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April 19, 2016
Study says rise in oncologists working for hospitals spurs higher chemo costs
If you have cancer, chances are your outpatient chemotherapy treatment costs are higher if your oncologist works for a healthcare system than if she
has her own practice, a recent study found.
The study by researchers at the University of Chicago analyzed private health insurance claims data from the Health Care Cost Institute , a nonprofit
research organization, and national data about consolidation among doctors and hospitals between 2008 and 2013.
It found significant consolidation between outpatient oncology practices and healthcare systems in the decade leading up to 2013. The researchers
linked that to a rise in spending on drug-based cancer care. Each 1-percentage-point increase in the proportion of medical providers who were
affiliated with a hospital or health system was associated with a 34 percent increase in annual average spending per person on outpatient cancer
drug treatment, they reported.
Part of the rise was fueled by the facility fees that hospitals and their outpatient clinics routinely add on to the bill, the researchers said.
“Provider consolidation must be changing the ability of providers in a market to extract higher prices [from insurers] for outpatient cancer therapy,”
said Rena Conti, an assistant professor at the University of Chicago and lead author of the study, which was published by the Health Care Cost
Institute in February. The study controlled for the volume of patients and the mix of cancers, among other things, she noted.
Spending on chemotherapy drugs has been in the news lately as some cancer specialists and patient advocacy groups have strenuously objected to
a proposal by Medicare to change how it pays for drugs that are covered under Part B, the program’s outpatient benefit.
This study suggests that for patients, it may be more cost-effective to get chemotherapy treatments at a community-based practice rather than a
hospital or hospital-affiliated clinic, Conti said.
Visit Kaiser for the story.
Antibiotic resistance 'could become bigger threat to mankind than cancer'
Resistance to antibiotics will become "an even greater threat to mankind than cancer" without global action, Chancellor George Osborne has
warned.
The latest evidence suggests 10 million people a year could die globally by 2050, as a result of antibiotics becoming powerless against common
infections - more than currently die from cancer, he will say.
The Chancellor told delegates at the International Monetary Fund (IMF) meeting in Washington that there will be an "enormous economic cost”. By
2050, antimicrobial resistance could reduce global GDP by up to 3.5% - a cumulative cost of 100 trillion US dollars.
He predicts, "Unless we take global action, antimicrobial resistance will become an even greater threat to mankind than cancer currently is. "It is not
just a health problem but an economic one, too. The cost of doing nothing, both in terms of lives lost and money wasted, is too great, and the world
needs to come together to agree a common approach.
"We have to dramatically shift incentives for pharmaceutical companies and others to create a long-term solution to this problem, with new rewards,
funded globally, that support the development of new antibiotics and ensure access to antibiotics in the developing world. To achieve a long-term
solution we also need better rapid diagnostics that will cut the vast amounts of unnecessary antibiotic use."
In 2014 the PM was the first G20 leader to speak out publicly about the magnitude of the threat, and asked the Treasury minister and economist
Lord O'Neill to come up with potential solutions to the growing global problem of drug-resistant infections.
The UK has implemented two of his initial recommendations: to increase Government funding for early stage research and to help build capabilities
in low-income settings to monitor the development and spread of drug resistance.
Visit the Independent for the article.
Chicago's upgrades to aging water lines may disturb lead pipes
Chicago has more than 4,000 miles of water mains under city streets. In 2012, the city announced a 10-year plan to replace 900 miles of water
pipes. The mains are not made of lead, but nearly 80 percent of the water lines that connect up to the water mains and bring water into homes and
businesses are lead pipes — and that's the problem, says attorney Steve Berman.
Berman filed a class-action lawsuit on behalf of three Chicago residents who say the city's process of replacing water mains actually disturbs the
lead service lines and increases the amount of lead in the drinking water. He says the city failed to warn residents or to tell them how to reduce the
risk of lead contamination from their taps.
A study was published in 2013 by the EPA and Chicago's Department of Water Management that aimed to figure out better ways to determine the
lead levels in the city's drinking water.
The EPA's Miguel Del Toral says while Chicago's overall water quality is good, what the study made clear is that the method or sampling protocol
that's used to measure the amount of lead in drinking water is not effective.
