Real World Health Care Blog

Tag Archives: costs

Five Ways to Manage the Costs of Your Medicine

While a main precept of the Affordable Care Act is to expand access to health care, in some cases that improved access means more patients are being treated with medications that come with a cost. As a pharmacist, I have to be an insurance sleuth, use common sense, and teach my patients the old-fashioned methods of negotiation.

Joel Zive

Joel Zive

I work in solid organ transplant, HIV, and Hepatitis C medicine. I have patients on regimes ranging from 4 to over 20 medications. For my patients, obtaining consistent, reasonably-priced medications – both over-the-counter and prescription – is vital.

1. Make sure all the medications are at one pharmacy.  It’s important to keep a clinical eye on things for drug interactions. As a bonus, the pharmacist and the patient know what costs need to be examined.

2. Seek out insurance prior authorization.  Some insurance companies require prior authorization to cover certain drugs. Your pharmacist can help you seek prior authorization for medications that require it using software that creates forms specific to each insurance company. Ask if your pharmacist can fill out the form as much as possible before sending it to your doctor.

3. Contact the drug company.  Many pharmaceutical companies offer patient assistance programs or co-pay assistance cards to help eligible patients obtain free medicines, particularly for biologics and expensive drugs. These programs are especially helpful for patients who have insurance gaps and need the medications quickly. Depending on the assistance from a case manager or care coordinator, I have received authorization for medications right away or within 72 hours.

4. Search for a co-pay assistance program that covers your condition.  If your drug company does not offer a patient assistance program or you are not eligible based on your income and insurance coverage, it is possible that a charitable patient assistance program through a non-profit organization such as the HealthWell Foundation may be able to help you.

5. Seek discounts for over-the-counter medications.  Over-the-counter medications can put a strain on the wallet. In many cases, purchasing over-the-counter medications is more expensive than prescription medications covered by insurance. Other items like vitamins, natural supplements, and enteral formulas (also known as ‘milks’) require the patient to do a little negotiating. If you tell the pharmacy or vitamin store you will be taking these items indefinitely, they may be inclined to discount. Also, be on the lookout for buy one get one deals (BOGOs). Finally, enteral formulas can be quite expensive, so if you get prescribed a specially formulated one, ask if you can take a more basic formulation instead. Remember to let your prescriber and pharmacist know which over-the-counter medications and supplements you are using.

In conclusion, while the path to affordable medications is not always easy, there are individuals, programs, and strategies that can help you meet your health care goals.

How do you manage your medications? Share your tips in the comments section.

Categories: General

Our Top 4 Most ‘Liked’ Health Care Stories

This week is Real World Health Care’s one-year anniversary. Over the past year, we showcased solutions that are proven to lower costs, increase access, and provide more patient-centered care. In celebration of this milestone, we are sharing the favorite posts as measured by Facebook ‘likes’ from our readers, who have visited the blog over 10,000 times.

 

#4 – Keeping Boston Strong: How Disaster Training at Osteopathic Medical School Helped Save Lives

In May, former RWHC editor Paul DeMiglio told the story of Dr. Danielle Deines’ emergency response to the Boston Marathon bombing. Dr. Deines’ education at the Edward Via College of Osteopathic Medicine – Virginia Campus (VCOM) required her to participate in a two-day, mandatory training curriculum on Bioterrorism and Disaster Response Program, which immersed her in real-life disaster training, field exercises and specialized courses.

(Photo courtesy of VCOM)

(Photo courtesy of VCOM)

The day of the bombing, after crossing the finish line, Dr. Deines found herself triaging runners in medical tents to make room for the victims. “The back corner became the most severe triage area, nearest the entrance where the ambulances were arriving,” she said. “I saw victims with traumatic amputations of the lower extremities, legs that had partially severed or had shrapnel embedded, and clothing and shoes literally blown off of victims’ bodies.”

