Wednesday, September 21, 2016

'Micro-hospitals' offer alternative to urgent care model | FierceHealthcare

A revolution is taking place in the delivery of health care

Bedless hospitals. 

Consumers like the convenience and accessibility of urgent care clinics. But hospitals may have found another model that better meets the needs of patients: the “micro-hospital.”
While the state of Colorado prefers to call them "community hospitals," these licensed facilities offer emergency medical care, inpatient care, surgery, laboratory and radiology services, Michael Slubowski, president of CEO of SCL Health told Hospital & Health Networks. SCL, which is based in Denver, plans to open four locations in neighborhood settings with it's partner Emerus. The facilities are priced higher than urgent care centers, but less than a full-service hospital, and can treat a wider range of conditions because they have inpatient beds, he said. 

Most micro-hospitals operate 24 hours a day, seven days a week and usually have eight to 10 inpatient  beds for observation and short-stays, according to the Advisory Board. "No two micro-hospitals are exactly the same in their design or service mix, but one trend is becoming clear. Most health systems are using them as entry points into markets where demand would not be able to support a full-scale hospital," the Advisory Board noted in a recent report. 

"Micro-hospitals like this are more suited for large urban and suburban metro areas," he told the publication. "This model would probably be too large and complex for a rural market. It definitely is a trend, among many trends occurring in healthcare, to create more accessible, cost-effective access points and alternative delivery models." Driving this experiment is the desire to have highly efficient operations and specialized care giving. Industry is finding bigger is not always better and cost containment may more easily be achieved in smaller facilities.


FTC, DOJ back Teladoc in battle with the Texas Medical Board  
Teladoc is getting support from the Federal Trade Commission and the Department of Justice in its lengthy battle with the Texas Medical Board (TMB) over the latter’s face-to-face appointment requirement before a physician can prescribe medications via telemedicine.

Teladoc says that such a requirement limits and hinders use of telemedicine services within the state.
Last December, TMB was denied a motion to dismiss Teladoc’s 2011 antitrust lawsuit--the board then appealed that decision in January.
In an amici curiae brief, filed in the Fifth Circuit Court, the FTC and DOJ call that appeal an attempt to “evade the substance of federal antitrust law," and add that, basically, the court doesn't have jurisdiction over the appeal. 
The brief goes on to say that if the court does feel it has a right to jurisdiction over the appeal, "it should hold that the state action doctrine does not shield the TMB’s rules from federal antitrust scrutiny because the TMB did not carry its burden to show active supervision."
"There is no evidence that any disinterested state official reviewed the TMB rules at issue to determine whether they promote state regulatory policy rather than TMB doctors’ private interests in excluding telehealth--and its lower prices--from the Texas market," the brief says.
In conclusion, DOJ and FTC say that the appeal should be dismissed "for lack of appellate jurisdiction."
The FTC has shown support for telemedicine before, backing a telemedicine provisionpresented in March as part of legislation working its way through the Alaska Senate.

Remote televideo visits and screening

This ability will decrease non compliance for non ambulatory and/or non compliant patients. It provides a means of communication visually, with a nurse practitioner or medical assistant. Some insurance companies already reimburse for diabetic retinopathy screening at home for non compliant patients. The socioeconomic benefit has already been demonstrated. 1

'Micro-hospitals' offer alternative to urgent care model | FierceHealthcare

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