HPN blogline

Dim Bulbs

2011-04-22T09:03:00.000-04:00

And the bright ideas emanating from the domed confines of Capitol Hill on how to fix healthcare and fuel reform just keep coming.

To wit, the federal government wants to impose a medical device excise tax on manufacturers to help finance the Patient Protection and Affordable Care Act of 2009. Surprisingly, this isn’t a shock because Sen. Max Baucus (D-MT) proposed it several years ago. Specifically, the ACA seeks to levy a tax “equal to 2.3 percent of the price for which a ‘taxable medical device’ is sold by a manufacturer, producer or importer.” This tax would apply to products made in 2013 and forward.

This has all the earmarkings and underpinnings of the government’s favored primary financing/fundraising mechanism, what we mere mortals among the unwashed masses would label a glorified legalized Ponzi scheme.

Like many disruptive pieces of legislation (Rep. Paul Ryan’s proposed Medicare and Medicaid reforms, anyone?) this one incites raucous debate and raises more questions than it answers.
Aside from whether it truly protects the patient or someone else in the chain and whether it really makes healthcare more affordable and for whom, the proposal’s language can be sliced and spread on wheat crackers. Yet more doctors than lawyers in Congress may not make a difference.

The proposal’s bubbly effervescence leaves the definition of manufacturer fuzzy and nebulous, but tries to persuade them and close the sale with good citizen talk about “shared responsibility” and dangling the prospect of income tax deductions.

Naturally, the providers are concerned that manufacturers merely would pass those additional costs to the hospitals that would then pass them on to the insurance companies and ultimately the patients themselves.

Save for explicitly interfering in capitalistic free enterprise by enacting rules that expressly and specifically prohibit such a shell game, taxpayers unfortunately will pay. While the government’s bailout of the banking and automotive industries may have established a precedent for the former, long-standing business and government history trumps it with latter. Good luck trying to change it.
Nevertheless, if everyone wants to benefit and prosper from a solid healthcare program that supposedly covers at least the basics for everyone then everyone should feel the growing and development pains as the fruit ripens.

Rather than belabor the foolhardiness and lambaste the silliness of this proposal any further, let’s make lemonade from this bushel of lemons with an alternatively bright idea.

Because nothing seems to please government bureaucrats more than to divert and shuffle funds from myriad projects and programs to keep all the bobbing buoys afloat, they simply should use the funds collected from healthcare providers and suppliers that run afoul of the law due to accounting improprieties, reimbursement tricks and product recalls. Within the last five years that amounts to hundreds of millions of dollars. And it’s all in the name of patient protection and safety anyway, right?

But if the government must tax (just like Tigger must bounce!), then let the government spin the tax closer to its intended message to the masses. The overarching theme interwoven throughout all healthcare reform measures is patient protection and safety to create and operate a system that delivers high quality service free of error. Although they stop short of calling it the silver bullet (count those denials among media reports since 2007) the primary weapon they promote as the saving grace is information technology.

So starting in 2013, impose a 2.3 percent income fee on every healthcare organization – provider, supplier (including manufacturer, distributor and service company) and payer that does not use IT for all healthcare financial transactions (that also would include patient records because they are tied to payments).

An 18-month lead time for adoption and implementation should be plenty even as the Food and Drug Administration mulls the eventual imposition of its Unique Device Identification (UDI) system. The feds could add a six-month grace period if it felt generosity or pity for procrastinators.
To operate as a taxpayer-funded, patient-focused accountable care organization you have to make meaningful use of rhetoric that reflects reality.

Comments?

Glancing back at 2010

2010-12-15T13:59:00.003-05:00

Reflecting on the last year’s events, here are 11 noteworthy happenings that piqued interest:

1. Obamacare perceptions.
2. ACOh please.
3. EHR goes LED.
4. Meaningful use.
5. Equipment spending.
6. Radiating personalities.
7. Mergers and acquisitions.
8. GLN sunrise date.
9. Uncalled-for recalls.
10. iGive up. iPhones and the new iPads gained prominence.
11. Florida elects former HCA chief Rick Scott as its new governor.

Use This Link to comment

Rigorous Supply Chain Practices are not as Common in Healthcare – Why?

