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Top Healthcare Quality Issues for 2015
Six quality issues warrant the attention of healthcare leaders: Misdiagnoses, star ratings, socioeconomic adjustment for readmissions, the end of Partnership for Patients programs, Medicaid parity expiration, and Disproportionate Share Hospital cuts. Healthcare has experienced fascinating changes during the last few years, and 2015 will be no exception.
Major programs stemming from the Patient Protection and Affordable Care Act are well under way, dozens of new quality measures and data galore are flowing into the public domain, and quality of care remains in the spotlight for providers at all levels.
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Kidney Disease on the Rise, but Patients on Dialysis or with Kidney Transplantation Living Longer
University of Michigan
Fewer new cases of end-stage renal disease are being reported in the United States and mortality rates are declining, indicating that patients on dialysis or with a kidney transplant are living longer. The trends were revealed by the United States Renal Data System (USRDS) coordinating center, based at the University of Michigan in partnership with Arbor Research Collaborative for Health, in its 2014 annual data report on the state of kidney disease in the United States.
More Bladder Cancer Patients Receiving Perioperative Chemotherapy
Renal & Urology News
Physician use of perioperative chemotherapy (POC) for muscle-invasive bladder cancer (MIBC) increased by 35 percent from 2006 to 2010, following the 2003 landmark SWOG-8710 trial favoring the treatment. The shift was driven mainly by neoadjuvant chemotherapy administration, which almost doubled. Adjuvant chemotherapy usage changed little.
Prostate Cancer 'Easier to Detect' with New Type of MRI
Medical News Today
Writing in the journal Prostate Cancer and Prostatic Diseases, a team led by the University of California San Diego (UCSD) School of Medicine, describes how the new MRI technique - called restriction spectrum imaging-MRI (RSI-MRI) - produces measurably better results in detecting prostate cancer tumors than the current standard, contrast-enhanced MRI. First author Dr. Rebecca Rakow-Penner, a research resident at the UCSD School of Medicine's Department of Radiology, says:
"This new approach is a more reliable imaging technique for localizing tumors. It provides a better target for biopsies, especially for smaller tumors."
CHD Risk Greater in Women with Kidney Stones
Renal & Urology News
Women with a history of kidney stones have a significantly increased risk of coronary heart disease, a new meta-analysis confirms.
According to researchers, kidney stone history may be a risk factor that impacts clinical management. For the meta-analysis, investigators led by Wisit Cheungpasitporn, M.D., of Mayo Clinic in Rochester, Minnesota, calculated CHD risk based on 52,791 patients with kidney stones. Data was pooled from observational cohort studies and a cross-sectional study, each with control groups. The researchers also conducted a separate sensitivity analysis.
US Healthcare Spending on Track to Hit $10,000 Per Person this Year
There's never a shortage of major healthcare policy events in any given calendar year ‒ and 2015 will be no exception. Here's a short list of some that are pending and noteworthy ‒ with a few predictions. First up isn't a prediction as much as a major milestone that's reflective of escalating healthcare costs. According to CMS, our National Healthcare Expenditure (NHE) is projected to hit $3.207 trillion this year.
ICD-10 Delay Appears DOA in Congress This Year
A proposal to delay implementation of ICD-10 diagnostic and procedure codes by an additional two years appears to be going nowhere in the current lame duck session of Congress". That's not going to happen," said a veteran healthcare consultant who tracks the issue closely, speaking on background. "The reports of them ever getting traction were overrated."
Congressional GOP Leaders Look to Score Early Hits on Obamacare
Republicans return to Washington from the holidays with full control of Congress and an ambitious legislative agenda. At the top of the to-do list for House Speaker John Boehner and incoming Senate Majority Leader Mitch McConnell when Congress reconvenes Jan. 6: Dismantling the Patient Protection and Affordable Care Act.
Steven Brill on How Healthcare Reform Went Wrong
The New Yorker
"Working in the White House on a Saturday afternoon had become routine for Zeke Emanuel and Bob Kocher," Steven Brill tells us at the beginning of Chapter 9 of his ambitious new history of the Affordable Care Act, "America's Bitter Pill" (Random House): But they were usually able to leave at a decent hour. However, at 5 p.m. on Saturday, April 25, 2009, they were thrown into a state of near-panic. Emanuel, Kocher, and the rest of the staff from the Office of Management and Budget and the National Economic Council had been blindsided by the domestic policy crew.
Futurist on Tech Backlash, Longevity, Transparency
Author David Brin expounds on artificial intelligence, bioterrorism, 3-D printing, gut flora research, and living in the age of transparency. There is no better way to reflect on passing the middle of the decade than turning the rest of this column over to futurist David Brin for some choice observations and predictions. The futurist and science fiction author is a recipient of the Freedom of Speech Award of the American Library Association for his 1998 nonfiction book, The Transparent Society. Brin was a featured speaker at HealthLeaders Media's inaugural Health IT and Quality Exchange this year, where he expounded on various topics.
Better Patient Engagement Needed for ACA Success
While the Affordable Care Act has achieved its goal of getting more Americans to carry health insurance, the result hasn't been universally positive for patients or physicians, according to an article from the Wall Street Journal that discusses the benefits and "side effects" of the healthcare reform law. Some of the law's biggest winners, for example, include patients who may have lost coverage due to prior conditions such as lung cancer.
Physicians Face a Wide Range of Tough Decisions
Few professions invoke such a sweeping array of ethical questions as medicine. Although ethics may factor into life-and-death decisions, they can also play a role in everyday decision-making, such as whether or not to accept a lunch invitation from a pharmaceutical representative or ask a former patient on a date. On many of these issues, physicians are sharply divided.
Since Obamacare, L.A. County ER Visits Show Hospitals in 'State of Flux'
Los Angeles Times
A key measure of hospital emergency room use in Los Angeles County shows continued growth during the first six months of Obamacare, but also points to shifting patterns of where patients are choosing to receive urgent medical treatment. With the healthcare expansion last year, many are watching how the Affordable Care Act affects emergency room use.
No Plans for California to Make Up for Expiring 'Medicaid Fee Bump'
Los Angeles Times
California officials have no plans to make up for an expiring federal pay incentive designed to entice doctors to treat low-income patients. The end of the subsidy with the start of the new year could result in steep pay cuts for many doctors participating in the Medicaid system for needy Californians.
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