Health Care Reform Articles - June 26, 2014

Hospital Uses Executive Bonus Money to Give Its Workers a Raise

By Bryce Covert

Parkland Health & Hospital System in Dallas will raise its own minimum wage to $10.25 an hour next month, paying for the increase with money originally devoted to executive bonuses.

The lowest-level employees at the hospital currently make $8.78 an hour, and the increase will give about 230 workers a raise. Those workers were already making more than Texas’s minimum wage, which is the same as the federal $7.25 an hour rate. The move also means that every worker employed by Dallas county, inside and outside the hospital, will make more than $10.25 an hour.

The wage increase will cost the hospital about $350,000 a year. The expense will be covered with money from the upcoming quarter’s bonus pool for the hospital’s 60 vice presidents and top executives. That pool was between $750,000 and $1.2 million in the most recent quarter, and it’s between $3 million and $5 million for the full year.

Dr. Jim Dunn, the hospital’s executive vice president and chief talent officer, told Modern Healthcare that the decision was made in the hopes of improving workers’ morale and to provide a living wage. “We really want, in any way possible, to break down any gaps or anything between the top leaders and those who are closest to our patients,” he said. “We feel like it’s the right thing to do.”

Raising wages can help businesses’ bottom lines, as it can improve efficiency, make it easier to recruit workers, and lower turnover. Losing employees to turnover is particularly expensive, as it can cost as much as 20 percent of a workers’ salary to replace her. Other companies have voluntarily raised their minimum wages lately, including retailer Gap, which boosted its lowest pay to $10 an hour.

Funding a raise with executive compensation also makes sense, given the growing disconnect between pay at the top and the bottom. CEOs’ pay is now 295.9 times the pay for their own workers, far higher than the 87.3-to-one ratio in the early 1990s. Average pay for a chief executive last year was $15.2 million, a 21.7 percent increase over 2010, while workers saw their pay fall by 1.3 percent in the same time. Corporate profits have also hit record highs as workers keep increasing their productivity, but they haven’t shared in that growth. If the minimum wage had kept up with rising productivity, it would be nearly $22 an hour, and if it had simply kept up with inflation since the 1960s it would be over $10 an hour.

http://www.nationofchange.org/print/45415

California probes Obamacare doctor networks at Anthem and Blue Shieldby CHAD TERHUNE

California regulators are investigating whether Anthem Blue Cross and Blue Shield of California have violated state law in connection to patients struggling to find doctors under Obamacare.

Officials at the California Department of Managed Health Care said they are looking into whether consumers were misled by inaccurate provider lists and the difficulty some patients are still having at locating a physician in narrower networks statewide.

"We began our review based on a pattern of complaints that came to our help center regarding provider access," agency spokeswoman Marta Green told The Times. "Our preliminary investigation gave us good cause to believe there are violations of the law."

Green said the department expects to wrap up its investigation within 60 days and then send its findings to the two companies. The insurers will then have 45 days to respond.

The disclosure of a state investigation raises the stakes for one of the biggest problems plaguing the initial rollout of the Affordable Care Act.

Both Anthem and Blue Shield have acknowledged that mistakes have been made with respect to their networks and some confusion was inevitable during such a massive overhaul. The two insurers say they have tried to contact doctors repeatedly to confirm their network status, and they have both added more providers since January.

Last week, the president of Anthem Blue Cross defended the use of limited networks as a way to get lower rates from medical providers and pass along the savings to consumers.

A poll this year by the Kaiser Family Foundation found that 54% of people who are uninsured or buy their own coverage would rather have a health plan that costs less, even with a limited range of providers. However, support fell to 35% when people were told they might not be able to use their regular doctor and hospital.

http://www.latimes.com/business/healthcare/la-fi-state-investigating-obamacare-networks-20140619-story.html

Maine Med, St. Mary’s may face penalties over infections, complications

The two score high in the latest effort by the Centers for Medicare & Medicaid Services to reduce costs and improve care.

BY KELLEY BOUCHARD STAFF WRITER

Two Maine hospitals are facing federal funding penalties because their Medicare patients had some of the nation’s highest rates of infections and complications in the last three years.