Read the post: http://www.realworldhealthcare.org/2013/05/keeping-boston-strong-how-disaster-training-at-osteopathic-medical-school-helped-save-lives/

 

#3 – Making Life Easier for Patients and Loved Ones: Meet MyHealthTeams

In April, Eric Peacock, Co-founder and CEO of MyHealthTeams, contributed a guest blog about the need for social networks for communities of people living with chronic conditions. These networks allow patients to “share recommendations of local providers, openly discuss daily triumphs and issues, share tips and advice, and gain access to local services,” he wrote.

“Sharing with people who are in your shoes offers a sense of community that can’t be found elsewhere – these are people who know the language of your condition; they understand the daily frustrations and the small triumphs that can mean so much,” he added.

Read the post: http://www.realworldhealthcare.org/2013/04/making-life-easier-for-patients-and-loved-ones-meet-myhealthteams/

 

#2 – When the Health Care Blogger Becomes the Cancer Patient

In August, even as she was still undergoing daily radiation treatments, contributor Linda Barlow shared her personal story of being diagnosed with cancer and the slew of medical bills she faced even though she had insurance.

Linda Barlow

Linda Barlow

“While these out of pocket costs are certainly hard to swallow – I can think of a hundred other things I’d rather spend my money on – for my family, they are doable,” she wrote. “We won’t have to skip a mortgage payment or a utility bill. We won’t have to dip into a child’s college tuition fund. We certainly won’t have to worry about having enough money for food. But I know – from my work on this blog and with its main sponsor, the HealthWell Foundation – that many families living with cancer aren’t so lucky.”

Read the post: http://www.realworldhealthcare.org/2013/08/when-the-health-care-blogger-becomes-the-cancer-patient/

 

#1 – What If You Want Politicians to Get Moving But You Can’t Move?

Neil Cavuto

Neil Cavuto

Last week, Neil Cavuto, Senior Vice President and Anchor, Fox News and Fox Business, contributed a moving guest post about his triumphs over multiple sclerosis (MS) for MS Awareness Week. His deeply personal blog inspired resounding praise in the comments section and 1,300 Facebook ‘likes’.

“If I can pass along any advice at all, it is…to simply never accept a prognosis as is,” he wrote. “Fight it. Challenge it. ‘Will’ yourself over it. Many doctors say it’s a naïve approach to the disease, but attitude counts a lot for me with MS, as it did for me two decades ago when I was battling advanced Hodgkin’s Disease. Then, as now, it was about one day at a time, and staying optimistic and positive all the time.”

Read the post: http://www.realworldhealthcare.org/2014/03/ms-awareness-week/

 

If you would like to suggest a topic, contribute a guest post, or learn more about short-term co-sponsorship opportunities, please contact us at dsheon@WHITECOATstrategies.com. As a blog currently sponsored solely by the HealthWell Foundation, an independent non-profit providing nationwide financial assistance to insured Americans with high out-of-pocket medication expenses, co-sponsorship helps us keep Real World Health Care alive and well as a resource for journalists, health care professionals, policymakers, and patients. Plus, co-sponsorship will increase your organization’s visibility among thought leaders in the health care sphere.

Do you have a favorite Real World Health Care post? Is there something you’d like to see more of? Post to the comments section or tweet at us at @RWHCblog.

Live Updates from 15th Annual Patient Assistance & Access Programs

Because this blog is all about increasing access, lowering costs, and improving patient outcomes, we think there’s no better place for us to share ideas that work than to report live from the 15th Annual Patient Assistance & Access Program, in Baltimore, March 5-7.  Check back often as we publish updates from sessions, and follow all of the developments by following #PAP2014.

UPDATE 9:45  Resources for navigators: www.nationaldisabilitynavigator.org; patient advocacy groups such as AIDS Institute are publishing helpful sites.  Also marketplace.comment@cms.hhs.gov is a place you can send questions. This is monitored 24/7 with staff – not interns – but people who really know how to help.  These are triaged and go up to leadership when there are problems or trends.

UPDATE 9:40 Lessons learned:

  1. Partner’s are critical to success of ACA implementation; reach out early, often because plan selection often isn’t a one step process.  Patients need to come back many times before ready to sign up.  Very real “huge” health literacy gaps.
  2. Things to come: we are in closing days of enrollment.  March Madness may be a great opportunity for outreach; then we’ll reach out to those most in need; final week will be “here we are.”  So theme weeks continue.   After window closes Mar 31, you’ll soon start seeing promotion of the new window.

