an out-of-network hospital for most insurance plans.

Under New Jersey law, patients treated in a hospital emergency room outside their provider’s network have to pay out of pocket only what they would have paid if the hospital was in the network. But an out-of-network hospital can bill the patient’s insurer at essentially whatever rate it cares to set. While the insurers can negotiate with the hospital, they generally end up paying more than they would have under a contractual agreement.

In recent years, Bayonne Medical put up digital billboards highlighting the short waits in its emergency rooms in an effort to attract more patients. Insurers complained that the hospital was seeking to take advantage of the higher rates it could charge.

While the law was aimed at giving patients more hospitals to choose from, it “has had the unintended consequence of rewarding folks for these inflated charges,” said Wardell Sanders, president of the New Jersey Association of Health Plans. “When people say these charges are just the sticker price and it’s meaningless, it’s not meaningless.”

Community leaders in Bayonne, fearing the hospital could close, said the buyers were always candid about the methods they intended to use to make the hospital a profitable enterprise.

Not surprisingly, the insurers fought back against the out-of-network model. In 2009, Horizon Blue Cross Blue Shield of New Jersey filed an injunction in New Jersey Superior Court saying Bayonne Medical’s owners had “flatly rejected” and refused to negotiate an in-network hospital contract with Horizon. When the existing agreement expired in early 2009, Horizon said Bayonne sharply increased its prices. Bayonne’s in-network charges to Horizon averaged $13,000 a day in 2008. A year later, when it was out of network, the charges soared to $29,000, the insurer said in a spring 2009 news release.

Bayonne Medical denied allegations in Horizon’s lawsuit that it was artificially inflating prices, and filed its own lawsuit against Horizon, claiming the insurer had intimidated patients and tried to get them to leave the facility before completing their treatments.

The two eventually settled in 2011, and Horizon became an in-network insurance provider. A spokesman for Horizon declined to comment on Bayonne Medical’s charges, citing terms of the settlement agreement. Still, many other large insurance companies, including Cigna, United Healthcare and Aetna, remain out of network at Bayonne and are paying the higher bills.

Like Horizon, Aetna said its bills from Bayonne Medical soared, and it also filed a lawsuit in 2011. The suit was dismissed.

Aetna’s internal data showed that Bayonne Medical’s emergency room charges jumped again in 2012 and are running 6 to 12 times as high as those of surrounding hospitals.

After purchasing Bayonne Medical, the investor group went on a buying spree, acquiring Hoboken University Medical Center in 2011 and the bankrupt Christ Hospital in Jersey City last year. Visit the New York Times for the article.