Source: California Healthcare Compare and Consumer ReportsCalifornia Healthcare Compare provides price and quality data for hospitals and physicians in 18 regions of California.
California has embraced the Affordable Care Act in big way. It launched one of the first and most robust state-run health insurance exchanges, and expanded its Medicaid program (known as Medi-Cal) to enroll the uninsured.
As a result, the state’s uninsured rate dropped from 6.5 million residents in 2013 (which is 17.2 percent of the state’s population) to 4.8 million last year (12.4 percent), according to the U.S. Census Bureau. (See AHCJ’s coverage of the bureau’s latest data release here and here.) Continue reading
Efforts to improve health care quality and safety are mostly missing one significant source of concern: diagnostic errors, according to a report Tuesday from the Institute of Medicine. Improving Diagnosis in Health Care is the fourth in a series of IOM reports on patient safety.
In this Sept. 22 report, the IOM said that about 5 percent of U.S. adults who seek outpatient care experience a diagnostic error each year. Diagnostic errors contribute to about 10 percent of patient deaths, and account for about 6 percent to 17 percent of adverse events in hospitals. Continue reading
A recent post by Bruce Japsen at Forbes makes a quick supplement to a post we did recently highlighting how hospitals are faring in Medicaid expansion states vs. nonexpansion states.
Japsen knows a lot about the business side of the hospital industry and has written about the ACA’s impact on hospital finance. Recently he’s been paying attention to second-quarter earnings reports of publicly traded hospital companies. (As he notes, it’s the sixth quarter since ACA coverage expansion began.) Continue reading
Vox’s Sarah Kliff, who has an AHCJ Reporting Fellowship on Health Care Performance, is writing a series about fatal, preventable medical errors.
Not the inevitable tragic things that can happen to a patient – but the ones that we know how to avoid, the lives that should not be at risk. Kliff spent several months on one story – actually a story and accompanying video and graphics – that combined insights about how hospitals think central line infections and a gripping narrative about the death of a 3-year-old girl. You can find the story here.
Kliff wrote a “How I did It” essay for AHCJ that addresses a lot of the nuts and bolts of a vast project like this. She outlines how she reached out to patients/families, how she organized the voluminous – initially not searchable – medical records, how she found researchers who could elucidate things she did not fully understand in those records.
And she talks about the power of a good analogy to both organize a 5000-word narrative and give readers an accessible entry point to her work. Read about how she did it.
We’ve all written a lot about the “Medicaid gap” – the low-income people who can’t get coverage under the Affordable Care Act because their states have opted out of Medicaid expansion. The Kaiser Family Foundation has estimated that 4 million people fall in this gap.
According to Moody’s Investors Service, nonprofit hospitals in expansion states have seen their bad debt from unpaid bills drop an average of 13 percent as they treated more patients who have coverage. In non-expansion states, bad debt rose.
Reuters’ Robin Respaut recently looked at how the Medicaid gap has affected two iconic urban safety net hospitals who treat a lot of low income people – Cook County in Chicago and Grady Memorial in Atlanta. Continue reading
We’ve told you over and over again on this blog that the Affordable Care Act isn’t just about coverage. It’s also about changing how health care is delivered, moving away from fee-for-service to a more value- and quality-based system. Medicare is aiming to have half of its payments under alternative payment models by 2018.
That means hospitals have to change. But not all of them want to.
Fee-for-service is the preferred business model for many. Why should those hospitals want to go through considerable expense and upheaval to switch to a new system that demands more – and may well pay less? Continue reading
As senior quality editor for HealthLeaders Media for more than six years, Cheryl Clark wrote more than 1,300 stories about hospitals’ efforts to improve quality and safety and related issues.
Rates of sepsis seemed to be one more dirty little hospital horror to explore, one that the Joint Commission said cost hospitals about $16.7 billion annually. Yet hospitals’ efforts to tackle it seemed hidden behind improvement initiatives attracting more attention, such as reducing hospital-acquired infections, and preventable readmissions, lowering emergency room wait times and raising patient experience scores.
The story she wrote for the June 2014 issue of HealthLeaders’ print magazine, on how U.S. hospitals are improving recognition and treatment of sepsis — which is diagnosed in 750,000 patients a year and kills 40 percent — won the 2015 National Institute of Health Care Management prize in the trade print category. They said the story was “most likely to save a life.”
In a new article for AHCJ, she explains how she did her reporting, despite a lack of data and sources who didn’t want to talk. Read more.
Photo: Pia Christensen/AHCJMedical student Russell Stanley (left) and Dr. Kevin Blanton (right) share the stresses and triumphs of providing care in rural settings at AHCJ’s June 19 Rural Health Journalism Workshop.
Distance dominated much of the conversation at AHCJ’s recent Rural Health Journalism Workshop in Fort Worth, Texas, a vast state with wide open spaces and far-flung cities.
While such expanses can offer a quiet alternative to urban areas, panelists at #ruralhealth15 also noted that such isolation can impact not only health, but education and other community resources. And that can present another challenge: attracting health professions to rural pockets to provide needed care for residents. Continue reading
Courtesy of Neel Shah, M.D.Health reformers are grappling with how to bring down the high rate of cesarean section deliveries in the United States. The U.S. isn’t the only country in the world overusing the procedure, but it does have one of the highest rates.
I recently heard Neel Shah, M.D., an obstetrician at Beth Israel Deaconess Medical Center, the founder of Costs of Care, and associate faculty at Ariadne Labs (more about all of that here) speak about health care quality and delivering babies.
We’ve all heard about unnecessary cesarean sections (and elective induced early births, although that’s a related but not identical set of challenges). Many of us tend to think of it as a doctor-centered issue. Some doctors perform more C-sections than others and there are a host of reasons, ranging from how and where they were trained to how they assess and tolerate maternal risk to time management and financial considerations.
But Shah challenged me to think of unnecessary C-sections as a hospital management or system engineering problem – not just a problem created by individual doctors. Continue reading
After we posted in May on issues concerning hospital patient satisfaction surveys, the Hastings Center, a Garrison, N.Y., research institute focusing on bioethics, published its own skeptical report. The full text requires a purchase, but the abstract raises some of the same questions we addressed and brings up a few more.
“The current institutional focus on patient satisfaction and on surveys designed to assess this could eventually compromise the quality of health care while simultaneously raising its cost,” authors Alexandra Junewicz and Stuart Youngner write in Patient-Satisfaction Surveys on a Scale of 0 to 10: Improving Health Care, or Leading It Astray?
Their main worries: Continue reading