Category: Health Care Reform

Was Kentucky Spared from CHI Layoffs?

Is there still a nursing shortage in Kentucky?

Earlier this year, and following a disappointing report for the first quarter of FY 2015, Catholic Health Initiatives announced that it would cut 1500 jobs nationally by the end of January.  The positions targeted were administrative and support staff representing some 1.7% of CHI’s total 90,500-person workforce.  KentuckyOne Health (CHI’s operation in the Commonwealth) had already absorbed an previous layoff of 500 employees one year ago but remains the weakest sister financially among CHI’s regions.  Locally, concerns were shared that we might take another hit this round. Has that happened?

To be fair, CHI is not the only big system to be laying off people.  A nationwide shift from inpatient to outpatient services has even the prestigious Cleveland and Mayo clinics trimming their staffs.  Frankly, I have not heard much of anything about layoffs in Kentucky– at least in the Louisville market. Even a usually productive Google search did not reveal much for me.  The most notable activity is in Omaha where CHI’s hospital and clinical system have no current network contract with Blue Cross/Blue Shield.  The drop in patient volume there is said to have sparked layoffs of at least 156 people including physicians! Additional job cuts were anticipated through attrition and by not filling open positions.  There have been layoffs reported in Oregon too. Otherwise things seem to be quiet. Is that what happens when administrative jobs get cut?

In fact, in the usual on-line places, KentuckyOne is advertising to fill quite a few clinical positions in Louisville. I am informed that some modest hiring of clinical-support people is also occurring. I do not know what is happening in the rest of the state.  Good! Lets face it– you can’t run a hospital or medical office without doctors, nurses, and technicians.  If you terminate too many of these, people tend to notice, including accreditors and regulators.  I asked KentuckyOne how much and in what way Kentucky might have shared in CHI’s nationwide job-reduction program but did not receive a reply. Continue reading “Was Kentucky Spared from CHI Layoffs?”

You Can’t Always Get [What You Pay For]

But if you try real hard— you might do better than Venezuela!

Providing healthcare to [some] Americans is the best economic development bonanza going. Alas, here in the exceptional USA, many people do not have access to mainstream healthcare.  Worse however, as pointed out in today’s Wall Street Journal [yes, I do subscribe], nearly all Venezuelans needing even standard medical or surgical care are plum out of luck— unless they can find and then afford to buy their own medical supplies from insulin to heart valves.  It sounds awful. Hyperinflation makes already overpriced medical devices and drugs impossible to afford. An exodus of physicians, including those whom were loaned by Cuba, makes matters worse. The situation is beyond frustrating for both patients and physicians alike.  At least our feared but imaginary American death panels would have actual choices to make!   Venezuelans are in very real death-spirals of the flesh, not the death-spirals health insurance companies face when they are left holding the bag for sick people when healthy and less ill people fail to enroll in their plans.

The disheartening article included the following graphic showing Venezuela at the bottom of the list of Latin American countries, spending in 2012 only 1.6% of its gross national product on healthcare (and that was 2 years ago). The numbers from the World Bank are only slightly different.  If fact, according to that source, its healthcare spending in 2012 puts Venezuela at the bottom of the list of every other ranked country in the world, occupying a healthcare category all of its own.  That country is suffering the melt-down that apocalyptic American alarmists either warn of, or alternatively fantasize about as a starting point from which to rebuild from the ashes. Continue reading “You Can’t Always Get [What You Pay For]”

Breach of Personal Healthcare Information at Anthem.

Healthcare data unchained!

We often hear the aphorism, “Anything put on the internet, stays on the internet.” I suggest a corollary, “Anything put on a computer can be retrieved by a determined inquisitor.” So it is even for the most intimate of personally identifiable information – healthcare records. Given massive nationwide efforts to digitize our healthcare encounters, and given the frequency with which those digits are shared among insurers, contractors, researchers, public health officials, health information exchanges, pharmaceutical companies, healthcare providers, and the host of other interested parties who claim a legitimate interest, it is inevitable that data will go astray and be misused – illegally or inappropriately! It is said of computer hard-drives that one does not ask if a failure will occur, but when. I maintain that the same dictum holds true of personal health information. If computer-wielding crooks can steal from banks (which we assume use the highest degree of on-line and network protection), how impregnable is the healthcare industry? Apparently not so much.

Big data-hack at Anthem.
Earlier this month, health-insurer behemoth Anthem announced that the personal healthcare and credit card information of as many as 80 million of its customers may have been compromised. A secondary wave of attacks is already occurring as scammers send email warnings pretending to be from Anthem or credit-protection companies seeking to extract even more personal information from frightened Anthem customers. The Anthem breach strikes close to home. At last week’s UofL board of Trustees meeting, it was announced that some 5700 UofL employees might be on the Anthem list. I may be one of them. Not a good feeling. I feel violated enough when my personal healthcare information is being used to target me with marketing propaganda cloaked as important medical information. Having the same information in the hands of bona fide crooks gives me the willies. Continue reading “Breach of Personal Healthcare Information at Anthem.”

Who Pays for Human Organ Transplantation?

In response to a recent article in these pages about human organ transplantation in Kentucky, it was alleged that the University of Kentucky Hospital accepted Medicaid as payment for solid organ transplantation but that the Jewish Hospital program did not. I interviewed a number of individuals with first-hand knowledge but was unable to dispute the assertion that the source (or lack thereof) of a patient’s health insurance makes a difference in who receives an organ— not only here in Kentucky but nationwide. I recently obtained comprehensive payer-specific information from the United Network for Organ Sharing (UNOS)– the government-sponsored organization that regulates and oversees virtually all organ transplants performed in the U.S. The short answer is that there is a considerable difference in the payer-mix for solid-organ transplantation between Jewish Hospital and the University of Kentucky (UK). In 2013– the last year for which a full 12 months of reporting is available– Medicaid beneficiaries made up 6.4% of all transplant recipients at Jewish and 15.9% at UK. These figures can be compared to the national proportion of 8.7% Medicaid beneficiaries. It cannot be said that the Jewish Hospital program does not accept Medicaid beneficiaries altogether. Additional details and commentary concerning local and national transplant programs are presented below. Frankly, I had not encountered such data before and I think it will be of general interest to many. Continue reading “Who Pays for Human Organ Transplantation?”