News & Updates

In cooperation with the American Ambulance Association, we and others have created a running compilation of local and national news stories relating to EMS delivery. Since January, 2021, over 1,800 news reports have been chronicled, with 49% highlighting the EMS staffing crisis, and 34% highlighting the funding crisis. Combined reports of staffing and/or funding account for 83% of the media reports! 96 reports cite EMS system closures/agencies departing communities, and 95% of the news articles reference staffing challenges, funding issues and response times.


Click below for an up to date list of these news stories, with links to the source documents.

Media Log as of 3-27-24 READ Only.xlsx

  • 24 Jul 2018 3:30 PM | AIMHI Admin (Administrator)

    BY MANDY ROTH  |   JULY 23, 2018

    https://www.healthleadersmedia.com/innovation/diminish-copd-readmissions-reducing-barriers-health-home

    Community hospital population health initiative reveals many patients don’t use equipment properly at home 

    With COPD comprising the second largest reason for 30-day readmissions at Johnston Health in Smithfield, N.C., the 199-bed community hospital system launched a population health initiative that has united forces inside and outside hospital walls to address this chronic and costly disease. The key focus: What barriers exist to keeping patients well at home?

    The comprehensive approach involves multiple initiatives, but the “secret sauce,” is a post-discharge, in-home patient visit, says Peter Charvat, MD, vice president and chief medical officer of Johnston Health, an affiliate of UNC Health Care, Chapel Hill, N.C. The on-site appointment is conducted by a paramedic who brings a respiratory therapist (RT) into the encounter via an electronic tablet. The duo explores every aspect of home care. Among their findings:

    1. Visits Reveal Improper Use of Home Equipment

    The program has homed in on a key problem: even patients who have had COPD for years often are not properly using their inhalers, or oxygen and nebulizing equipment. It’s not unheard of to find equipment stowed in a closet, unused.

    1. Medication and Transportation Create Challenges

    Other issues include improper use of medication, plus lack of transportation to numerous post-discharge appointments, which might include primary care providers, pulmonary rehabilitation and smoking cessation classes offered by the county.

    1. Complexity Creates Chaos

    COPD patients have to deal with multiple, disconnected entities and processes, such as complex discharge instructions, durable medical equipment companies, home health services, and possibly skilled nursing facilities.

    MULTIDISCIPLINARY APPROACH
    Dr. Charvat, a member of HealthLeaders’ Population Health Exchange, brought all these outside entities into the process. The group also included hospitalists and respiratory therapists, as well as representatives from nursing, the emergency department, outpatient rehabilitation and administration. They opened lines of communication and devised a plan for better approach to COPD care.

    One unique element: leveraging a partnership with the county EMS system to use their paramedics to conduct home visits. Cost is shared by the health system and the county.

    4-STEP PROGRAM
    The COPD program included four elements:

    1. Multidisciplinary team approach
    2. Standardization of practice and a reduction of inappropriate provider variation
    3. Patient education
    4. Post-discharge patient contact

    Post-discharge patient contact included:

    • The on-site paramedic/RT tele-visit during week one to review proper use of equipment and medication
    • Phone calls during weeks two through four, when possible
    • Pulmonary rehabilitation
    • Smoking cessation, if applicable

    LONG-TERM PERSPECTIVE
    In the four months after launching the program, readmissions dropped about 35 percent, then rose, and, in recent months they have fallen below the 17% threshold the team wanted to surpass. Eleven months into the program, overall readmission rates are about even with the previous period, but most patients are being readmitted for reasons other than COPD, Dr. Charvat says.

    “I’ve been very clear to our people,” says Dr. Charvat. “this is a thousand-day journey. In our first year, we developed the infrastructure, and we started doing things that we had never done before.” Year two will determine what program elements are successful and year three will result in further development.

    “We set out to better manage patients and we have done that,” Dr. Charvat says. “I really believe we’re managing the disease better overall, because in the end, our efforts are really focused on COPD.”

