Another St. Joseph- London Cardiologist Is Sentenced to Prison.

Could this have been averted early on before this unfortunate result?

Last week, following his conviction last April for medical billing-fraud related to medically unnecessary placement of cardiac pacemakers, Dr. Anis Chalhoub was sentenced to 42 months in prison; required to pay $257,515 restitution to Medicare, Medicaid, and private insurers; and fined an additional $50,000.  Dr. Chaloub’s attorneys had requested a shorter time in prison and perhaps it is possible they will appeal the sentence.

According to the press release from the U.S. Attorney’s Office, an additional term in the sentence was that following release from prison he will remain on probation for a three-year period during which the “court has prohibited him from practicing cardiology during that time.”  I am puzzled about whether a federal court has superior jurisdiction over Kentucky’s Medical Licensure Board for such a restriction on licensure.  If I were the Kentucky Board, I would be embarrassed or angry, or both.  Out of curiosity, I looked today at the Kentucky Board’s website which informs me and potential patients that Dr. Chalhoub still has an active Kentucky medical license with “no actions” or restrictions mentioned. (I confirmed this with a call to the Board.)  Although several physician-referral & rating websites have him affiliated with hospitals in Lousiville and Indiana, I do not know if he is still practicing medicine. Continue reading “Another St. Joseph- London Cardiologist Is Sentenced to Prison.”

University of Louisville Hospital Pledges To Do Better.

I was both pleased and proud to read yesterday’s letter in the Courier-Journal by Ken Marshall, President of University of Louisville Hospital, recommitting to a higher quality of medical care for our community, including its most vulnerable citizens. Alas, under the clinical and management captivity by Catholic Health Initiatives and KentuckyOne Health, the hospital has performed unfavorably in virtually every quality-comparison with other hospitals, including other teaching and safety-net hospitals. Indeed, major layoffs of clinical and support staff by KentuckyOne, and concerns about quality of care by some staff physicians drew Federal attention that threatened the Hospital’s accreditation.

Various of the many items measured and methodologies used by the numerous evaluating entities have been criticized, and in my opinion sometimes rightly so. After all, what constitutes quality? One major criticism of current federal and proprietary hospital quality assments is that they do not adequately take into consideration the socio-economic status or severity of illness in the patient populations served. With all the valid current emphasis on the nonmedical determinants of health care status and outcomes, how can we not take these into consideration? Nevertheless, for University Hospital there is nowhere to go but up. Continue reading “University of Louisville Hospital Pledges To Do Better.”

Medicare Releases New 5-Star Rating System for Acute Care Hospitals.

Not everyone is happy, but Kentucky doing better than the rest!

Yesterday, the Centers for Medicare & Medicaid Services (CMS) released its first iteration of a new and simplified method of presenting the results of the awkwardly named HCAHPS survey that is administered to patients after their discharge.  The survey is intended to capture the patients’ own perceptions of their hospital experience and it is now part of the larger CMS Hospital-Compare initiative. As with previously released quality and safety initiatives, the reaction of individual hospitals is mixed.

The survey of 32 questions is administered to randomly selected adult patients who are between 48 hours to 6 weeks after being discharged alive from acute-care Medicare hospitals.  Unlike most other quality and safety programs managed by CMS, individual patient participants are not limited to the Medicare or Medicaid programs.  Hospitals attempt to reach a target of 300 surveys per year by telephone or mail, but some smaller hospitals struggle to do this.  Additionally, hospitals that are exempt from having to submit the more objective Medicare process and outcome measurements (including Medicare’s Critical Access Hospitals) can participate voluntarily in this patient experience program.

Hospitals have been submitting this information voluntarily since 2006, it has been mandatory since 2007, and the results have been reported publically since 2008.  A similar program for nursing homes and a few other healthcare providers already exists.  Future plans are to include these patient experience scores with the other more blood-and-guts process and outcome measures to provide a single global star-score for all Medicare hospitals. Proprietary quality and safety organizations are already doing this. Continue reading “Medicare Releases New 5-Star Rating System for Acute Care Hospitals.”

All But 2 Kentucky Hospitals Receive Medicare Penalties for Quality.

Some Hospitals Get the Triple Whammy.

It can’t be easy to be a hospital administrator nowadays. It probably never was. It has always been a delicate balance to juggle dealing with the feelings and physical needs of the sick and their families, courting professional staff members, the business priorities of the community, the never ending march of new technologies, the ever-present possibility of malpractice suits, labor and staffing issues, competition from other hospitals, the spiraling costs of healthcare, and more recently the expanding expectation of transparency and measurable outcomes. There are few industries subject to as much regulation and oversight as the hospital industry. With the authority of the federal government behind it, Medicare– whose lead is followed by much of the private-payer world– is arguably the regulator-in-chief and is increasingly more willing to use its control of the purse strings to advance public health policy priorities. Highly visible in the last three years are Medicare programs that seek to change the metric for payment of hospitals from paying for volume and procedures to quality, value, and desirable health outcomes. Measurement of these latter is now being tied to Medicare hospital payments. Continue reading “All But 2 Kentucky Hospitals Receive Medicare Penalties for Quality.”