Randi Redmond Oster's Blog, page 5
March 19, 2013
Malcolm Baldrige Quality Award
I am proud to announce that I have been selected to the Board of Examiners for the Malcolm Baldrige National Quality Award. The board provides advice and guidance to the Baldrige Panel of Judges in selecting Baldrige Award recipients. I will also serve as an ambassador for the Baldrige Performance Excellence Program.
They will be assigning business soon. Training is next month.
I hope I can use the knowledge I gain to help improve the health care system!
February 26, 2013
Ask for an alternative. You may find a safer and cost effective solution.
“The doctor wants to take an X-ray of the tube to make sure it is positioned correctly in his stomach. They need to confirm Norwalk’s ER procedure.
She has got to be kidding me. Another X-ray? When my husband had pre-cancer nodules on his thyroid as an adult, a doctor-friend speculated he probably had too many X-rays as a child. My father-in-law says that my hypochondriac mother-in-law took Steve routinely for an X-ray to check his lungs for bronchitis. Now, Steve has had thyroid surgery and parathyroid surgery. That pediatrician might be long gone, but my husband lives with the results of too much testing. There is no way my kid is going to be so over-radiated that he ends up with cancer in 30 years. My exhaustion and skepticism lead me to shout “No!”
I never shout and Gary looks up at me. The nurse says, “We need to know that the NG tube is positioned correctly.”
Does she think I didn’t hear her the first time? Or maybe she thinks if she just keeps repeating the same thing my response will change?
I tell her, “Look, I am finding it very difficult to believe that the only way you can tell if this is in correctly is with an X-ray.” I am firm, not even trying to be friendly. I look like a dried out drowned rat and feel the same. My wet sneakers squeak as I walk closer to her.
“That’s what the doctor wants,” she says.
I’ve seen this before. The protocol train provides her comfort with a clear track to follow. I get it. There needs to be consistent processes. There need to be rules of authority. There shouldn’t be mavericks running loose. But, this does prevent people from thinking for themselves.
“Look, there will be no X-ray. Find another way,” I insist.
“So, may I state this correctly? You are refusing medical treatment for your son.”
Here we go again. Only this time, I see the clearness of her question and guilt-producing tactic. Either I’ll change my mind or, if I do not, the hospital will document my response and protect itself legally. I don’t even find it hard to muster up the courage to say, “Yes, no X-ray. Find another way.”
She leaves the room without smiling. Gary screams that he doesn’t care about another an X-ray. He just wants this NG tube out. To him, the point I am making about excessive radiation seems to be missing his. Gary switches to the silent treatment. I don’t know which I hate more, this or his heavy metal version of “I hate it.” Time could not be moving any slower. The nurse finally opens the door. She repeats that the doctors wanted an X-ray to be done in the ER, but since I am refusing treatment, they will be moving Gary, now, to a room upstairs.
She looks at Gary and says, “The ER doctor said the tube stays in.” She is letting us both know we lost the battle. But, I am glad he didn’t get the X-ray. Where else could this tube be but in his stomach? Is there another path from the esophagus in the body I don’t know about? As an attendant wheels Gary into the elevator, there is no excitement to see the room. As the floor nurse points us to our new home, for I have no idea how long, I notice that the day bed for me seems to at least have a better mattress. The last one had those separate cushions that I tightly tucked a sheet over each night to keep my body from falling between the cushions onto the wooden frame. This one has a single cushion, no sagging possible. Why would the hospital even have day beds with separate cushions, when there is a better way? I bet no one in purchasing ever slept on one of those beds.
Gary’s new nurse enters. She looks like she graduated yesterday. I hold back my question to find out if this is her first patient. I know the importance of the nurses and don’t want to piss her off right away. Maybe later, but I should at least try to be nice.
“I understand they are concerned about whether the NG tube is placed properly,” she says, smiling.
“Yeah,” I say.
“I understand you said no getting an X-ray?”.
“Yeah.”
“I learned in nursing school that the PH of the stomach is in the one-to-three range. I bet I can get some PH papers and take some of the stuff out from the tube and then I can test it.”
“Really?” I can’t believe there can be a solution as simple as this.