    ADDITIONAL BENEFITS
    The Johnston Health COPD program also produced additional benefits:

    • Using paramedics and RTs eliminates the need to navigate around physicians’ schedules and help reduce their load
       
    • Patients without technology, or those who are technology averse, can still participate in the telehealth aspect of the program because paramedics bring the electronic tablet with them and set up the connection with the respiratory therapist. In addition, the service does not require a home Internet connection. 
    • The program helped standardize care delivered between inpatient and outpatient RT departments
    • The process helped build a connection between the hospital, durable medical equipment providers and skilled nursing facilities

    COST AND IMPACT OF COPD

    • “COPD is the third leading cause of death in the United States. More than 11 million people have been diagnosed with COPD, but millions more may have the disease without even knowing it,” according to the American Lung Association. “COPD causes serious long-term disability and early death. At this time there is no cure, and the number of people dying from COPD is growing.”
    • study published June 17, 2013, in ClinicoEconomics and Outcomes Research online quantified the financial impact: “In 2010, the cost of COPD in the USA was projected to be approximately US$50 billion, which includes $20 billion in indirect costs and $30 billion in direct health care expenditures.”

    Mandy Roth is the innovations editor at HealthLeaders.

  • 24 Jul 2018 1:00 PM | AIMHI Admin (Administrator)

    The emerging role of emergency medical services in reducing readmissions

    by Tammy Leytham

    July 1, 2018 

    https://www.homecaremag.com/july-2018/community-paramedicine

    When Lt. J.D. Postage makes house calls as a community paramedic in Violet Township, Ohio, his goal is to ensure patients stay out of the hospital and have their basic needs met. 

    He’s part of the rapidly-evolving field of mobile integrated healthcare or community paramedicine (MIH-CP) finding a foothold in metropolitan areas as well as in rural communities. Goals range from reducing the number of hospital readmissions to keeping patients out of emergency rooms to signing up residents for Meals on Wheels.

    When it comes to community paramedicine, a one-size-fits-all mentality just doesn’t fit.

    Reducing Readmissions

    For some patients, follow-up instructions after hospital visits can be a daunting task. Add to that issues with being low-income, and many patients end up right back in the hospital with more medical issues.

    Climbing health care costs have led many EMS providers to put this new tool in their medical chest. Avoidable hospital readmissions cost an estimated $40 billion a year, according to a Department of Health and Human Services (HHS) report.

    Heart failure readmission rates nationwide are more than 20 percent for cardiac patients, according to data published in 2017.

    The Hospital Readmissions Reduction Program, mandated by the Affordable Care Act (ACA), gave an extra incentive to providers to cut those numbers. It requires the Centers for Medicare & Medicaid Services (CMS) to reduce payments to hospitals with excessive readmissions. Recent studies show readmission rates have declined since the program began, according to a CMS spokesperson.

    But lowering re-admission rates is not the only goal for MIH-CP programs

    “It’s across the board in terms of what departments are doing,” said Scioto Township Fire Chief Porter R. Welch. As chair of the Ohio Fire Chiefs’ Association MIH-CP Committee, Welch helped draft and adopt legislation that permitted community paramedicine in Ohio.

    “It’s really based on the needs of the community,” said Postage, the only community paramedic on staff at Violet Township.

    In 2016, Mount Carmel Health collaborated with first responders in four departments (soon to be five) to implement the community paramedicine program in central Ohio.

    It started with heart patients, working to see what the triggers were causing them to go back to the hospital. “What are the common themes,” Postage said. “Are they taking medications right? Do they understand the diet?”

    Now, Postage has developed resources throughout the community to provide whatever the patient needs. “I get referrals from apartment complexes, from the food pantry, from guys at the fire station, from doctors’ offices,” he said.

    Providing Social Services

    Churches are also on the front lines in providing volunteers and financial assistance for patients who need it. One church donates medical supplies.  In Delaware, Ohio, “they’re doing something a little different,” Welch said.

    With no official community paramedic, EMS responders there take note when an elderly patient needs Meals on Wheels, help obtaining and taking medication, or transportation to doctors’ appointments. In those cases, a county-funded senior citizen program has an on-staff liaison who makes contacts and gets the patient in touch with proper services.

    It’s the same approach taken at Welch’s department in Scioto Township. “It’s filling the gap in terms of what the community needs, and every community is different,” he said.

    The biggest hurdle his department faces is “making sure we’re putting these folks in touch with the right social services.”

