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PHA E-Pulse: April 23, 2015

Thursday, April 23, 2015   (0 Comments)
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Physician-Owned Hospitals Excel in CMS Star Ratings

On April 16, the Centers for Medicare and Medicaid Services (CMS) released summary star ratings based on patient satisfaction and experience in its HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) Survey for hospitals nationwide. 67% of the participating physician-owned hospitals received a 4- or 5-star rating, compared to 41% of all hospitals nationwide.

PHA has widely distributed press releases to announce the high-quality of our hospitals. The story has already been picked-up by a number of major news outlets including Reuters, the Boston Globe, and business journals in 24 major cities including Chicago, Dallas, Houston, Kansas City. Los Angeles, Milwaukee, and more. We are continuing our efforts to gain further national attention.

We need the help of physician-owned hospitals nationwide. If your facility ranks highly in the star rating program, please reach out to your local media outlets to share the news. You may modify this press release to include local information about how YOUR hospital excels, as verified by this CMS quality rating. Include your specific rating, how it compares to other hospitals in your community or state, and include a quote from your CEO or a physician-leader at your facility.

Finally, please be sure to share any media coverage that you have already received, or that you receive in response to this effort by sending it to Leslie Fossey at PHA.
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PHA News
Save the Date for the 2015 PHA Executive Summit
September 30 - October 2, 2015
Meritage Resort and Spa, Napa, CA

Physician-Owned Hospital News
"Obama Signs Overhaul of How Medicare Pays Doctors"
"5-Star Hospital Ratings Elusive in North Carolina"
"Kansas Spine Ranks Top in Country for Procedure, Rankings Firm Says"
"Medicare Overpays as Hospital Prices Rise"
"ONC Updates Guide to Safety, Privacy of Electronic Health Information"
"The Next ICD-10 Hurdle? Processing Claims"
"Moving Out: Hospitals Leave Downtowns for More Prosperous Digs"
"HIMSS Analytics Modifies Stage 7 Revalidation Process"
"CMS Draft Rule Would Ease EHR Program Demands"
"Obama Administration Report Slams Digital Health Records"
"Medicare Is Stingy in First Year of Doctor Bonuses"

PHA News

Save the Date for the 2015 PHA Executive Summit
September 30 - October 2, 2015
Meritage Resort and Spa, Napa, CA

Mark your calendars for the first ever PHA Executive Summit, September 30 – October 2, in Napa, CA at the beautiful Meritage Resort and Spa. Specifically tailored to physician-owned hospital executives and physician-owners, this invitation-only event has been developed exclusively for PHA members, featuring educational and social activities that emphasize one-on-one and small group interactions to create deep, year-round connections between members in attendance.

As an attendee you will:
  • Discuss topics and issues that directly impact you and your facility with fellow executive-level attendees and physician-owners in highly interactive sessions engaging your peers and thought-leaders in the industry
  • Engage in networking opportunities that can expand your professional community and strengthen your relationships via organized social functions and as you enjoy this fantastic venue
  • Explore the surrounding wine region and see what Napa has to offer
Registration for this invitation-only event will be available exclusively to employees and physician-owners of PHA member facilities. PHA member CEOs will automatically receive invitations to attend.

CEOS, physician-owners and employees of member facilities may use this webform to request formal invitations for themselves and colleagues.

The full program, online registration, and mailed invitations will be posted soon. We look forward to seeing you in Napa this fall.

Sponsorship opportunities are available.
Please download our industry partnership prospectus to learn more.
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Physician-Owned Hospital News

Obama Signs Overhaul of How Medicare Pays Doctors
Associated Press (04/16/15) Kuhnhenn, Jim; Fram, Alan

President Barack Obama recently signed legislation permanently changing how Medicare pays doctors. The bill overhauls a 1997 law that aimed to slow Medicare's growth by limiting reimbursements to doctors. Obama said the new law helps Medicare by giving assurance to doctors about their payments. "It also improves it because it starts encouraging payments based on quality, not the number of tests that are provided or the number of procedures that are applied but whether or not people actually start feeling better," Obama said. "It encourages us to continue to make the system better without denying service." The bill blocked a 21 percent cut in Medicare payments that was due to take effect this month.
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5-Star Hospital Ratings Elusive in North Carolina
Triangle Business Journal (04/16/15) deBruyn, Jason

