Literature Review

HHS to impose penalties on providers that block patients’ health information McKnights Home Care; by Adam Healy; 6/24/24In a bid to promote easier access and exchange of patients’ health records, the Department of Health and Human Services published a final rule Monday outlining penalties for providers that block access to electronic health information. ... Fragmented and inaccessible patient data can prevent long-term and post-acute care providers from seeing the full picture of a patients’ health. Hospitals, for example, are not required to share updates about a patient’s health with the patient’s post-acute care provider. As a result, home health and home care agencies frequently cannot access patients’ electronic health records to help assess and treat patients. Three disincentives: ... First, hospitals that commit information blocking can be subject to a reduction of three quarters of an annual market basket update. Second, clinicians eligible for the Merit-based Incentive Payment System will receive a zero score in the “promoting interoperability performance” MIPS category, which can be equivalent to roughly a quarter of the clinician’s MIPS score in a given year. Lastly, providers that participate in information blocking can have their Medicare Shared Savings Program or Accountable Care Organization eligibility revoked for at least one year. ...Editor's Note: Almost any solution raises additional challenges. How does HIPAA interface with this? How might a cyberattack at a hospital (or other healthcare agency) affect the patients' other agencies, putting them at risk as well?

48 health systems with strong finances Becker's Hospital CFO Report; by Andrew Cass; 6/20/24 Here are 48 health systems with strong operational metrics and solid financial positions, according to reports from credit rating agencies Fitch Ratings and Moody's Investors Service released in 2024. Note: This is not an exhaustive list. Health systems were compiled from credit rating reports. [Click on the title's link for the list.] Editor's Note: This list is from larger "health systems," and does not reflect stand-alone hospice and palliative organizations.

Novant scraps $320M hospital deal with CHS Becker's Hospital Review; by Alan Condon; 6/18/24 Winston-Salem, N.C.-based Novant Health has called off its planned $320 million acquisition of two North Carolina hospitals from Community Health Systems after an appellate court granted the Federal Trade Commission an emergency injunction blocking the deal. In a 2-1 decision, the 4th U.S. Circuit Court of Appeals said it would allow the FTC to prevent the two-hospital acquisition from proceeding until its appeal is resolved. ... The FTC argues that the transaction would "irreversibly consolidate the market for hospital services in the Eastern Lake Norman Area in the northern suburbs of Charlotte."

University Hospitals to cut more than 300 positions Modern Healthcare; by Paige Bennett; 6/19/24 University Hospitals is eliminating more than 300 positions amid challenges in the healthcare industry. The health system announced Wednesday, June 19, that it was reducing its leadership structure by more than 10% as part of an organizational reset. The move comes at a time when healthcare systems across the U.S. are grappling with rising costs and labor shortages. UH Chief Operating Officer Dr. Paul Hinchey said in a phone interview with Crain’s that the cuts focused on leadership and support services, not frontline workers. Affected employees began being notified by the health system on Monday, he said. The health system said the vast majority of the cuts were non-clinical and will not impact patient care. The move “complements a plan over the past three years to increase efficiency, consolidate service lines and close hospitals in Bedford and Richmond Heights,” according to UH. 

More COVID-19 patients died in understaffed hospitals, new data showUniversity of Minnesota [reported by KFF Health News]; by Stephanie Soucheray, MA; 6/13/24A new study in the International Journal of Nursing Studies suggests chronically understaffed US hospitals had higher rates of COVID-19 patient deaths early in the pandemic. "Our study found that individuals' likelihood of surviving was related to hospitals' investments in nursing services prior to the pandemic—in terms of hiring sufficient numbers of RNs, employing nurses with bachelor's educational preparation, and sustaining favorable work environments," said Karen Lasater, PhD, RN, the lead author of the study, in a press release from the University of Pennsylvania School of Nursing. The study was based on outcomes seen among 87,000 Medicare enrollees (ages 65 to 99) hospitalized with COVID-19 from April through December 2020 in 237 general acute-care hospitals in New York and Illinois. ... Overall, the average age of patients was 78 years, and 31.5 % died within 30 days of admission, with 23% of those patients dying during the hospitalization.

4 CFOs' keys to improved operating performance Becker's Hospital CFO Report; by Andrew Cass; 6/13/24Altru, Memorial Health, Penn State Health and Sharp HealthCare are among the systems that reported improved year over year operating performance in their most recent financial reports.  Becker's asked the CFOs of the four health systems to share one key to their boosted operating performance: ...

