After years of delay in the federal bureaucracy, a national data base for background checks on licensed medical professionals from all 50 states will be available for hospitals to examine on March 1, the Health Resources and Services Administration announced today.
Hospitals can already access the National Practitioner Data Base, which contains records on physicians and dentists, such as license or privilege suspensions, and malpractice payments that are reported by state and federal oversight agencies and health plans.
Now, restricted access data stored in the separate Healthcare Integrity Protection Data Bank, which records adverse licensure actions for all medical professionals, including nurses, technicians, chiropractors, and podiatrists, will be added to the NPDB for hospitals to examine.
HIPDB has been available only to health plans, state and federal oversight agencies, and individual medical professionals for self-queries.
"This means there will be a wider variety of information available to hospitals on healthcare professionals whose information wasn't available before," says HRSA spokesperson David Bowman. "They will have access to a broad array of information that will assist them in making their due diligence when they are in the hiring process."
The data will be collected by sources that include malpractice payers, state licensing and certification boards, hospitals, peer review organizations, accreditation organizations, and professional societies that conduct peer review.
It will be available for hospitals, healthcare professional societies that conduct peer review, state medical and dental boards, law enforcement, and for self-queries from medical professionals.
Businesses like temporary healthcare staffing companies, however, will usually not be allowed access to the data.
Hospitals must prepare for the retirement of the aging Baby Boomer workforce, improve efficiency and staff satisfaction to retain existing workers, and make the healthcare industry an attractive job choice for a new generation of workers as the labor market tightens in the coming decade, recommends a new long-range report released this week by the American Hospital Association.
"For more than 30 years, the U.S. workforce has been dominated by the growing presence of the 'baby boomers' and their characteristics. The workforce has grown rela¬tively rapidly because of the large number of boomers and the employment of large numbers of women," stated the report Workforce 2015: Strategy Trumps Shortage, written by the AHA's Long-Range Policy Committee.
"The boomers are now beginning to approach retirement, and there is little room for a substantial growth in the percentage of working women. Thus, hospitals and health systems face a workforce environment characterized by limited growth in the number of workers. Large numbers of employers throughout the economy will also need those workers," the report stated.
AHA Chairman Richard P. de Filiippi, a trustee at Cambridge (MA) Health Alliance, and the chair of the Long-Range Policy Committee in 2009, said the report "focused on changing environments" and the changes in how healthcare will be delivered and demographics and cultural attitudes of the future workforce.
"It will be critical for us to work with these new realities in devising strategies for best utilizing scarce human resources—strategies that include using new technologies, accommodating the blend of work cultures and habits of multiple generations and retaining existing employees well into traditional retirement years," he said.
The report's recommendations included a call for hospitals to:
1. Redesign work processes and introduce new technologies to increase efficiency and employee satisfaction; retain existing workers, including those able to retire; and attract the new generation of workers.
2.Help staff develop the skills necessary to work effectively in teams.
3. Prepare to provide care with a smaller workforce, and increase the involvement of patients and families in the care process, including home- and community-based services.
4. Continuously assess whether changes in payment, scope of practice regulations, and work practices are reinforcing the current occupational patterns or encouraging new caregiver occupations and task allocations.
5. Work with colleges and universities to help them rapidly transform their traditional degree programs to meet the requirements of new work models, and to provide the critical thinking skills necessary to work with the increasingly sophisticated technology.
6. Work with employees approaching retirement age to identify attractive options regarding roles, schedules, and benefits for continuing to work full- or part-time.
7. Replace traditional HR policies, which were applied uniformly to all workers with policies and programs that include flexibility and choices, to accommodate the preferences of the multiple workforce generations.
8. Orient young workers to the expectation of patients and staff from the traditional, baby boomer, and Y generations as well as to differences in expectation by gender, race, and ethnicity. This should include more substantial orientation and mentoring programs as well as clear policies and guidelines for access to and use of internet sites, including social networking sites.
Carilion Labs, a for-profit affiliate of Roanoke, VA-based Carilion Clinics, will merge with Spectrum Laboratory Network to form one of the nation's largest regional hospital lab companies, the two companies announced today.
The merger, which is expected to close by the end of February, will create a new company serving 37 hospitals and 14,000 physicians in eight states, with more than 2,600 employees and annual revenues above $300 million, the two companies said in a joint media release.