Medicare for the first time has released star ratings on hospitals based on patient surveys. Only three hospitals in North Carolina received a 5-star rating. One of those, N.C. Specialty Hospital in Durham, has many differences when compared to other hospitals in the state. It is a private, physician-owned medical center, does not operate an emergency department, and is not required to see patients on drug overdose or requiring detox. These services, and others, drain a hospital's finances because the hospital must treat patients even if they will never receive a penny to cover costs. A Kaiser Health News review of national scores points out that these specialty hospitals “have traditionally received more positive patient reviews than have general hospitals, where a diversity of sicknesses and chaotic emergency rooms make it more likely patients will have a bad experience.”
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Kansas Spine Ranks Top in Country for Procedure, Rankings Firm Says
Wichita Eagle (KS) (04/09/15) Siebenmark, Jerry

CareChex, a healthcare data company, has identifiedphysician-owned Kansas Spine & Specialty Hospital in Wichita, KSas the top hospitalin the nation for medical excellence in spinal fusion. Kansas Spine & Specialty also ranked second in the nation for patient safety in spinal surgery. CareChex completed the rankings after studying three years of public data from the Centers for Medicare & Medicaid Services.
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Medicare Overpays as Hospital Prices Rise
Wall Street Journal (04/15/15) Weaver, Christopher; Mathews, Anna Wilde; McGinty, Tom

Substantially rising hospital list prices are causing a rise in Medicare overpayments despite safeguards meant to protect the government from large increases. Hospitals are allowed to collect for complicated cases called "cost outliers" based on actual treatment costs, and the government estimates costs based on list prices, among other things. Medicare overpays when prices rise faster than actual costs. Medicare "is constantly working to maintain the integrity of the Medicare hospital-payment systems," said Sean Cavanaugh, a deputy administrator at Medicare. "We believe that outlier payments have decreased considerably since the concerns about some hospitals' rapid increases in charges to manipulate outlier payments were identified more than a decade ago."
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ONC Updates Guide to Safety, Privacy of Electronic Health Information
Becker's Hospital Review (04/14/15) Jayanthi, Akanksha

The Office of the National Coordinator for Health Information Technology (ONC) has published a revised version of its Guide to Privacy and Security of Electronic Health Information, which was last published in 2011. The newest version accounts for new information related to privacy and security for small- and medium-sized providers, health IT professionals, and the public at large. The updated version of the guide includes new examples of HIPAA privacy and security rules, offering examples to readers of how the rules may impact businesses and clients. The guide also offers a sample seven-step approach to implementing a security management process, which ONC says providers can use as a reference.
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The Next ICD-10 Hurdle? Processing Claims
Hospitals & Health Networks (04/15) Morrissey, John

Hospitals and other healthcare providers have prepared for ICD-10 over the last several years, and with six months left before the new codes become law, there are concerns about what will happen when claims are filed. According to a survey conducted earlier this year by the American Hospital Association, 93 percent of hospitals are moderately or very confident about reporting under ICD-10 by the October 1 deadline. High levels of ICD-10 readiness were also reported by vendors, clearinghouses, and physician practices. However, there is less certainty in regards to successful claims processing, although the Centers for Medicare & Medicaid Services reports an 81 percent success rate in tests of incoming claims. Despite the 19 percent failure rate, Sue Bowman, senior director of coding policy and compliance for the American Health Information Management Association, says just three percent of rejected claims involve ICD-10 problems. She adds that extensive testing by private payers shows equal if not better results than CMS. According to Charles Christian, CIO at St. Francis Hospital in Columbus, Ga., each practice and the hospital's point person with owned and affiliated groups ultimately are responsible for ICD-10 testing.
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Moving Out: Hospitals Leave Downtowns for More Prosperous Digs
Kaiser Health News (04/13/15) Galewitz, Phil

