The Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS), which CMS launched in 2006, helped to produce the new HCAHPS Star Ratings. The survey reports 11 measures based on patients’ perspectives of hospital care and includes topics such as nurse and doctor communication with patients, hospital staff responsiveness to patient needs, cleanliness and quiet environments, and how well patients were prepared for post-hospital settings.

Twelve HCAHPS Star Ratings appear on Hospital Compare – one for each of the 11 publicly reported HCAHPS measures, plus the new HCAHPS Summary Star Rating. HCAHPS Star Ratings are the first star ratings to appear on Hospital Compare, and CMS plans to update the HCAHPS Star Ratings each quarter.

When CMS examined the star ratings, it found 67 percent of physician-owned hospitals received a four- or five-star rating (the highest possible ratings). That is impressive. Physican-owned hospitals seem to be extremely popular. A lot of them are so popular that they have to regularly recruit new employees to cope with the patient demand. They are often recruiting physician assistants to make the physician’s jobs a lot easier. To become one, people do have to be educated to a mpas degree level. This ensures that they are educated and knowledgeable enough.

“The numbers are astonishing but not surprising – physician-led health care delivers high-quality results,” said Dr. Blake Curd, president of Washington, D.C.-based Physician Hospitals of America (PHA), an association for physician-owned hospitals, in a statement. “When you couple patient satisfaction with CMS-quality data, there is no doubt patients do much better when they are treated at a physician-owned hospital.”

Despite accounting for only 5 percent of all U.S. hospitals, physician-owned hospitals represented 84 of the 251 hospitals receiving five-star ratings. This wasn’t unexpected, according to CMS, because hospitals with physician ownership comprised seven of the top 10 and 43 of the top 100 hospitals in the country in the Hospital Value-Based Purchasing Program, a CMS program that measures the quality of care at hospitals.
“It is of the utmost importance that patients receive individualized and appropriate treatment in a hospital setting where they will receive the highest-quality outcomes,” said John Richardson, PHA director, in a statement.
Ironically, physician-owned hospitals are banned from expanding their services to additional patients under the Affordable Care Act.
“Inconsistently under-performing hospitals without physician ownership have no similar federal restrictions on expansion,” Curd said in a statement. “This is not good for patients, not good for the long-term stability of Medicare and not good for taxpayers.”
PHA is asking Congress to change existing laws so that hospitals with physician ownership can once again expand to meet the growing demand for health care services in their communities.

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The Meaningful Use program is an electronic health record (EHR) incentive program initiated following the American Recovery and Reinvestment Act of 2009 that authorizes the Centers for Medicare and Medicaid Services (CMS) to award incentive payments to eligible professionals who demonstrate meaningful use of a certified EHR. The program has three stages, but incentives were only provided in Stage 1, which began in 2011. Stage 2 of Meaningful Use began this year and by 2015, eligible providers that have not adopted an EHR will face a financial penalty.

The AMA, headquartered in Chicago, is pressing for changes to the program after new analysis from CMS showed only 2 percent of physicians and less than 17 percent of hospitals have demonstrated Stage 2 Meaningful Use as of Sept. 30, the required reporting date for the 2014 fiscal year.

In response to the data, the AMA is urging policymakers to fix the program by adding more flexibility and shortening the reporting period to help physicians avoid penalties. Physicians representing the AMA also say that full interoperability is necessary to achieve the goals of EHRs — which are to facilitate coordination, increase efficiency and help improve the quality of care — but that is not widely available today.

"The AMA has been calling for policymakers to refocus the Meaningful Use program on interoperability for quite some time," said Dr. Steven J. Stack, AMA president-elect, in a statement. “The whole point of the Meaningful Use incentive program was to allow for the secure exchange of information across settings and providers and right now that type of sharing and coordination is not happening on a wide scale for reasons outside physicians’ control. Physicians want to improve the quality of care and usable, interoperable electronic health records are a pathway to achieving that goal.”

Although there are some systems on the market capable of interoperability, when data is transferred it is not always incorporated into the receiver’s EHR in a digestible way, making it difficult to act on and defeating the purpose of sharing, the AMA argues. Additionally, interoperability often comes at a price, which further hinders its use.