David Weavil, a laboratory industry veteran executive, will be CEO of the new company—the name of which has yet to be announced. The new company will be headquartered in Roanoke, and Greensboro, NC, where Spectrum is located.
Carilion Clinic will own 33% of the new company. Carilion President/CEO Edward G. Murphy, MD, and two other Carilion appointees will sit on the board.
"A new company that combines the strengths and shared values of Carilion and Spectrum with a focus on hospital laboratory services will significantly improve services to our customers and their patients, and provides a strong platform for further expansion within the region and across the nation," Murphy said.
Novant Health, a minority owner in Carilion Labs, will remain an equity owner in the new company and will hold a seat on the board.
The pending merger, subject to FTC approval, follows the recent purchase of Spectrum by Welsh, Carson, Anderson and Stowe, a private equity firm.
Florida Gov. Charlie Crist has immediately suspended state licensure requirements for traveling U.S. nurses, who have valid licenses in their home states or territories, and who want to work in Florida. The suspension is slated for 90 days.
The governor said in an executive order this week that the move was needed to cover a temporary nursing shortage that was created because many Florida nurses are in Haiti to help the recovery effort from the Jan. 12 earthquake.
Willa Fuller, executive director Florida Nurses Association, says her organization supports the governor's order.
"From my understanding, some of the nurses down in south Florida are Haitian and wish to go home to help, but that would affect the staffing at their hospitals," Fuller says. "This would allow nurses at other states who have licenses that are pretty much equal to ours could come here and work and cover them in the hospital so those nurses could take short trips to Haiti. We certainly support anyone who wants to help."
The American College of Radiology, The Joint Commission, and the Intersocietal Accreditation Commission have been designated as accrediting organizations for medical imaging facilities, CMS said in a Federal Registry notification published today.
The designation gives the three organizations the authority to accredit providers of advanced medical imaging mandated by the Medicare Improvements for Patients and Providers Act of 2008, which requires that providers of CT, MRI, PET, and nuclear medicine exams, who bill Medicare for the technical component under the fee schedule, be accredited by Jan. 1, 2012.
"While advanced diagnostic imaging procedures can be useful in identifying health problems that might otherwise require surgery, the rapid growth in their use raises important questions of quality and safety," said CMS' Barry Straube, MD, CMO, and director of the Office of Standards and Quality in a media release. "The three organizations that will be accrediting suppliers have the expertise and authority to set a standard of excellence industry-wide."
The three accrediting organizations had to demonstrate that they were experienced in advanced diagnostic imaging, and that their accreditation requirements met or exceeded the standards set out in MIPPA, including requirements for:
Qualifications of non-physicians performing the imaging
Qualifications and responsibilities or medical directors and supervising physicians
Procedures to ensure the safety of the individuals furnishing the imaging procedure and of the patients
Procedures to ensure the reliability, clarity, and accuracy of the technical quality of the diagnostic images
Procedures to assist the patient to obtain his/her imaging records on request
Procedures to notify CMS of changes to the imaging modalities subsequent to the accrediting organization's decision
The accrediting organizations were also required to develop a plan for reducing the burden and cost of accreditation to small and rural suppliers, and to provide CMS with detailed information about their survey processes.
MIPPA specifically excludes from the accreditation requirements: X-rays, ultrasound, and fluoroscopy procedures. The law also excludes diagnostic and screening mammography, which are regulated by the FDA under the Mammography Quality Standards Act.
CMS plans a provider education outreach program to ensure that suppliers understand the requirements and are able to comply with them prior to the Jan. 1, 2012, deadline.
Two former hospital executives in Los Angeles have agreed to pay the State of California and the federal government $10 million to settle civil claims that they recruited and treated homeless people for unnecessary medical procedures and then billed the government, according to the Department of Justice.
Robert Bourseau and Rudra Sabaratnam, MD, the former owners of City of Angels Medical Center, have already pleaded guilty to separate criminal Anti-Kickback Statute charges stemming from the case, in which City of Angels reportedly paid "recruiters" employed at homeless shelters in the skid row area to deliver their homeless clients by ambulance to the hospital for unneeded medical treatment.