    Birmingham Fire & Rescue Service in Alabama works with local hospital systems and community resources through its Community Assistance Referrals and Education Services (C.A.R.E.S.) program, started in February 2016.

    It began with scheduled home visits conducted with frequent 911 users, said Lt. Ben Thompson, one of two EMTs assigned to the program. “From there, we integrated ourselves in the greater health care community.”

    Responders found a “multitude of issues being faced by our citizens upon returning home from the hospital,” Thompson said. “The harsh reality is that many in Birmingham are living far below the poverty line. For these folks, the problems never stop.”

    So, it is difficult, if not impossible, to properly follow through with their discharge instructions. “What we do is try and coach them along so they don’t get sick again,” he said. It can be a task as simple as calling their doctor to schedule an appointment.

    “Sometimes, they just enjoy having someone coming in to check on them,” Thompson said. “Everyone likes to feel important. Many of these people rarely have had that opportunity. So, if anything, this is our goal: To let every Birmingham citizen know that they are important and their health matters. Sometimes that’s all they need.”

    Similar community paramedicine programs have taken root and expanded across the country, treating and keeping patients in their home by having EMS personnel visit patients in a non-emergent situation. Responders provide post-hospital follow-up visits, chronic disease management, preventive care, non-emergency evaluations, lab work, wound checks, cardiac checks and in-home safety risk assessments.

    Care Around the Nation

    The Mayo Regional Hospital Emergency Medical Services in Dover-Foxcroft, Maine, launched its community paramedicine program this past May, as did Haywood County with the Haywood Regional Medical Center in Clyde, North Carolina.

    The Albuquerque, New Mexico, Fire Department started its community paramedicine program in April. Last fall, Wisconsin Gov. Scott Walker signed legislation allowing its EMS responders to make non-emergency house calls.

    Climbing health care costs have led many EMS providers to put this new tool in their medical chest. Avoidable hospital readmissions cost an estimated $40 billion a year, according to a Department of Health and Human Services (HHS) report.

    Haywood Regional Medical Center sees a paramedicine program as a way to cut down hospital readmissions that are reimbursed at a lower rate by Medicare, Medicaid and insurance programs, The Mountaineer newspaper reported. Haywood County emergency officials also want to cut down on the number of calls from those who repeatedly use EMS for non-emergency situations.

    In Bergen County, New Jersey, Valley Health Systems has seen more than 950 patients in their homes since launching its MIH in 2014, said Christina Pratti, RN and clinical coordinator. Their program works hand-in-hand with providers and the hospital to extend this home-style option of EMS, specifically for cardiac patients.

    The team works with Valley Home Care and focuses on patients who refuse or don’t qualify for homecare services in order to fill in the gaps in care. And it’s working.

    Pratti said her team’s ability to administer things like Lasix via IV at home while communicating with a patient’s primary care doctor has reduced the number of hospital visits and re-admits for congestive heart failure.

    Funding Concerns

    Funding for MIH-CP programs is as varied as the way programs are administered.

    “There’s not a lot of consistent funding,” Welch said of the Ohio programs. In Delaware, Ohio, for example, the liaison is funded by a county senior citizen group.

    Postage’s position is paid for by the Violet Township Fire and EMS Department, though they have a contract with Mount Carmel Health for some high-risk patients.

    “Pretty much, the fire department foots the bill,” Postage said. “There’s no structure for patients to pay for the services so pretty much everything I do is free to the public.”

    Birmingham C.A.R.E.S. took a big step forward recently when it negotiated a contract with UAB Hospital to conduct follow-up home visits on frequent Emergency Department users. C.A.R.E.S. will be compensated by the hospital for carrying out these home visits, Thompson said.

    “We also have another large hospital system in negotiations to do the same for their patients,” he said. “The compensation piece was a huge achievement because now we can actually self-sustain our efforts. From what I know, we are the first in the state to negotiate such a contract.”

    While it’s just a two-man shop for now, the department has plans to add personnel as the patient pool grows, Thompson said.

    Community paramedics in Ohio go through additional training and 232 hours of clinicals, Postage said. “My program is mirrored through several other fire departments. We all work together,” he said.

    Mount Carmel Health works with those departments in obtaining clinicals. A new program is being launched on stroke follow-ups.

