Saturday, April 1, 2017

AAMC increases projection of physician shortage up to 100K | Healthcare Dive


AAMC increases projection of physician shortage up to 100K



  • The Association of American Medical Colleges' (AAMC) new estimates of the country's growing physician shortage shows it will range from 34,600 to 88,000 doctors by 2025 and from 40,800 to 104,900 by 2030.
  • The AAMC's estimates in 2016 showed a projected shortage ranging between 61,700 and 94,700 by 2025.
  • The number of new physicians is "not keeping pace with the healthcare demands of a growing and aging population," according to the study conducted by a division of the global information company IHS Markit. 
  • The growing awareness of the physician shortage has helped many in the healthcare industry develop new strategies to better help the dwindling amount of medical professionals meet the increased demand for care services, which is partly due to a larger portion of the population having health insurance coverage. 
    These range from allowing nurse practitioners to practice independently to easing at least some of doctors' administrative burdens. The number of administrative tasks that physicians are required to do on a daily basis, including imputing health data into electronic health record systems, has been continuously cited as the main cause of burnout by physicians who have responded to surveys like the one conducted by Medscape.
    A medical student and a radiation oncology specialist wrote a shared byline published by Stat on Tuesday that argues addressing the concerns medical professionals have with debt and their financial stress will help prevent burnout and depression. They offered "six strategic solutions" to focus on, such as limiting tuition increases and increasing federal funding.
    However, the shortage is not just among physicians but also among nurses. A report released earlier this month shows nearly half of surveyed nurses (49.8%) are considering leaving the profession, which will in turn exacerbate the problem at a time when the country's aging population will continue to increase the demand for care. 
    “By 2030, the U.S. population of Americans aged 65 and older will grow by 55%, which makes the projected shortage especially troubling,” AAMC President and CEO Darrell G. Kirch said in a statement. “As patients get older, they need two to three times as many services, mostly in specialty care, which is where the shortages are particularly severe.”
    The AAMC once again recommended a multi pronged solution to the problem. This includes "expanding medical school class size, innovating in care delivery and team-based care, making better use of technology, and increasing federal support for an additional 3,000 new residency positions per year over the next five years."
  • Physician burnout: What can be done 

AAMC increases projection of physician shortage up to 100K | Healthcare Dive

AMR teams up with Lyft for nonemergency patient rides | Healthcare Dive

AMR teams up with Lyft for nonemergency patient rides

  • American Medical Response has partnered with rideshare firm Lyft to provide nonemergency transportation for patients in 42 states where the ambulance company operates.
  • Hospitals and caregivers can arrange for Lyft rides via AMR’s One Call phone or online portal services.
  • While millions have gained health coverage under the Affordable Care Act, many still face barriers to care because of transportation. Community hospitals average 62 no-shows a day, at an annual cost of $3 million, according to a study by BMC Health Services Research. For teaching hospitals, no-show and late arrival rates average 25% and 31%, respectively.
    Patients with multiple chronic conditions, the poor and the elderly are especially likely to need assistance with transportation. According to the Centers for Disease Control and Prevention, lack of access to transportation, along with finances and scarcity of specialists, particularly in rural areas, partially accounts for delayed care and unmet medical needs.
    The efforts by ridesharing companies are good news not only for hospitals, but for the federal government as well, which spends an estimated $2.7 billion a year on nonemergency medical transportation. That figure is expected to grow under Medicaid expansion. To boost ACA enrollment for 2017, HHS partnered with Lyft to provide discounted rides during Open Enrollment events last fall.
    Lyft also provides nonemergency rides to New York City Medicaid patients via the National Medtrans Network and through a partnership with Carelinx.
  • Recent advances and integration of mobile applications such as Lyft and Uber will increase availability and accessibility for patients needing transportation.  It remains to be seen if payors and medicare will accept this mode for reimbursement without further qualifications.


Will Lyft drivers be qualified in CPR, or to assist chronically impaired riders?




AMR teams up with Lyft for nonemergency patient rides | Healthcare Dive

Future Pandemics INFOGRAPHIC


As predictions go, pandemics are one of the scariest. Inevitable and with a huge unknown quantity, pandemics are something that even the World Health Organisation are urging people not to ignore, with the frightening forecast that there will be, “sometime in the future, an event that will kill…somewhere between 80 and 90 million people.”
There are lots of hypothetical situations and theories about where a virus will come from, what it will do and the devastation it will have. In fact, there are already scientists working on vaccines that the human population may need in the event of a global outbreak. There’s actually a World Health Organisation Global Vaccine Plan!
In this infographic, we take a look at some of the possible pandemics of the future and how you can best prepare yourself against the spread of germs.