UPDATE 9:25 25 states and DC have indicated they will expand Medicaid.  About 85% of Americans already have minimum essential coverage.

UPDATE: 9:15 Health care law saved $8.9 M in drug costs for Medicare, said Janet Miller, Division of Strategic Partners, Office of Communications, Centers for Medicare and Medicaid Services.  2014 changes: no discrimination due to pre-existing conditions, annual limits on insurance coverage eliminated, small business tax credit increased; more people are eligible for Medicaid in some states.

Essential benefits include at least 10 general categories such as emergency services, hospitalization, maternity and newborn care, prescription drugs, mental health and substance abuse, lab services, preventive and wellness  services and chronic disease management.

Categories: Access to Care

What’s Getting Lost in the Health Care Debate?

Health care has never been more highly politicized than today.

Last year, it was central to the third longest government shutdown in U.S. history. This week, it consumed a large chunk of President Obama’s State of the Union address. Every day, we are inundated by news of health exchange website defects, insurance policy cancellations, coverage that forces people to switch doctors, and a laundry list of other problems attributed to the Affordable Care Act. On the flip side, advocates complain of the problems that make the U.S. rank among the lowest in health system efficiency among advanced economies and hail the health care law as a ray of hope.

Jamie Elizabeth Rosen

Meanwhile, a new study from the U.S. Centers for Disease Control and Prevention (CDC) revealed that one in four American families struggled to pay medical bills in 2012. Pretty dismal.

But there’s something missing from this barrage of coverage. Incredible advances are being made in health care every day, providing Americans with innovative ways to stay healthy, treat illnesses when they arise, and save money on medical problems. Just this month, a new program was launched to help people on Medicare living with multiple sclerosis afford copays for treatment; the FDA for the first time approved a postnatal test that can help parents identify possible causes of their child’s developmental delay or intellectual disability; and a study published in the Lancet showed that it is possible to train children’s immune systems to become less sensitive to peanuts.

At Real World Health Care, we focus on what is working.

That’s why I am proud to take over this week as editor of Real World Health Care. While much of my professional focus has been on health internationally – advocating for the development of vaccines to prevent tuberculosis, policies that save mothers and infants from dying during childbirth, and the formation of emergency medical systems in places where people have nowhere to turn – I am compelled by the notion that more attention must be focused on solutions that are improving U.S. patient care today. By serving as a central clearinghouse for information about improvements to segments of the U.S. health care system, we hope that our readers and those journalists who get ideas from our blog will be inspired to expand innovations that are working in health care today.

Real World Health Care – only entering its 11th month – already has a reputation for covering solutions to enhance nutrition, prevent diseases, reform medical education, improve hospitals, support patients, fund research, increase treatment adherence, and reduce costs. The blog serves as a resource for policy makers, health systems, research universities, non-profit health organizations, leading biopharmaceutical companies, government agencies, and the nation’s leading health journalists among thousands of others interested in practical and well-researched health care success stories.

We need your help to continue to grow our success. Have an idea for a story or a guest blog? Email me at jrosen@WHITECOATstrategies.com. Want to take part in advancing solutions in health care? Sign up for updates and share stories that inspire you via Twitter at https://twitter.com/RWHCblog. Do you believe in our mission to expedite improvements to our health care system? Consider co-sponsoring the blog while gaining visibility for your organization. We are now followed by over 300 health industry leaders each week, and journalists turn to us for story ideas about the good news on what’s working in our health care system. For more information, email dsheon@WHITECOATstrategies.com.

I look forward to continuing to cut through the political vitriol around health care with inspiring stories of what is keeping Americans healthy and saving lives. Thank you for giving meaning to our work by using this blog as a resource for yours.

