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The Center for Medicaid & Medicare Services has decided to eliminate patient satisfaction with pain management from Medicare's value-based purchasing program. The change--which removes the item from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS)--is part of the proposed rule for the 2017 Hospital Outpatient Prospective Payment System issued last week. CMS also plans to stop paying hospital off-campus facilities the same as hospital-based outpatient departments, a move that has angered hospitals, Modern Healthcare reports. (Modern Healthcare; proposed rule)
 
Although there have been more health data hacker attacks in the first half of 2016 than during the first half of 2015, they've affected fewer individuals than those in 2015. According to the Department of Health and Human Services Office for Civil Rights "wall of shame" website, there were 43 reported hacking/IT incidents affecting roughly 2.7 million individuals in the first half of 2016. During the same period in 2015, 37 reported hacking incidents affected 93.2 million individuals. (HealthcareInfoSecurity)
 
Widespread use of EHRs may be contributing to errors and malpractice liability, according to a recent report by The Doctors Company, a California medical malpractice insurance company. It closed 97 claims between January 2007 and June 2014 in which EHRs were a contributing factor. The top allegation was for diagnosis-related errors, followed by medication-related errors, with the wrong medication, the wrong dose or improper medication management given to the patient. Researchers also found EHR use is increasingly a factor in malpractice liability; in the 2007-2010 period, there were two malpractice claims involving EHRs. There were 26 through the first half of 2014. (North Bay Business Journal)
Innovation & Transformation  
Increased investment in selected social services, and improved coordination between medical and nonmedical services, can improve health outcomes and lower health care costs for certain populations. The latest research to show this comes from a report supported by Blue Cross Blue Shield of Massachusetts Foundation. It finds that investment in three social services in particular is associated with such improvements and savings: housing support, nutritional assistance and case management. The evidence suggests targeting people in greatest need of social services--low-income individuals or families, the elderly, the disabled--is critical to yield the benefits. (Health Affairsreport)
 
Executives at rural and a few urban Arizona hospitals are joining together to save money and improve quality, the idea being that the hospitals can maximize each other's resources. "I think savings through supply chain is really just the tip of the iceberg," Arizona Health Collaborative Executive Director Matt Horn said. "By coming together and collaborating we can offer value-added benefits to both urban and rural hospitals throughout the state." (Phoenix Business Journal)
 

As the health conditions of seniors become more complex, geriatric emergency rooms are slowing spreading across the country, offering seniors a more thorough screening and discharge evaluation as well as thicker mattresses to reduce bedsores, raised toilets and reduced-noise curtains. In a time when the Affordable Care Act penalizes hospitals for readmissions, geriatric emergency rooms could reduce readmissions and lower health care costs, CNN reports. One federal study shows 60 percent of elderly patients who are hospitalized come through the ER and 25 percent of those hospitalizations are preventable. (CNNKasier Health News) 
 
Consumers & Providers
According to a new study published in Mayo Clinic Proceedings, of those physicians who used EHRs, only 36 percent were satisfied or very satisfied with them; 43.7 percent were dissatisfied or very dissatisfied. Of those who used computerized physician order entry (CPOE), 38 percent were satisfied or very satisfied; 41.9 percent were dissatisfied or very dissatisfied. Physicians who used EHRs and CPOE had higher rates of burnout. Of physicians who used EHRs, only 36.3 percent agreed or strongly agreed the systems improved patient care. Younger physicians generally were more satisfied with their systems than older ones. (FierceHealthcareMayo Clinic Proceedings)
 
 
The answer is unclear. "The healthcare delivery system has put in a lot of effort to make the system more efficient and effective, to reduce unnecessary use of healthcare services and reduce hospital readmissions," says Ed Salsberg of George Washington University School of Nursing. "We don't know for sure whether this is going to increase or decrease demand for nurses. It's one of the big questions as we look towards the future." (Healthcare Dive; report)
 
 
Starting moderate-intensity workouts a few times a week didn't prevent cardiovascular events for sedentary, functionally limited older adults, according to trial research published in JAMA Cardiology. "It is possible that exercise needs to be started earlier in life to reduce heart attacks and strokes, or that even more exercise is needed," researcher Anne Newman, MD, MPH, tells MedPage Today. She emphasizes that despite the findings, recurrent heart attacks are prevented with exercise. (MedPage Today; JAMA Cardiology)
 
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New & Noted   
They come out at night: Hospitals, in an effort to boost patient safety, are beginning to employ nocturnalists--physicians who work in the hospital overnight. Traditionally, residents and nurses have managed patients during this time, with an off-site physician on call. (The Boston Globe)
 

SCOTUS wrap up: Just because King v. Burwell wasn't on the docket doesn't mean the just-completed session of the U.S. Supreme Court was dull for policy wonks. Modern Healthcare offers a recap. (Modern Healthcare)
Gray

Insurers turn to gamification: Insurers are using gamification not only to promote behavioral changes that will improve customer health, but to enhance marketing, sales and customer engagement--and to improve internal productivity. Driving this trend: the shift to outcomes-based medicine, the trend toward consumer-based business models and the growth of Generation Y. (Healthcare Dive)

Multi-media 
The population is getting older, but the number of geriatricians isn't keeping pace, NPR reports. The United States has 130 geriatric fellowship programs, with 383 positions. In 2016, only 192 of them were filled. (NPR)
 
MarketVoices...quotes worth reading
     
"The current workforce is inadequately trained and inadequately prepared to deal with what's been called the silver tsunami--a tidal wave of elderly people--increasing in the population in West Virginia, across America, and across the world really."--Todd Goldberg, MD, FACP, one of only 26 geriatricians in West Virginia, on NPR
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Wednesday, July 13, 2016