Monthly Archives: April 2014

More hospital systems are now offering their own insurance plans

KS97462(300x200)Hospital systems offering their own insurance plans is not a new phenomenon. The Affordable Care Act was simply the catalyst for change. The effort to gain more control over their own destiny starts with reducing unnecessary inpatient treatment and re-admittance rates. But the lines between traditional healthcare services will gradually disappear as they offer their own insurance products.

This February, CentraState Healthcare System in Freehold, NJ announced the creation of their own insurance product. In January these three hospital systems were reported as actively enrolling members in their own health insurance plans:

  • Health and Hospitals Corporation (New York City) has 22,000 members enrolled and expects 40,000 by the end of the year
  • L.A. Care in Los Angeles has enrolled about 8,000 members
  • Henry Ford Health System in Detroit signed up 4,000 members

But clear back in Dec, 2012 the Wall Street Journal reported these healthcare systems were offering their own health insurance plans: Piedmont Healthcare and WellStar Health System in Atlanta; North Shore-LIJ Health System in New York; MedStar Health, in DC and Baltimore; Ford Health System in Detroit; UPMC in Pittsburgh; Sentara Health Care in Norfolk; and Inova Health System in Falls Church.

Yet none of them compare to the member-based systems with their own providers, RN nurses, physical therapists, hospitals, clinics, and insurance products, such as: Group Health Cooperative in Washington and Idaho, with 600,000 members; and Kaiser Permanente with over 7 million members in California, and close to 2 million more in other states.

Our country’s healthcare system will continue to morph as more and more hospitals merge and evolve into full service providers, including offering their own insurance products and anything else they can think of to leverage their assets, increase cash flow and manage their own fate.

Think out of the box? There is no box.

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Why you need to add your quality of care results to your website

iStock_000019600470(138x100)It’s time to put your patient survey results and quality of care information on your website. It’s just a matter of time before it’s out there from one source or another. Might as well be proactive and make it a win!

Transparency in prices of services, level of quality of care, and patient satisfaction are becoming increasingly available online, but often the information is compiled by vendors that don’t use the same definitions of quality and outcomes.

Centers for Medicare & Medicaid Services’ (CMS) Hospital Compare website has information about the quality of care at over 4,000 Medicare certified hospitals across the country. As of April 17, 2014 Hospital Compare includes data from 1,753 inpatient psychiatric facilities (period: October 1, 2012 through March 31, 2013).

Disgruntled patients can be quick to criticize on social media. Medical information websites (ie. Healthgrades and Vitals) and general consumer websites (ie. Consumer Reports and Yelp) already offer physician reviews.

University of Utah Health Care is controlling the message by ensuring their rating information is being prominently displayed when search engines reply to requests about their doctors.

Integris Health, Oklahoma’s largest hospital system, plans to start posting consumer satisfaction scores for 70 of its physicians by the end of April.

The Cleveland Clinic, which already shows doctors how they compare to each other on the ratings, is also considering publishing the data.

Your primary reason for publishing your quality of care information can be transparency with your patients. But it’s also just good business to communicate the huge overall successful practice and offset the few disgruntled messages.

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Washington state’s excellent rankings in U.S. News Best Hospitals 2013-14

Congratulations to the University of Washington Medical Center and Seattle Children’s Hospital for their national ranking in the U.S. News Best Hospitals 2013-14!

U.S. News surveyed nearly 10,000 specialists and sifted through data for approximately 5,000 hospitals to rank the best in 16 adult specialties, from cancer to urology. Death rates, patient safety, and hospital reputation were a few of the factors considered.

U.S. News surveyed 179 pediatric centers to obtain clinical data in 10 children’s specialties and asked 150 pediatric specialists in each specialty where they would send the sickest children. Eighty-seven hospitals ranked in at least one specialty.