Categories: General

Give Patients the Gift of Hope and Health by Supporting HealthWell for #GivingTuesday

We are proud to announce that the HealthWell Foundation – an independent 501(c)(3) charity that provides financial assistance to insured patients living with chronic and life-altering illnesses – is joining the #GivingTuesday campaign, which launches today. 100 percent of your donation to HealthWell goes directly to grants and services that will benefit patients in need across the country. This week we are sharing some powerful real-world examples of how your gift to HealthWell will help transform lives.

Lynn Harcharik

Lynn, who received financial assistance from HealthWell for cancer treatments.

As one of our country’s most trusted independent charities, we believe that no patient, including those living with cancer, should go without health care because they can’t afford it. By donating to HealthWell for #GivingTuesday, you’ll join us in making that commitment a reality that will change lives for the better, one patient at a time – just like Lynn.

It was ovarian cancer spreading to the colon. My husband called many places, no cancer society would help! One society asked what type of cancer it was, and replied: there are no funds for ovarian cancer – we cannot help. Another organization had already used their funds. It was very discouraging, but my oncologist’s secretary told us about the HealthWell Foundation. After calling and talking to your group, the answer was YES, you would help. (Thanks!) In October of 2008, reversal surgery was done with the ileostomy. And yes, the cancer came back, or maybe was not completely gone from before, but-more chemo! Thank you for being there in my time of need. My prayers are with your group and your work. Thanks!

– Lynn (Streator, IL)

We want to make a difference for even more patients like Lynn so they can access critical medical treatments and get better. But that can only happen with your support.

That’s why, for this year’s #GivingTuesday, we’re urging Real World Health Care (RWHC) Blog readers to donate to the HealthWell Foundation’s Emergency Cancer Relief Fund (ECRF). Your generous holiday gift will help ensure that patients living with cancer are not forced to choose between paying the rent or buying food and affording life-saving care.

So what, specifically, will your tax-deductible #GivingTuesday donation do? Giving to ECRF will bring us closer to meeting our $100,000 goal by the end of the year so the fund can open in January. We are almost halfway there with more than $46,000 raised so far. Every dollar counts, and with just a little more help, we will hit our goal so that more cancer patients can start 2014 off right.

To help more families and patients afford the urgent medical treatments they desperately need, we need you to support #GivingTuesday starting today. Please contribute as generously as you possibly can.

Thank you for giving the gift of health this holiday season.

Categories: Cost-Savings

Hospitals See Early Signs of Cost-Savings through Energy Efficiency Project

Hospitals are notorious for being energy hogs. With 24/7 operation, lots of energy-consuming equipment, and strict codes for lighting, air circulation and heating/cooling, there should be little wonder why. In fact, it’s estimated that the operation and construction of hospitals uses five percent of all the energy consumed in the U.S. (ENERGY STAR).

Linda Barlow

Linda Barlow

Targeting 100! is making inroads to reverse this trend. The research project is a roadmap for hospital design, construction and operation, seeking to develop more energy-efficient hospitals at little additional first capital cost investment from the owner. It provides climate-specific guidance for hospitals to achieve the goals of the 2030 Challenge for 2010-15, with a 60 percent energy reduction from the current U.S. average energy performance while complying with U.S. energy and health-related codes and improving the quality of healing and work environments.

“At a time when health care reimbursements are decreasing for many health care organizations, spending on energy is one area that can become less costly with greater efficiency,” said Heather Burpee, Research Assistant Professor, Health Design & Energy Efficiency, University of Washington. “Reducing energy use also has a direct impact on carbon emissions, thus having a positive impact on environmental health.”

Though energy represents a small portion of a hospital’s overall operating costs, reducing utility expenditures can create a low-risk, high-yield and stable investment:

  • $1 of net savings translates into $50 of gross revenue.
  • For a typical Targeting 100! hospital that saves 60 percent on energy and 35 percent on annual utility costs, the average annual savings of $575,000 equates to $28.5 million in gross revenue that would have otherwise been generated through providing patient services.

“In this way, the operations of the hospital are less expensive and the extra ‘revenue’ can be used to service additional care, acquire new equipment or go back into additional energy efficiency upgrades,” Burpee said.

