As the new St. Joseph’s Hospital in Highland, Ill., prepared to open in August, its chief executive exulted, “You feel like you could be at the Marriott.”
In the $63 million community hospital, patients all enjoy private rooms, with couches, flat-screen TVs and views of nature. Its lobby features stone fireplaces and a waterfall.
Some hospitals in the United States, like Cedars-Sinai in Los Angeles, have long been associated with deluxe accommodations, and others have always had suites for V.I.P.’s. But today even many smaller hospitals often offer general amenities, like room service and nail salons, more often associated with hotels than health care.
In the current boom of hospital construction, private rooms have become the norm. And some health economists worry that the luxury surroundings are adding unneeded costs to the
nation’s $2.7 trillion health care bill.
There are some medical arguments for the trend — private rooms, for example, could lower infection rates and allow patients more rest as they heal. But the main reason for the largess is marketing.
In a highly competitive field, patients — sometimes now referred to as “guests” — appreciate amenities. The tactic works. “We found that patient demand correlates much better to amenities than quality of care,” said
Dr. John Romley, a research professor at the Leonard D. Schaeffer Center for Health Policy and Economics of the University of Southern California, who has studied the trend. That means that hospitals can improve their bottom line and their reputation by focusing more on hospitality than health care — offering organic food by a celebrity chef rather than lowering medication errors, for example.
As a result, American hospitals are looking less and less like their more utilitarian counterparts in Europe, where the average hospital charges per day are often
less than a quarter of those in the United States, according to the International Federation of Health Plans.
The Henry Ford health system in Michigan caused a stir after it hired a hotel industry executive,
Gerard van Grinsven of the Ritz-Carlton Group, in 2006 to run its new hospital, Henry Ford West Bloomfield. He had opened 20 hotels and his “focus on people and service excellence” has helped the hospital thrive in a competitive market, said Nancy M. Schlichting, Henry Ford’s chief executive, who decided to hire him. The idea was to take care of patients’ needs, she said, clinical and otherwise.
While no one is getting nostalgic for traditional hospital food, open wards or revealing gowns, some worry that hospitals are going too far with the creature comforts. They are particularly concerned since most hospitals are nonprofit, so construction — directly or indirectly — is subsidized with public money.
With the prospect on the horizon of the Affordable Care Act’s lowering reimbursement, and interest rates rising, the hospital construction boom appears to be slowing. And, in choosing a hospital, patients should probably think beyond room service anyway. Many years ago, when I was a doctor-in-training, I was assigned to work on a hospital floor with V.I.P. rooms. Though the views were spectacular, the cardiac arrest team could not get there as quickly as it could to the regular wards. We called it “a hotel near a major teaching hospital.”
Can you tell the difference between a hotel and a hospital? Take the quiz.
Healthcare reform heats up drugstore battle
CVS, Rite Aid and Walgreens aim to play a bigger role in healthcare as the reform law is due to expand access to medical services for millions of people.
Michael Hiltzik
8:19 PM PDT, September 20, 2013
Obamacare is driving a transformation in the way pharmacies do business, so get ready.
The healthcare reform law will expand access to medical services for millions of people. That's going to place added pressure on primary healthcare providers and challenge the system to meet the new demand.
So it may not be surprising that the nation's three major drugstore chains are gearing up to play a bigger role. They're placing retail health clinics in their stores, pushing their pharmacists to be more proactive with their prescription customers, and even entering partnerships with big medical groups.
One other thing: They're battling for market share. If there's a vacant street corner in your neighborhood where a gas station lost its lease, don't be surprised if it sprouts a new CVS, Rite Aid or Walgreens within a couple of months.
Those three national pharmacy chains have been jostling with one another over prime locations for years. Recently the competition has stepped up.
"Retail competition is coming to healthcare, and pharmacies are on the leading edge," says Adam J. Fein, a healthcare industry consultant who runs the
Drug Channels blog.
The chains are aiming to become your one-stop shop for all your prescriptions. In California and most other states they already can vaccinate you against common diseases like flu. They're adding other services of the type that physicians traditionally claim as their monopoly, such as managing diabetes and other chronic diseases.
Most dramatically, Walgreens announced in January that it had formed Accountable Care Organizations in partnership with three big medical groups in New Jersey, Texas and Florida. These organizations, which are encouraged under Obamacare, replace Medicare's traditional fee-for-service model with pay-for-performance: When they deliver better patient results at less cost, they get to keep some of the savings.
Pharmacies charge nominal fees for routine vaccinations to cover the cost of the medication, but by law they're not allowed to charge for healthcare advice. The industry wants to change that. "To make that role viable, we'd like to get the pharmacists compensated," says Harry Leider, Walgreens' chief medical officer.
That's a major thrust of the industry's lobbying at the federal and state levels and it's got powerful support in Washington, notably in the
surgeon general's office. In a 2011 report, the surgeon general's office of the chief pharmacist said pharmacies were well-positioned to help fill some of the gaps as demand for healthcare grows.
Who opposes this trend? That's right, your local medical association. The physicians lobby contends that expanding the pharmacists' role would fragment patients' care, fomenting conflicts between two different levels of provider and possibly resulting in contradictory services.
But on balance, expansion of the retail pharmacist's role is likely to be positive for consumers. Consolidating a patient's prescriptions at one location helps pharmacists monitor refills and stay on the lookout for harmful interactions. This is good because patients' failure to comply with their doctors' orders is a big cause of poor medical outcomes, as is multiple doctors prescribing at cross-purposes for a single patient. And anything that makes vaccinations and other preventive measures more accessible is a plus.
http://www.latimes.com/business/la-fi-hiltzik-20130922,0,5782171,print.column
People in need of health insurance worry more about the costs of the options starting Oct. 1 than the government mandate to sign up.
Buy health insurance or pay a penalty.
That's the incentive -- or what critics would call a threat -- that Congress built into the Affordable Care Act in 2010 to encourage all Americans to buy coverage.
Attacked by opponents as an unwanted intrusion into free choice, the individual mandate issue went all the way to the U.S. Supreme Court, which decided in 2012 that the requirement was legal.
But for all of the fierce political and ideological battles over the requirement, experts working on the front lines to implement the law on Oct. 1 say the penalty lacks muscle. And they say consumers don't seem to be concerned about being forced to purchase insurance.
"When we have a chance to explain it to people, it's been very positive," said Libby Cummings, an outreach specialist at Portland Community Health Center. "People are excited about it and want to have health insurance. People see it as an opportunity to get coverage that was never open to them before."
Cummings' job includes identifying people eligible to buy insurance and helping them choose a plan on Maine's new health exchange, which begins accepting enrollments Oct. 1. The insurance options on the exchange are open to Mainers who don't have insurance and are now self-insured.
Consumers must choose a plan by March 31. Cummings said the key issue people are concerned about is whether they can afford it, not whether they are forced to purchase insurance.
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