Thursday, November 08, 2018

Thursday Thoughts

Of course, as we know, the mid-term elections resulted in divided government with the executive branch and the Senate remaining in Republican hands and the House of Representatives moving to  Democrat hands. The new Congress assumes office in early January 2019. The current Congress will be holding a lame duck session beginning next week.

In Tuesday's Tidbits the FEHBlog highlighted a Healthcare Dive interview with Geisinger Health Systems's CEO David Feinberg. The Wall Street Journal reports tonight that Dr. Feinberg who was wined and dined by the new Amazon healthcare operation, has decided to take a top healthcare position with Google. "Geisinger said that current chief medical officer Jaewon Ryu, an emergency-room physician and former executive at health insurer Humana Inc., will become the system’s acting president and CEO on Dec. 1. Dr. Feinberg will aid with the transition and depart Jan. 3."

Last Friday, the FEHBlog pointed out an Oliver Wyman study finding the people trust their own doctors over their insurance companies. Hardly surprising. The FEHBlog was not intended to know health insurers but rather to point out that the quality oriented messaging of health insurers is  presented by their members' doctors. In that regard, MedPage Today reports on recent remarks from the HHS Secretary Alex Azar. The FEHBlog was struck by fact that the Secretary "highlighted the role of physicians and other clinicians not as 'gatekeepers' but as 'navigators' of the healthcare system." Bingo. The Secretary also noted that his department intends to start experimenting with mandatory bundling of oncology for Medicare patients.

MedPage Today also reports on a panel discussion looking at patient safety nearly twenty years after the landmark report To Err is Human. Our health care system apparently still has a long way to go.
In a recent Health Affairs study, Aiken and colleagues assessed safety at 535 hospitals in four large states during two time points between 2005 and 2016, and reported that the results were "disappointing." Only 21% of the hospitals showed "sizeable improvements" in "work environment scores" while 7% saw their scores worsen, [Linda] Aiken, PhD, RN, professor and director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania in Philadelphia] said. 
Another 71% of hospitals "basically remained the same," she said.\ 
Aiken also reported a similar lack of improvement in patient safety measures at hospitals that showed little improvement in their work environment. In the study, about 30% of nurses graded their own hospitals "unfavorably" on measures of patient safety and infection prevention and about 31% of nurses had high scores on the Maslach Burnout Inventory.
Finally, Healthcare Dive tells us about a U.S. Department of Agriculture report finding that the fundamental problem with using telehealth in rural communities is the lack of adequate broadband internet coverage. From the USDA report --
"In-home broadband Internet access, whether by choice or happenstance, may not have been a significant factor in 2015 for either rural or urban residents. Many still conducted health activities although they had no Internet subscription," the report says. "Health providers, however, continue to improve their offerings, so needs for high-quality household broadband service will likely increase if patients are to avail themselves of these new services, especially in rural and poor areas where lower quality broadband Internet service tends to be more common."

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