    “With each program we roll out, we do additional training,” Postage said.

  • 18 Jul 2018 9:56 PM | AIMHI Admin (Administrator)

    This is notable for a couple of reasons….

    1. This clearly articulates Value-Based Transformation and Innovation as one of Azar’s 4 priorities.
    2. Congressional representatives and their staffers have told us that CMMI has the authorization to change payment policy, without Congressional action.
    3. Some EMS representatives have already met with Mr. Boehler promoting alternate economic models for EMS.

    —————————–

    HHS Secretary Azar Announces Senior Advisor for Fourth Departmental Priority

    https://www.hhs.gov/about/leadership/secretary/priorities/index.html

    On Wednesday, Health and Human Services Secretary Alex Azar announced that Adam Boehler, currently Director of the Center for Medicare & Medicaid Innovation (CMMI), will also begin serving as Senior Advisor for Value-Based Transformation and Innovation 

    Boehler is the fourth individual Azar has appointed to serve as a senior advisor to the secretary overseeing one of his four key departmental priorities, following the naming of Jim Parker as Senior Advisor to the Secretary for Health Reform and Director of the Office of Health Reform, Dan Best as Senior Advisor for Drug Pricing Reform, and Dr. Brett Giroir as Senior Advisor for Opioid and Mental Health Policy.

    “Adam is the kind of results-oriented, transformational leader we need to deliver on what President Trump has promised the American people: better healthcare at a lower cost,” said Secretary Azar. “At CMMI, he has already demonstrated an ambition for bold change, and will now be able to bring his deep experience with private sector innovation to help HHS execute on the long-talked-about goal of transforming our healthcare system into one that pays for value.”

    Since April, Boehler has served as Deputy Administrator and Director of the Center for Medicare & Medicaid Innovation. Boehler is the former CEO and founder of Landmark Health, a company focused on delivering medical services to the most chronically ill patients. Boehler is also the founder of Avalon Health Solutions, a leading provider of laboratory benefit management services in the country. Additionally, Boehler was an Operating Partner at Francisco Partners a leading global private equity firm focused on healthcare technology and services investing.

    The senior advisers will help advance the four initiatives Secretary Azar has identified for his transformation agenda: combating the opioid crisis; bringing down the high cost of prescription drugs; addressing the cost and availability of health insurance; and transforming our healthcare system to a value-based system.

  • 17 Jul 2018 9:55 PM | AIMHI Admin (Administrator)

    His Job Is Saving Lives When Others Are Sleeping

    By Patricia R. Olsen

    July 13, 2018

    https://www.nytimes.com/2018/07/13/business/paramedic-emt-saving-lives.html

    He works for a big city ambulance service until 3 a.m.: “We get the most stabbings, shootings and drug overdoses on this shift. 

    Charlie Rose, 43, is a paramedic at Grady E.M.S. in Atlanta.

    E.M.S. stands for emergency medical service. What, exactly, is Grady E.M.S.?

    We’re a hospital-based 911 provider and ambulance service owned by Grady Health System. I’m part of the ambulance staff. Residents with medical emergencies in Atlanta call 911, an operator there contacts us, and we respond to the call and transport the person to the hospital.

    Besides treating patients, do you drive an ambulance?

    It depends on the condition of the person we pick up. My partner, Pete Nelson, is an emergency medical technician. As a paramedic, I have a higher level of training and can administer narcotics such as pain medicine, for example. I’m also trained in cardiology.

    He drives if someone is in cardiac arrest or has another life-threatening problem so that I can attend to the patient. I drive when the problem is less critical.

    If it’s a really bad situation and, for example, the Fire Department is present, we can elect to have one of their members ride along and assist us while we work on the patient.

    When do you work?

    Three days a week, Wednesday, Thursday and Friday, from 2:30 p.m. to 3 a.m

    What’s it like working a night shift?

    We get the most stabbings, shootings and drug overdoses on this shift. I like the adrenaline rush. I’ve probably seen more things in four years than most paramedics have seen in 10.

    We learned in training that if we’re dispatched to a location where a violent crime has occurred, we should park a few blocks away and wait for law enforcement to secure the scene. I rarely do that, but I use common sense.