According to Targeting 100!, one of the biggest uses of energy within a hospital is re-heating centrally cooled air. For example, at Vancouver, Washington’s Legacy Salmon Creek Medical Center (LSCMC), a 220-bed, state-of-the-art facility – which acted as a benchmark for the program – re-heat consumed 40 percent of the hospital’s energy.

The Targeting 100! program saves re-heat energy expenditures by reducing loads on the building envelope through solar control, turning down air changes in unoccupied areas, and other mechanical ventilation strategies.

Burpee highlighted several recent Targeting 100! projects that are starting to demonstrate positive results:

The Swedish Issaquah Hospital in Issaquah, Washington is exceeding its energy goal of 125 kBtu/SF (amount of heat required to change the temperature of one pound of water by one degree fahrenheit at sea level) per year by a significant margin after just nine months.

Seattle Children’s Bellevue Clinic at the University of Washington Medical Center is on track to see an annual energy cost benefit of approximately $1.32 million – a return on investment of more than 50 percent that will pay back the provider’s investment in less than two years. According to the project’s engineer, the total investment needed to implement the energy-reduction strategies amounted to less than one year of typical operating costs.

“Developing a healthier and more sustainable hospital environment requires an exceptionally high level of owner support to achieve carefully gauged high performance goals,” Burpee said. “A project team structure and culture that enables cooperative decision-making with key stakeholders is essential for creating a truly high-performance hospital: one that has a low-energy footprint and embodies qualities that foster health, productivity, and well-being.”

Targeting 100! notes that implementing energy-efficiency options incurs a three percent incremental cost premium, with the inclusion of a utility incentive, and that cost savings in some categories can offset incremental cost increases for energy improvements in other areas. These energy options would pay back, on average, in less than 11 years, a nine percent return on investment.

Should a three percent increase in capital cost be considered “cost-neutral?” Are relatively modest increases in initial costs for strategies that yield projected long-term energy savings a good investment?

Categories: Cost-Savings

Striking the Right Balance for Better Patient Outcomes

A recent article in Health Affairs reports that ChenMed – which serves low-to-moderate income elderly patients primarily through the Medicare Advantage program – is achieving better health outcomes for Medicare-eligible seniors, including those living with five or more major and chronic health conditions.  Dozens of Chen and JenCare Neighborhood Medical Centers are helping tens of thousands of seniors live better, longer: 

chris_chen

Dr. Christopher Chen, ChenMed CEO

  • Total hospital days per 1,000 patients at ChenMed in 2011 were 1,058 for the Miami area in comparison with 1,712 total US hospital days per 1,000 patients in the same year (Centers for Medicare and Medicaid Services Office of the Actuary).
  • Just one year prior, according to Dartmouth Atlas of Health Care, the Miami Hospital Referral Region was above the 90th percentile in inpatient hospital days.

Why is ChenMed so successful?

Dr. Christopher Chen, CEO of the organization, says its patient care model integrates cutting-edge medical expertise in a way that empowers physicians to ensure patients receive personalized attention and optimal care.

“People always ask, ‘What is your secret?’ There really is no secret,” he says. “It comes down to having the right incentives, the right physician and staff culture, and the right philosophy of care. My goal at the end of the day is to be cost-effective through improvement of outcomes by changing the philosophy of care. We care about results.”

The group practice’s popularity also attests to its effective one-stop-shop approach to patient-centered care through multi-specialty services. Smaller physician panel sizes of 350-450 patients spur intensive health coaching and preventive care, and prescriptions are given to patients during their visits at all Chenand JenCare Neighborhood Medical Centers.

This aspect of ChenMed’s model makes the biggest difference in boosting medication adherence, followed by strong one-on-one doctor-patient relationships that help to change habits for the better. Receiving meds within 3-5 minutes of ordering drugs not only means patients don’t have to wait for the treatment they need, but that they receive their medications while having face-to-face interactions with their primary care doctors.

“In our model we aren’t looking for high-income patients,” Dr. Chen says. “People ask, ‘Are you saying that patients like you because you give more attention to them and provide more access to doctors than those who pay for concierge service?’ I would say yes.”