“Sure! Let me get the papers.” She races out of the room seeming rather excited.
Gary, who hasn’t spoken to me since we were in the ER, reiterates that his issue is not the X-ray. He wants the tube out. If the X-ray shows it is in the wrong place and they take it out, then getting the X-ray is worth it. To him, I am missing the entire point and I am a bad mother. I’m acting like a radiation maniac. In less than two minutes, the nurse is back and she goes to the bag that collects the stuff from Gary’s stomach and puts some of the cloudy gel-like liquid in a cup. Without speaking, she takes a PH strip and places it in the cup.
Gary looks over and she brings the color guide over to him. She says if it turns in the reddish area we know that the PH level is in range and that means the stuff is from your stomach and the tube is in properly. It takes seconds for the strip to turn scarlet. So, the weird liquid is the acid from his stomach. I am thrilled but also perplexed.
How come they couldn’t do this in the ER? Isn’t this cheaper than an X-ray? I know it is safer. And faster.
February 25, 2013
Facts from “Bitter Pill,” TIME’s Blockbuster Cover Story
20%
Percentage of the gross domestic product Americans spend on health care, nearly double that of most developed countries. In every measurable way, the results are no better and often worse.
Next 10 Biggest
Americans spend more on health care than Japan, Germany, France, China, the U.K., Italy, Canada, Brazil, Spain and Australia.
$60 Billion
Price tag for cleaning up after Hurricane Sandy and also U.S. weekly health care bill.
25% to 75%
Overcharge Medicare pays for durable medical devices like canes and wheelchairs as mandated by Congress.
8-and-4
Of New York’s 18 largest private employers, eight are hospitals and four are banks.
$1,845,000
Total compensation paid to Ronald DePinho in 2012. DePinho is President of MD Anderson, a medical center which is part of the University of Texas.
$674,350
Total compensation paid to William Powers, Jr., in 2012. Powers is President of the entire University of Texas system.
10-out-of-20
The Bureau of Labor Statistics projects that half of the 20 fastest growing occupations in the U.S. by 2020 are related to health care.
$5.36 Billion
Amount spent on lobbying in Washington since 1998 by the pharmaceutical and health-care-product industries, combined with organizations representing doctors, hospitals, nursing homes, health services and HMOs.
$1.53 Billion
Amount spent on lobbying since 1998 by the defense and aerospace industries.
$1.3 Billion
Amounts spent over the same period by oil and gas interests.
$2.8 Trillion
Americans will spend this much on health care during 2013.
$750 Billion
Amount Americans would save if we spent the same per capita amount on health care as other developed nations.
$800 Billion
Medicare and Medicaid bill for 2013 which keeps rising faster than inflation and the gross domestic product and which drives the federal deficit.
10-to-15 a day
A typical piece of medical equipment will pay for itself in one year if it carries out this number of procedures a day.
7-to-10 years
The expected life span of medical equipment. Combine this fact with the one above and the result is medical tests become highly profitable.
71%
Health care providers in the U.S. conduct this percentage more CT tests per capita than Germany.
$2.586 Billion
2012 revenue of the Montefiore Medical Center, a large nonprofit hospital in the Bronx.
6X
Montefiore Medical Center’s revenues is this times as large as the Bronx’s most famous enterprise, the New York Yankees.
$4,065,000; $3,243,000; $2,220,000; and $1,798,000
Salaries paid to Monteifiore’s CEO, CFO, Executive VP and head of the dental department, respectively.
60%
Percentage of personal bankruptcy filings each year in the U.S. that are related to medical bills.
$2.5 million
Amount paid in 2012 to Marna Borgstrom, CEO of the Yale New Haven Health System.
$1.6 million
Amount paid to Yale University’s president.
35%
Average hospital profit on nonemergency outpatient care, which compares to only 2% for inpatient care.
$34 Million
Operating profit from most recent tax return (2011) of Oklahoma City unit of Sisters of Mercy hospital based revenues of $337 million after paying 10 executives more than $300,000 each including $784,000 to the regional president.
$319 Million
Operating profit of Mercy branch in Springfield, Missouri (pop. 160,660) on revenues of $880.7 million.
