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CMS Site Now Includes Mortality Data
Last month, the Centers for Medicare and Medicaid Services (CMS) added data on hospital mortality rates among patients admitted for acute myocardial infarction (AMI) or heart failure. The public Web site, Hospital Compare, reports how a hospital's mortality rate during the 30 days after admission for AMI or heart failure compares with the national average rate: the same, better, or worse. Hospitals' specific mortality rates were not reported, though CMS does name a handful of hospitals deemed to be high risk. CMS' goal is that the public reports will prompt hospitals to improve their quality and safety of care. However, some critics say the approach is overly cautious—noting that the vast majority of hospitals landed in the "no different than national average" category, with very few either below or above average. The mortality data analysis relies on a complex formula that adjusts for the varying health status and medical histories among patients. Still, some physicians and hospitals have raised concerns that the comparisons do not adequately account for sick, poor, or at-risk patients.

Medicare Beneficiaries to Test-Drive Personal Health Records
Under an 18-month pilot project launched in late June, Medicare beneficiaries will be able to create their own personal health records (PHRs) at a new site, The records will be pre-populated with data from Medicare files on beneficiaries' medications and medical conditions, claims status, eligibility to services, and other information. The PHRs will belong to beneficiaries, who can enter in their own information and choose which providers and family members can access their records. CMS launched the program together with four health plans: HIP USA, Humana, Kaiser Permanente, and the University of Pittsburgh Medical Center. Each plan will offer different tools through the PHR, and CMS will monitor beneficiaries' use of the four systems to assess the most useful content and functionality.

Hospitals Hire Factory Managers to Improve Efficiency
Many health care organizations look to management and "lean" manufacturing techniques from non-medical industries as models for their own quality improvement efforts. But recently, according to the Wall Street Journal (June 25, subscription required), hospitals are beginning to hire one-time factory managers to help them streamline operations, reduce costs, and avoid errors. One executive recruiter reports a tenfold increase in demand for experts in lean manufacturing by health care providers, compared with last year. The trend can be explained by the pressures hospitals face to reduce costs and, at the same time, to ensure patient safety. Top-performing factories produce less than 10 defects per million, while studies suggest that medical errors are much more common.

Health Care Cost Growth to Slow in 2008, Report Says
U.S. health insurers expect the growth in medical costs to slow in 2008, according to a new report from PricewaterhouseCoopers. The findings are based on a survey of five U.S. carriers that together insure more than 30 million people. The insurers say that they expect medical costs to rise 9.9 percent next year, down from 11.9 percent for preferred provider organizations and 11.8 percent for health maintenance organizations this year. The report suggests that the decline can be contributed to slower spending growth for prescription drugs and increased employee cost-sharing. In addition, more employers have been investing in wellness programs and offering employee incentives for healthier lifestyles. The use of health information technology is also expanding.

A Third of Physicians Will Have EHRs by 2011, Survey Says
In 2006, nearly 18 percent of U.S. physicians had an electronic health record (EHR) system, according to a new survey by the Millennium Research Group, while 30 percent will have a system in place by 2011. The survey suggested that government efforts to spur adoption of health information technology (HIT), such as allowing hospitals to help affiliated physicians by donating or subsidizing the cost of EHR systems, has helped to drive growth. Confirming previous research, the survey also found that small practices that are not affiliated with hospitals—the vast majority of office-based physicians—will continue to find it difficult to devote time and resources toward the adoption of HIT.

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