ChenMed continuously employs top specialists from a variety of fields to conveniently provide fully integrated medical services to patients.  It effectively combines services like acupuncture into its portfolio of care, and improves outcomes and patient experience with customized end-to-end technologies enhancing its daily operations. For example, all the medical assistants and staff are equipped with iPads and can offer physician support tailored to each patient. This fuels collaboration, enabling doctors to work side by side with patients and providing a significant convenience to all parties as a result.

Primary care physicians at Chen and JenCare Neighborhood Medical Centers also meet three times a week, engaging in thoughtful ongoing discussions that generate numerous enhancements to care and delivery for better outcomes.

“We discuss whether a hospitalization could be improved through better outpatient care. We ask, ‘What can we do to improve patient outcomes while the patient is in the hospital?’ We innovate to improve outcomes and can achieve great things for patients because of our small panel sizes. These meetings have saved many lives and continue to do so,” explains Dr. Chen.

When interviewing prospective doctors to work at ChenMed, they are asked whether they like spending time with patients and whether they love the complexity of medicine. If they say no to either of those questions, then this group is probably not the best place for them, Dr. Chen says, underscoring that:

“We want you to practice medicine the way you thought you would when you graduated from medical school. It’s not about how many patients you see, how many procedures you do, or how much you bill. You should want to be a doctor to make people feel better.” 

ChenMed, through its Primary Management Resources subsidiary, also provides behind-the-scenes consulting services to enhance medical practice operations nationwide.  Physicians interested in end-to-end solutions that streamline operations while enhancing patient health outcomes and the patient experience should contact ChenMed at (305) 628-6117 or go to ChenMed.com.

Eco-Friendly Strategies Plant Seeds for Long-Term Savings Among Hospitals

In the past couple of years, 149 hospitals saved $55 million as a result of developing and implementing environmentally friendly initiatives. So why are more and more health providers going green and what’s behind this rising trend?

David Sheon

David Sheon

“Increasingly health care leaders are recognizing the critical role environmental stewardship plays in quality health care,” said Janet Brown, Director of Facility Engagement, Practice Greenhealth. “Going Green is moving beyond the blue bin by the photo copier and in alignment with other strategic priorities – prevention, wellness, mission, staff engagement, community benefit, fiscal responsibility and the right thing to do.”

Hospitals are going green in many ways, from turning to sustainable energy to finding synergies in hospital transportation services. Dell’s Children’s Medical Center of Central Texas and Beth Israel Deaconess Medical Center in Boston, MA, illustrate how being environmentally friendly translates to significant cost savings. Both hospitals, in fact, earned platinum certification from LEED (leadership in energy and environmental design), the most widely recognized and widely used green building program in the world.

  • Dell’s Children’s Hospital saved $6.8 million as a result of a successful collaboration with Austin Energy that eliminated the need to build a central plant (source of energy typically used to power multiple buildings). Using a combined heat and power (CHP) system instead, Dell Children’s became one of the first hospitals in Texas to leverage an onsite energy system as its primary source of electricity and one of the first grid-independent hospitals in the U.S.
  • Beth Israel Deaconess Medical Center reduced its annual lab energy consumption by $270,000, while lessening its carbon footprint and maintaining a commitment to safety in lab and research facilities as a top priority. In addition to reducing its annual lab energy by recycling lab materials, the medical center also combined its transportation service with other hospitals, began using reusable plastic mugs, and sent their leftover food to the compost.

Health systems participating in the Healthier Hospital Initiative – a national campaign to improve environmental health and sustainability in health care through innovative approaches – also report strong fiscal returns:

  • The Hospital Corporation of America (HCA) saved $21.7 million by diverting 364 tons of waste through reprocessing single use devices in their hospitals.
  • Kaiser Permanente saved $4 million in annual energy costs after its initial purchase of environmentally responsible computers for all of their facilities.

Going green benefits stakeholders in health care and beyond. When hospitals reduce expenses through environmentally smart investments, they improve their overall long-term performance and encourage the community to make eco-conscious choices too. When hospitals save costs patients also benefit because the money can be put toward health practitioners or other needs to improve care.

