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Number of System-Affiliated vs Independent Community Hospitals, 1999-2015

System-affiliated hospitals outnumber those that remain independent. In 2015, 66% of community [acute care, non-federal] hospitals were affiliated with a health care system. This compares to 51% in 1999. Conversely, 34% of community hospitals were independent facilities in 2015, down from 49% in 1999.system-vs-nonsystem-comm-hosp-fy15

 system-vs-nonsystem-comm-hosp-fy15-chart

Sources:

Fast facts on US hospitals: pie charts. American Hospital Association, Jan. 2017. http://www.aha.org/research/rc/stat-studies/Pie-charts2017.shtml

Table 2.1: Number of community hospitals, 1991-2014. In: Trendwatch Chartbook 2016, American Hospital Association, May 12, 2016. http://www.aha.org/research/reports/tw/chartbook/2016/table2-1.pdf. Related chart 2.4: Number of hospitals in health systems, 2004-2014: http://www.aha.org/research/reports/tw/chartbook/2016/chart2-4.pdf

Posted by AHA Resource Center, (312) 422-2050, rc@aha.org

SURGERY: Use of surgical robots has changed the way radical prostatectomy procedures are done in the U.S.

The volume of radical prostatectomy procedures decreased 7 percent from 1425 procedures per million men over age 45 in the late ’90s to 1330 per million in 2010-2011.  There was a big change, however, in the way that the surgery was performed as surgical robots came to the fore in urological surgery.  This study of national data shows that open radical prostatectomy procedures dropped from 1424 per million older men to 435 per million during the 14-year time period.  Much of that procedure volume was moved over to robotic surgery.

This study also analyzes hospital procedure volume – finding that 18 percent of hospitals stopped providing open radical prostatectomy since 2006.  The number of hospitals providing the minimally invasive version of the procedure increased by 191 percent during the same period.  The percentage of hospitals with a low-volume (fewer than 50 procedures) program of minimally invasive radical prostatectomy doubled – to 26 percent – by the end of the study period.

Source: Tyson, M.D., and others. (2016, Jan.). Radical prostatectomy trends in the United States: 1998 to 2011. Mayo Clinic Proceedings, 91(1), 10-16.  Click here for full text: http://www.mayoclinicproceedings.org/article/S0025-6196%2815%2900771-5/pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

Top 10 Patient Safety Concerns for Healthcare Organizations for 2016

The ECRI Institute has released its annual ranking of the top patient safety concerns for healthcare organizations. Based on a review of its patient safety organization [PSO] database of reported safety events, its PSO members’ root cause analyses and research requests, and a vote by an expert panel, these are currently the top issues:

  1. Health IT configurations and organizational workflow that do not support each other
  2. Patient identification errors
  3. Inadequate management of behavioral health issues in non-behavioral-health settings
  4. Inadequate cleaning and disinfection of flexible endoscopes
  5. Inadequate test-result reporting and follow-up
  6. Inadequate monitoring for respiratory depression in patients prescribed opioids
  7. Medication errors related to pounds and kilograms
  8. Unintentionally retained objects despite correct count
  9. Inadequate antimicrobial stewardship
  10. Failure to embrace a culture of safety

Source: Top 10 patient safety concerns for healthcare organizations 2016: executive brief. ECRI Institute, April 2016. www.ecri.org/patientsafetytop10 [free registration required]

Posted by AHA Resource Center (312) 422-2050 rc@aha.org

Accountable Care Organizations in 2016: Private and Public-Sector Growth and Dispersion

There were 838 active accountable care organizations as of January 2016, and they have service areas in every state. That’s all according to a new analysis by Levitt Partners  and the Accountable Care Learning Collaborative. The count of ACOs has grown from 64 in early 2011, and has increased 12.6% just over the past year. The number of accountable care contracts is now at 1,217, and an estimated 28.3 million people are covered by an accountable care arrangement.