    If I hear shots, I wait. However, the shooter has probably bolted right away, and if someone is shot in the chest and bleeding, waiting five minutes for the police could be the difference between life and death. The quicker I get the person to a surgeon, the greater the chance they’ll survive.

    Have you always worked in this field?

    No, I was a tattoo artist, and before that I had various jobs like waiting tables and repossessing cars. I blame wanting to be a paramedic on William Shatner. When I was a teen I watched “Rescue 911,” which he hosted, and saw paramedics saving lives on some episodes.

    About five years ago I went to Metropolitan Community College in Omaha and got certified as an emergency medical technician. I worked as an E.M.T. in Omaha while I went back to college for a certificate in para-medicine, and then got the job at Grady and moved here.

    What job experience has really stuck with you?

    We were en route to a skate park to help a teenager who had a seizure when a 911 operator alerted us that his condition had changed to cardiac arrest. A bystander was performing CPR when we pulled up.

    We shocked the boy’s heart three times and got it restarted, and two days later I got to talk to him in the hospital and shake his hand, which is unusual. You can only have so much time to bring someone back before the brain is deprived of oxygen. When that happens, there’s often neurological damage, but the teen made a full recovery. It was truly the best save I’ve ever had.

    After four years at Grady E.M.S., is there anything that still surprises you?

    What people do to each other, for no reason. I helped one guy who had been stabbed over a hamburger. The lack of humanity is unbelievable.

  • 17 Jul 2018 9:30 AM | AIMHI Admin (Administrator)

    The IHI just released an excellent work product on principles and recommendations for advancing patient safety in the home.

    There is a specific reference to EMS’ role in this endeavor, and recommendations regarding alignment of financial incentives.  A link to the full report is below, and attached is an abridged version that highlights the EMS recommendations.

    Click here to view the abridged version of the EMS highlights.

    —————————-

    http://www.ihi.org/resources/Pages/Publications/No-Place-Like-Home-Advancing-Safety-of-Care-in-the-Home.aspx

    No Place Like Home: Advancing the Safety of Care in the Home

    No Place Like Home: Advancing the Safety of Care in the Home. IHI Report. Boston, Massachusetts: Institute for Healthcare Improvement; 2018. (Available at ihi.org)

    Caring for patients in their homes holds many potential benefits, yet the safety of care provided in the home has not received as much attention as patient safety in hospitals and other clinical settings.

    This report describes the findings of an expert panel and considers the physical and emotional safety of the care recipient, the family caregiver, and the home care worker, while recognizing the interconnected nature of the safety of all these individuals.

    The report provides recommendations, strategies, and tools for realizing five guiding principles:

    • Principle 1: Self-determination and person-centered care are fundamental to all aspects of care in the home setting.
    • Principle 2: Every organization providing care in the home must create and maintain a safety culture.
    • Principle 3: A robust learning and improvement system is necessary to achieve and sustain gains in safety.
    • Principle 4: Effective team-based care and care coordination are critical to safety in the home setting.
    • Principle 5: Policies and funding models must incentivize the provision of high-quality, coordinated care in the home and avoid perpetuating care fragmentation related to payment.

    Background

    With support from the Gordon and Betty Moore Foundation, IHI conducted this project to better understand the scope of patient safety issues in the home setting and identify strategies and best practices for improvement. Following the completion of a landscape analysis, IHI convened a multidisciplinary expert panel to consider the challenges and opportunities related to advancing patient safety in this area and develop strategic recommendations for moving forward. This report is the result of the panel’s work.

  • 6 Jul 2018 9:30 AM | AIMHI Admin (Administrator)

    Many EMS system stakeholder (internal and external) have asked about a compendium of peer reviewed studies and reports on the new EMS model of Mobile Integrated Healthcare and Community Paramedicine.

    AIMHI is beginning to compile as much of this information as possible for use by EMS agencies, as well as our key stakeholders.

    If you would like to have your report or study listed here, or would like to have a study you find added to the compendium, email MZavadsky@medstar911.org.

