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| News and Notes |
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UNITED SURGICAL PARTNERS INTERNATIONAL, which owns stakes in or operates 141 surgery centers in the U.S., has agreed to a buyout by a unit of Welsh, Carson, Anderson & Stowe, a private equity firm and the company's founding shareholder, for $1.8 billion. USPI said the transaction was likely to be completed in the second quarter.
HEALTH INVENTURES HAS SOLD A MAJORITY INTEREST in its ASC, surgery center and diagnostic imaging center management company to Hammes Co., a Brookfield, Wisc.-based healthcare facility planner and developer. Jon Hammes, the company's chief executive officer and managing partner, says Health Inventures' existing presence in European markets will accelerate Hammes Co.'s plans to go international. Terms of the transactions were not disclosed.
THE NURSING SHORTAGE MAY BE DECLINING, according to researchers; they predict that the nursing shortfall in 2020 will be 340,000 RNs, down from the previously projected 760,000 RNs. The improved forecast is based on a large influx of individuals to the nursing profession who are in their late 20s and early 30s. According to a study published in the January/February issue of the journal Health Affairs, older professionals who face difficult economic conditions and decreased job security are drawn to the nursing industry. The study suggests that the increase may also be related to accelerated bachelor of science degree programs, a growing number of foreign applicants, medical manufacturer Johnson & Johnson's national campaign to attract nurses and a response to the events of September 11, 2001. The researchers warn, however, that the nation's nursing shortage is far from over, claiming that the number of people in their mid-20s entering the nursing field is at its lowest point in 40 years. In addition, the study reports that graduating classes of registered nurses would have to increase by 50 percent over current levels to erase the conservatively projected 2020 nurse deficit.
CALIFORNIA HOSPITALS CAN NOW HIRE specially trained pharmarcy technicians to check medication cassettes and the work of other technicians, thanks to a regulation that took effect Jan. 5. The regulation was initiated in large part because of studies led by the Cedars-Sinai Medical Center and the University of California and San Francisco School of Pharmacy. These studies demonstrated the safety of having specialty-trained techs checking the work of other techs and the ability of pharmacists to prevent medication errors when they are freed from clerical tasks to take a more active role in patient care. Rita Shane, PharmD, director of pharmacy services at Cedars-Sinai and one of the principal investigators on the study, hopes the regulation will assist other states that are considering an expanded role for pharmaceutical techs. |
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| Healthcare Spending Growth Down, Remains Top Tax Expenditure
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As 2007 gets under way, the federal government looked to the past and the future to get a grip on healthcare spending. The field's growth slowed for the third consecutive year in 2005, CMS announced Monday, but most corporate and individual federal taxes went toward healthcare funding, according to U.S. Comptroller General David M. Walker in a separate presentation last week.
Overall, healthcare spending reached almost $2 trillion in 2005, or $6,697 per person, up from $6,322 per person in 2004, according to the CMS report, which was published in the journal Health Affairs.
That increase, however, was smaller than those of recent years. Between 2000 and 2003, the average growth of annual Medicare spending was 8.1 percent, fueled by legislative changes that included the Medicare Modernization Act of 2003. In 2004, spending increased 7.2 percent, and in 2005 only 6.9 percent. The report by CMS's Office of the Actuary attributes the slowdown to several factors, including facilities' "stronger negotiating positions and their ability to pass costs on to private payers," reduced or frozen physician fees, recession and weaker prescription drug growth.
To better contain healthcare costs, the system must be reformed, says Mr. Walker, ideally through proposals that will "align incentives for providers and consumers to make prudent choices about health insurance coverage and ... the use of medical services; foster transparency with respect to the value and costs of care; and ensure accountability from health plans and providers to meet standards for appropriate use and quality."
He adds that limiting the percentage of the federal budget that can be dedicated to healthcare should be among the possible objectives of reform. Little about the "potential healthcare reform approaches" in Mr. Walker's speech was new; suggestions included fostering cost and outcome transparency, making better use of technology, developing national practice standards and limiting spending growth for government-sponsored healthcare programs.
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| Early Patients Get the Best Colonoscopies
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Whether your surgeons see their colonoscopy patients in the a.m. or the p.m. can have a significant effect on how likely they are to successfully complete the procedure, according to a study published in the December issue of the American Journal of Gastroenterology. The fatigue that creeps over a surgical staff as the clock ticks closer to closing time may be an independent factor in how successful the procedure will be, researchers suggest, which may mean it could be best to undertake the more challenging cases early in the day.
Researchers at the MetroHealth Medical Center in Cleveland reviewed the charts of 2,087 colonoscopy patients who'd undergone the procedure over the course of one year. Of those patients, 1,084 had the procedure done in the morning and 999 in the afternoon. The researchers found that the incompletion rate was significantly higher for the afternoon group than for the morning group — 6.5 percent compared to 4.1 percent. Inadequate bowel preparation was found in 19.7 percent of the afternoon cases and 15.4 percent of the morning cases. Even after excluding the inadequately prepared cases, incompletion was still higher in the afternoon (5 percent versus 3.2 percent).
The study's authors calculate that scheduling all colonoscopies in the morning can avoid suboptimal procedures in five percent of patients and the need for unnecessary repeat colonoscopies or an alternate imaging study in 2.4 percent of patients. In situations where this is not feasible, they say, consider giving earlier appointments to the sub-groups of patients who are most likely to experience problems with this procedure.
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| Utah Bill Would Mandate Insurance Payments for Gastric Bypass
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Utah's health insurers would be required to cover gastric bypass surgery for morbidly obese residents under a bill the state legislature will consider in its upcoming session, which begins Jan. 15. Similar measures have already been passed in Maryland and Indiana.
State Rep. Steve Mascaro (R-West Jordan), who drafted the bill, says he believes morbid obesity should be defined as a disease, given its economic and social impact. As a result, its treatment should be covered by health insurance. He acknowledges, however, that insurance companies will likely oppose the addition as being too costly.
Under Rep. Mascaro's House Bill 225, morbid obesity is determined by the patient's body mass index. BMI is a ratio of weight to height; 24.9 and under is considered normal, 25 to 29 overweight and higher than 30 obese. Rep. Mascaro's bill, following clinical standards, suggests defining morbid obesity as a BMI of 40, or as 35 or higher when combined with a medical condition such as hypertension, cardiopulmonary problems, sleep apnea or diabetes.
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