Archive for July 2016

Can Eating Well Improve Patient and Provider Satisfaction?

I am conflicted when I travel. Do I savor the new city and adventure in small doses or try to see as much as I can? I favor the former but often find myself navigating like the latter. For instance, during a recent visit to NYC, we scurried from activity to activity, hungry pizza rats in the city. During our yearly visits, we seek out basic New York staples.  It was a day of bagels at a stand in Chelsea Market, NY pizza in an Uber as we hustled with the kids across town, a cart knish and pretzel outside Central Park, and a hot dog dinner standing up on my sister’s patio on the Upper West Side. As we lingered outside, my wife pointed out that we ate all our meals standing up, constantly on the move. We reached our food goals, without taking the time to enjoy and appreciate…

Star Rating Concerns, MACRA & the Opioid Epidemic Top Hospital Medicine News

SHM & Hospital Medicine in the News: July 7 – 21, 2016 The following are among the top hospital medicine and SHM-related topics in mainstream and healthcare-centric news coverage. For the full stories, click on the hyperlinks below: Hospital groups’ demands that the CMS postpone star ratings after concerns over their accuracy and validity in judging care quality (Modern Healthcare, 7/8/16) A potential delay in the implementation of MACRA, as per CMS Acting Administrator Andy Slavitt in response to a number of providers’ concerns (Modern Healthcare, 7/13/16) The Senate passing a groundbreaking bill penned to address the nation’s opioid epidemic via training programs for providers for at-risk patients and an interagency task force to examine best practices for pain management (MedPage Today, 7/14/16) A New York Times feature on the pay gap between male and female physicians, including commentary from SHM’s own Dr. Vinny Arora (The New York Times, 7/11/16)…

5-Star Ratings Don’t Mean 5-Star Care

Despite aggressive criticism, CMS is proceeding to release its star ratings for hospitals this month. Hospital advocates have been among the most vocal opponents, citing two primary concerns: The ratings vastly oversimplify a complex set of metrics. There are no concessions for social determinants of illness. Ashish Jha, MD, a professor at Harvard’s T.H. Chan School of Public Health, has advocated against the ratings, predominantly for the two reasons stated above. Rick Pollack, president and CEO of the American Hospital Association, expressed similar reservations: “As currently designed, CMS’ star hospital ratings program is not up to the task of providing the public with meaningful and accurate assessments of hospital performance. Patients need reliable information to make important choices regarding their healthcare. And hospitals and health systems need reliable information so that they can continue to improve the quality of the care delivered. CMS star ratings misses the mark on both…

The Next Hospital Decade: Broken Hips Versus Band-Aid Strips

  I had planned on writing on MACRA and the inability of those who criticize the law to offer up alternatives to fix the flaws.  I got tired of the conclusions from the skeptics: let providers be and they will do the right thing.  That is a recipe for the pendulum to swing too far in one direction.  The "right thing" will wind up costing the Treasury a ton of dough.  History has already born that out. I am one of the skeptics as well, though.  I had no idea how CMS was planning to stitch this whole thing together--and I was waiting for hints from Andy Slavitt, top dog at CMS, based on his testimony last week on the Hill. Well, if you shorted Kleenex stock, pat yourself on the back. You can put your hankies away because it looks like CMS may postpone the start date.  My screed…

What I Did on My Summer Vacation

One of the best parts of my “job” as a more-or-less emeritus member of SHM’s Practice Analysis Committee is the chance to be involved up close and personal in the development, analysis, and reporting of the biannual State of Hospital Medicine (SoHM) survey. In fact, I’ve either led or been integrally involved in every SoHM survey since 2006, and that has enabled me to gain an extremely valuable perspective on how the specialty of hospital medicine has evolved over the last 10 years. During the last few weeks, I’ve been up to my eyeballs reviewing sections of the new 2016 survey report that were drafted – as was the case in 2014 – by Patrick Vulgamore, MPH, SHM staffer extraordinaire. While some of the data is still being analyzed, my excitement is growing about the new survey results. The State of Hospital Medicine Report will be available to the public…
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