3/10-of-1%
The actual percentage costs of charity care for the entire Mercy Health chain based on revenues of $4.28 billion.
$800 Million
Amount the four dominate manufactures in the hip-and-knee-replacement industry paid to 6,500 “physician consultants” from 2002 through 2006.
$70 Billion
Estimated amount Americans will spend on lab tests in 2013.
$25 Billion
Amount of over-ordering and overpricing in the above bill.
72%
Doctors’ urology groups with their own labs who bill Medicare analyze this many more prostate tissue samples per biopsy while detecting fewer cases of cancer than their counterparts who send specimens to outside labs.
54%
Percentage of physician practices owned by hospitals in 2012, up from 22% 10 years before, primarily a move to increase the hospitals’ leverage in negotiating medical bills with insurers.
6%
As mandated by Congress, Medicare determines the price it pays for drugs by first determining the average market price of the drugs and adding this percentage. Congress prohibits Medicare from negotiating for better prices.
$20 Billion
Estimated amount Medicare will pay for cancer drugs in 2013, up from $11 billion in 2004, $3 billion in 1997.
Source: “Bitter Pill: Why Medical Bills are Killing Us” by Steven Brill, TIME, February 20, 2013
January 28, 2013
QUIZ: Health Care Laws: one question, big answer
The Health Care Laws are changing. One method I’ll use to get you useful quick information is posing a question, just like the kids do with the SATs.
All of the following are TRUE except –
A) Insurers can no longer cancel your policy if you get sick.
B) Consumers can appeal insurance company decision to an independent review and receive a response in 72 hours for urgent medical situations.
C) In 2013, there are no limits an insurance company can set for how much they will pay for an individual’s medical expense each year.
D) Insurance companies must spend 80% of the premiums on medical care and quality improvements. If they spend too much on salaries, bonuses or administration costs, as opposed to health care, they must issue premium rebates to consumers.
First, thank you to Consumer Reports, “Health Reform: Seven things you need to know now” for their pamphlet I used to create today’s quiz question. http://www.consumersunion.org/pub/pdf/healthcare2012.pdf
The FALSE answer is: (C)
There is still a limit of $2 million for insurance company payouts. Starting January 2014 the law requires limits to be completely eliminated. However, insurers can still impose other benefit limits like number of doctor visits, prescription limits or limits on days in the hospital.
I found it horrible when my son, Gary, was sick and I felt like I knew nothing about our coverage. I was telling my husband to call his HR dept. as Gary was under the knife. It really bothered me that my son was being operated on and I had to be concerned about the payment.
http://www.consumersunion.org/pub/pdf/healthcare2012.pdf
www.consumersunion.org
Local Hospitals: How Do YOURS Compare?
Want to see how your local hospital compares to others in the area? Now you can type in your zip code, pick up to three hospitals and compare their results.
You’ll see patient feedback – like cleanliness of bathrooms, quiet nights and clear doctor communication. Plus learn how fast the hospital is at handling emergencies. It might change where you tell the ambulance to go if your loved one is having a heart attack. You can even find out the readmissions, complication and death rate at hospitals.
If you are curious if you hospital tends to overuse medical imaging tests now you can learn how your hospital compares to other hospitals in your area. You’ll even see the hospitals history of follow ups after the tests. It is quick, easy to use. Plug in your zip code and pick the hospitals you want to compare. It may change your perspective.
Hospitals rewarded with higher reimbursement from Medicare
http://www.kaiserhealthnews.org/Stories/2012/December/21/value-based-purchasing-chart.aspx
Hospitals are being rewarded for high quality with higher reimbursement rates from Medicare. It’s the pay for performance model. It is based on surgical results, treatments and patient satisfaction.
Hospitals not meeting Medicare expectations are penalized with the reimbursement rate reduced.
Now you can see how your favorite hospital fared. For example, in Connecticut, 86% of the state 30 acute-care hospitals were penalized.
Just type in your state to check out the results.
Feb. 26 Speaking Engagement
Key Note Speaker
What you need to know NOW
Anderson Wealth Management
Westport, CT
