Don't miss Statewide Nursing Summit
Nursing in Florida: Celebrating the Past and Advancing the Future will take place November 13-15, 2013 at the University of South Florida Health Center for Advanced Medical Learning (CAMLS) in Tampa. The Statewide Nursing Summit, presented by the Florida Blue Foundation in Partnership with the Florida Action Coalition, will include interactive workshops and renowned speakers including keynoters the University of Miami's Donna Shalala and Peter Buerhaus from Vanderbilt University. To register, please click here. For additional information, please call 800-477-3736, ext. 63215 or send an e-mail to TheBlueFoundation@bcbsfl.com. Special $139.00 room rates are available at The Embassy Suites Tampa - Downtown Convention Center. Those preferring not to travel to Tampa are encouraged to register to participate by simulcast at the University of Miami Hospital.
Choosing Wisely list updated for adult, pediatric hospital medicine
As part of the Choosing Wisely campaign, experts have developed recommendations for improving hospital medicine for children and adults. Recommendations for pediatric care, reported in the Journal of Hospital Medicine, include forgoing chest radiographs in children with bronchiolitis or asthma and avoiding routine acid suppression therapy for gastroesophageal reflux in infants. Recommendations for adult care include refraining from red blood cell transfusion to meet arbitrary hemoglobin or hematocrit levels and not prescribing a prophylactic for stress ulcers in inpatient care.
CBO report looks at reasons for Medicare spending slowdown
Changes in Medicare payment rates and in beneficiary demand for services account for only about one-quarter of the slowdown in fee-for-service Medicare spending growth for elderly beneficiaries between 2000 and 2010, according to a new report from the Congressional Budget Office. While the other causes of the slowdown remain unclear, it “appears to have been caused in substantial part by factors that were not related to the recession’s effect on beneficiaries’ demand for services,” the report states. “Some of the other influences on Medicare spending that may have contributed to the slowdown, such as changes in how care is delivered to beneficiaries, might well have persistent effects on spending growth. The fact that growth slowed even further in 2011 and 2012 for the fee-for-service portion of Medicare indicates that the slowdown persisted, and perhaps intensified, after our study period. That view is consistent with CBO’s recent forecast of Medicare spending growth, which projects slower growth in the next few years than prior forecasts anticipated.”
CMS announces Medicare premiums and deductibles for CY 2014
The Medicare Part A deductible – for inpatient hospital, skilled nursing facility and home health services – will increase by $32 in calendar year 2014, to $1,216, according to an announcement by the Centers for Medicare & Medicaid Services. The daily coinsurance amounts will be $304 for days 61-90 of hospitalization in a benefit period; $608 for lifetime reserve days; and $152 for days 21-100 of extended care services in a skilled nursing facility in a benefit period. The monthly Part A premium, paid by just 1% of beneficiaries who have fewer than 40 quarters of Medicare-covered employment, will decline by $9 or $15 in CY 2014 (to $234 or $426, respectively), depending how long they had Medicare-covered employment. The base Part B monthly premium and annual deductible – for physician and hospital outpatient services, certain home health services, durable medical equipment and other items – will be unchanged for CY 2014 at $104.90 and $147, respectively. The base Part B premium is adjusted upward for higher income beneficiaries.
Health care price growth remains low
National health care prices in August were 1% higher than a year ago, down 0.1 percentage point from July and equal to the historically low growth recorded in May, according to the latest economic indicators from Altarum Institute's Center for Sustainable Health Spending. Year-over-year hospital prices fell to 1.5% growth in August, the lowest rate since December 1998. National health expenditures were 3.8% higher than a year ago, equal to the Centers for Medicare & Medicaid Services recent forecast for 2013. “Note that CMS also states that, due to drug price mismeasurement, health care prices are even lower than reported; that is, 1.5% growth in 2012 rather than the 2.1% reported,” Altarum said.
Study: Using gloves/gowns for all ICU patients may not be more effective
Requiring health care workers to wear gloves and gowns for all patient contacts in intensive care units may not reduce the spread of drug-resistant bacteria more than wearing them only for patients with known exposure or infection, according to a study published in the Journal of the American Medical Association. Based on cultures collected at 20 hospitals from patients at admission and ICU discharge, the study found that overall patient contact with methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus bacteria declined with both approaches to the prevention measure, but that the difference in change was not statistically significant.
Burnes Bolton new AONE President-elect
The American Organization of Nurse Executives has announced that its 2014 president-elect is Linda Burnes Bolton, vice president for nursing, chief nursing officer and director of nursing research at Cedars-Sinai Medical Center in Los Angeles. As president-elect of the AONE Board of Directors, Burnes Bolton will serve as AONE president in 2015. A registered nurse with more than 40 years of experience as a clinician, researcher and administrator, Burnes Bolton has served as past president of the American Academy of Nursing and the National Black Nurses Association, and as vice-chair for the Robert Wood Johnson Foundation Future of Nursing initiative at the Institute of Medicine. For more on the announcement, including other new board members, see the AONE news release.