“There are numerous win-win opportunities for cost saving environmental improvement strategies in the health care sector,” Brown said. “As health care leaders become increasingly engaged, environmental stewardship programming is further integrated into the day to day operations of the vibrant health care environment and its benefits are maximized.”

Are hospitals in your local community adopting environmentally friendly initiatives? What could they be doing to conserve energy, reduce waste or go green in some other way?

Categories: Cost-Savings

Saving Green by Going Green

Daniel J. Vukelich, Esq., President, Association of Medical Device Reprocessors

Daniel Vukelich

In August 2012, Forbes ran an article by Richard Crespin entitled, “If Sustainability Costs You More, You’re Doing it Wrong.”  Never before has this been more true for health care providers than it is right now.  In fact, data shows that if hospitals put in place certain green initiatives, they would save a lot more green – to the tune of more than $15 billion over the next 10 years.  In this era of shrinking budgets, escalating health care costs, and the growing problem of medical waste, isn’t it about time that all hospitals explore these sustainable options?

Research from the Commonwealth Fund, with support provided by Health Care Without Harm and the Robert Wood Johnson Foundation, concluded in their report Can Sustainable Hospitals Help Bend the Health Care Cost Curve? that “the savings achievable through sustainable interventions could exceed $5.4 billion over five years and $15 billion over 10 years.”

One of the initiatives considered was the reprocessing of select “single-use” medical devices (SUDs).  In the study, hospitals contracted with an FDA-regulated medical device reprocessor, which are firms that specialize in collecting medical devices – decontaminating, cleaning, repairing, and remanufacturing the devices for resale back to hospitals.  Extrapolating on the data collected, the researchers estimate that “hospitals’ cost savings over five years was about $57 per procedure and if hospitals nationwide adopted SUD reprocessing, cost savings would be $540 million annually, or $2.7 billion over five years.”

That’s billion with a “b,” it does not require any up-front hospital capital investment to get started, and is proven to provide patients with the same standard of care.  With these reprocessing programs, hospitals are able to extend the life and value of the medical devices they already own, not only dramatically reducing the amount of medical waste hospitals generate, but saving money as well.

The savings associated with reprocessing have been recently bolstered by other sources.  According to Modern Healthcare, the Healthier Hospitals Initiative, comprised of about 700 hospitals and three non-profit organizations (Health Care Without Harm, Practice Greenhealth and the Center for Health Design), found that its members “saved a collective $32 million in 2012 by reprocessing single-use medical devices,” a practice that was highlighted by the Healthier Hospitals Initiative (HHI) in its first milestone report.

HealthLeaders found in the report that “recycling, regulated medical waste reduction, energy management, and single-use device reprocessing were the four HHI Challenge areas with highest participation levels and represented the areas with the fastest financial rewards.”

Just two weeks ago, in an article from Becker’s Hospital Review, Huron Consulting Group issued a briefing entitled, “Ten Overlooked Opportunities for Significant Performance Improvement and Cost Savings.”  The briefing lists reprocessing among the ways hospitals and health systems can save their organizations millions.  Jim Gallas, managing director and Performance Solutions leader at Huron Healthcare, said, “As market pressures on hospitals and health systems continue to grow, a comprehensive yet granular approach to reducing expenses in every possible area creates a tremendous opportunity to make healthcare delivery more efficient, as well as fund the changes that reform is bringing.”

Of the 10 areas for performance improvement at hospitals and health systems, Huron experts identified medical device reprocessing as reducing device costs between 15 and 40 percent for an average 350 bed hospital, which saved $175,000-$315,000 a year.

Last week, Sterilmed, an affiliate of Ethicon-Endo Surgery, Inc. (a Johnson & Johnson company) and Stryker Sustainability Solutions (a division of Stryker Corporation), the nation’s leading two medical device reprocessors, were awarded Practice GreenHealth’s 2013 “Champions for Change Award” for Environmental Excellence.  This commitment to environmental sustainability measures is an example other hospitals can follow to save costs and reduce expenses.

