Aug 25, 2010 | Laboratory News, Laboratory Pathology
Topping the list are, the Veterans Administration and HCA, which together employee almost 200,000 people
Recently, a ranking of the nation’s top 25 healthcare systems by number of employees was published. In the number one spot is the Veteran’s Affairs (VA) Department. It employs 207,000 employees. Ranked number two is HCA, Inc., the for-profit hospital corporation. It has 77,000 employees.
Pathologists and clinical laboratory managers will recognize that both the VA and HCA are national healthcare systems. By contrast, New York-Presbyterian Healthcare System ranks number five on the list with 55,048 employees and its locations are clustered in and around New York City.
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Nov 13, 2009 | Laboratory News, Laboratory Pathology
Rankings based on annual revenue and the Veterans’ Administration tops the list
When Dark Daily recently published a list of the Top Ten Largest Medical Groups in the United States, not only was it a popular topic, but many readers asked us to present a similar list for healthcare systems. Dark Daily is glad to oblige and presents below a list of the Top Ten Largest Healthcare Systems in the United States, ranked on annual revenue.
This ranking of the Top Ten Biggest Healthcare Systems includes government healthcare systems, not-for-profit healthcare systems, and for-profit healthcare systems. As you will see, the U.S. Department of Veteran Affairs holds down the number one position, with annual revenue of $40.7 billion. Coming in second on this ranking is HCA, Inc., with annual revenue of $28.4 billion. Of the ten largest healthcare systems, three are owned by Catholic organizations and three are for-profit hospital corporations.
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Feb 2, 2009 | Laboratory News, Laboratory Pathology
As part of its plan to stake out a place in the international market for healthcare quality standards, Joint Commission International (JCI), the international arm of The Joint Commission (JC), in partnership with the World Health Organization (WHO), launched a new global program to improve patient care and safety worldwide.
JCI’s first demonstration project involves financially strapped, low-performing hospitals in Mexico, China and Palestine, according to JCI Chief Medical Officer David Jaimovich. In an interview with Modern Healthcare, he suggests that the demonstration project allows JCI to measure the program’s capabilities under the worst conditions.
The program, “Essentials of Health Care Quality and Patient Safety”, focuses on five high-risk areas known to have the greatest impact on quality and safety. It provides a way to evaluate progress and defines the levels of effort for each criterion. The five areas include:
1) leadership process
2) accountability,
3) competent and capable workforce,
4) safe environment for staff and patients, and,
5) clinical care of patients.
In an interview with Modern Healthcare, Asian healthcare expert Tsung-Mei Cheng, editor of Princeton’s International Forum, says China is committed to updating and upgrading its hospitals, so international benchmarking should be “enormously helpful.”
In Mexico, President Felipe Calderón emphasizes improvements to healthcare as way to maintain the healthy workforce required to sustain the strong economy vital to keeping the nation’s skilled workforce at home. Mexico’s status as a trade partner, neighbor and destination for Americans traveling and living abroad makes the United States a stakeholder in ensuring healthcare quality and safety in Mexico.
In fact, the increased migration of Americans, Canadians, and Europeans to Mexico is an important factor in Mexico’s efforts to upgrade its healthcare system to U.S. standards. Physicians in Mexico, many of whom were educated in U.S. medical schools are forming physicians groups and establishing American-style medical testing and diagnostic services. Some of these physicians have a goal and a hope that they can negotiate contracts with Medicare and other U.S insurers to provide services to U.S. citizens living in Mexico.
The push for international healthcare quality standards will continue to be a priority in a global economy. Foreign markets attractive to aging Baby Boomers, however, also provide tremendous opportunities for healthcare service providers. So it is no surprise that the Joint Commission wants to play an increased role in helping establish and maintain health quality and accreditation standards in many countries across the globe.
Related Information:
Jan 16, 2009 | Laboratory News, Laboratory Pathology
Rising costs of employer-sponsored health plans now threatening both sustainability of a healthy workforce and the viability of U.S companies in a global marketplace. That means the business sector may be the most likely game changer in reforming the U.S. healthcare system. So argues Modern Healthcare Editor David Burda. He contends that the business sector is poised to dictate healthcare costs. Based on defined healthcare goals, business will decide for what and how much it will pay.
Burda, who attended the National Business Coalition on Health (NBCH) conference last fall, says there is a sense of urgency among employers to act now. Otherwise the government will step in to do it. If that happens, it will stifle innovation.
The NBHC is made up of nearly 60 employer-led coalitions which share the common goal of improving the value of employer-sponsored health plans. The organization represents 10,000 employers with 34 million employees and their families. NBHC was established to implement national purchase initiatives. It wants to help employers get more value for healthcare services. In recent years, NBCH’s role has expanded as employers strive to accelerate progress towards safe, efficient, high-quality healthcare.
Employers are in the forefront of efforts to link value to quality of care. Topping their list of desired innovations is implementation of financial incentives that are linked to health improvement programs. These programs are designed to encourage employees to quit smoking, eat right, exercise, and better manage chronic medical conditions.