Maine Medical Center in Portland and St. Mary’s Regional Medical Center in Lewiston are among 175 hospitals across the country that are most likely to be penalized because their preliminary scores are at least 9 on a scale of 1 to 10, according to an analysis by Kaiser Health News.

Maine Med’s score is 10 and St. Mary’s score is 9.025 under the new Hospital-Acquired Condition Reduction Program, the latest effort by the Centers for Medicare & Medicaid Services to reduce costs and improve care.

Other Maine hospitals have scores nearly as high and are at risk of similar financial penalties.

Relatively few infections and complications can cause high scores, which surprised some hospital administrators.

“We knew what our data was. We didn’t know we’d have some of the highest scores,” said Betsey Shew, St. Mary’s director of performance improvement, in a telephone interview Monday. “These are all things we’re always working on.”

Medicare has identified 761 hospitals in the United States that had high rates of urinary and bloodstream infections among Medicare patients in intensive care units, and high rates of surgery-related complications among all Medicare patients. Sanctioned hospitals could lose as much as $330 million nationwide.

Based on preliminary scores, hospitals scoring 7 or above would be penalized, though that could change by the time final scores are released in September, Kaiser reported. Hospitals that get penalized will lose 1 percent of Medicare reimbursements for a year starting in October.

Maine hospitals scoring higher than 7 are MaineGeneral Medical Center in Augusta (8.375), Inland Hospital in Waterville (8), Mercy Hospital in Portland (8) and Eastern Maine Medical Center in Bangor (7.35).

http://www.pressherald.com/2014/06/23/medicare-may-penalize-maine-med-over-rate-of-complications/

Salesforce Takes Its Cloud Model to Health Care

By STEVE LOHR

 JUNE 26, 2014 2:30 AM

Salesforce, the cloud pioneer known for customer management software, is going into health care.

In an announcement on Thursday, Salesforce and Philips, the Dutch electronics maker, are jointly announcing what they call an “open cloud-based, health care platform.” That means, they say, health care software developers, producers of medical devices, health care providers and insurance companies will be able to link to the Salesforce health cloud.

The foray into health care is a significant step by Salesforce into a specific industry, as opposed to supplying offerings that span industries, like customer relationship management software as a service. It is part of the growth strategy at Salesforce, and is being led by Vivek Kundra, a former chief information officer of the federal government in the Obama administration, who joined Salesforce two years ago. His title is executive vice president of industries.

There have been other high-profile cloud entries in health care, notably Google Health, a personal health records initiative, which opened in 2008 and was shut in 2011. But Salesforce is an enterprise cloud company and it is taking a very different approach. Its initial move, with Philips, is to focus on a specific target in health care — using technology to manage chronic ailments.

http://bits.blogs.nytimes.com/2014/06/26/salesforce-takes-its-cloud-model-to-health-care/?_php=true&_type=blogs&emc=edit_tnt_20140626&nlid=1311158&tntemail0=y&_r=0

Longer Heart Monitoring Backed for Stroke Patients

By ANAHAD O'CONNOR

 JUNE 25, 2014 5:06 PM

More than a half-million Americans every year have an ischemic stroke, the most common form, which disrupts blood flow to the brain. And at least a quarter of these cases have no apparent underlying cause.

Now two major studies suggest that many of these strokes of unknown origin — up to a third — may stem from atrial fibrillation, a common irregularity of the heartbeat that often goes unrecognized.

The findings are likely to encourage doctors to look more aggressively for signs of atrial fibrillation in patients who suffer strokes of unknown cause.

After such strokes, doctors usually prescribe a mild blood thinner such as low-dose aspirin. But aspirin alone may not be enough to prevent additional strokes in patients with underlying atrial fibrillation. These patients generally require more powerful anticoagulant medications to prevent clotting that can lead to additional strokes.