    —————————————-

    Studies:

    MedStar MIH Study in American Journal of Emergency Medicine – 2017

    American Journal of Emergency Medicine 35 (2017) 1702–1705

    https://www.ncbi.nlm.nih.gov/pubmed/28495031  

    CARES: A Community-Wide Collaboration Identifies Super-Utilizers and Reduces Their 9-1-1 Call, Emergency Department, and Hospital Visit Rates

    ES Bronsky et al. Prehosp Emerg Care 21 (6), 693-699. 2017 Jun 28

    https://www.ncbi.nlm.nih.gov/labs/articles/28657819/

    Update of Evaluation of California’s Community Paramedicine Pilot Program

    https://healthforce.ucsf.edu/publications/evaluation-california-s-community-paramedicine-pilot-program 

    Northwell Health CP Study Published in the Journal of the American Geriatric Society

    J Am Geriatr Soc. 2016 Dec; 64(12):2572-2576.

    https://www.ncbi.nlm.nih.gov/pubmed/27575363

    Assessing call demand and utilization of a secondary triage emergency communication nurse system for low acuity calls transferred from an emergency dispatch system

    Annals of Emergency Dispatch and Response. 2015;3(2):11-15

    https://www.aedrjournal.org/assessing-call-demand-and-utilization-of-a-secondary-triage-emergency-communication-nurse-system-for-low-acuity-calls-transferred-from-an-emergency-dispatch-system/ 

    The Distribution of 911 Triaged Call Incident Types within the Emergency Communication Nurse System

    https://www.semanticscholar.org/paper/The-Distribution-of-911-Triaged-Call-Incident-Types-Scott-McQueen/034069cba706c88266443255b62c0888c616f000

    MIH Study in Journal of Patient Experience

    J of Patient Experience Volume: 3 issue: 1, page(s): 20-23

    http://journals.sagepub.com/doi/10.1177/2374373516636742 

    MIH Study in Journal of Public Health Management

    Popul Health Manag. 2017 Feb;20(1):23-30. doi: 10.1089/pop.2016.0076

    https://www.ncbi.nlm.nih.gov/pubmed/27563751

    Evolution MIH Study in JHEOR

    JHEOR 2016; 4(2):172-87

    https://www.ncbi.nlm.nih.gov/pubmed/29240530 

    Independent Evaluation Reports:

    RTI International Evaluation of the Health Care Innovation Awards: REMSA Community Health Program

    August 2017

    Other Reports:

    No Place Like Home: Advancing the Safety of Care in the Home

    EMS’ role in achieving patient safety in the home.

    July 2018

    Community Paramedics: Health Share of Oregon Evaluation Report

    March 31, 2016

    PWC Report on Primary Care Dream Team – Including Community Paramedics

    October 2016

    GOVERNING Magazine Supplement – HHS Focus Report – Smart HHS strategies for uncertain times

    June 2017

    A MODEL FOR BETTER COMMUNITY HEALTHCARE: How the Regional EMS Authority (REMSA) in Reno, NV Achieved the Triple Aim from a Federal Health Care Innovation Award Grant

    October 2017

    Make Your Patients Healthy and Your ED Happy with Community Paramedicine

    The Advisory Board Company

    October 2016

    MedStar-Vitas Hospice Case Study The Advisory Board Company

    The Advisory Board Company

    March 2016

  • 27 Jun 2018 9:49 PM | AIMHI Admin (Administrator)

    Very comprehensive report this month from the Florida Office of the Insurance Consumer Advocate…

    Major highlights below.   Full document available at the link below

    ————————

    Ground EMT Collections: Best Practices

    Providers must be more transparent in dispelling the myth of full tax funding and provide consumers with more information about the EMT service costs in their area

    Recommendation: Ban Aeromedical Balance Billing

    Due to the severity in financial hardship experienced in the air emergency transport landscape, the ICA recommends that steps be taken to deregulate the air ambulance industry from coverage under the federal Aviation Deregulation Act (ADA), giving states the authority to prohibit the practice of balance billing consumers.

    Recommendation: Reform Ground EMT Billing Models

    Insurance companies and ground EMT service providers should move to a value-based billing model. By shifting to a value-based model for ground transportation, providers can charge for treatment that does not specifically include transportation of the patient. Treatment by a first responder without transport can be an effective means of delivering necessary care to a patient. This would be a reversal of the current fee-for-service model which requires that the patient be transported and prevents EMT services from billing an insurance company for care if no transport is provided.