City of Angels billed Medicare and Medi-Cal for treatment allegedly rendered to the homeless patients, much of which was not medically necessary, said the Department of Justice. The two men are awaiting sentencing.
One other former senior executive of City of Angels and two of the medical center's recruiters have also pleaded guilty to similar charges in connection with the alleged scheme.
"Performing unnecessary medical procedures just to take money from taxpayers' pockets is bad enough, but to prey on homeless people struggling to survive day to day is particularly reprehensible," said Tony West, DOJ's assistant attorney general for the civil division, in a media release. "We won't tolerate illegal conduct and we will continue to hold companies, institutions and individuals accountable for health care fraud."
DOJ said it has used the False Claims Act to recover approximately $2.2 billion since January 2009 in cases involving fraud against federal healthcare programs. DOJ's total recoveries in False Claims Act cases since January 2009 have topped $3 billion, according to the department.
Language in the House healthcare reform bill that would strip an antitrust exemption for medical professional liability insurers could increase premiums, the American Academy of Actuaries (AAA) said.
"The end result of the enactment of H.R. 3962, relative to medical professional liability insurance, is likely to be reduced availability with fewer willing insurers, less vigorous competition among those that do write the coverage, and higher costs to the consumer," Kevin Bingham, chairperson of AAA's Medical Professional Liability Subcommittee, told congressional leaders in his Jan. 21 letter.
If Congress repeals the exemption, AAA wants lawmakers to restore language from an earlier version of the bill that would permit information gathering and rate setting activities, which are currently allowed under the McCarran-Ferguson Act. He said aggregated data "provides credible information, supports competition, and guides companies, self-insurers and regulators in reducing the likelihood of insolvencies."
Bingham said that a single company's data is often not sufficiently credible to determine basic loss costs and determine reasonable premiums. He attributed this to the "low-frequency, high-severity, long-tailed" nature of medical professional liability claims, which makes the estimation of losses and premiums more uncertain than in other insurance lines.
"The bill does not specify what loss data may be collected. Additionally, it is unclear about what actuarial activities are allowable," Bingham wrote. "If such limitations on data-gathering apply, it will result in a reduced level of reliability of determinations, with less data available to state regulators charged with evaluating rates."
Nine in 10 hospitals use social media to some degree, but most of them say they're having little luck attracting new patients with it, and only one in three has a formal social media plan in place, a new study by Greystone.Net shows.
"It is impossible to ignore the effect that social media is having on the Internet in general, and on hospitals and health systems specifically," said Mike Schneider, executive vice president of Greystone.Net. "Organizations that have a formal plan to manage their social media interactions are more likely to be successful, and we expect more and more hospital Web departments to embrace this strategy moving forward."
The research, conducted over two months using Greystone.Net's research panel of more than 100 hospital marketers, also showed that budgeting for social media, including hiring social media employees, is still relatively rare among hospitals. However, many respondents told Greystone.Net that that is likely to change in the near future.
Other key research findings include:
Monitoring social media is handled by relatively few people within a hospital's Web department—70% report they have three or fewer people monitoring.
Twitter, YouTube, and Facebook are the most popular social media for hospitals, and also the most effective in terms of driving traffic to the Web site.
Despite the fact that 92% of respondents originally got involved with social media to attract new patients, only 12.5% said they had had some success.
Hospitals are struggling to find success with other goals of social media, with only small numbers reporting that they have been successful improving community relations (16.7%), customer service (8.7%), employee engagement (8.7%), and crisis management (4.5%).
Cleveland Clinic should be commended for expanding its free employee wellness and health programs to more than 35,000 dependents.
This simple, common sense move is exactly the far-sighted, cost-effective, proactive action needed to address many of the preventable chronic illnesses that otherwise drive healthcare costs beyond control.
The fact that a high-profile healthcare institution like Cleveland Clinic is aggressively expanding wellness benefits is another sign that wellness programs work.
Since Jan. 1, Cleveland Clinic dependents who participate in its corporate employee health plan have had access to weight loss support services, memberships to fitness facilities, and smoking cessation treatment and medication, all at no cost to the employees.