2010-03-31T08:12:00.000-04:00

In a session at the GHX 2010 Supply Chain Summit, Brent Johnson, VP Supply Chain, Intermountain Healthcare said that rigorous supply chain practices are not being used in healthcare. Why?

Because of their not-for-profit presence that reduces the focus on running an efficient business; because of industry dependence upon GPOs & distributors for contract and supply chain management; lack of supply chain talent – pay & strategy opportunities are lacking; and hospital executives haven’t viewed traditional Materials Management as strategic – leaving them in the basement versus part of the C-Suite where they are in other industries.

Is this the same problem that your healthcare organizations are having?

VHA survey reveals patients stealing items from hospital rooms

2010-02-17T10:16:00.002-05:00

After reading the VHA report on theft trends in healthcare facilities, what's the largest theft threat at your facility? And secondly, what's the most unusual item being stolen?

For the full VHA article please link here:
https://www.vha.com/News/PressReleases/Pages/SurveySouvenirs.aspx

Making the Grade

2009-12-16T15:42:00.000-05:00

The January 2010 edition of Healthcare Purchasing News asked experts to evaluate the industry's and government's overall performance in 12 areas as they responded to the H1N1 pandemic. HPN's aim was to use the H1N1 response as a likely forecast of how both might respond to an even more serious and lethal pandemic. How would you grade the industry's and/or government's performance in any or all of the areas featured?

2010 GLN Standardization

2009-03-24T16:47:00.004-04:00

What, if anything, is your organization doing to meet the 2010 GLN standardization deadline?

Bottled water versus tap - Response to HPN Daily Update item

2008-10-23T08:20:00.010-04:00

In response to the Los Angeles Times article "Bottled water versus tap: Which is safer to drink? " reprinted in your Daily Update newsletter, I respectfully ask you consider the following:

Dr. Janssen and the NRDC’s laudable agenda of improving public water systems is ill served by attacking the bottled water industry. The mantra of “tap water is just as good or better” - repeated often - will require return scrutiny of what we actually get out of the 55,000 different municipal systems in our country. Much of what is known is not all that pleasant.

I could begin to detail the low standards and lax regulation of tap water by the EPA instead of the more rigorous requirements imposed on bottled water by the FDA. I could cite the recent AP reports of pharmaceuticals in tap water or refer to the numerous and readily available violation reports in state and federal records. Or you could simply go the NRDC’s own website and find that they find municipal tap water not all that tasty. http://www.nrdc.org/water/drinking/uscities/contents.asp.

Let’s not try to further our own causes by tearing down others. We don’t really want to be party to the “negative sell” against tap water. It is not only distasteful but it doesn’t make common sense because growth of bottled water has not come at the expense of tap water. All industry statistics show bottled water has taken “share of stomach” from sugary carbonated soft drinks as Americans have become more health conscious in recent years. It is a good trend that should continue.

We do have real issues we could work together with current bottled water critics to solve. We need a serious program to recycle consumer packaging. Our bottles are a piece of the overall puzzle and we are willing to work clean up our own mess. My company currently is doing its own small part using 25% recycled content in both our glass and PET plastic bottles. We need to get all of this packaging back, though, along with all of the other packaging American consumers currently discard.

Oh, and that old saw of “water is more expensive than gasoline.” That changed long before the current run up in fuel prices. We’ll deliver five gallons to your home for $7.50 in a multi-use, returnable bottle. Try asking the local gas station to do that!

Breck Speed
Mountain Valley Spring Company
Chairman/CEO
Hot Springs, AR

What to consider before adopting RFID/RTLS

2008-06-27T08:54:00.003-04:00

For healthcare facilities considering investing in RFID/RTLS technology, how should the recent JAMA study results affect their decision to adopt and implement the technology?

(Read JAMA article)

Managing existing RFID/RTLS

2008-06-27T08:50:00.003-04:00

For healthcare facilities that already are RFID/RTLS-equipped, how should they react and change their operations in light of the recent JAMA study results?

(Read JAMA article)

What are we missing?