In addition to calling for EHRs to be more interoperable, physicians are also recommending that policymakers ease regulations to allow for EHRs to become more usable. To back its position, the AMA has been citing a 2013 report from AMA-RAND — a collaboration between the AMA and research firm RAND Corporation — that stated EHRs are a major source of dissatisfaction for physicians. The report found that physicians want to embrace technology, but they’re frustrated that regulatory requirements are forcing them to do clerical work and distracting them from paying close attention to their patients.

Physicians also raised concerns about interoperability in the study, saying that the inability of EHRs to "talk" to each other prevents the transmission of patient medical information when it is needed.

The AMA has provided the Office of the National Coordinator for Health IT (ONC) and CMS with a blueprint for improving the Meaningful Use program as well as a framework that outlines eight priorities for more usable EHRs.
 

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According to the CMS, round two of the Health Care Innovation Awards program focuses on four priority areas: rapidly reducing costs for patients with Medicare and Medicaid; improving care for populations with specialized needs; testing improved financial and clinical models for specific types of providers, including specialists; and linking clinical care delivery to preventive and population health. The 12 prospective recipients will test models in all four categories throughout 13 states, impacting a wide range of patient populations across the care continuum.

Ranging in value from an expected $2 million to roughly $18 million, the average grant will total $9 million and will be awarded over a three-year period. Additionally, all awardees will be monitored for measurable improvements in both savings generated and quality of patient care.

The list of 12 prospective recipients includes a University of Michigan project, focuses on improving abdominal surgery outcomes, and the University of California San Francisco’s Care Ecosystem program, which builds on the school’s existing dementia care research and services. An Avera Health project that spans Iowa, Minnesota, Nebraska and South Dakota could also provide substantial funding to test the virtual wrapping of comprehensive, resident-centered geriatric care services around the long-term care population. Other potential awardees focused on reducing childhood dental disease, controlling primary and specialty care costs, improving child wellbeing through integrated care and preventing avoidable emergency department and inpatient use. Additional prospective recipients will be announced in the coming months.

Along with the Health Care Innovation Awards announcement, the Department of Health and Human Services (HHS) also made more than $700 million available as part of the State Innovation Model initiative. This initiative will help states design and test improvements to their public and private health care payment and delivery systems.

“As a former governor, I understand the real sense of urgency states and local communities feel to improve the health of their populations while also reducing health care costs, and it’s critical that the many elements of health care in each state — including Medicaid, public health, and workforce training — work together,” said HHS Secretary Kathleen Sebelius. “To help, HHS will continue to encourage and assist them in their efforts to transform health care.”

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SurroundHealth, an online community of health educators and healthcare professionals, was developed by HealthEd Academy, a Clark, N.J.-based division of HealthEd dedicated to fostering research and development in health education that targets health professionals in the trenches of patient education and health education.

The site provides best practices information, industry news, job openings, discussion opportunities, research opportunities, resources and links.

The site is not limited to any specific discipline, making it unique, says SurroundHealth Community Leader Susan Eno Collins.

“This community is multiple disciplines and people come together to focus on areas and issues that are challenges within health – things like health literacy, cultural humility and cultural competence, the use of technology in patient education and health education,” she said. “The things that help keep people on the cutting edge of that is really where the community is at.”

Although SurroundHealth counts physicians among its members, it particularly targets “health extenders” such as diabetes educators, nurse practitioners, registered dieticians and health educators.

“We also have people from within public health and that gives us the perspective of people who are working deep within communities on areas of prevention, so you get really the spectrum of perspective and expertise sharing,” she said.

The site launched in April 2011 and has experienced month-over-month growth of 40 percent on average since then, says Collins. Grassroots promotion through LinkedIn, Twitter and appropriate health professional conferences has fueled interest, and by taking a look at growth services like Upleap or gramista at some point in the near future, it won’t be long until the same level of interest could be sparked through Instagram too. Membership comes from 40 countries and will reach 1,000 this month.

Future plans call for membership growth and expanding ways people can engage in sharing the aggregation or content creation. SurroundHealth is looking to expand engagement around resources of interest and topics of interest so the site becomes a way to quickly get to the needed information and best practice approaches.

“We are trying to fulfill that need of a place to share and have discussions and forums, but also a place to help organize around areas of issues and really organize both the resources as well as the information,” Collins said.

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