From Today's Crain's:
NYC Health + Hospitals/Coney Island is requesting the state's permission to transfer the operating certificate for its ambulatory care clinic to its Cumberland Diagnostic and Treatment Center.
The move is part of a reorganization of the public health system's neighborhood ambulatory care clinics. More such requests for operating certificate changes are in the offing, an H+H spokesman said
"It's part of a broader systemic approach," he said. "We're moving all of these sites off of the hospital operating certificates."
H+H is reorganizing its neighborhood outpatient clinics so that they will be under the umbrella of Gotham Health NYC, a designated Federally Qualified Health Center Look-alike, which is operated by the public health system, according to its certificate-of-need application. Gotham Health serves more than 140,000 city residents annually through 39 sites, which include Cumberland and five other diagnostic and treatment centers, 19 extension clinics and 14 school-based clinics.
A FQHC Look-alike doesn't qualify for the same federal funding as a standard FQHC, but it does get enhanced Medicare and Medicaid reimbursement rates.
Besides saving the health system money, the FQHC model also allows for greater responsiveness to community needs, such as providing trauma-informed care, the H+H spokesman said.
CVS Health is well-positioned to manage its customers' care needs, and its role will only grow if its proposed $69 billion acquisition of Aetna gets regulatory approval, Dr. Troyen Brennan, CVS' executive vice president and chief medical officer, said Thursday.
"We're trying to shrink the distance between the patient's everyday life and care engagement," Brennan said at a forum hosted by Northwell Health at the Time Warner Center in Manhattan. "Our physical footprint is the big strategic value we have associated with that."
That footprint, which includes nearly 10,000 outposts, puts 71% of Americans within 5 miles of a CVS store, according to Quartz. CVS is trying to extend its reach through telehealth. It announced this week that it has partnered with Teladoc to make video visits available for $59.
Through a team of coordinators, pharmacists and MinuteClinic nurses, CVS has targeted five chronic diseases that it believes it can address—diabetes, hypertension, high cholesterol, asthma and depression—to drive savings, Brennan said. It is targeting $20 million in savings per 100,000 commercially insured members and double that amount for Medicare members.
But Brennan stressed that CVS hopes to complement, not replace, primary care.
"We're not going to buy up an entire layer of primary care, urgent-care centers and ambulatory surgery and then play the hospitals against one another," he said. "We see ourselves as part of the medical home, with everyone having their primary care provider."
From Today's Crain's
Jonathan S. Halpert MD FACEPChair, Government AffairsNorth East Regional Urgent Care Associationwww.neruca.org
By Priyanka Dayal McCluskey GLOBE STAFF AUGUST 02, 2018
Frustrated hospital leaders say they will continue pushing for legislation to help struggling community hospitals after Massachusetts lawmakers failed in their last-ditch attempt to find consensus on a sweeping health care bill this week.
Spiros Hatiras, chief executive of Holyoke Medical Center, said he was in disbelief that lawmakers ended their formal sessions without approving a health care bill. “After all that was said, after all the discussions — to come up with nothing?” he said.
Hatiras said he and other Holyoke Medical executives now must decide whether to cut programs because of tight finances. “The only thing you can do in a situation like this is close services,” he said.
Kim Hollon, chief executive of Brockton Hospital’s parent company, Signature Healthcare, said he was “extremely disappointed” that legislators failed to pass a bill.
Community hospitals have long argued that they are underpaid by insurers because they lack the market power of big teaching hospitals. Both the Senate and the House sought to address this issue, but in different ways.
A bill approved by the House in June charged new assessments on insurers and large hospitals, funneling more than $330 million back to community hospitals. Walk-in clinics and surgery centers also would have paid new fees under the House bill.
The Senate bill, passed last November, set a “rate floor” for insurance payments, mandating that hospitals be paid at least 90 percent of the average price of a medical service. The legislation would have charged hefty fines to large hospitals — such as those owned by Partners HealthCare — if spending grew too fast.
Senators said their bill would have reined in health care costs, while House leaders said their bill was aimed primarily at boosting community hospitals.
Both bills ran into opposition from various business and health care industry groups who argued the proposals would raise costs.
For weeks, House and Senate members held secret talks to hash out a compromise. They were still exchanging proposals Tuesday, hours before their deadline. A deal appeared to be on the horizon at one point, according to people familiar with the talks.
But around 11 p.m. Tuesday, lawmakers abandoned their negotiations and said their “philosophies” were too different to reconcile.
Senate President Karen E. Spilka said senators will begin work on another health care bill when they reconvene next session. “I hope the House takes it up and gets it done, and we can start meeting a little earlier in the session,” she said Wednesday.
Hatiras, the Holyoke Medical Center CEO, blamed health insurers and Partners, the state’s most powerful hospital system, for trying to thwart a compromise bill.
Partners has fought hard against the Senate’s version of health care legislation. Leaders of Partners’ largest hospitals, Massachusetts General and Brigham and Women’s, went to Beacon Hill to argue that the legislation was damaging and unfair. (Partners was more supportive of the House’s approach.)
Partners officials denied that they tried to kill a final bill and said they were disappointed that lawmakers didn’t reach a deal.
“We have long supported fair and balanced approaches that get community hospitals the targeted resources they need,” Partners spokesman Rich Copp said in a statement. “We look forward to working with all stakeholders during the next session to revisit these issues.”
Steve Walsh, chief executive of the Massachusetts Health & Hospital Association, also said it was unfortunate that legislators couldn’t find a compromise.
“To best protect patients across the Commonwealth, it is imperative that we stabilize our high-value community providers and ensure their long-term viability,” he said in a statement. “Although a resolution was not reached, we know for certain by the efforts of both the House and Senate that they share this common goal and we look forward to continuing our collaborative efforts.”
