Best read of the week


At the Health IT Summit-Philadelphia, a frank discussion of the challenges around MACRA

Healthcare Informatics:  Katherine Schneider, MD, CEO of the Delaware Valley Accountable Care Organization, noted, “We have a team of practice support people to help our physicians develop patient-centered medical homes, and to do what they need to do in terms of what has been meaningful use and is now MACRA.”


Additional news media reports on MLH physicians and the health care industry, excerpted from MLH’s daily Morning News Report:


Main Line Health News

Deppen Day will finally salute man who has helped so many

News Item: Joseph H. Deppen left money with Lankenau Medical Center in the Philadelphia suburb of Ardmore for the health care of needy Mount Carmel residents. Services can range from surgery at Lankenau to routine visits to Mount Carmel area dentists and eye doctors.


Becker’s Hospital Review Names 110 ACOs to Know

DVACO: Becker’s Hospital Review has named the Delaware Valley Accountable Care Organization (DVACO) to their 2017 list of 110 ACOs to Know. The list features a variety of Medicare and commercial payer ACOs, led by hospitals, health systems, physician groups and other organizations, that have experienced success with their quality metrics.




Regional Health Care News

Fight over decisions on what health insurance covers heats up in Pennsylvania

Lancaster Online: Pennsylvania Medical Society is backing House Bill 1293, which proposes what advocates describe as streamlining and simplifying prior authorization, in part by requiring availability of an electronic system to handle it.


Report: Number of infants exposed to illegal drugs soars in SE Pennsylvania

PhillyVoice: At least 1,085 infants born at Southeastern Pennsylvania hospitals in 2016 were exposed to illegal drugs, the report found. That marked a 27.8 percent increase from 2013, when at least 849 infants were affected. On Thursday, President Donald Trump declared the opioid crisis a national emergency, a move that is expected to help increase access to addiction treatment, expand treatment facilities and supply law enforcement officers with naloxone, an overdose antidote.


Pennsylvania hospital neurosurgeon performs first endoscopic minimally invasive spinal surgery in PA

MedicalXpress: The first patient in Pennsylvania to undergo a life-changing, minimally invasive spine surgery through a single incision in his side was up and walking just hours after surgery.


UPMC announces definitive agreement to acquire Pinnacle Health

Philadelphia Inquirer: With the acquisition of Pinnacle — which had $1.05 billion in revenue in the fiscal year ended June 30, 2016 — UPMC moves into direct competition with the University of Pennsylvania Health System, which owns Lancaster General Health. Penn is the biggest health system in Southeastern Pennsylvania.


$650M bond issue OK’d for Reading Health System to help fund acquisition of 5 area hospitals

Mercury: The bond will also be used to pay for the design, construction, installation and furnishing of the Reading HealthPlex for Advanced Surgical and Patient Care, a 476,000-square-foot surgical and inpatient tower in West Reading.



Patient Care News…

Organ Transplants Delayed in Large US Cities

Medscape:  Geography is not the only determinant of who gets an organ. Each transplant center has different regulations and thresholds for acceptable organs. But it is the geographic inequity that disturbs physicians who have to watch patients die because of the randomness of where they live.


Prescribing Antibiotics Just Got More Complicated

HealthLeaders Media: No one knows for sure how long a patient should take an antibiotic, new research suggests.


‘How Long Have I Got, Doc?’ Why Many Cancer Patients Don’t Have Answers

Kaiser Health News: At a time when expensive new cancer treatments are proliferating rapidly, patients have more therapy choices than ever before, yet are largely kept in the dark because their doctors either can’t or won’t communicate clearly. Many patients compound the problem by avoiding news they don’t want to hear.


End-Of-Life Advice: More Than 500,000 Chat On Medicare’s Dime

HealthLeaders Media: In 2016, the first year health care providers were allowed to bill for the service, nearly 575,000 Medicare beneficiaries took part in the conversations, new federal data obtained by Kaiser Health News show.


New research could lead to pig-to-human organ transplants, experts say

The Advisory Board: Scientists have edited piglets’ genes to eradicate viruses that could cause disease in humans, according to research published Thursday in the journal Science, and some experts say the advancement eventually could make it possible to transplant organs from pigs into humans.


Heart Risks May Rise After Cancer Diagnosis

HealthDay: Researchers said the risk for the clotting event varied by cancer type. Patients with lung, stomach and pancreatic cancers were found to be at highest risk.


Pneumonia, Sepsis Associated With Increased Risk Of Heart Disease, Report

KYW Newsradio: When you compare it with other issues like being overweight, having high blood pressure, and physicial fitness, severe infection actually has the highest magnitude of cardiovascular risk three years after the hospitalization.


Express Scripts to limit opioids, concerning doctors

STAT: The nation’s largest pharmacy benefit manager will soon limit the number and strength of opioid drugs prescribed to first-time users as part of a wide-ranging effort to curb an epidemic affecting millions of Americans.