"Our sampling protocol is not really capturing the high lead that's there," he says. "Everywhere, not just in Chicago. It's a national issue."
Del Toral, who was among the first at the EPA to raise concerns about the water crisis in Flint, says disturbing lead pipes can cause lead levels to
spike. But it depends on how severely the pipe is shaken and how much of the pipe's protective coating is knocked off.
Chicago recently announced that it will resume a water testing program at homes in some neighborhoods where children have tested positive for
elevated blood lead levels. In an interview with WFLD-Fox TV in Chicago, Tom Powers, the city's outgoing commissioner of water management,
says Chicago water is safe.
Visit NPR for the story.
Hot-air hand dryers ‘worst’ at spreading germs than paper towels- study
Paper towels and hot air dryers are commonly used to dry washed hands. In public places, specifically, people prefer to use air hand dryers as it
dries up their hands quickly and hygienically in just few seconds without requiring them to actually touch anything.
If findings of the recent study are to be believed then jet dryers in restrooms, such as the Dyson Airblade hand dryers, spread more germs than
paper towels or other regular dryers.
“The work we have done has gone through a rigorous process of peer review by three experts. In addition, the fact remains that many individuals do
not wash their hands thoroughly and/or do not use any kind of soap or sanitizer and this means that if their hands are contaminated with a pathogen
it may still be present after ‘washing’. We were testing this scenario in our study,” one of the study authors, Dr. Patrick Kimmitt, stated.
For the study, researchers at the University of Westminster in London tested three different drying methods- warm air drying, jet air drying and paper
towel drying- and found that the jet air dryer similar to the Dyson Airblade was likely to spatter 60 times more germs than regular dryers and up to
1,300 times more viruses than a paper towel.
Furthermore, the researchers found that the Airblade also spread contaminants much farther than the other two hand drying methods. They blasts
about 430 mph of air and spread germs about three meters or nearly 10 feet across the room, while a regular dryer and paper towels spread air 75
centimeters and 25 centimeters, respectively.
The viruses sprinkled by the jet dryer would float beyond the 15 minutes, and some 70 percent of those viral particles float at the height of a small
child’s face.
“The results of this study suggest that in locations where hygiene and cross-infection considerations are paramount, such as healthcare settings and
the food industry, the choice of hand-drying method should be considered carefully,” the authors, Patrick Kimmitt and Keith Redway of the University
of Westminster, concluded.
Visit Healthnewsline for the study.
Nominate a deserving colleague for the AHE Phoenix Award
The Association for the Healthcare Environment (AHE) is looking for nominations for their annual Phoenix Award, Heart of Healthcare Award,
Environmental Services Department of the Year Award, and more.
The Phoenix Award is the highest honor bestowed upon an AHE member. The Award recognizes a professional who has made an unselfish, lasting
impact as well as outstanding contributions to the growth and professionalism of AHE, the membership, and to the field of environmental services.
The Awards will be presented during the AHE EXCHANGE Conference, David L. Lawrence Convention Center in Pittsburgh, Pennsylvania,
September 25-28, 2016. Applications due June 17, 2016.
Who should be nominated:
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members with board service
members who have served on committees
members who are dedicated leaders in Environmental Services
Developed by AHE and Kimberly-Clark Professional, the Heart of Healthcare Award recognizes and honors outstanding frontline environmental
services technicians making a contribution to support safety initiatives and reduction and prevention of Healthcare-Associated Infections (HAIs).
The program purpose is to elevate the critical role that frontline environmental services technicians play in the care of patients and the healthcare
environment. Step up for someone you know is doing an outstanding job in environmental services by nominating him or her today!
The Environmental Services Department of the Year, award recognizes and celebrates best practices in cleaning and caring for the environment. It
was designed to highlight the outstanding achievements of a leading edge environmental services team in maintaining high levels of performance in
cleaning, disinfecting, infection prevention, environmental sustainability and stewardship, use of technology, patient satisfaction, education and
training in critical areas. Environmental services departments are key contributors to a hospital's overall success when measuring patient
satisfaction, timely patient flow, infection prevention, environmental stewardship and providing a Heart of Healthcare Award
Candidates may be nominated by an AHE member or non-member or may nominate themselves. The current AHE Recognition Committee will
select award winners based on submitted nominations. The committee may request additional information if needed.
