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Industry News
Critics--especially those representing hospitals--have warned that CMS' readmission penalties unfairly punish hospitals caring for large numbers of patients of low socioeconomic status because those patients have an unavoidably higher risk of readmission. But new research published in Health Affairs suggests otherwise. "Our results demonstrate that hospitals caring for large proportions of patients of low socioeconomic status have readmission rates similar to those of other hospitals," the researchers write. "Moreover, our results suggest that adding patient-level socioeconomic status risk adjustment would not change hospital results in a meaningful way." (Health Affairs)


Increasingly, small and midsized companies are opting to pay their employees' medical claims directly. The percentage of private-sector establishments offering health plans, at least one of which is self-insured, increased from 28.5 percent in 1996 to 39 percent in 2015 (a 36.8 percent increase). Between 2013 and 2015, the proportion of midsized companies (100-499 employees) which were self-insured increased 19 percent, to 30.1 percent, according to analysis from the Employee Benefit Research Institute. This was not unexpected, Kaiser Health News reports, noting many predicted the Affordable Care Act would push employers in this direction. (Kaiser Health News; EBRI)
 
Karen DeSalvo stepped down from her role as national coordinator for health IT Friday, replaced by Principal Deputy National Coordinator Vindell Washington. As news spread, industry leaders issued statements praising her. For example, College of Healthcare Information Management Executives President and CEO Russell Branzell issued a statement calling DeSalvo "instrumental in advancing adoption of health information technology," saying her efforts helped "push the entire industry toward higher-value and better care." DeSalvo will remain at the Department of Health and Human Services. (FierceHealthcare)
 
 
Innovation & Transformation  
Microhospitals continue to gain traction. Now mostly in Texas, Colorado, Nevada and Arizona, they are fully licensed hospitals with inpatient beds and, often, surgical suites, labor and delivery rooms and primary care specialist services; they help fill a void in smaller communities without large hospitals. Microhospitals offer an opportunity to "really ramp up outpatient services," Priya Bathija, senior associate director for policy development at the American Hospital Association, said. (Kaiser Health News)

Study: Integrated behavioral health may improve ACO efficiency
The integration of behavioral health services into primary care may help ACOs improve their efficiency, according to research published in Health Affairs. UCLA researchers created Behavioral Health Associates (BHA), which operates as part of UCLA Health. "After receiving BHA treatment, patients had a 13 percent reduction in emergency department use. Our efforts can serve as a model for other ACOs seeking to integrate behavioral health care into routine practice." (Healthcare Divestudy)
 
Consumers & Providers
In-office testing is lucrative for physicians using the latest tools--and costly to Medicare--according to a Wall Street Journal analysis of Medicare billing data. Four of the top 10 fastest-growing Medicare services from 2012 to 2014 involved new devices. Medicare's tab for those four services rose by $123.5 million from 2012 to 2014, to $135 million. In each case, a handful of doctors---fewer than 10 percent--accounted for more than half the rise in spending for each service. (Wall Street Journal)
 
 
Many elderly patients deteriorate mentally or physically in the hospital, even if they recover from the original illness. In fact, research shows that a third of patients over 70 and more than half over 85 leave the hospital more disabled than when they arrived, according to US News and World Report and Kaiser Health News. As a result, many seniors are unable to care for themselves after discharge. Compounding this is that hospitals face few consequences if elderly patients become more impaired or less functional during their stays. (US News and World Report)
 
Does physician kindness really make a difference in outcomes? Dr. Michael Stein of Boston University probes the question in a Washington Post opinion piece. He finds the empirical evidence supporting the benefits of kindness weak. "But kindness at every visit is never too much to ask. [...] There is no burden added to the work of doctors if we expect them to be kind. Sometimes doctors don't need to wait for evidence to do what is right." (Washington Post)
 
 
Millions of Medicare beneficiaries require home-based medical care. However, the United States faces a shortage of providers who care for homebound patients, and most homebound people live more than 30 miles from a high-volume provider, according to research published in Health Affairs. "Home-based medical care has the potential to address health care challenges that result from an aging population with an increasing burden of complex chronic diseases. However, the shortage and maldistribution of the workforce for home-based medical care constitute a continuing challenge to realizing the potential of that care," researchers conclude. (Health Affairs)
 
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New & Noted   
Soon, 911 from cell phones: Google announced that a new Android feature would send location information automatically when someone calls emergency services. It uses the same location technologies available to Wi-Fi, GPS and cell towers, to produce a more reliable emergency location both indoors and outdoors, according to Google. (MedPage Today; Google Europe blog)
 

Here comes the judge: In December, a federal judge is slated to hear the government's antitrust challenge against the Aetna/Humana proposed merger. A decision is expected in mid-January, Modern Healthcare reports. (Modern Healthcare)
Gray

Health benefits costs steady for big employers: Overall health care benefit cost increases at large U.S. employers are expected to hold steady at 6 percent in 2017, according to an annual survey by the National Business Group on Health. (NBGH)


Funding Zika means cuts elsewhere: Health and Human Services Secretary Sylvia Mathews Burwell last week announced plans to move $81 million away from biomedical research and other health programs to continue Zika vaccine development funding, which would run out by the end of the month otherwise. Congress failed to allocate funding before going on break. (Kaiser Health News roundup)

Multi-media 
Eight people who spent years paralyzed from spinal cord injuries have regained partial sensation and muscle control after training with brain-controlled robotics, according to a Duke University study published last week in Scientific Reports. The patients used brain-machine interfaces, including a virtual reality system that used their own brain activity to simulate full control of their legs. Videos accompanying the study illustrate their progress.
  
MarketVoices...quotes worth reading
     
"The older you are, the worse the hospital is for you. A lot of the stuff we do in medicine does more harm than good. And sometimes with the care of older people, less is more."--Dr. Ken Covinsky, a physician and researcher at the UC San Francisco division of geriatrics, quoted in US News and World Report.
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Wednesday, August 17, 2016











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