Hospitals Not to Blame for Most Opioid Addiction: Study

HealthDay News: Painkiller prescriptions that lead to prolonged opioid use tend to be written by doctors in outpatient settings, not hospitals, new research indicates.


‘Liquid biopsy’ spots early-stage cancers in blood, study finds

Fox News: For the study, the team screened blood samples from patients with breast, lung, ovarian and colorectal cancers, looking for 58 genes typically linked with these cancers. Overall, they were able to detect 86 out of 138 stage I and stage II cancers.


Why U.S.-Trained Surgeons Often Aren’t Ready For Humanitarian Work Abroad

NPR: What poor countries need are surgeons who can do C-sections and hysterectomies, skills honed in the U.S. by OB-GYNs. But only 0.1 percent of general surgery residents in the study had been trained to do a C-section.



Quality and Safety News…

The Dangers Of Viewing Solar Eclipse Without Special Glasses

CBS3: “It’s so dangerous for people to look at the sun even for brief periods of time because you can cause permanent damage to the retina. We call it solar retinopathy and it’s really very close to burning a hole in the retina,” said Dr. Russell Van Gelder, spokesperson with the American Academy of Ophthalmology.


New Numbers Reveal Huge Disparities in Opioid Prescribing

Stateline: Using 2015 data from retail pharmacy receipts, the CDC for the first time reported the volume and potency of pain tablets sold in the nation’s drugstores and calculated per capita rates of morphine equivalent doses sold at the county level.


Most patients expect health care professionals to protect them during active shooter events in hospital

Medical Life Science News: Likewise, more than half of health care professionals believe they have a special duty to protect patients under these circumstances. But the two groups differ about the inherent safety of hospitals, with most people viewing them as safe havens, while health care professionals are more likely to view the hospital as a potentially risky setting for an active shooter event.


More U.S. women are dying in childbirth. What can be done?

Philadelphia Inquirer: Safe Start, funded by the pharmaceutical giant Merck, is a small but innovative example of efforts to reverse a disturbing trend: While deaths as a complication of pregnancy have been falling around the globe, including in many poor countries, the U.S. maternal mortality rate has doubled since the 1990s. And Philadelphia’s rate is even higher than the national average.


Healthcare data breaches caused by hacks are on the rise

Modern Healthcare: Many of the attacks in the U.S. come from tools bought on the darknet or illicit websites, and there’s been a particular uptick in attacks that compromise email.



Health Care Business News…

Hospital volumes laid low by high-deductible health plans

Modern Healthcare: Patients avoiding elective surgeries and other procedures because of skyrocketing out-of-pocket costs were cited by hospital chains as a primary cause of softening hospital volumes in the second quarter.


Medical emergency: ER costs skyrocket, leaving patients in shock

CNBC: On average, emergency-room bills for out-of-network care is 4.4 times higher than what Medicare allows for the same services, costing consumers more than $3 billion a year, according to a nationwide study by the Johns Hopkins School of Medicine


Hospitals Putting Their Labs in One Place

Hospitals & Health Networks: Several organizations are finding greater efficiencies and cost savings in centralizing their lab operations into a single core facility. They’re aided in this endeavor by new concepts in lab design and Lean principles.


The Chief Primary Care Medical Officer: Restoring Continuity

Annals of Family Medicine: The CPCMO can lead hospital efforts to create systems that ensure primary care’s continuum is complete, while strengthening physician collaboration across specialties, and moving toward achieving the Quadruple Aim of enhancing patient experience, improving population health, reducing costs, and improving the work life of health care providers.


Physician compensation: 5 questions before you roll out a new model

The Advisory Board: Even the best-conceived mechanics will not hold up to clashes with physician ethos, unplanned shifts in reimbursement, and mismatched system-level goals.


Millennials are changing health care. Is your hospital ready?

The Advisory Board: Millennials are more likely to demand a top-notch consumer experience; they’re also more cost-conscious than older generations and more likely to switch doctors, use retail clinics and urgent care facilities, or travel further to save money.


3 mandatory bundles will likely be canceled, a 4th scaled back: What you need to know

The Advisory Board: All the pay-for-performance programs are here to stay and the optional Medicare ACO models continue. Also, MACRA certainly isn’t going away, spurring physicians to take a new look at alternative payment models. What was unique about CJR and EPM is that they are the only mandatory alternative payment models (APMs), so we are seeing the Trump administration scale back on the rollout of mandatory APMs. However, signs continue to point to new voluntary programs emerging.


How to address PACT—a hidden threat to your TAVR margins

The Advisory Board: CMS’s Post-Acute Transfer (PACT) policy costs hospitals nationwide more than pay-for-performance penalties; at least 1,300 hospitals lose more than $500,000 per hospital in Medicare fee-for-service inpatient revenue annually because of PACT.


CMS to waive restrictions to reimburse for telemedicine in the joint replacement payment model

Healthcare Finance News: CMS will include practice expense payment for the comparable office and other outpatient visits. These services were not included in the past because CMS said it believed any practice expenses incurred were marginal or paid through other services.



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