Stroke patients are generally screened with electrocardiographic monitoring for 24 hours to rule out atrial fibrillation. But the new studies, published Wednesday in The New England Journal of Medicine, suggest that some patients may need their hearts monitored much longer to detect abnormal rhythms.

http://well.blogs.nytimes.com/2014/06/25/longer-heart-monitoring-backed-for-stroke-patients/?_php=true&_type=blogs&hpw&action=click&pgtype=Homepage&version=HpHedThumbWell&module=well-region&region=bottom-well&WT.nav=bottom-well&_r=0

Doctors have it pretty good

BY CATHERINE RAMPELL June 26 at 8:00 AM 

I’ve seen a bunch of whiny op-eds and essays from doctors recently, complaining that it’s oh-so-terrible to be a physician these days and that every M.D. wants out.

I’ve seen some good rebuttals to these complaints, including this one from Aaron Carroll. I’ll add to his takedown the chart below, from PayScale:

PayScale collects salary data, but it also surveys workers about whether their work makes the world a better place (a measure of how “meaningful” the job is). Few occupations rank as both well-paid and highly meaningful. If you mouse over the chart, you’ll see that people in those few careers that are both financially and psychically rewarding tend to be some flavor of physician, including surgeons, anesthesiologists and psychiatrists.

There are, of course, plenty of careers that are lucrative but not terribly meaningful. Lawyers fall into this category: Only 40 percent of lawyers say their work makes the world a better place, despite a median salary of $89,900.

Among the occupations with the lowest pay and highest perceived meaningfulness: clergy (97 percent find it meaningful, and median pay is $45,400). Alas, there are no data specifically looking at that other narrow group of professionals doing God’s work: investment bankers. Probably the closest category is financial analysts, of whom only 40 percent find meaning in their work; their median pay is $64,900.

http://www.washingtonpost.com/news/rampage/wp/2014/06/26/doctors-have-it-pretty-good/?hpid=z3

LePage includes Social Security among ‘welfare’ programs

He also puts Medicare and jobless aid in that category while arguing that Maine’s personal-income ranking would be better if such federal payments were excluded.

BY ERIC RUSSELL 

Gov. Paul LePage has long cast a wide net for programs that he says fit the definition of welfare. On Wednesday, in a media release written as an alternative take on new personal-income data from the federal Bureau of Economic Analysis, he lumped Social Security and Medicare into that definition.

The federal data released Tuesday put Maine’s personal-income growth at 0.5 percent in the first three months of 2014, which ranked 39th nationally, last in New England and well below the national rate of 0.8 percent. One of the biggest reasons cited for the low ranking was Maine’s refusal to expand Medicaid under the Affordable Care Act.

LePage, however, said in the media release that Maine’s net personal earnings increased by 0.8 percent, in line with other New England states and slightly higher than the national rate of net personal earnings, 0.7 percent.

The governor arrived at his number by excluding what the federal bureau calls “personal current transfer receipts” and dividends, interest and rental income.

Personal current transfer receipts include payments from the federal government to states for Social Security, Medicare, unemployment benefits and Medicaid expansion. Maine is one of only four states (Indiana, Tennessee and Wyoming are the others) where transfer receipts declined in the first quarter of this year. Nationally, transfer receipts grew by $41.1 billion.

LePage said he chose not to follow the federal bureau’s definition because it conceals welfare benefits.

“It doesn’t matter what liberals call these payments, it is welfare, pure and simple,” LePage said in the statement. “Liberals from the White House all the way down to Democratic leadership in Augusta believe that redistribution of wealth – taking money from hard-working taxpayers and giving it to a growing number of welfare recipients – is personal income. It’s not. It’s just more welfare expansion. Democrats can obfuscate the numbers any way they want. The fact is that we have created thousands of jobs, more Mainers are working, and their income is going up.”

The LePage administration’s version of the Bureau of Economic Analysis report supports the narrative that Maine’s ability to rebound from the recession will be dictated by private-sector growth and the addition of jobs.

However, while personal current transfer receipts include programs that are commonly considered welfare, such as food stamps and Temporary Assistance for Needy Families, his inclusion of Social Security and Medicare – entitlements for seniors who have paid into the programs over many years – prompted quick criticism.

U.S. Rep. Mike Michaud, LePage’s Democratic opponent in this year’s race for governor, called LePage’s comments “an insult to Maine seniors.”

http://www.pressherald.com/2014/06/25/gov-lepage-views-social-security-medicare-as-welfare/