The consumer advocacy group Health Care For All called the Legislature’s failure to pass a health care bill “a missed opportunity.”
But insurers and employers — who lobbied against the bills because of concerns about costs — expressed relief at the legislation’s demise.
“I think the best result is that no bill emerged — unless they dealt rationally with those provisions and ensured they didn’t increase costs,” said Lora M. Pellegrini, chief executive of the Massachusetts Association of Health Plans.
James E. Rooney, chief executive of the Greater Boston Chamber of Commerce, said it wasn’t surprising that the bill didn’t make it past the finish line. “Negotiating consensus on such complex issues is always a challenge,” he said in a statement.
Dr. Alain Chaoui, president of the Massachusetts Medical Society, said in a statement that he looked forward to working with lawmakers in the next session to craft legislation that promotes “the highest value settings of care.” The medical society opposed a House provision to impose new fees on surgery centers, saying it was too costly and would have forced physicians offices to stop performing certain services.
Officials at the North East Regional Urgent Care Association, a trade group, said they were pleased that lawmakers failed to approve a bill with “unprecedented taxes” on urgent care centers. They said the House bill would have devastated the urgent care industry.
Also dying with the health care legislation this week was a measure to allow midlevel dental providers called dental therapists to treat patients in Massachusetts. The now-defunct House and Senate bills also included several other provisions on telehealth, out-of-network medical bills, prescription drug costs, and more.
Massachusetts passed a landmark health care law in 2006 to expand insurance coverage to nearly all residents. In 2012, the state approved a law that set an annual target for statewide health spending and took other steps to curb costs.
“There always seems to be health care legislation pending on Beacon Hill,” said Richard C. Lord, president of Associated Industries of Massachusetts, a business group. “I’m sure we will back at it.”
As its formal session barreled toward a close early Wednesday, the Massachusetts Legislature passed broad changes to how the state targets the opioid epidemic, but it failed to reach deals on major legislation addressing health care and the state’s school funding formula.
The success — and death — of several closely watched pieces of legislation buffeted state lawmakers’ dash to wrap any remaining formal business from the past 19 months.
The Legislature brushed aside its own rules to cast votes more than an hour past its midnight deadline to finish off several measures, including passing a sprawling economic development bond bill with language limiting noncompete agreements.
But while the chambers pecked away at scores of lesser legislation, negotiators conceded they couldn’t agree on how to reconcile two disparate health care bills passed by the House and Senate, ending talks around 11 p.m. Legislators also fell short of consensus on how to overhaul the state’s formula for doling out funds to schools after meeting for the last week behind closed doors.
Click Here to read the full Boston Globe article
House-Senate negotiators were unable to reach consensus on a major overhaul of the health care system, dooming the issue until next year. "Unfortunately, we couldn't come to an agreement," said Sen. Jim Welch, D-West Springfield, chairman of the Committee on Health Care Financing and one of the lead negotiators on the bill. "It became very clear unfortunately that the large dominant players in the industry just had too much influence over the negotiations, and we weren't able to get past it."
Click Here to read the full MassLive article
The New York Times (7/22, Pear) reports, “The Trump administration is proposing huge changes in the way Medicare pays doctors for the most common of all medical services, the office visit, offering physicians basically the same amount, regardless of a patient’s condition or the complexity of the services provided.” The Times says that under the proposal, payments for office visits for cancer and the “sniffles” would be the same. CMS Administrator Seema Verma said, “Time spent on paperwork is time away from patients,” and estimated the change would save 51 hours of clinic time per doctor per year. Critics say the proposal “would underpay doctors who care for patients with the greatest medical needs and the most complicated ailments – and could discourage some physicians from taking Medicare patients.” CMS said the proposal would “radically reduce paperwork burdens.”
By Zoe Greenberg
The New York Times
July 17, 2018
One person has died in connection with a cluster of Legionnaires’ disease cases in Upper Manhattan, city health officials said on Tuesday.
The city declined to release the name of the person who died, but said he or she was over 50 years old and had risk factors for Legionnaires’ disease. Common risk factors include heavy cigarette smoking, chronic lung disease and a weakened immune system.
“This case was not caught early,” said Mark Levine, a City Council member who represents the area and who had been briefed by the city. He added that the person had died in the last week.
In total, 18 people have been sickened in the area. City officials said the cluster of cases was found between 145th and 165th streets.
The fourth annual urgent care conference, hosted by the North East Regional Urgent Care Association (NERUCA), will bring together urgent care owners, providers and staff members to learn more about the current state of the industry, specifically in the northeastern region.
(July 16, 2018) - The North East Regional Urgent Care Association (NERUCA) announced this week that registration is now open for the fourth annual urgent care conference, which will will be held at the Hilton Hotel in Albany, New York on October 29-30. This year's conference presentations will be centered around The Urgent Care Landscape: Stepping Into a New Generation.
The conference is expected to have up to 150 attendees and host vendors from the urgent care industry. Planned speakers are David Stern, CEO of Practice Velocity, Alan Ayers, CEO of Velocity Urgent Care, and many more. Topics being covered include integrating world class service into your culture and care model, payor negotiations, compliance, marketing, provider compensation, advocacy strategy, on-demand services, and much more! The conference includes a leadership and provider track in which providers will be able to earn CME credits.
Todd Martin, NERUCA’s vice president, expects NERUCA members to gain more insight into the future of the urgent care industry at this year's conference.
“We hope to create an environment that is conducive to urgent care owners, providers, and staff members,” says Todd Martin. “We want to help generate learning and networking opportunities for NERUCA members that will help them navigate the ever-changing urgent care industry and prepare for what lies ahead.”
To register or learn more, go to www.neruca.org/nerucaconference.
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