Day in the Life of a Nurse 2013 set for this Friday
Nearly 900 students to participate
Day in the Life of a Nurse 2013 will take place this Friday, November 1, at 57 South Florida hospitals and nursing schools. "This will be the fifteenth time that the Nursing Consortium of South Florida organizes this opportunity for high school and middle school students to gain a unique perspective on the nursing profession, noted Joanne Masella, Dean of Nursing at Palm Beach Atlantic University and this year's DITLOAN Committee Chair. "We are delighted that more hospitals are hosting students this year. A number of nursing schools are also participating leveraging their simulation facilities. Thanks to broad community support, nearly 900 students from Tavernier to Jupiter will have a Day in the Life of a Nurse experience this Friday. We could not do this program without the wonderful collaboration with our partners at the South Florida public school systems and the hosting locations."
Moody’s: Hospital expenses outpace revenues for first time in 3 years
Expenses grew faster than revenues for not-for-profit hospitals in fiscal year 2012, according to a report released by Moody's Investors Service, a situation the credit rating agency calls “unsustainable.” Expenses grew by a median 5.5% for 402 hospitals and health systems rated by the agency, while median operating revenues grew just 5.2%. Moody’s expects operating performance for the sector to remain weak. “We expect revenue growth will remain pressured in FY 2014 following the Centers for Medicare & Medicaid Services’ final ruling that hospitals will receive a slim 0.7% net increase on inpatient reimbursement rates in federal FY 2014,” writes Deepa Patel, Moody's assistant vice president/analyst. “The continued sequestration and Medicare disproportionate share reductions that began on Oct. 1, 2013 will also hamper performance. Further, many hospitals report that rate increases from commercial payers are lower than historical levels.…Most management teams will respond aggressively with expense growth containment strategies to combat limited revenue growth. However, it will be difficult to make swift expense reductions since many cost savings measures have been exhausted following the recession.”
There are limits with high-intensity workouts, experts say
High-intensity workouts are getting attention, but fitness experts caution that, like medicine, there are dosage and frequency limitations for safety. Allen Jackson of the University of North Texas said four minutes at 90% of maximum heart rate is the highest range of intensity recommended by the American College of Sports Medicine, and no one should attempt that four minutes unless they have worked up to that extreme.
Study: Strong hospital-SNF relationship reduces readmissions
Hospital patients discharged to a skilled nursing facility are less likely to be re-hospitalized within 30 days if the hospital has a strong relationship with the SNF, according to a recent study published in Health Services Research. The study found that for hospitals that own a SNF, the readmission rate was lower for referrals to its own SNF (17%) than to SNFs outside of the organization (21%). The study of Medicare claims from 2004 to 2006 also suggests that when hospitals concentrate their discharges in a particular SNF, the readmission rate is lower. “It would appear that this offers an explanation of why hospitals which own a SNF have lower rehospitalization rates,” the authors write. The study also suggests that other hospitals might establish preferred provider relationships with a SNF that could function as “virtual hospital-based” facilities.
Higher nurse staffing associated with lower readmissions penalties
Hospitals with higher nurse-to-patient staffing ratios have lower odds of being penalized for excessive readmissions under the Hospital Readmissions Reduction Program, according to a study in the October issue of Health Affairs. Researchers at the University of Pennsylvania examined nurse staffing levels and data on readmissions penalties for 2,826 hospitals and found that hospitals with higher nurse staffing had 25% lower odds of being penalized than similar hospitals with lower nurse staffing ratios. Each additional nurse hour per patient day was associated with an estimated 10% lower odds of receiving penalties under the program. “By focusing on a system factor such as nurse staffing, administrators may be able to address multiple quality issues while reducing their likelihood of penalty for excess readmissions,” the authors said.
Quality measure may penalize hospitals for detecting blood clots
The rate of postoperative blood clots, or venous thromboembolism (VTE), may not be a valid hospital quality outcome measure, according to a study published online by the Journal of the American Medical Association. “Our study calls into question the merit of the PSI-12 VTE outcome measure as a quality measure and its use in public reporting and performance-based payments,” the authors write. “Hospitals reported to have the highest risk-adjusted VTE rates may in fact be providing vigilant care by ordering imaging studies to ensure that VTE events are not missed.” The study by researchers at Northwestern University and Northwestern Memorial Hospital in Chicago found a positive correlation between VTE imaging and event rates for Medicare patients undergoing major surgical procedures at 2,786 hospitals in 2009 and 2010.