by Atul Gawande from the New Yorker I 8-23-2012
It was Saturday night, and I was at the local Cheesecake Factory with my two teen-age daughters and three of their friends. You may know the chain: a hundred and sixty restaurants with a catalogue-like menu that, when I did a count, listed three hundred and eight dinner items (including the forty-nine on the “Skinnylicious” menu), plus a hundred and twenty-four choices of beverage. It’s a linen-napkin-and-tablecloth sort of place, but with something for everyone. There’s wine and wasabi-crusted ahi tuna, but there’s also buffalo wings and Bud Light. The kids ordered mostly comfort food—pot stickers, mini crab cakes, teriyaki chicken, Hawaiian pizza, pasta carbonara. I got a beet salad with goat cheese, white-bean hummus and warm flatbread, and the miso salmon
From Fierce Healthcare August 17, 2012 | By Ron Shinkman
More than 2 million Medicare beneficiaries now are enrolled in accountable care organizations, and their ranks continue to grow, according to a new survey by the Commonwealth Fund. However, Kaiser Health News reported that many hospitals may not yet be ready to assume the financial risks of an ACO operation.
According to the report, 2.4 million Medicare enrollees are involved in some form of ACO. Altogether, there were 221 ACOs in 45 states as of May. Of those, 148 are Medicare-oriented, with the rest serving private sector patients.
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A sizable percentage of hospitals expect to reduce their spending on capital projects during 2012 as they confront a variety of budget issues, according to a new survey of 730 hospitals from Premier healthcare alliance.
Premier’s 2012 Economic Outlook indicated that 35 percent of healthcare leaders said their capital budgets declined over the past year–a tougher climate than the 2011 survey, when 28 percent reported a drop, reported DOTmed News.
However, 65 percent of those surveyed believed their budgets remained about the same or have increased compared with 2011. Premier noted that 72 percent of those surveyed last spring reported flat or increased capital budgets.
The survey also found that 76 percent of the healthcare leaders said future reimbursement cuts were dictating most capital budget decisions.
Next year, most of the capital investments will go to information technology and telecommunications, according to more than 40 percent of respondents; 30 percent said the majority would go toward infrastructure.
“The nation’s current debt concerns and looming reductions in reimbursement have, for the most part, slowed hospital spending and increased demand for greater value,” Premier Chief Operating Officer Mike Alkire said in a statement yesterday. “The one exception is HIT, where hospitals are placing a great deal of fiscal and operational focus.”
Premier’s survey also indicated that hospitals are trying to cut costs by standardizing more care.
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From the Harvard Business Review:
Other countries spend less of their GDP on health care but have the same increasing trend. Explanations are not hard to find. The aging of populations and the development of new treatments are behind some of the increase. Perverse incentives also contribute: Thirdparty payors (insurance companies and governments) reimburse for procedures performed rather than outcomes achieved, and patients bear little responsibility for the cost of the health care services they demand.