2007-10-25T14:15:00.000-04:00

Over the course of our 30th Anniversary year we have spotlighted who we think are the best and the brightest. Let us know if there is anyone who missed being recognized.

Story links to refresh your memory:
Peering off the ledger: Big deals move market share roller coaster
Recalling supply chain’s high and low points
30 years of CS pros worth knowing
Spotlighting significant news events, supply chain opportunities and threats
Three decades of MM pros worth knowing
Saluting materials management leaders

How has MRSA affected your community or hospital? We want to hear from you…

2007-10-23T11:40:00.000-04:00

Superbugs such as MRSA are in the spotlight around the country. Tell us how MRSA is affecting your community. What is your hospital doing to fight back? What more could be done? Share your stories and post comments here.

If you missed the MRSA stories featured in the HPN Daily Update, click here to read them.

ASHCSP - IAHCSMM Merger

2007-09-18T16:13:00.000-04:00

ASHCSP dropped a bombshell at its annual conference in St. Louis today (Tuesday, September 18) announcing it’s intent to merge with IAHCSMM. The breaking news, if finalized, will unite the profession’s two pre-eminent educational associations – one on the eve of its 40th anniversary (ASHCSP) and the other on the eve of its 50th (IAHCSMM). Talk of the two associations merging has ebbed and flowed with passion for more than two decades at least. Today’s newsflash propels the debate farther than it’s ever gone. What do you think this will mean for the unified association? What will this mean for the sterile processing profession, in terms of influence with other associations, such as AAMI, APIC and AORN, as well as AHRMM? How do you think this will affect certification? Will a unified front finally usher in a golden era of sterile processing where the profession garners the respect it deserves within their individual facilities and the medical profession? Tell us what you think.

HD in the Surgical Suite

2007-03-29T12:22:00.002-04:00

Going high definition is all the rage in the consumer world, in terms of televisions and computers. But is that visual advancement really necessary in the surgical suite – especially if you’re paying at least a 30 percent premium for the privilege? Certainly, going digital is all the rage because of the data transmission and visual improvements it offers but the term “digital” can be a misnomer. If you’re not wired both to receive and send digital signals, but can only do one or the other, you’re not digital. As a result, you’re not realizing fully the benefits that digital technology has to offer. By the same token, you have to be wired properly to receive and send high-def signals. But if you already have three-dimensional imaging capabilities (or even if you don’t) what does high-def really do for a surgical team in the OR, in terms of providing better patient care?

Redesigning CS/SPD

2007-03-29T12:22:00.001-04:00

An effective and efficient central service/sterile processing and distribution department can make or break a healthcare facility. One misstep could lead to a device malfunction, a device not performing the way it was designed, or worse yet, deadly patient infection. By the same token, operational challenges could negatively impact performance and productivity, making it a drain on resources. So if you were given carte blanche (money no option) to redesign how a CS/SPD should operate, what would you do? If you could create the most futuristic CS/SPD department via technology and human ingenuity, what would you do and why?

Infection Prevention Influencing Product Evaluation

2007-03-29T12:21:00.000-04:00

Infection Control Professionals are no strangers to evaluating products and services of interest to their facilities, particularly as influential members of the product evaluation committee or the value analysis team. In fact, sometimes their experience and expertise leads them to put the kibosh on a particular product or service that they determine would negatively affect patient care and safety or would not improve outcomes measurably. How much influence and control should ICPs have in this process, say, over doctors, nurses and materials managers? What do you think and why?

Supply Chain Managers & the Revenue Cycle

2007-03-29T12:20:00.000-04:00

Historically, bottom-line-focused healthcare materials managers are best known for controlling and reducing costs on the expense side of the balance sheet. However, a small but growing number of forward-thinking materials managers are crossing the aisle, so to speak, to work with key financial executives on the revenue side, too. Sometimes, the materials manager is driving the relationship; other times, the revenue cycle executive approaches the materials manager to become a partner. Depending on your facility’s financial situation, who should approach whom? Should materials managers confine themselves to traditional expense-related issues or should they also venture out to the non-traditional in proving their worth by generating revenue – even if they have more work to do in expense management? The bottom line: Should materials managers concern themselves with top-line issues? What do you think and why?