Productivity, Ownership Linked
Billable work per patient appears to be increasing only at physician groups under the “private practice model,” but expenses have also grown, according to a Medical Group Management Association study. Over the past 5 years, relative value units per patient rose by 13% at private medical practices but declined nearly 18% at practices owned by hospitals or integrated delivery systems, analysts found. Meanwhile, operating costs for private practices increased by nearly 2% last year, in contrast to a slight decline for practices owned by the larger entities. MGMA attributed part of the increase in expenses for private practices to the cost of implementing electronic health record systems. “In the private practice model, EHR incentives have provided a catalyst for practices to purchase systems and deploy electronic health records, therefore increasing the practice's information technology expenditures,” said Kenneth Hertz, a principal with MGMA Health Care Consulting Group, in a statement.
California Limits CT Radiation
California Gov. Arnold Schwarzenegger (R) has signed a bill that limits the radiation dose provided in computed tomography scans. The new law comes in the wake of patients at at least six California hospitals having received up to eight times the normal radiation from their CT scans. Beginning in 2012, technicians must record the radiation dose from every scan, and radiology reports must include that information. Each year, a medical physicist will be required to confirm each CT machine's readings. Beginning in 2013, medical imaging facilities need to report to the state any medical injury from CT radiation and any instance in which certain doses have been exceeded.
Hospital Care Is Improving
Hospitals have improved their care for heart attack victims, pneumonia and surgery patients, and children who have asthma, according to the Joint Commission. The group's annual report shows 8 years of continuous improvement on measures that produce the greatest positive impact on patient outcomes, according to the commission's report. For example, in 2009, hospitals provided evidence-based heart attack treatments such as aspirin at arrival and beta-blockers at discharge in 98% of encounters with the appropriate patients, up from 89% in 2002. Pneumonia patients in 2009 received evidence-based treatments about 93% of the time, compared with 72% in 2002. However, hospitals need to improve performance on two measures: providing fibrinolytic therapy to heart attack patients within 30 minutes of arrival and giving antibiotics to pneumonia patients in intensive care units within 24 hours, the Joint Commission said.
Giving Back to the DEA
Americans turned in more than 242,000 pounds of unused or unwanted prescription drugs for disposal as part of the first national prescription drug “Take-Back” campaign, the Drug Enforcement Administration said. The agency reported a huge turnout of people turning in large quantities of old drugs at more than 4,000 disposal sites being run by law enforcement personnel around the country. For example, at one site a woman turned in nearly 50 years' worth of medications for disposal, while at another site a man brought in his kitchen drawer, full of medications, to dump, a DEA announcement said. “The Take-Back campaign was a stunning nationwide success [and] a crucial step toward reducing the epidemic of prescription drug abuse that is plaguing this nation,” said DEA Acting Administrator Michele Leonhart in the announcement.
Reform Yields New Training Slots
Nearly 900 additional primary care physicians will be trained through $167 million in new federal grants funded by the Affordable Care Act, according to the Department of Health and Human Services. The 5-year grants will go to 82 accredited training programs to increase the number of residents in general internal medicine, family practice, and general pediatrics. By 2015, about 500 more residents will have completed their training than would have done so under past funding, and more will still be in the pipeline, HHS said. Additional grants will expand training for physician assistants and nurses, and will help low-income individuals enter and advance in health sector careers.
Nursing Report Spurs Controversy
Nurses' roles and responsibilities should change significantly to meet the increased demand for care created by health care reform, according to an Institute of Medicine report that immediately drew criticism from the American Medical Association. The report urged removal of regulatory and institutional obstacles to nurses taking on additional patient-care duties. To handle these new responsibilities, nurses should receive higher levels of training through an improved education system, including a new residency program and additional opportunities for lifelong learning, the institute report said. The AMA took issue with the report's call to expand nurses' scope of practice, saying that nurse practitioners don't have nearly the amount of training and clinical experience that doctors do. “With a shortage of both nurses and physicians, increasing the responsibility of nurses is not the answer to the physician shortage,” said AMA board member Dr. Rebecca J. Patchin in a statement.