Politics of Medicine
Dr. Oz tapped to head CMS; possible Medicaid changes ahead
The incoming administration this week named Mehmet Oz, MD, MBA, to head up CMS, according to a report in STAT. The former cardiothoracic surgeon became much more well-known as a TV personality who promoted weight loss and exercise for a healthier lifestyle as well as vaccines and masks during covid. He also used his platform to hawk a variety of diet supplements and unproven covid treatments during the pandemic, and he has repeatedly touted the benefits of joining Medicare Advantage plans. He ran an unsuccessful Senate campaign in Pennsylvania in 2022. In related news, the New York Times looked at what changes may be coming to Medicaid under the new administration. The government program, which insures about 20% of Americans, may find funding cut for Medicaid expansion and new work requirements being imposed for program enrollees.
Hospitalist Compensation
Hoping for a big pay raise? This may not be your year
Medical Economics
Report: Hospitals paying $300,000 a year to subsidize employed doctors
A new report found that hospitals are subsidizing physicians they employ to the tune of $300,000 a year, an amount that analysts say isn’t sustainable. Data from KaufmanHall said that in the third quarter of 2024, hospitals needed to spend $304,312 above and beyond what their employed physicians generated in medical billings. A MedPage Today report said an analyst with KaufmanHall noted that physician compensation accounted for 60% of that figure; the rest came from office staff (medical assistants and receptionists, for example), real estate and utilities. Another analyst in the MedPage Today report pointed out that physicians help produce other sources of revenue that don’t appear to be counted in the KaufmanHall report, including diagnostics, specialty referrals and admissions. Those “downstream” revenue sources could help offset the subsidy that hospitals are paying. But another analyst noted that a bigger problem is physician pay is gradually shrinking as reimbursement rates have stagnated. Physicians’ earnings, he said, aren’t keeping up with inflation, so the amount of money they’re bringing to employers is shrinking over time.
Errors
Leapfrog data show gains in safety at hospitals
The Leapfrog Group’s latest round of safety grades for hospitals have found improvements in several areas. Leapfrog’s data on 3,000 hospitals found that since 2022, when the group began reporting data on health-care acquired infections, central line-associated bloodstream infections decreased by 38%, catheter-associated urinary tract infections dropped by 36% and methicillin-resistant Staphylococcus aureus decreased by 34%. A press release noted that since the group began monitoring hand hygiene in 2020, the percentage of hospitals meeting the group’s hand-hygiene standard has jumped from 11% to 78%. Leapfrog also found that the number of hospitals using barcode systems to help reduce errors in the dispensing of medications jumped from 47.3% in 2018 to 86.9%, and the number of hospitals meeting the group’s standard to use CPOE to reduce prescribing errors jumped from 65.6% in 2018 to 88.1%.
Staff Shortage
“Virtual nurse” program helps free up, extend bedside nurses
A hospital in Des Moines, Iowa, is making use of virtual nurses to offload charting and other demands from bedside nurses, giving the in-person nurses more time with patients. Local TV coverage reported that the virtual nurse program at MercyOne Des Moines Medical Center started during the pandemic as a way to stretch short-staffed nurses. Since then, the program has been expanded into using three-person teams, pairing a virtual nurse with both a bedside nurse and a patient care technician. The virtual nurses—who are all local—call into patients’ rooms from a call center, maintaining conversations through screens by patient beds. They take care of nurse charting, make calls to doctors and help walk patients through discharge instructions and questions. Virtual nursing has allowed some nurses who were burned out during the pandemic to return to health care. One challenge of the program is the same as telehealth challenges everywhere: Nurses filling that role need to be able to engage with and establish rapport with patients and their families remotely.