Today, it seems the demand for everyone in health care is to do more with less.  Device reprocessing doesn’t require hospitals to make tough sacrifices, but allows hospitals to use existing resources in a safe, FDA-regulated manner.

If the immediate cost-savings opportunities aren’t enough to persuade hospitals to reprocess, the long-term impacts should.  As the Commonwealth report found, “hospitals create 6,600 tons of waste per day and use large amounts of toxic chemicals. Reducing such pollution and greenhouse gas emissions would reduce the incidence of human disease, thereby saving money for the health care system and society as a whole.”

Going green saves green now, and helps decrease demands on the health care system later.

Categories: Cost-Savings

It Takes a Community for Effective Disease Prevention and Management

To help stem the tide and high cost of persisting disparities in U.S. health care, providers are leveraging Community Health Workers (CHWs) as critical players in improving health outcomes by successfully linking “vulnerable” patient populations to better care. Living in the communities where they work, CHWs understand what is meaningful to those communities, communicate in the language of those they serve, and incorporate cultural buffers to help patients cope with stress and promote health outcomes.

As the CDC reports, growing evidence supports the involvement of CHWs as a critical link between providers and patients in the prevention and control of chronic disease:

  • They help high-risk populations, especially African-American men in urban areas, to control their hypertension.
  • They enable diabetic patients to reduce their A1C values, cholesterol triglycerides and diastolic blood pressure.
  • Their interventions improve knowledge about cancer screenings as well as screening outcomes.
  • Their interventions help patients reduce the severity of asthma.

Many Americans – especially those with low incomes, have no insurance or face other socio-economic barriers to primary care – often distrust the health care system, or lack the resources and awareness needed to take charge of their health. As a result, they wait until health issues and chronic disease escalate enough to drive them into the emergency department, where they receive short-term solutions that drive up the total cost of health care.

CHWs are changing that, community by community. Examples of CHW programs – both at home and abroad – abound. One is Penn Medicine’s IMPaCT Program.

IMPaCT (Individualized Management for Patient-Centered Targets) pairs patients in need of extra support with relatable neighbors and peers (people who have shared language, ethnic and geographic backgrounds) to assist them in navigating the medical system and identify the underlying causes of illness.

“Lower income patients tend to poorly manage chronic disease and have worse health outcomes than other patient populations,” explains Dr. Shreya Kangovi, Director of the Penn Center for Community Health Workers, which houses the IMPaCT program. “They are less likely to get preventive care and more likely to end up in the hospital. This scenario leaves health care practitioners frustrated, because they can’t move the needle on health outcomes. And it makes it difficult for the health system to meet its quality targets.”

Dr. Kangovi notes that many patients served by IMPaCT didn’t have a relationship with a primary care physician prior to joining the program.

“There is a lot of focus today on reducing hospital re-admissions,” she says. “But before we can reduce re-admissions, we need to make sure patients have a substitute for the emergency department.”

She shared the story of “Ben,” a young man with a bad case of lupus and no insurance. Ben had been visiting Penn’s Emergency Department regularly for lupus flare-ups. There, he received steroids and pain medications before being sent along his way. Thanks to IMPaCT, Ben was set up with a primary care doctor who understands his health problems, and placed Ben on a better medication regimen. Not only does Ben now feel better, he has more trust in the health care system that he sees as an ally, she says.

IMPaCT currently serves about 500 patients via two programs – one for hospitalized inpatients and one for primary care outpatients. The program’s CHWs meet with patients upon admission to the hospital to set short-term goals and identify pathways to solving their clinical and socioeconomic hurdles. They advocate for patients during their hospitalization, then work with them during discharge and beyond to get them connected to resources in their community. On the primary care side, patients work with their IMPaCT partner over six months to break long-term health goals down into smaller, achievable steps.

“Once patients leave the hospital, real-life issues intervene,” Dr. Kangovi says. “IMPaCT’s community health workers address these health and life issues on the ground, and do so much better and at a much lower cost than clinically trained personnel.”

Are CHWs making a difference where you live? How are they helping to reduce costs and improve access to health care?

Categories: Access to Care