tag:blogger.com,1999:blog-32053362.post5953922408598131260..comments2024-03-29T06:37:18.029-04:00Comments on Not Running a Hospital: What Scott and Martha got wrongPaul Levyhttp://www.blogger.com/profile/17065446378970179507noreply@blogger.comBlogger13125tag:blogger.com,1999:blog-32053362.post-73950823216941238462014-07-12T10:06:27.947-04:002014-07-12T10:06:27.947-04:00anon 9:52PM
There is not full year data yet for S...anon 9:52PM<br /><br />There is not full year data yet for Steward (their fiscal year ends Dec 31), but through the first three quarters, the mass agency collecting this data has released this. <br /><br />Carney (4.5)<br />Good sam 4.2<br />Holy Family 7.5<br />Merrimac (7.5)<br />Morton (3.7)<br />Nashoba 0.1<br />Norwood 0.1<br />Qunicy (13.8)<br />St Anns 13.8<br />St Eliz 9.5<br /><br />Total 5.7 M in the black<br /><br />That is through three quarters of Stewards fiscal year for 2013. <br /><br />Unlike every other hospital in mass Steward's data for Q4 of last year and Q1 of this year hasn't been released yet.<br /><br />Note: all data from Mass CHIA<br /><br />http://www.mass.gov/chia/researcher/hcf-data-resources/hospital-financial-performance/historical-financial-performance.htmlAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-3123390801535501422014-07-11T21:52:00.255-04:002014-07-11T21:52:00.255-04:00Paul, Steward will implode after the November elec...Paul, Steward will implode after the November election. Cerberus has collected enough in dividends to make up for all the money that it spent on GSH ER, SEMC ICU etc. They have sold their labs, they have sold the Medical Office Building on Nevins street and on Washington street and now they are leasing them back. That's how Steward is paying Cerberus. No one will buy Steward as a Health Care system because it is losing money by the buckets. Cerberus has made what they wanted to make and are thinking of how to unload it. De La Torre is not running the show any more - they have brought folks from NYC who are stationed in 500 Boylston. They are just waiting for the election, since slicing Steward in pieces and selling it over the summer would cause an uproar in Boston (where will the indigent Carney patients go, where will all the unemployed SEIU members go - under Coakley's watch...). She has asked them to hold off until the fall - and that's exactly what is going to happen. Go to St. Elizabeth's at 11AM and see how empty it is. Then go to the cafeteria for lunch and you will notice that everyone having lunch is wearing scrubs, white coats and/or has a St. Elizabeth's ID badge on them. In the weekend it looks like an Arizona ghost town. The party is over...Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-47546002696532952642014-07-11T16:50:40.867-04:002014-07-11T16:50:40.867-04:00Users from Epic across the country will tell you t...Users from Epic across the country will tell you that they cannot share information with other Epic users.Paul Levyhttps://www.blogger.com/profile/17065446378970179507noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-57041005471257468102014-07-11T16:48:33.534-04:002014-07-11T16:48:33.534-04:00Anon 8:26AM
Epic does "ALLOW" shared in...Anon 8:26AM<br /><br />Epic does "ALLOW" shared information, but will Partners allow the software to share with other academic medical centers?<br /><br />for that matter eclinicalworks has some capability to interoperate with epic. And many Mass doctors groups use eclinical works, which is based locally. <br /><br />Now if the state mandated open access to that data if patients request it, that changes the ballgame. <br /><br />Require open access to EMR records if patients request it. That would enhance healthcare competition and begin to create a real market.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-65563912190457905322014-07-11T08:26:54.181-04:002014-07-11T08:26:54.181-04:00Except Epic does allow for shared information acro...Except Epic does allow for shared information across providers using Epic - and a significant number of other hospitals in the Eastern Mass / Boston area are also implementing Epic clicnal systems.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-61778901898780462402014-07-10T11:41:54.606-04:002014-07-10T11:41:54.606-04:00A different split would be nice but I would guess ...A different split would be nice but I would guess it depends which hospital has the closest connections to the community hospitals<br /><br />The Brigham could also try to take back Harvard Vanguard from BID<br /><br />I think the most important think to force Partners to divest is <br /><br />Neighborhood Health Plan<br />(which it took over last year)<br /><br />NHP has a low cost structure even though it still refers to Partners for its plans....the though it is the only Health Plan that refers to MGH and B&W for its low cost products.<br /><br />As long as NHP is owned controlled by MGH and B&W...it will be difficult for other <br /><br />Limited Network Health Plans to draw patients from the Partners hospitals........<br /><br />Parnters control of NHP is one of the things preventing real price competition from developing in Massachusetts (Partners is subsidizing its own health plan) <br /><br />Real Price competition with Limited Network plans could hurt MGH and Brigham and Womens as referral sites, but owning NHP limits that damage......<br /><br /><br /><br />Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-7175947590775432372014-07-10T11:30:18.612-04:002014-07-10T11:30:18.612-04:00So perhaps a different split is better. The basic ...So perhaps a different split is better. The basic idea remains. Paul Levyhttps://www.blogger.com/profile/17065446378970179507noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-9720959285406832232014-07-10T11:27:31.865-04:002014-07-10T11:27:31.865-04:00Note sure that splitting up Partners will result i...Note sure that splitting up Partners will result in lower prices for consumers either. <br /><br />MGH will end up with most of the current Partners community hospitals beds and outpatient centers....