The New Health Reform Bill: Do You Know How It Will Affect You? from Nurse Together

Unprecedented evolution of the health system in our country is beginning with the institution of the new health care bill. Over one thousand pages of legal-ease have made it virtually impossible for anyone to understand the changes and far less a chance to predict the outcomes. Most hospitals and healthcare organizations have appointed entire legal teams to attempt to assess the effects of this new legislation on their organizations. There are also many potential effects on the nursing profession that in some cases may be an advantage. Some could also be problematic. To attempt to predict the effects of the bill on nursing, let us attempt to explore the bill in simple terms.

There are three main problems with the current health system that this bill will attempt to address. These include rising costs secondary to insurance premiums and aging population, holes in coverage for most people with preexisting conditions, lifetime limits on benefits and rising costs to employers who are reducing coverage and individuals without access to healthcare at all. The bill will be phased in over time beginning now. The following will be the highlights of each phase.

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Employing Docs Without a Strategy? Think Again from H and HN

Click here to view and excellent video on doctor hiring strategies.

Reducing Hospital Readmissions from H and HN

The Centers for Medicare & Medicaid Services have been focusing on reducing acute care readmissions within 30 days of discharge through its Hospital Readmissions Reduction Program. Hospitals with higher than expected 30-day readmission rates will incur penalties against their total Medicare payments beginning in federal fiscal 2013.

Commercial payers likely will follow suit, as organizations such as the Joint Commission, Partnership for Patients and the National Quality Forum support this program.

To meet the challenge, hospitals need to take a structured approach to reducing readmissions — an assessment of the organization's risk and a comprehensive strategy that transitions the patient from the hospital to post-hospital care.

For the full article please go here.

In Focus: Rural Health from H and HN

Last month, regular H&HN Daily contributor Ian Morrison wrote a compelling column (aren't they all?) on reinventing rural health. In it he discussed the multitude of challenges facing rural providers — staff shortages, payer mix, capital and IT gaps, and more. The column also spends a fair amount of time discussing the hurdles rural providers will face as we move to a value-based, accountable care system.

In a bit of an understatement, he wrote: "Rural health is tough to manage, from both a policy and practical point of view." But he's then quick to note: "As we redesign the overall health care delivery system from volume to value, we raise the question of what happens to rural health care. While the challenges described here are real, in my travels I detect a growing openness to reinvention of rural health among community leaders and hospital CEOs across the country."
I couldn't agree more. I'm always amazed by the can-do attitude exhibited by rural health care leaders. They approach the hurdles in front of them head on, knowing that in so many cases they are the lifelines of their communities. That's part of the reason that I'm eager to board a plane Saturday afternoon and head to Phoenix for the 25th Annual Rural Health Care Leadership Conference. Year in, year out, it is one of my favorite meetings (and I'm not just saying that because it's our meeting).

For the full article please go here.

States Under Pressure As Health Law Deadlines Approach from Kaiser Health News

The health law's biggest changes don't take effect until 2014, when states and insurers must be ready to begin signing up an estimated 32 million people in Medicaid and private insurance. But a successful rollout in two years hinges on critical decisions that states must make – and take quick action on – this year.

It will be difficult for many states to meet fast-approaching deadlines, and some may not make it, says Brett Graham, a managing director at Leavitt Partners, a consulting firm working with states on implementation of the law.

Time is short, and states are missing key pieces of how-to guidance from the federal government about everything from what various insurance exchange options will look like to which benefits must be included in health plans, he says. To make matters worse, states are competing for a limited pool of information technology vendors to help them get started.

"It's a pressure cooker," said Graham. States are "in a position where they have to act with imperfect information."

One of the most pressing tasks for states this year has to do with the creation of exchanges, through which individuals and small businesses can buy insurance starting in 2014.

For the full article please go here.

Riding Herd on the Silver Stampede from H and HN

Are you ready for the "Silver Stampede?" That's the question contributing editor Geri Aston asked hospital leaders in her December Hospitals & Health Networks article on the onslaught of older patients, which will have — indeed, already is having — an enormous impact on our health care system. Like most of the stories we run in H&HN, the focus of Geri's article was on real-world solutions — positive, practical ways health care organizations are confronting a difficult issue, in this case senior care, so that other hospital leaders can decide whether those strategies might be worth adapting in their own organizations.

I write frequently in this space about generational issues in health care, and after Geri's article ran, I heard from a number of readers wanting to let me know that they and their colleagues also are taking creative steps to confront this issue. Here are four you might find interesting and useful:

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Medication Errors In Hospitals Reduced By e-Prescribing from Medical News Today

A study published in this week's PLoS Medicine shows that commercial electronic prescribing systems (commonly known as e-prescribing, in which prescribers use a computer to order medications for their patients through a system with the help of prompts, aids, and alerts) could substantially reduce prescribing error rates in hospital in-patients.

In the study, led by Professor Johanna Westbrook from the University of New South Wales in Sydney, Australia, the authors studied the introduction of the Cerner Millennium e-prescribing system into one ward in one hospital (Hospital A), and used three other wards as controls. At another hospital, the authors compared the error rates on two wards before and after the introduction of the e-prescribing system iSoft MedChart.

For the full article please go here.