Thursday, March 30, 2017

Catholic Health Initiatives suffers $483 million in operating losses in 2016 | Healthcare Dive

  • Catholic Health Initiatives is including its $483 million operating loss in its merger plans with Dignity Health. 
  • CHI says the losses were due to “lower patient volumes, higher labor costs, increased pharmacy prices, and reduced reimbursement in Medicare and Medicaid,” according to a Modern Healthcare report.

An aggressive growth strategy was driving losses at CHI.  Fueled by anxiety and market share health systems merged in order to capture market and become more efficient.  The results were opposite.  

Electronic health records increase operating costs and decreased margins significantly.

Catholic Health Initiatives is not alone with the backlash on expenses, investment, and reduced in patient volume

Revenues for the nonprofit health system with 103 hospitals in 17 states increased 7.4% from $14.8 billion in 2015 to $15.9 billion in 2016. However, expenses rose 10.2% over the same time to $16.1 billion from $14.6 billion in the previous year. Losses occurred even though the struggling health system has laid off workers, sold off $600 million in real estate, and stepped back from its failed health plan.


Catholic Health Initiatives suffers $483 million in operating losses in 2016 | Healthcare Dive

Our Health California


Provider reimbursement is only a small part of what Medi-Cal pays.  It pays for indigent care, skilled nursing facilities, home health services. Providers receive only a small portion of the total budget for medi-cal patients.

The Affordable Care Act has made insurance available to many who live at or near the poverty line. However it does not assure access to providers who are the entry level into the system.

Contrary to prediction patient flows the emergency rooms have become even bigger since few providers accept medi-cal.  Medi-Cal's rates do not cover overhead for providers, and they are often seen at a loss unfortunately.

Insurance and access are two sides of the coin in regard to health care.

Click on the link to learn more about Medi-Cal and the Our Health California Community.  Join and get involved.







Our Health California

Cleveland Clinic suffers 71% operating income drop | Healthcare Dive

Cleveland Clinic suffers 71% operating income drop | Healthcare Dive

Monday, March 27, 2017

Here's the bipartisan path forward on health care: Andy Slavitt

This is the way to bringing a sensible and workable plan with bipartisan support.  No matter what the plan patients and providers need to get behind the plan . There is not perfect plan, and the perfect plan is the enemy of the good.

Trumpcare failure is an opportunity to end the divisiveness that hampered the Obamacare era.

The failure of Trumpcare last week can be seen as a rejection of policies that Americans judged would move the country backwards. But it also presents the opportunity to end the divisiveness that hampered the Obamacare era and move forward in a bipartisan direction that focuses not on destructive rhetoric, but squarely on reducing premiums and expanding access for all Americans.

The policies and the politics of Trumpcare were extreme and favored by only 17% of voters as compared with the Affordable Care Act (ACA), which enjoys support from 50%. The central plank of the bill cut care for the neediest children, elderly and disabled to pay for a large tax cut for the wealthy. The process, likewise, began with the most partisan approach possible. Republicans skirted Democratic input, avoided public hearings, and ended up rushing a bill without enough time for impartial evaluation.
The president has a chance now to turn this around. Last week, he invited Ezekiel Emanuel, a Democratic policy expert who helped craft the ACA, to the White House. Emanuel and I had dinner after his visit to the Oval Office, and he reviewed the commonsense ideas he shared with the president that were neither Democratic- nor Republican-leaning. The president had already chosen to head down a partisan path, but by inviting Emanuel, he might have signaled a potential interest in a bipartisan approach should that one fail.
Trump has an immediate opportunity to help Americans reduce their costs by choosing to enforce and properly steward what House Speaker Paul Ryan rightly called the "law of the land." The administration has the power to impact the cost of insurance by 25% to 30% with two simple decisions, according to a conversation I had with Mario Molina, CEO of Molina Health, one of the largest insurers in the exchange.

First, the administration, with support from Congress, should commit to permanently funding payments that reduce the size of deductibles for lower-income Americans (called cost-sharing reductions). Republicans need to drop a lawsuit they filed to stop these payments, or Trump needs to say they are going to continue. Second, the administration should enforce the individual insurance mandate until a different approach can be agreed upon. Those two actions will reduce costs for millions and need to be done now before insurers submit initial premiums for next year, or inaction will drive up premiums. Americans should watch this intently.
A third step would be to grant states the flexibility to increase competition and reduce costs. Non-partisan analysts such as Standard & Poor's confirm that the online exchanges that sell ACA insurance policies are stable, but in some states the cost of insurance is out of reach for those who earn too much to receive tax credits.
The administration has tools to do this, including a section of the ACA designed to allow states to pursue different approaches, including those more suited to their political philosophy, so long as they continue to meet the basic aims of covering more people with high-quality coverage. Alaska was the first to use this process last year by creating a statewide reinsurance pool. Such pools protect insurers against losses in high-cost cases, and the savings are passed along to consumers. In Alaska, the result was a dramatic reduction in premiums.

Here's the bipartisan path forward on health care: Andy Slavitt