Literature Review

4 health systems shrinking their hospital portfolios Becker's Hospital Review; by Alan Condon; 8/14/24 Merger and acquisition activity is picking up steam this year after a decline in deal volume during the pandemic, with some large health systems reorganizing their portfolios and offloading hospitals in various markets. Four health systems that have sold or plan to sell multiple hospitals this year:

Factors associated with Do Not Resuscitate status and palliative care in hospitalized patients: A national inpatient sample analysis Palliative Medicine Reports; by Jean-Sebastien Rachoin, Nicole Debski, Krystal Hunter, Elizabeth CerceoIn the United States, the proportion of hospitalized patients with DNR, PC, and DNR with PC increased from 2016 to 2019. Overall, inpatient mortality and LOS fell, but hospital charges per patient increased. Significant gender and ethnic differences emerged. Black patients and males were less likely to have DNR status and had higher inpatient mortality, LOS, and hospital charges.

Why more than 30% of rural hospitals are at risk of closureMedCityNews; by Katie Adams; 8/8/24More than 700 hospitals across the rural U.S. are at risk of closing due to their financial woes — and for more than half of these hospitals, the risk of closure is immediate, according to a new report. The report argued this is due largely to inadequate reimbursement from health plans. More than 700 hospitals across the rural U.S. are at risk of closing due to their financial instability — that’s over 30% of the country’s rural hospitals. And for more than half of these 700 hospitals, the risk of closure is immediate, according to a new report from the Center for Healthcare Quality and Payment Reform (CHQPR).Publisher's note: The CHQPR report linked above is very interesting, including a table listing states with the most hospitals at immediate risk of closing - the top 5 states are Kansas, Texas, Oklahoma, Mississippi, and Alabama.

Hospital assets before and after private equity acquisitionJAMA; by Elizabeth Schrier, Hope E M Schwartz, David U Himmelstein, Adam Gaffney, Danny McCormick, Samuel L Dickman, Steffie Woolhandler; 7/24Private equity firms spent $505 billion on health care acquisitions between 2018 and 2023. Financial infusions may augment resources for care. However, firms have sometimes sold acquired hospitals’ land and buildings, repaying investors with proceeds and burdening hospitals with rent payments for facilities they once owned. We assessed changes in hospitals’ capital assets after private equity acquisition. After private equity acquisition, hospital assets decreased by 24% relative to that of controls during 2 years. Private equity acquisitions appear to have depleted, rather than augmented, hospital assets. Although funds from asset drawdowns might be redeployed to enhance care or efficiency, previous studies suggest such effects may not occur.

Tenet to sell majority stake in 5 hospitals in $910M dealModern Healthcare; by Caroline Hudson; 8/5/24Tenet Healthcare is selling its majority stake in Brookwood Baptist Health to Florida-based Orlando Health in a $910 million cash deal. The transaction is expected to close this fall and involves five Alabama hospitals: Brookwood Baptist Medical Center, Princeton Baptist Medical Center, Walker Baptist Medical Center, Shelby Baptist Medical Center and Citizens Baptist Medical Center, as well as affiliated physician practices and other operations, according to a Monday news release.

Cancer care deserts are spreadingBecker's Hospital Review; by Mariah Taylor; 8/2/24Cancer treatment deserts are growing as more rural hospitals close and cut services, CBS News reported Aug. 1. Many hospitals are discontinuing essential services, such as chemotherapy and labor and delivery, due to financial strains and staffing challenges. Between 2014 and 2022, 382 rural hospitals halted chemotherapy services, Charis, a health analytics and consulting firm, found in a report published this spring. Texas had the highest percentage of rural hospitals that eliminated chemotherapy services at 47%. Next came Alabama (46%), Mississippi (45%), Tennessee (44%), and Florida (39%).Publisher's note: Cancer care deserts impact hospice referrals, and raise the question of "hospice deserts".