    Stakeholders and members of the EMT Working Group have identified this billing scheme as an antiquated model of reimbursement. The current EMT payment scheme is not reasonably aligned with its self-proclaimed mission to be faster and more efficient first contacts in patient health care. Continuing in a fee-for-service model and subscribing to a comprehensive first responder mission are incompatible, and leave EMT services unable to adequately fund their programs without relying on cost shifting to consumers. The funding system of emergency medical services needs to therefore adapt to realign with the current goals and mission of the industry

    Highlights – Florida EMS Transportation Costs Report 2018 

  • 20 Jun 2018 10:00 AM | AIMHI Admin (Administrator)

    Big, BIG announcement!!  Perfect role for Dr. Gawande in this space…

    Dr. Gawande has written excellent and insightful articles in The New Yorker Magazine, including most notably:

    Overkill: An avalanche of unnecessary medical care is harming patients physically and financially. What can we do about it?

    Health Care’s Price Conundrum

    The Hot Spotters: Can we lower medical costs by giving the neediest patients better care?

    ————————

    Dr. Atul Gawande to lead Amazon, JPMorgan, Berkshire healthcare venture

    By Alex Kacik  | June 20, 2018

    http://www.modernhealthcare.com/article/20180620/NEWS/180629998

    Dr. Atul Gawande will lead the Boston-based Amazon, Berkshire Hathaway and JPMorgan Chase healthcare venture, the companies announced Wednesday.

    Gawande practices general and endocrine surgery at Brigham and Women’s Hospital and teaches at the Harvard T.H. Chan School of Public Health and Harvard Medical School. He is also the executive director of Ariadne Labs, a staff writer for The New Yorker and a best-selling author who is widely recognized for his contributions to the healthcare industry.

    “We said at the outset that the degree of difficulty is high and success is going to require an expert’s knowledge, a beginner’s mind and a long-term orientation,” Jeff Bezos, founder and CEO of Amazon, said in a statement. “Atul embodies all three, and we’re starting strong as we move forward in this challenging and worthwhile endeavor.”

    E-commerce giant Amazon is partnering with JPMorgan Chase and Warren Buffett’s Berkshire Hathaway to take a bite out of employer healthcare spending.

    The group has offered few details on how it plans to tackle healthcare costs, but the companies said they would initially focus on technology solutions to provide employees and their families “simplified, high-quality and transparent healthcare at a reasonable cost.” The joint venture will operate as an independent entity that is free from profit-making incentives and constraints, executives said.

    The companies seem to be focused on lowering the cost of care primarily for their nearly 1.2 million employees, but successful solutions could eventually be scaled. It’s unknown if they will simply self-fund employee benefits together, or if they will build out their own insurance operation.

    “I have devoted my public health career to building scalable solutions for better healthcare delivery that are saving lives, reducing suffering, and eliminating wasteful spending both in the U.S. and across the world,” Gawande said in a statement. “Now I have the backing of these remarkable organizations to pursue this mission with even greater impact for more than a million people, and in doing so incubate better models of care for all. This work will take time but must be done. The system is broken, and better is possible.”

  • 18 Jun 2018 9:45 PM | AIMHI Admin (Administrator)

    Interesting study… 

    ————————

    Satisfaction With Care After Reducing Opioids for Chronic Pain

    Adam L. Sharp, MD, MS; Ernest Shen, PhD; Yi-Lin Wu, MS; Adeline Wong, MPH; Michael Menchine, MD, MS; Michael H. Kanter, MD; and Michael K. Gould, MD, MS

    Am J Manag Care. 2018;24(6):e196-e199

    https://www.ajmc.com/journals/issue/2018/2018-vol24-n6/satisfaction-with-care-after-reducing-opioids-for-chronic-pain

    ABSTRACT
    Objectives: An epidemic of opioid overuse has resulted in nationwide efforts to decrease prescribing, but there is concern that implementing these recommendations will cause patients who are accustomed to opioids for chronic pain to be dissatisfied with care.

    Study Design: Retrospective cohort study of satisfaction scores for patients prescribed opioids for non-cancer chronic pain for at least 6 consecutive months from 2009 to 2014.