<br /><br />MGH outpatient centers<br /><br />Danvers<br />Chelsea<br />Waltham<br /><br /><br />North Shore<br />Cooley Dickson<br />Newton Wellsley<br />Spaulding<br /><br />and has the closest connections to <br /><br />Hallmark <br />Emerson<br />Southern New Hampshire Medical <br />(But in New Hampshire so not regulated by Mass)<br /><br />Brigham and Womens would get:<br /><br />Faulkner<br />Southshore<br /><br />Foxboro outpatient center<br /><br />already has close links to <br /><br />Care New England in Rhode Island (not regulated by Mass) eg<br />Kent Hospital<br />Memorial Hospital <br /><br />that means Brigham and Womens would want to add to its network in Massachusetts<br /> <br /><br />Which means what was Partners has an even larger community network that its current one........<br /><br />Potential new Brigham and Womens sites<br /><br />Milford Regional<br />(where it has a cancer center with Dana Farber)<br /><br />Cape Cod Hospital - which has long standing close links to Brigham and Womens<br /><br />Southcoast which is developing links to Brigham and Womens<br /><br />Might it develop links to Steward? <br /><br />Dana Farber a close Brigham parters is now providing care at St. Elizabeths and has taken over commonwealth hematology and oncology. <br /><br />Be careful what you wish for.....Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-81789230315178506632014-07-10T07:31:01.029-04:002014-07-10T07:31:01.029-04:00Paul,
To the extent that there are procedures tha...Paul,<br /><br />To the extent that there are procedures that used to require an inpatient stay and can now be done on an outpatient basis for significantly less cost, the system is net better off even if that care is still delivered by a high cost PHS facility. However, I understand that system wide costs would be lower if PHS weren’t able to extract significantly higher prices from insurers.<br /><br />Second, I presume that PHS can NOT extract significantly higher prices from Medicare and Medicaid and those two systems combined serve about one-third of the population nationally and probably account for close to half of medical spending including long term care and home healthcare.<br /><br />Finally, most of the newer health insurance plans purchased through the exchange are excluding PHS from their network in order to offer the lowest possible premium. These plans are attractive to the lower middle income segment of the population that might otherwise not be able to afford health insurance at all even with subsidies.<br /><br />As nonlocal noted, the public so far unfortunately seems to support PHS and its market power. Until they come to better understand that most of PHS’ care is no better that what competitors provide and they face more out-of-pocket exposure through tiered networks, the status quo will likely persist.<br />Barry Carolnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-55476602252562898362014-07-10T07:24:21.092-04:002014-07-10T07:24:21.092-04:00Great posting Paul. It has always mystified me th...Great posting Paul. It has always mystified me that the costs in medicine continue to rise (driven by technology, new procedures, new medications, and now consolidation) while the costs of everything else in society (computers, communications, consumer electronics,travel, even labor when adjusted for inflation) seem to continually fall.Neville Sarkari MD, FACPhttps://www.blogger.com/profile/01096155690678788954noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-48838661293556248072014-07-10T06:32:15.658-04:002014-07-10T06:32:15.658-04:00You can definitely hold Martha accountable, by not...You can definitely hold Martha accountable, by not electing her governor of your fine state. Do you really want Partners' puppet in the governor's mansion?<br />As for divestiture, PHS has successfully fended that off by having their puppet call off the feds' antitrust investigation. <br />The bottom line is that Partners will do what it wants because the public supports them. This may be their ultimate achievement; subverting the hearts and minds of the patients. Until, of course, we inevitably all have to pay more out of pocket for our health care, when they will start complaining - too late.nonlocal MDnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-43286500394462435302014-07-10T05:50:29.417-04:002014-07-10T05:50:29.417-04:00Barry, on your first point, that doesn't matte...Barry, on your first point, that doesn't matter in this case, as PHS also has dominance in the outpatient arena in the Eastern Massachusetts region. In fact, it used those excess revenues to build some massive outpatient facilities.<br /><br />On the second point, it is technically possible, but PHS has signed a master contract (for close to $1 billion) with Epic, which has chosen to keep its technology closed with regard to interoperability.Paul Levyhttps://www.blogger.com/profile/17065446378970179507noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-27382784003566545422014-07-10T03:29:18.076-04:002014-07-10T03:29:18.076-04:00One positive is that the long term trend in the de...One positive is that the long term trend in the demand for inpatient hospital care is declining as more care can be safely shifted to outpatient facilities including ambulatory surgical centers. Shortly after World War II, we had about 10 hospital beds per 1,000 of population nationally. Now the number is around three and continues to decline.<br /><br />Separately, how close are we to interoperable electronic medical records? <br />Barry Carolnoreply@blogger.com