Visit AHE for more information and specifics on each award.
Massachusetts General: More people are using drugs on hospital property
One of Boston's top hospitals is seeing an increasing number of drug abusers shoot up on its property, a tactic experts say opioid addicts hope will
save them from lethal overdoses.
Massachusetts General Hospital has equipped its security guards with the overdose antidote Narcan after seeing an increase in the past 18 months
of addicts shooting up in MGH walkways, parking garages and bathrooms, where addicts tie emergency pull cords to their bodies in case they
collapse.
Dawn Williamson, an MGH clinical specialist in addiction, tells the Boston Herald using drugs near the hospital is addicts' "way of kind of mitigating
the risk."
Boston Medical Center is the only other city hospital that that equips security guards with Narcan, but Brigham and Women's Hospital will do so next
month.
Visit NHPR for the report.
InterQual 2016 evolves utilization management for a value-based world
The new release of InterQual from McKesson is about helping manage appropriate care. InterQual 2016 introduces a new tools, content models, and
cloud technology that, taken together, make utilization management a more holistic, proactive, and efficient process for organizations focused on
value-based care.
The new Care Management Tools to foster a more holistic view of care and help facilitate discussions between care managers and physicians
include:
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The new InterQual Benchmark Length of Stay helps drive a target date to support discharge planning, better manage care timelines,
conduct timely interventions, reduce avoidable days, and improve bed management.
The new Proactive Care Management Guidance offers “expected progress” and “care facilitation” information, to help ensure your patient
is progressing as expected, identify ways to address potential barriers, and support the most appropriate care transitions.
InterQual Behavioral Health Criteria has been transformed to a new “continuum” format, which shows care settings in a single view to
better address level-of-care needs, facilitate transitions across the care continuum, help speed reviews, and increase transparency.
And InterQual Coordinated Care Content has a new streamlined primary assessment that makes it faster and easier to create a
comprehensive care plan.
InterQual evidence-based criteria and technology solutions help improve clinical decision-making and care management across the medical and
behavioral health continuums of care. The InterQual clinical development team synthesizes the most current, best evidence into a fully referenced
decision support tool. InterQual’s development process is founded on rigorous review of the literature, and includes extensive peer review by
practicing clinical experts across the United States.
Visit Business Wire for the full release.
GHX launches enhanced version of its healthcare industry portal to reduce costs by aligning product and contract pricing across the
supply chain
Global Healthcare Exchange, LLC (GHX) has launched the latest version of its interoperable industry portal for contract price alignment functionality
designed to resolve the root cause of price alignment issues in healthcare. The GHX Collaboration Portal is designed to sync information on all
stakeholders involved in a contract within the healthcare supply chain - the manufacturer, distributor, group purchasing organization (GPO) and
provider - in one place to achieve price alignment.
The new features and functionality in GHX Collaboration Portal have been integrated with Premier, Inc.’s performance improvement platform
PremierConnect to improve the price activation experience for manufacturers. The portal is also being enhanced to include distributors in the price
activation workflow.
With Collaboration Portal, a contract can be delivered via electronic data interchange (EDI) to a distributor the same day it is executed and new
prices loaded by all stakeholders more quickly and efficiently. This helps to eliminate inaccurate purchase orders, disputed invoices and
rebate/chargeback discrepancies, as well as provide timelier response rates for all stakeholders.
Contract price misalignment results in pricing errors throughout the supply chain, which require manual intervention, adding unnecessary costs to the
process. This is largely due to the fact that eligibility and agreed-upon contract prices often take 30-45 days to be received and then loaded into the
respective systems, further resulting in costly price exceptions.
The enhanced Collaboration Portal includes an advanced account lookup service for the manufacturer that provides a holistic view of all of the
locations that are included in the contract at time of execution. By linking the distributor, GPO and manufacturers’ view of the customer before the
letter of commitment (LOC) is executed, GHX can help the industry reduce disputes in the chargeback and rebate process, and help ensure the
hospital receives the correct price for all their facilities.
Visit GHX for the release.