The report also charts:

  • ACOs over time
  • ACOs by state
  • ACOs by hospital referral region
  • ACO lives over time
  • ACO lives per payer type
  • ACO penetration by state
  • ACO penetration by hospital referral region

ACO contract renewals and dropouts, policy drivers, ACO challenges, and the future of accountable care are all discussed briefly.

Source: Muhlestein D; McClellan M. Accountable care organizations in 2016: private and public-sector growth and dispersion. Health Affairs Blog, April 21, 2016. http://healthaffairs.org/blog/2016/04/21/accountable-care-organizations-in-2016-private-and-public-sector-growth-and-dispersion/

Posted by AHA Resource Center (312) 422-2050 rc@aha.org

ROBOTICS: How many robotic surgery procedures per year?

This is an infographic with interesting tidbits about the dispersion of the da Vinci surgical robot – the market leader in robotic laparoscopic surgery.  Here is a look at the market (there are other vendors, but this is looking at the da Vinci):

  • One quarter of US hospitals have one or more da Vinci robots
  • 79 percent of procedures using a da Vinci robot are done in the US
  • 570,000 da Vinci robotic procedures worldwide in 2014
  • This is a 178 percent increase worldwide in 5 years
  • 450,000 da Vinci robotic procedures: US 2014
  • Here is a distribution of the types of da Vinci robotic procedures: 52 percent are gynecological; 24 percent are general surgery; 20 percent are urological; and 4 percent are other
  • Incremental cost per procedure using da Vinci ranges from $3,000 to $6,000.

Source: ECRI Institute. (2015). Robotic surgery: Arm yourself with the latest information on pricing, performance, clinical efficacy, and safety.  Click here for free full text:  https://www.ecri.org/Resources/ASG/Robotic_Surgery_Infographic_MS15369_web.pdf  Posted by AHA Resource Center (312) 422-2050, rc@aha.org

Top 10 Issues Facing Community Hospital CEOs

Last month the American College of Healthcare Executives released the results of its annual CEO survey on the top concerns confronting community hospitals. The most pressing concerns of the CEOs in 2015 were:

  1. Financial challenges
  2. Patient safety and quality
  3. Governmental mandates
  4. Personnel shortages
  5. Patient satisfaction
  6. Physician-hospital relations
  7. Access to care
  8. Population health management
  9. Technology
  10. Reorganization [mergers, acquisitions, restructuring, partnerships]

Financial challenges has remained the top concern when compared to 2013 and 2014 surveys. Transition from volume to value, Medicaid reimbursement, bad debt, and increasing costs were among the financial challenges most often mentioned. Engaging physicians in improving the culture of safety/quality and in reducing clinically unnecessary tests and procedures were top concerns related to patient safety and quality.

Access to care and reorganization were new to the top 10 list in 2015, and personnel shortages rose to 4th place on the list, up from the 10th spot in 2014.

Source: Top issues confronting hospitals in 2015. American College of Healthcare Executives, Feb. 2, 1016. http://ache.org/pubs/research/ceoissues.cfm [press release: http://ache.org/pubs/Releases/2016/top-issues-confronting-hospitals-2015.cfm]

Posted by AHA Resource Center (312) 422-2050, rc@aha.org

FORECASTS: Top health care trends in 2016

This is a list of likely developments in the health care field in 2016 – largely from the point of view of payers / insurers.  Here they are:

  • Consolidation will continue.
  • Continued movement towards value-based payment
  • Enrollment in ACA health plans will slow
  • High price of pharmaceuticals will raise concern
  • PPO plans may be scaled back
  • Surprise out-of-network billing will be examined
  • Affordable Care Act will be frequently mentioned during Presidential campaign
  • Demand for quality data will grow
  • Cybersecurity will be an issue
  • Balance between preventive screening and overdiagnosis will be sought
  • Providers will start to work through how MACRA legislation will affect reimbursement
  • Insurance coverage for genetic tests will be debated.

Source: 2016 year in preview. (2015, Dec.). Managed Care, 24(12), 30-36, 45-47.  Click here: http://www.managedcaremag.com/issue/2015/December  Posted by AHA Resource Center (312) 422-2050, rc@aha.org