MGH surgeon, who treated #bombing victims in Afghanistan and #Boston, brings #tourniquet campaign to area schools

How sad is it that teachers are learning how to use tourniquets?  Dr. David King, a Mass General surgeon tells the Globe that he thinks some of the students at Newtown might have survived if teachers had those skills.

After a stint in Afghanistan, where he responded to a truck bomb, and hours the Mass General OR working on the those injured in the marathon bombing,  King is familiar with lower limb injuries.

The lay people, the volunteers, the teachers: Those are the people who are truly the first who can respond to these kinds of incidents,” he said.

To prepare for such unforeseen events, King and other doctors are calling for greater access to commercially manufactured tourniquets and for training in their proper use.

In this story from Health Leaders Media, he explains why the marathon bombing made this clear.

His experiences here and overseas where 75 percent of all injuries were caused by explosions— have made King a huge promoter of the tourniquet. The bystanders at the finish line did their best with t-shirts, belts, and other makeshift tourniquets, he said. But, it takes a medical-quality device to stop arterial hemorrhaging and prevent blood loss that can make a leg wound fatal.

Here he talks about his own experience that day, when he was called in MGH after finishing the marathon himself.

Dr King’s Marathon from Tinker Ready on Vimeo.

If you can’t join them, beat them: BIDMC in takes over Milton hospital

When the Harvard hospitals decided to join forces as Partners, they cut BIDMC out of the deal. So, this story from the Globe  – on Beth Israel Deaconess Hospital-Milton –is worth noting:

partnersdownloadConsolidation in the health care industry has been viewed with suspicion, leaving critics worried that the state’s biggest health care networks want to leverage increased market power into higher rates. Partners HealthCare, the largest health care system in Massachusetts, recently abandoned its bid to acquire South Shore Hospital in Weymouth in the face of such criticism and a ruling from a judge who said Partners’ growth would raise costs for consumers.

…The Milton case shows how consolidation — though it often increases costs to consumers — can also offer a lifeline to a struggling hospital. The brand alone of a big Boston health care network can be a powerful force, analysts said.

 

Hospitals consolidation: Brill says yes, new Massachusetts AG says no

From Shirley Leung’s Monday column in the Globe:

partnersNo judge or jury delivered a verdict on the Partners HealthCare settlement Monday, but we didn’t need either after Attorney General Maura Healey’s three-page court filing.

She thinks the deal stinks, and if given the chance, she would bring an antitrust suit to block Partners’ efforts to expand. And just like that, the 43-year-old rising political star dared to rock the biggest boat in Massachusetts health care. In the wake of her threat, Healey left a list of winners and losers.

From Steven Syre’s column in today’s Globe:

Maura Healey has been on the job less than a week, but we don’t have to wonder where she stands on the biggest health care conflict in Massachusetts.

And, a Q. & A. from Steven Brill, author of “America’s Bitter Pill: Money, Politics, Backroom Deals and the Fight to Fix Our Broken Health System. That book looks at focuses on the debate over the Patient Protection and Affordable Care Act. But it also returns to Brill’s indictment of high hospitals costs that filled an entire issue Time magazine in 2013. His solution looks very much like a combination of the Kaiser Permanente insurer-plus-provider approach and the Partners’ plan.

HLM: Why will this consolidation approach work to curb costs where other reforms have failed?

Brill: The reason this idea may work is it is going to happen without my writing about it. It’s going to happen. The question is, do we seize that momentum, turn it around jujitsu- style and attach a whole bunch of regulations to it?

I really started thinking about this after my [heart] surgery. I decided: New York Presbyterian, it’s a damn good place and the guy who runs it is a good guy. [Later] I was watching a panel including Toby Cosgove [CEO of Cleveland Clinic] and someone said: You’re gobbling up Cleveland and your market share is way too high.

Cosgrove said, the FTC would never let us have too much of a market share. I’m thinking, this guy Cosgrove, he’s a celebrated surgeon, a war hero. He seems like a pretty good guy to me. The idea the he wants to control and provide healthcare all over Ohio, why is that such a bad thing?partners-logopartners-logo

Readmission penalties in Massachusetts hit teaching hospitals

wheelchairsMedscape reports on a JAMA article looking at readmission rates:

Ninety-five-bed Falmouth (Massachusetts) Hospital on Cape Cod doesn’t have the national reputation of Massachusetts General Hospital, 77 miles to the north in Boston.