Steward Health finds buyers for 2 hospitals amid Senate probeModern Healthcare; by Jonathan Randles; 7/22/24Bankrupt Steward Health said it found buyers for two of its hospitals in Arkansas and Louisiana, as the nation’s largest for-profit health system braces for a bipartisan Senate investigation into its financial woes. Steward is selling the Wadley Regional Medical Center in Hope, Arkansas, to Pafford Health Systems Inc. and Glenwood Regional Medical Center in West Monroe, Louisiana, to an affiliate of American Healthcare Systems.

‘Good’ death different for everyone Altoona Mirror, Altoona, PA; 7/26/24 The social and economic inequities patients suffer in life often shapes their death” was a key point of a July 13-14 article in the Review section of the Wall Street Journal. ... In the article, which was written by Dr. Sunita Puri, a palliative care physician and the author of “That Good Night: Life and Medicine in the Eleventh Hour,” Puri focuses on the conundrum many families face when dealing with the question of where to spend the final days of life. ... “New research classifies the rise in home deaths as progress,” the message immediately under the article’s headline begins, “but we need to look more closely at what these deaths look like.” ... Puri, now 10 years into her physician career, says it is now clear to her that there is much more to a “good” death than where it occurs. “Presuming a home death is a success obscures important questions about the process,” she wrote. “Did this person die comfortably? Did their caregivers have the resources and guidance they needed? Was dying at home a choice or simply the only option?” 

Baptist Health taps 3 vendors to build a population health system that works Healthcare IT News; by Bill Siwicki; 7/26/24With help from Oracle, Innovaccer and Salesforce, the South Florida provider is scoring big population health wins, including a 7% increase in coding gap closure rate and a 17% increase in annual wellness visit completion rates. Baptist Health South Florida operates a network of 11 hospitals covering four counties. It also includes numerous ambulatory facilities, urgent care centers and emergency departments to provide comprehensive healthcare services across the region. ... "One of our primary issues was the fragmented nature of patient data across multiple provider organizations and electronic health record systems," said Milady Cervera, vice president, population health and physician integrated networks, at Baptist Health South Florida. "This lack of interoperability made it difficult to gain a comprehensive view of our patients' health status, care history and ongoing needs. ..."

Rady Children's Hospital nurses strike begins after union turns down deal ABC News 10 San Diego, CA; by Perla Shaheen, Dani Miskell; 7/23/24 The Rady Children's Hospital nurses started hitting the picket line Monday morning. The union representing the nurses recently turned down the hospital's offer of a 25% pay bump over the next three years. The executive director for UNOCH Teamsters Local 1699 says this is the first time they've ever gone on strike. On Sunday, both sides thought they had a deal and would avoid the strike, but late last night, union members voted the agreement down.

5 takeaways from CEO and CFO compensation report Becker's Hospital Review; by Kristin Kuchno; 7/17/24 Compensation Advisory Partners' July 12 report highlighted compensation trends for CFOs and CEOs in 2023, based on data from 132 companies, including those in the healthcare sector, with a median revenue of $14.6 billion. Here are the key takeaways:

More people are dying at home. Is that a good thing? The Wall Street Journal; by Suniat Puri; 7/11/24 New research classifies the rise in home deaths as progress, but we need to look closely at what these death look like. In photos taken a year before we met, my patient smiled widely, flashing a peace sign, her feet planted in the damp sand of a local beach. “Mom was a firecracker,” her daughter told me. My patient, who now slurred her sentences, was dying of cirrhosis. Her jaundiced skin was golden, the corners of her pale lips crusted with dried blood. She wanted to die at home, according to her daughter, who had been estranged but re-entered her mother’s life to care for her. I was still in my training in palliative medicine and, like my patient’s daughter, I believed that a “good death” took place at home, surrounded by family. I shared her view that a hospital death was a failure, painful and undignified. I was glad to help her leave behind uncomfortable tubes and noisy machines for a death I presumed would be more peaceful. [Subscription may be required to continue reading.]