St. Elizabeth's Hospital has been a staple of Belleville, Ill. for several decades. But the hospital is facing dire financial times due to an obsolete facility and patients who are low-income or uninsured. To address this problem, officials want to close the hospital and move it to a $303 million building in O'Fallon, Ill. O'Fallon is one of the fastest growing cities in the region, and the city is wealthier than Belleville. Critics of the move argue that the hospital is leaving poor and needy citizens behind. There is fear that the hospital will ultimately treat fewer low-income patients,resulting in overcrowding at neighboring hospitals. There could potentially also be a substantial job and economic loss generated by the hospital leaving Belleville. Industry trends show that many hospitals across the nation have migrated to locations where better insured patients are located. Many hospital officials argue that old facilities warrant the moves, and it is much cheaper to build a new hospital rather than upgrade old ones. Industry insiders note that non-profit hospitals, like St. Elizabeth's, often face heavier scrutiny because of ties to the community and tax exemptions.
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HIMSS Analytics Modifies Stage 7 Revalidation Process
Healthcare IT News (04/12/15) Pizzi, Richard

HIMSS Analytics has modified its revalidation process for Stage 7 of the Electronic Medical Record Adoption Model, and healthcare organizations that reached Stage 7 before last year will receive instructions about the new process by the end of this year. The Stage 7 validation lifespan will now be three years, and healthcare organizations will have to complete the revalidation process in the year between the second year anniversary of the original validation and its expiration, says John Hoyt, executive vice president of HIMSS Analytics. "The revalidation process will ensure that Stage 7 organizations reflect the optimal use and sharing of patient data toward improved healthcare quality and safety," he says. "For the majority of organizations, a one-person site visit should suffice." However, he notes that a full three-person site visit will be required for organizations that implemented a new core clinical vendor or changed ownership since their last validation. Since 2009, Stage 7 has been achieved by more than 2,600 hospitals and clinics, and these organizations are virtually paperless.
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CMS Draft Rule Would Ease EHR Program Demands
Modern Healthcare (04/10/15) Conn, Joseph

A proposed rule from the Centers for Medicare & Medicaid Services (CMS) would standardize the 2015 reporting period for the Electronic Health Record (EHR) incentive-payment program to 90 consecutive days of achieving meaningful-use criteria, giving more flexibility to healthcare providers. The proposal would also change the reporting year for hospitals to the calendar year, rather than their fiscal year. Among other things, CMS also wants to eliminate some requirements that have become routine and ease other requirements, such as requiring eligible providers to have a single patient electronically download, view and transmit health records instead of the current requirement that 5 percent of patients do so.
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Obama Administration Report Slams Digital Health Records
Wall Street Journal (04/10/15) Beck, Melinda

Hospitals have logged complaints against vendors of EHRs for making it difficult to transfer patient records to other systems or physicians, which they say enables those firms to control referrals, according to a report from the Office of the National Coordinator for Health IT. Complaints suggest that these obstacles to information sharing have made it costly for hospitals to use EHRs to improve care quality and reduce costs, according to the Obama administration. Among the complaints cited by the report were hefty fees to establish connections and share patient records, requiring customers to use proprietary platforms and making it prohibitively expensive to switch systems. Some have suggested that the ONC could decertify EHR systems that deliberately block data sharing, but the report warns that strategy could unfairly harm consumers.
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Medicare Is Stingy in First Year of Doctor Bonuses
Kaiser Health News (04/06/15) Rau, Jordan

Under a new payment system that will soon apply to all physicians who accept Medicare, just 14 of 1,010 large physician groups that the government evaluated will receive payment increases this year, and only 11 groups will receive reductions for low quality or high spending. Within three years, the Obama administration wants quality of care to be considered in allocating nine of every 10 dollars Medicare pays directly to providers to treat the elderly and disabled. One part of that effort, revising hospital payments based on excess readmissions, patient satisfaction and other quality measures, is already underway. The new financial incentive for doctors, called a physician value-based payment modifier, allows the federal government to boost or lower the amount it reimburses doctors based on how they score on quality measures and how much their patients cost Medicare. How doctors rate this year will determine payments for more than 900,000 physicians by 2017.
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April 23, 2015

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