June 7, 2013
By Ben Daniels and Lindsey Gabrielsen*
Edited by Amy Kaufman
UCSF CEO Encourages Substantial Changes by Academic Medical Centers
University of California San Francisco (UCSF) (6/3) reports that Mark Laret, chief executive officer of UCSF Medical Center and UCSF Benioff Children's Hospital, advocated for substantial changes in the world of academic medicine in a recent address. Observing the financial cuts to medical education, clinical income, and disproportionate share payments, Laret noted that "the entire academic enterprise of each of our centers is threatened as never before." He went on to urge academic medical centers to use this financial crisis as an impetus for change. Laret's suggestions included rewarding team-based science, exploring partnerships with industry, basing accreditation for medical training on competency rather than time, including specialty cross-training in residency, and reworking provider systems to focus less on inpatient revenues and more on cost-effective models like home-based care.
Boston Children's Hospital Piloting New iPad App for Patient and Parent Engagement
MobiHealthNews (6/5) reports that Boston Children's Hospital is extending the pilot phase of an experimental iPad app called MyPassport due to its success. The purpose of MyPassport is to bolster patient and parent interaction with the medical care team in several ways. It provides pictures and a description of each member of the treating medical team, allowing parents to keep track of those involved in their child's care. Lab results and radiology images are sent directly to the app and include contextual information, such as optimal test ranges, to help parents understand their child's results. The app also includes a patient care plan and allows parents to send questions to the doctor at any time.
PA Court Concludes Hospital Work Stoppage Caused Unemployment
Law 360 (6/4) reports that a panel of the Pennsylvania Commonwealth Court upheld the state's Unemployment Compensation Board of Review decision that Temple University Hospital (Hospital) triggered a work stoppage in 2010. The decision affirmed the eligibility of 1,100 unionized hospital employees for unemployment benefits. The court characterized the Hospital's decision to make changes to its employee tuition reimbursement program as resulting in a lock-out rather than a strike, based on Pennsylvania's "status quo" test. The work stoppage began in March 2010 and lasted for nearly a month, ending with a settlement between the parties. (Note: registration is required to access the full article.)
Medicare Data Show Large Billing Discrepancies for Outpatient Procedures
Kaiser Health News (6/3) reports that new Medicare data showing the average billed charges for 30 outpatient procedures highlights the substantial discrepancies between initial hospital charges and average Medicare reimbursement. For instance, Medicare reimburses a Level 2 hospital clinic visit for $76 on average, but hospitals billed an average of $148 per visit. Hospitals also charged more than seven times the average Medicare reimbursement for other popular services. The data also underscored the differences between specific hospitals, with one California hospital charging 40 times the Medicare average for an ultrasound and a New York hospital charging $29 less than the Medicare average of $186 for the same procedure.
Hospitals Win 72% of Medicare RAC Appeals
Becker's Hospital Review (6/5) reports that the most recent RACTrac Survey done by the American Hospital Association shows that hospitals appealed approximately 44% of Medicare recovery audit contractor (RAC) denials in the first quarter of this year, and won 72% of those appeals. The Medicare RAC program began in October 2009 and has since recovered $4.5 billion in overpayments. The RACTrac Survey also showed that one-day stays in the wrong setting resulted in approximately 68% of medical necessity denials.
*We would like to thank Ben M. Daniels, Esquire (Foley & Lardner LLP, Boston, MA), and Lindsey Gabrielsen, JD/MPH Candidate, Summer Associate (Boston University, Foley & Lardner LLP, Boston, MA), for providing this week's update. We would also like to thank Amy E. Kaufman, Esquire (Patton Boggs LLP, Washington, DC), for coordinating and editing the update.