Cleveland Clinic CEO Toby Cosgrove, MD, said the expansion is the latest step in the employee wellness campaign launched in the summer of 2008. Since then, more than 10,000 employees enrolled and participated in smoking cessation, weight management, and fitness programs. Collectively, Cleveland Clinic says 5,000 weight management program participants have lost more than 88,000 pounds–an average of 17 pounds per employee.
"Our nearly 40,000 employees and their families represent a crucial part of our community, both locally and around the world," Cosgrove said. "By giving them access to wellness and prevention programs at no cost, we can make a significant impact on the health and wellness of our community."
Cleveland Clinic banned tobacco use from its campus on July 4, 2005. In September, 2007, the hospital said it would no longer hire smokers. It has since banned trans fats from its cafeteria, and inpatient menus.
The clinic opened a Wellness Institute nearly three years ago to promote healthy lifestyle choices among employees. Chief Wellness Officer Michael F. Roizen, MD, said that extending the wellness benefits to employees' families will decrease chances that they will become one of the 30 million Americans affected by chronic illness. "Lifestyle choices that include smoking, poor nutrition and lack of physical activity are key contributors to the increased rate of chronic disease affecting our families and neighborhoods," he said.
Expanding free wellness programs to include dependents is a smart move for several reasons. From the employee productivity side, healthier families mean fewer sick days for employees, and fewer employees missing work to provide dependent care, and obviously, lower healthcare costs.
For recruiting, this will do nothing but enhance Cleveland Clinic's status. Taking proactive and progressive actions to improve the quality of life for employees is a powerful draw, and sends a strong message that management cares about the employees. Quality people want to belong to vanguard institutions.
Most importantly, it makes wellness not just an employee benefit, but a family benefit. This changes not just the behaviors at work, but the more-crucial behaviors at home. Now, mother, father and even the children can go together to the health club, or they can join Weight Watchers or smoking cessation programs, and support each other at home to meet – and maintain – health goals.
We will only reduce our nation's healthcare costs when we as individuals take personal control of our own health. Cleveland Clinic and other businesses that recognize the importance of promoting wellness for the entire family are providing the tools to do it.
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The staff at a Lorton, VA family physician practice thought they were dealing with a malfunctioning heating duct when they heard what sounded like a small explosion in a vacant examination room Monday night.
"We didn't know what it was. We left the room as it was and went home. We thought we would deal with it in the morning," says Kathy Ciampi, RN, with Williamsburg Square Family Practice. "We just had the heating system tweaked, and I thought something probably blew up in the system. We'll call the repairman in the morning."
As it happens, the explosion was caused by a grapefruit-sized meteorite that punched through the shingled dormer roof, insulation, and ceiling tiles on the one-story building, and came to rest in three large pieces on the concrete floor.
"It looked like it was fired out of something. It did a lot of devastation to the room. Everything was scattered everywhere," Ciampi says. "It was about 300 grams, the size of a grapefruit, a light gray concrete color on the inside, but the outside was dark and streaked and shiny. Our office manager's husband is a geologist. She described it to him. He drove an hour to get here and said 'you've got a meteorite.' We didn't believe him."
Ciampi thought the mysterious object more likely fell off an airplane or a helicopter from nearby Ft. Belvoir.
"We're doctors and nurses. Nobody's thinking meteorite. So we went on the Internet to look up meteorite, got a magnet to see if it was magnetized. It was magnetized," she says. "In the meantime, we called the Fairfax County police because we weren't sure if it came out of an airplane. The policeman was rolling his eyes when we told him. 'Yeah sure it's a meteorite.' And when it magnetized, his eyes got really big and then all the TV stations started calling."
The extraterrestrial rock was donated to the Smithsonian Institution, which has named it Meteorite Lorton.
"We have had a lot of people coming out of the woodwork. It's been a circus here," Ciampi says. "Yesterday was very difficult for the doctors because we had people with cameras in the waiting rooms, and we were trying to maintain patient privacy. They hung in there, but we had a tough day."
The happy ending for Ciampi is that nobody was hurt by the one-in-a-billion shot.
"We were very fortunate nobody was in the room. Our two physicians were about eight to 10 feet away. One doctor had a patient scheduled for that room who had cancelled."
After the last few days of media attention, Ciampi says everyone at the two-physician practice is ready for a return to normal. "We are just a doctors' office," she says. "We need to take care of our patients."
