Literature Review

Memorial Hermann drops Humana Medicare AdvantageBecker's Payer Issues, by Jakob Emerson; 1/4/24Houston-based Memorial Hermann Health System is no longer in network with Humana's Medicare Advantage plans, effective Jan. 1. The 17-hospital system told Houston Public Media that it continues to participate in Humana's commercial network. Humana told the outlet that its Medicare Advantage members who are actively receiving treatment at Memorial facilities, can "continue care until treatment is completed." In November, Memorial Hermann issued termination notices after the reimbursement dispute came to an impasse. It is unclear how many people are affected by the dispute. Along with its hospitals, Memorial has 6,700 affiliated physicians across 260 care delivery sites. Humana is the country's second largest MA insurer, with 5.9 million members as of Nov. 1.

Optum, SSM Helath end partnershipBecker's Hospital CFO Report, by Jakob Emerson; 1/3/2024St. Louis-based SSM Health and UnitedHealth Group's Optum have ended their administrative partnership around inpatient care management, digital transformation and revenue cycle management, an SSM Health spokesperson confirmed with Becker's. The health system declined to provide any additional information when asked on Jan. 3. The partnership was announced in October 2021 and formally began in early 2022. The deal included the hiring of about 2,100 SSM employees by Optum.

How do you ethically integrate a GIP hospice service into the hospital?Hospitalist.org, by William Frederick, et.al.; 1/2/24[General inpatient (GIP) hospice] ... provides holistic end-of-life care and family support in acute-care hospitals. Patients who are appropriate for GIP hospice services often have a life expectancy of hours to days, require care that cannot be delivered at home, and have symptoms that are difficult to control in any other settingEditor's Note: Examine this article for (1) a flow chart of the "GIP Hospice Process at UCSD Health System" and (2) Indications for GIP Hospice Care Indications for GIP Hospice Care."

Man 'accidentally' fires gun in Iowa hospital: policeBecker's Clinical Leadership, by Mackenzie Bean (Twitter); 1/2/24 Police are investigating an incident in which a gun was discharged at MercyOne Waterloo (Iowa) Medical Center Dec. 29, according to NBC affiliate WHO 13 News. Authorities found damage from a single gunshot in a restroom after responding to a report of a gun being fired at the hospital around 9:40 a.m. CST. No injuries were reported.

From -10.6% to 11.1%: 34 systems ranked by operating marginsBecker's Hospital CFO Report, by Alan Condon adn Madeline Ashley; 12/29/23Hospitals began 2023 with a median operating margin of -0.9%, but that figure has increased steadily month over month to hit 2% in November — the ninth consecutive month of positive margins. Despite a modest positive turning point for some hospitals and health systems this year, Fitch Ratings projects 2024 to be another "make or break" year for a significant portion of the sector.

‘Medicare Advantage plans are crippling rural hospitals,’ CEO saysModern Healthcare; 12/28/23Delayed Medicare Advantage reimbursement is among the top concerns of rural hospital operators, one of several factors expected to be a drag on rural hospital finances in 2024. Rural hospitals, which tend to run on thinner operating margins than metro-area hospitals, have been hurt by reimbursement cuts, staffing constraints, inflation, the aging population and interest rate hikes.

How broadband expansion is bolstering rural healthcareModern HealthcareDecember 26, 2023Health systems have emerged as crucial collaborators in government efforts to improve access to high-speed internet in rural communities. Nearly 30 million people in the U.S. live in places that lack broadband infrastructure, according to the Commerce Department. 

Palliative Care Consultation and Family-Centered Outcomes in Patients With Unplanned Intensive Care Unit AdmissionsJournal of Palliative MedicineJamie T Nomitch, et.al.December 25, 2023Context: Hospitalized patients who experience unplanned intensive care unit (ICU) admissions face significant challenges, and their family members have unique palliative care needs. Objectives: To identify predictors of palliative care consultation among hospitalized patients with unplanned ICU admissions and to examine the association between palliative care consultation and family outcomes.Conclusions: For patients experiencing unplanned ICU admission, palliative care consultation often happened after transfer and was associated with illness severity, comorbid illness, and hospital site. Patient death was associated with family symptoms of psychological distress.

Serious Medical Errors Rose After Private Equity Firms Bought HospitalsNew York TimesDecember 26, 2023The rate of serious medical complications increased in hospitals after they were purchased by private equity investment firms, according to a major study of the effects of such acquisitions on patient care in recent years. The study, published in JAMA on Tuesday, found that, in the three years after a private equity fund bought a hospital, adverse events including surgical infections and bed sores rose by 25 percent among Medicare patients when compared with similar hospitals that were not bought by such investors. The researchers reported a nearly 38 percent increase in central line infections, a dangerous kind of infection that medical authorities say should never happen, and a 27 percent increase in falls by patients while staying in the hospital. 

‘Fight’s not over’ striking Lower Bucks Hospital nurses say as they head back to workBucks County Courier TimesDecember 26, 2023Bucks County, PA—Nurses at Lower Bucks Hospital are scheduled to return to work Wednesday morning after a five-day strike without having reached a deal with the hospital owner Prime Healthcare Services Inc. 

St. Francis Medical Center workers fired 5 days before ChristmasLos Angeles Daily News, 12/22/23Striking workers at St. Francis Medical Center who have openly complained of understaffing and inadequate patient care were fired Wednesday, Dec. 20, just five days before Christmas.

Workers launch 7-day strike at 4 Prime Healthcare hospitalsLos Angeles Daily NewsDecember 20, 2023Nurses, medical assistants, ER techs and others at four Prime Healthcare hospitals launched their second strike of the year Wednesday, Dec. 20, claiming severe understaffing and high turnover have undermined patient care. 

Madera hospital could reopen with new management partners. What to knowFresno (CA) BeeDecember 20, 2023Nearly a year after shutting down operations, Madera Community Hospital has approved a second deal with a financial partner to help it reopen. The hospital board of trustees approved a temporary management service agreement on Monday with American Advanced Management Inc., a Modesto—based hospital management company.