Palliative care considerations in frail older adults Annals of Palliative Medicine; by Andrew E Russell, Rachel Denny, Pearl G Lee, Marcos L Montagnini; 6/6/24, online ahead of print...This paper aims to guide clinicians in providing patientcentered care for older adults with frailty in the outpatient setting. Through a comprehensive literature review, we describe the leading models of frailty, frailty screening tools used in the clinical setting, and the assessment and management of palliative care needs in frail patients. We also describe emerging models of care focusing on palliative care for older adults with frailty and discuss issues related to access to palliative care for this population.

White House enlists Microsoft, Google for rural hospital cyberdefense Becker's Health IT; by Naomi Diaz; 6/10/24 The Biden-Harris administration has secured commitments from Microsoft and Google to offer free and low-cost resources to rural hospitals nationwide to help them boost their cyber defenses. As part of the effort, Microsoft will be extending its nonprofit program to provide grants and up to a 75% discount on security products for independent critical access hospitals and rural emergency hospitals, according to a June 10 news release from the White House. Additionally, larger rural hospitals using eligible Microsoft solutions will also receive the most advanced security suite at no additional cost for one year. ... Meanwhile, Google committed to offering endpoint security advice to rural hospitals and non-profit organizations at no cost, alongside funding support for software migration. 

Palliative care in the intensive care unit: The standard of care AACN - American Association of Critical-Care Nurses; by Clareen Wiencek, PhD, RN, ACNP, FAAN; 6/7/24Intensive care unit–based palliative care has evolved over the past 30 years due to the efforts of clinicians, researchers, and advocates for patient-centered care. ... This article provides an overview of the current state of intensive care unit–based palliative care, examines how the barriers to such care have shifted, reviews primary and specialist palliative care, addresses the impact of COVID-19, and presents resources to help nurses and intensive care unit teams achieve optimal outcomes. [Access to the full article requires subscription or purchase of the individual article.]

Dr. Marc Boom confronts the new dynamics of CEO burnoutBecker's Hospital Review; by Kelly Gooch; 5/23/24While the topic of burnout among hospital CEOs is not new, there are new dynamics in play to consider as part of the discussion. Those in the role today encounter increased pressures ranging from financial to operational. "There are new pressures that have emerged in the healthcare delivery world - everything from reimbursement cuts and escalating drug and supply costs, and labor expenses - that have created a lot of financial headwinds for organizations," said Scott Sette, a partner with Chicago-based executive search firm Heidrick & Struggles. "Plus, regulatory changes have forced CEOs to spend more resources on compliance, cybersecurity, EMR administration." Additionally, "there have just been so many workforce challenges. ... Then you have the impact of the remote and hybrid workforce and the impact of that on organizational culture. Plus, you've got many social issues going on. Clearly, [diversity, equity and inclusion] continues to be top of mind, but also you've got political unrest. You have mass shootings. You have gender-affirming care and other social issues that organizations have to address. And all of these topics [have] created even more pressures for hospitals and health systems to deal with, in addition to delivering high-quality care and delivering customer-centric experiences. There is a lot for CEOs to deal with on a daily basis." Marc Boom, MD, has served as president and CEO of Houston Methodist, an eight-hospital system with more than 32,000 employees, since 2012. He acknowledged these pressures in a recent interview with Becker's. He also discussed the prevalence of burnout and shared advice for how leaders can reduce the potential for it.

7 health systems hit by cybersecurity incidents in May Becker's Health IT; by Naomi Diaz; 5/24/24 Several hospitals and health systems have reported cybersecurity incidents that have led to compromised patient data and IT systems during May. Here are seven cybersecurity incidents as reported by Becker's during May. [Click on the title's link for details.]

Kaiser physicians vote to unionizeBecker's Hospital Review; by Kelly Gooch; 5/24/24Resident and fellow physicians employed by Kaiser Permanente hospitals in Northern California voted to join the Committee of Interns and Residents, a local chapter of the Service Employees International Union. Nearly all participating voters (99%) cast ballots in favor of unionization, according to a May 23 CIR/SEIU news release. The National Labor Relations Board has not yet certified the results. Pending certification, the total percentage of residents represented by CIR/SEIU in California will reach 82%, according to the union.