The strategy appears to be working, according to NBCH’s 2008 eValue8 report, which employers use to compare the quality and efficiency of health plans. Andrew Webber, NBCH President and CEO wrote that: “Given today’s dire economic climate, purchasers need to continue to encourage health plans to adopt plan designs that will enable consumers to keep themselves healthy and not incur higher, preventable healthcare costs in the future.”
The report, which represents information from 100 HMO and PPO plans, found that many health plans have reduced barriers to essential treatments: 43% of plans waive co-pays for preventive health visits; 27% waive co-pays for diabetes drugs and equipment and 33% reduce co-pays; 20 % of plans waive co-pays for drugs and equipment and 28% reduce co-pays.
While keeping people healthy is good for society, Burda notes that healthcare providers must figure out a way to make money by keeping people healthy-rather than by treating them when they’re sick. Those providers who are reluctant to change, he suggests, can expect a return to the good old days when providers got paid to take care of someone-albeit cheaply, slowly, and only after complying with complex reporting and billing rules.
NBCH’s eValue8 report offers medical laboratories and other providers a compass for designing value-added strategies that meet the evolving goals of employers-who fund lots of healthcare in this country. Clinical laboratories are well-positioned to support changes in healthcare delivery for improved accountability, better quality and lower costs. – P. Kirk
Related Information:
Oct 1, 2008 | Instruments & Equipment, Laboratory Pathology
As the nation’s healthcare system pursues the goal of a universal electronic medical record (EMR) and a paperless, all-electronic environment, one barrier to adoption may be the large number of physicians nearing retirement. That’s the opinion of a neurosurgeon in his recent testimony before a congressional committee.
Physicians within five years of retirement may not get a return on their investment, Philip Tally, M.D., a neurosurgeon in Bradenton, Florida, told a hearing on “Cost and Confidentiality: The Unforeseen Challenges of Electronic Health Records in Small Specialty Practices,” on July 31 before the House Committee on Small Business.
Just 4% of physicians have an extensive, fully functional EMR and only 13% have a basic system, Tally told the committee, citing an article, “Electronic Health Records in Ambulatory Care-A National Survey of Physicians,” in the July 3, 2008, issue of the New England Journal of Medicine. The committee hearing was on the unforeseen challenges faced by small specialty medical practices when installing an EMR system.
“If you’re not thinking about practicing more than five years, don’t bother because the transition and the cost and the time to make it proficient for you in a small practice is probably not worth it-with one exception and that would only be if you intend to sell your practice someday,” Tally told Modern Healthcare magazine. When selling a practice, the physician who buys the practice is likely to want the EMR, he added.
The American Medical Association’s Physician Characteristics and Distribution in the U.S., 2008 edition, shows how physician demographics are weighted toward approaching retirement. There are 921,900 physicians in this country, of which 343,200 (37.2%) are over age 54. Approximately 166,000 physicians are aged 55 to 64 and 177,200 are aged 65 and older.
Interestingly, Tally was speaking from experience. His three-physician practice of neurosurgeons installed an EMR in 1992, making the group just the fifth in the nation and the first neurosurgery group to do so. At the time, the practice spent $50,000 for the EMR and about $5,000 annually to maintain the system. Tally, who chairs the Florida Medical Association’s IT committee, the congressional hearing that his group spent about 1,000 hours to configure the system after it was installed. His medical office staff found the process challenging, as the staff turnover rate climbed to 30%. Tally did observe that the EMR system, once implemented, significantly increased productivity.
Accurately measuring the return on investment (ROI) that accrues to a physician group from implementing an EMR is complicated by many factors. These include: 1) savings from eliminating the need to maintain and store paper charts; 2) savings in time for physicians to see patients under the new EMR system versus the time it took under the old system; and, 3) savings from electronic data entry of laboratory tests results in the EMR. Perhaps most difficult to measure is physician and patient satisfaction with the new EMR system versus the old.
Tally has an overlooked perspective on why physician age is likely to be an impediment to EMR adoption. He points out that more than one in three physicians in this country are within a decade or less from retirement-and are thus likely to find the transition to an electronic medical records system to be both uneconomical and unwelcome. It may turn out that more financial incentives from federal and state government sources, along with private payer incentives, will be required to encourage smaller physician groups to implement an EMR system. Clinical laboratories will need to take these factors into consideration as they develop effective strategies for supporting to move to a fully-digital patient health record by their office-based physician clients.
Physicians in America (In round numbers)
Younger than age 35 141,500
35 to 44 213,300
45 to 54 223,900
55 to 64 166,000
65 and older 177,200
Total 921,900
Source: American Medical Association’s Physician Characteristics and Distribution in the U.S., 2008 edition
Related Information:
Dr. Tally’s prepared remarks for the House Small Business Committee:
Committee Examines Costs and Challenges of Electronic Health Records to Small Medical Practices