But the small hospital bests the big teaching hospital in the big city on this point — it’s not getting penalized by Medicare for excessive readmissions within 30 days of discharge. Massachusetts General, in contrast, will forego about 0.5 percent of its Medicare reimbursement in fiscal year 2013 because its readmission rate was higher than what the Centers for Medicare & Medicaid Services (CMS) projected based on the case mix, or medical complexity, of their patients.

Cambridge-based Institute for Healthcare Improvement offers a little perspective:

In this Viewpoint, we suggest that it may be more advantageous to view readmissions within a broader systems and community context that effectively engages all stakeholders to cooperatively improve outcomes…The Hospital Readmission Reduction Program has raised awareness of readmissions as an indicator of a fragmented health care delivery system. Yet financial penalties alone are not likely to drive change. As the nation moves toward comprehensive payment and delivery system reforms to promote integrated care, the focus should shift toward reducing avoidable hospital use, not just readmission, by strengthening primary and preventive care and chronic disease management for populations of patients at risk of poor health outcomes.

The “end of fee for service”: Health cost wars break out in in New England #hcr #mapoli #aca

More than a river divides Vermont and New Hampshire. In the state that lives by the motto, ” Live Free or Die,” regulators and politicians declined to set up a health insurance exchange mandated as part of the health reform law. From the June 22 Concord Monitor:

John Lynch signed into law a bill that prohibits New Hampshire from planning, creating or participating in a state health care exchange under the 2010 federal health care law. The Democratic governor did so with the support of the state Insurance Department and conservative Republicans dead set against the health care law passed under the Obama administration.

Opponent were predicting — at the time of this story — that the Supreme Court would rule against the individual mandate and the health law would “fall apart.” That didn’t happen and now the feds will come in and set up the exchange.

Next door in Vermont,  the Green Mountain Care Board is reviewing hospital budgets. From Vermont Public Radio:

The board has established a cap on spending increases of no more than 3.75 percent annually. But as a group, Vermont’s 14 hospitals are seeking increases of roughly 7 percent for the coming 12 month period. “We know there are some legitimate reasons that hospitals might need to grow higher than the 3.75 percent, most of those having to do with circumstances beyond their control,” said Anya Rader Wallack, the chairwoman of the Green Mountain Care Board.

The board may allow some increases above 3.75 percent, if the hospitals can prove that they are using the money to make investments that will lower costs in the long run.

But Wallack says the bottom line is that hospital spending needs to be kept under control: “We have a responsibility to hold down costs. So we’ll be looking at all of these requests with an eye toward how we can stay within that target, because we don’t think Vermonters can afford more than that.”

Welcome to your future Massachusetts.  Health care cost containment can get ugly. For reporting on the Massachusetts cost control law, go no further than the Globe’s special section. From today’s Bill signing story:

Six years after Governor Mitt Romney required every resident to obtain health insurance, Governor Deval Patrick signed a law that many consider the second phase of that groundbreaking experiment: trying to rein in the state’s health costs, which are among the highest in the nation.

The new law — which Patrick signed Monday at a State House ceremony packed with hospital executives, health care advocates, and lawmakers — seeks to keep health spending from growing faster than the state’s economy through 2017. For five years after that, the law aims to further slow spending, to half a percentage point below the growth of the economy.

The Globe on alarm fatigue, HIT and a hit to the hospital association

Hospital philanthropy: Madoff and The $50,000 receptionist desk

Over at Nature Network Boston, we report on campus donations from two philanthropers who had to repay money they earned from Bernie Madoff investments. 

MIT was a beneficiary of the Picower family, which this past week got the final order to return $7.2 billion (not a typo) they earned in Bernie Madoff’s upscale Ponzi scheme. In 2002, the now-defunct Picower Foundation gave the school $50 million to set up the Picower Center for Learning and Memory. No matter that MIT already had a neuroscience program named for a big donor. The school simply put them in the same building with separate entrances. Call it a neuroscience duplex.

Across town, you can’t turn a corner on Longwood Avenue without seeing the name of another major Madoff beneficiary – Carl Shapiro. In December Shapiro agree to pay $627 million into the Madoff fund, but not before he spread a lot money around at Boston hospitals.

See NNB for more, including details on how to get a waiting room named after you at the new Dana-Farber building for $1 million.

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