Rank Hospitals (Adult Specialities) City Nationally Ranked Specialties High-Performing Specialties
#1 University of WA Medical Center Seattle, WA #7 in Cancer 3
#8 in Diabetes & Endocrinology
#32 in Ear, Nose & Throat
#25 in Geriatrics
#43 in Gynecology
#24 in Nephrology
#27 in Neurology & Neurosurgery
#48 in Pulmonology
#4 in Rehabilitation
#38 in Urology
#2 Evergreen Health Medical Center Kirkland, WA 10
#2 Providence Sacred Heart Medical Center Spokane, WA 10
#4 Harborview Medical Center Seattle, WA 9
#5 Providence Holy Family Hospital Spokane, WA 6
#5 Virginia Mason Medical Center Seattle, WA 6
#7 Stevens Healthcare Edmonds, WA 5
#7 Tacoma General Hospital Tacoma, WA 5
#9 Northwest Hospital and Medical Center Seattle, WA 4
#9 PeaceHealth Southwest Medical Center Vancouver, WA 4
#11 Providence Regional Medical Center Everett, WA 2
#11 Swedish Medical Center-Cherry Hill Seattle, WA 2
#11 Swedish Medical Center-First Hill Seattle, WA 2
#14 MultiCare Good Samaritan Hospital Puyallup, WA 1
#14 Valley Medical Center Renton, WA 1
Rank Hospitals (Children’s Specialties) City Nationally Ranked Specialties
#1 Seattle Children’s Hospital Seattle, WA #6 in Pediatrics: Cancer
#15 in Pediatrics: Cardiology & Heart Surgery
#18 in Pediatrics: Diabetes & Endocrinology
#15 in Pediatrics: Gastroenterology & GI Surgery
#11 in Pediatrics: Neonatology
#4 in Pediatrics: Nephrology
#12 in Pediatrics: Neurology & Neurosurgery
#40 in Pediatrics: Orthopedics
#13 in Pediatrics: Pulmonology
#18 in Pediatrics: Urology

Washingtonians should be proud of our state’s excellent healthcare systems.

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CDC reports leading causes of death, by gender and ethnicity

Center for Disease Control and Prevention (CDC) publishes the leading causes of death by gender and ethnicity. 2010 is the latest data available.

2010 total deaths, by leading cause of death 
Heart disease 597,689
Cancer 574,743
Chronic lower respiratory diseases 138,080
Stroke (cerebrovascular diseases) 129,476
Accidents (unintentional injuries) 120,859
Alzheimer’s disease 83,494
Diabetes 69,071
Nephritis, nephrotic syndrome, and nephrosis 50,476
Influenza and Pneumonia 50,097
Intentional self-harm (suicide) 38,364
All Females, All Ages Percent
1) Heart disease 23.5
2) Cancer 22.1
3) Stroke 6.2
4) Chronic lower respiratory diseases 5.9
5) Alzheimer’s disease 4.7
6) Unintentional injuries 3.6
7) Diabetes 2.7
8) Influenza and pneumonia 2.1
9) Kidney disease 2.1
10) Septicemia 1.5
All Males, All Ages Percent
1) Heart disease 24.9
2) Cancer 24.4
3) Unintentional injuries 6.2
4) Chronic lower respiratory diseases 5.3
5) Stroke 4.2
6) Diabetes 2.9
7) Suicide 2.5
8) Alzheimer’s disease 2.1
9) Kidney disease 2.0
10) Influenza and pneumonia 1.9

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Chest pain test that might prevent unnecessary hospital admissions!


15-20 million people (U.S. and Europe) visit an E.R. with chest pains every year. Now, finally, the elusive test to determine if a patient should be admitted or not may have been found!
My ‘non-heart’ episode occurred a few years ago. I was angry that I had to stay overnight. After various outpatient tests over the next two days, including an angiogram, the doc declared it a panic attack and I said should lose 20 pounds (at 6’6” and 220?). He also said I shouldn’t tell anyone I had a heart problem. It was a very expensive experience.

It looks like high-sensitivity cardiac troponin T (hs-cTnT) may be useful in helping identify chest pain patients in the emergency department who do not need to be admitted to the hospital. 14,636 patients at a Swedish hospital E.R. were tested and the results were very encouraging.

  • 61% (8,907) had test results below 5 ng/l
  • At 30 days: only 0.44% (39) of those patients had an MI
  • None of those patients died
  • The authors calculated a negative predictive value of 99.8%

This is seriously great news. Besides the enormous financial benefits, the emotional benefits alone would make it a worthwhile test. Let’s hope this works.

Read more: New Test Could Identify Low Risk Chest Pain Patients In The Emergency Department (Forbes, 3/30/2014)