    Methods: We used mixed effects regression to examine the association between opioid dose reduction and the frequency of unfavorable patient satisfaction scores. Subgroup analysis compared the effect of dose reduction on satisfaction scores for encounters between patients and their assigned primary care provider (PCP) versus encounters between patients and an unassigned provider.

    Results: Included were 2492 encounters involving patients with high-dose chronic opioid use for non-cancer pain. A reduction in opioid prescribing occurred in 29% of encounters, and most of these resulted in favorable satisfaction scores (86.4%). After adjustment, the odds of an unfavorable score in the dose reduction group were just marginally higher and not significant (odds ratio [OR], 1.31; 95% CI, 1.00-1.73). Stratified by different encounter types, opioid dose reduction was not associated with unfavorable scores for visits with an assigned PCP (OR, 1.16; 95% CI, 0.79-1.70), but the odds of an unfavorable score were higher for encounters with an unassigned provider (OR, 1.50; 95% CI, 1.01-2.23).

    Conclusions: Overall, reducing opioid use for chronic pain is not associated with lower patient satisfaction scores, but encounters with unassigned providers may be associated with slightly lower satisfaction when opioids are reduced.

  • 18 Jun 2018 2:30 PM | AIMHI Admin (Administrator)

    Interesting scoreboard….

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    9 private equity firms gobbling up healthcare businesses

    Written by Morgan Haefner | June 15, 2018

    https://www.beckershospitalreview.com/hospital-transactions-and-valuation/9-private-equity-firms-gobbling-up-healthcare-businesses.html

    Fifty-two percent of executives are on the hunt for acquisitions in the next year, according to Ernst & Young’s 2018 Global Capital Confidence Barometer

    Private equity companies are increasingly a part of that deal-making. “The private equity deal activity increase we saw in 2017 looks to be accelerating. Interestingly, while we can anticipate intense competition, we may also see more collaboration as private equity investors club together with corporates to do deals,” Steve Krouskos, EY’s global vice chair of transaction advisory services, said.

    Healthcare has not escaped this trend. Here are nine private equity firms that have made a bid for or acquired a healthcare company’s business this year:

    1. Aquiline Capital Partners.New York City-based Aquiline Capital Partners acquiredrevenue cycle management company Aspirion Health Resources May 31.

      2. BlueMountain Capital Management. New York City-based private equity firm BlueMountain Capital Management will reportedly decide soon whether it will assume control of several of Louisville-based KentuckyOne Health’s assets.

      3. Clayton Dubilier & Rice. Cardinal Health sold a 55 percent stake in naviHealth — a six-year-old, Nashville, Tenn.-based startup that helps manage post-acute care in value-based care arrangements — to the New York City-based private equity firm Clayton Dubilier & Rice.

      4. KKR & Co. New York City-based private equity firm KKR & Co. has entered a definitive agreement to acquire Envision Healthcare, a Nashville, Tenn.-based physician services provider, in an all-cash transaction for approximately $9.9 billion, including the assumption of debt.

      5. Platinum Equity. Johnson & Johnson will sell its LifeScan diabetes unit to the private equity firm Platinum Equity for $2.1 billion, according to CNBC.

      6. Summit Partners. On April 21, Fresenius Medical Care, a division of Bad Homburg, Germany-based Fresenius SE, sold its majority share in Tacoma, Wash.-based Sound Inpatient Physicians Holdings to Boston-based Summit Partners. UnitedHealth Group’s Optum also has stake in the $2.2 billion deal.

      7. Veritas Capital. Veritas Capital entered into a definitive agreement April 2 with General Electric Healthcare to purchase its value-based care division for $1.05 billion in cash.

      8. & 9. Welsh, Carson, Anderson & Stowe and TPG. In a deal with Humana, Welsh, Carson, Anderson & Stowe and TPG will acquire Louisville, Ky.-based acute care provider Kindred Healthcare’s facility-focused arm, comprising long-term acute care hospitals and contract rehabilitation services businesses. Humana and the two private equity firms signed a definitive sale agreement Dec. 19 for $4.1 billion in cash, including assumption of debt. The trio also will purchase hospice operator Curo Health Services, based in Mooresville, N.C., for $1.4 billion.

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