Tag Archives: Health care facility operation

1st US patient with new virus leaves hospital, is recovering

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The man who became the first U.S. patient with the new virus from China has left the hospital and says in a statement that he is getting better and looks forward to life returning to normal

SEATTLE —
The man who became the first U.S. patient infected with the new virus from China has left the hospital and said in a statement that he is getting better and looking forward to life returning to normal, according to a statement from the man provided to The Associated Press on Monday.

The 35-year-old man thanked his doctors, nurses and other staff at Providence Regional Medical Center in Everett, Washington, about 30 miles (48 kilometers) north of Seattle, according to the statement from the unidentified man given to the AP by hospital officials.

The unidentified man fell sick after returning home from a visit to China and was admitted to the hospital on Jan. 20. He was still there as of last Friday and is now in isolation at home, monitored by officials with the Snohomish Health District in coordination with the hospital.

“I am at home and continuing to get better,” the man said. “I ask that the media please respect my privacy and my desire not to be in the public eye.”

The man added in the statement: “I appreciate all of the concern expressed by members of the public, and I look forward to returning to my normal life.”

The hospital has been coordinating with U.S., state and local health officials about the man’s care.

The hospital declined to provide information about when he was discharged or the process of his discharge from the hospital.

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Well being system pays $575 million to settle anti-trust lawsuit

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Considered one of Northern California’s largest well being techniques is paying $575 million to settle claims that it used anti-competitive practices to bump up prices for sufferers

SACRAMENTO, Calif. —
Considered one of Northern California’s largest well being techniques pays $575 million to settle claims that it used anti-competitive practices to bump up prices for sufferers, the state’s legal professional normal mentioned Friday, although that falls wanting damages sought in a associated personal lawsuit that would have exceeded $1 billion.

California Legal professional Normal Xavier Becerra had sought an injunction to cease the alleged anti-trust practices by Sutter Well being, however no financial damages. The settlement imposes a brand new court-approved monitor on the well being system for 10 years to make sure it’s not utilizing anti-competitive practices with insurance coverage corporations to extend sufferers’ prices.

Becerra known as it “one of many largest actions in opposition to anti-competitive conduct within the well being care market throughout the nation, with unprecedented ranges of injunctive reduction to revive competitors available in the market.” It’s bigger than latest comparable settlements with different suppliers in North Carolina and Washington state, his workplace mentioned.

The settlement instantly set off a debate between hospitals and client advocates over whether or not it can restrict or enhance well being care prices.

About 1,400 self-funded employers individually obtained the $575 million in damages from Sutter and can have claims paid by means of an impartial administrator, minus attorneys charges. It is not clear if customers will get a share of the settlement, Becerra mentioned, however he mentioned sufferers ought to profit from elevated competitors.

Below earlier market situations a typical inpatient process may cost a little $90,000 extra in Northern California than within the southern a part of the state, he mentioned citing a college examine. The state had mentioned Sutter was largely guilty.

The Sacramento-based nonprofit didn’t admit wrongdoing and denied the allegations, arguing that there’s loads of competitors and that insurance coverage corporations had been those boosting prices.

“There have been no claims that Sutter’s contracting practices with insurance coverage corporations affected affected person care or high quality,” Sutter Well being Senior Vice President and Normal Counsel Flo Di Benedetto mentioned in a press release hailing the settlement.

Sutter and Becerra introduced in October that that they had settled the class-action lawsuit simply in time to keep away from a trial. However they didn’t present particulars till Friday, after it was submitted to a San Francisco Superior Court docket choose for approval. The swimsuit was first filed by employers and unions in 2014, however Becerra filed the same lawsuit final 12 months after a six-year investigation.

Amongst different issues, the settlement limits what Sutter can cost for out-of-network procedures and will increase pricing transparency.

It bars Sutter from blocking insurance coverage corporations from utilizing incentives to direct sufferers to cheaper well being care suppliers, a observe that critics mentioned made it more durable for sufferers to make use of Sutter’s lower-priced rivals. And it prohibits what Becerra known as Sutter’s “all or nothing” strategy with insurance coverage corporations, which required insurers to incorporate all the corporate’s hospitals of their supplier networks even when it did not make monetary sense.

American Hospital Affiliation normal counsel Melinda Hatton mentioned industrial medical health insurance corporations will profit most as a result of it can allow them to “cherry-pick” hospitals and remove incentives for them to work with hospitals to offer decrease price care. She predicted it can enhance well being care prices, warning that sufferers in rural or weak communities could possibly be harmed most by the settlement.

Anthony Wright, government director of the well being care client advocacy coalition Well being Entry California, countered that Sutter’s pricing is one cause that sufferers in Northern California sometimes pay $3,000 extra in medical health insurance premiums than in Southern California.

“We wish hospitals to compete on decrease prices and better high quality, and never on whether or not they can get bundled in with larger and larger hospital techniques,” he mentioned. ”This settlement takes a primary step to altering the incentives to the market and competitors we would like. That advantages customers.”

Wright was hopeful the settlement would set a nationwide precedent and reignite stalled proposals in Congress and California to restrict “shock medical payments” for out of community procedures.

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Audit: Hospitals put Native Americans at risk with opioids

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Government hospitals placed Native American patients at increased risk for opioid abuse and overdoses, failing to follow their own protocols for prescribing and dispensing the drugs, according to a federal audit released Monday.

The report by the U.S. Department of Health and Human Services’ Office of Inspector General doesn’t draw any conclusions about actual abuse or overdoses. But it said all five Indian Health Service hospitals it reviewed had patients who were given opioids in amounts that exceeded federal guidelines.

“There are vulnerabilities with this particular population in the opioid prescribing and dispensing practices,” said Carla Lewis, one of the auditors.

The overdose epidemic that has killed more people than any other drug epidemic in U.S. history has hit indigenous communities hard. Native Americans and Alaska Natives had the second-highest rate of opioid overdose out of all racial and ethnic groups in 2017, according to the federal Centers for Disease Control and Prevention.

The report made more than a dozen recommendations to the Indian Health Service to better track patients’ health records and pain management, ensure opioids are kept under tighter security and update its information technology systems. The agency agreed on every point and said changes are coming.

The Indian Health Service, the federal agency that administers primary health care for Native Americans, has put an increased focus on opioids lately with a new website and the creation of a committee focused on decreasing overdose deaths, promoting culturally appropriate treatments and ensuring that communities know how to respond.

The audit covered five of the 25 hospitals directly run by the Indian Health Service: the Phoenix Indian Medical Center in Phoenix; Northern Navajo Medical Center on the Navajo Nation in Shiprock, New Mexico; the Lawton Indian Hospital in Lawton, Oklahoma; the Cass Lake Indian Hospital on the Leech Lake reservation in Cass Lake, Minnesota; and the Fort Yates Hospital on the Standing Rock Sioux reservation in Fort Yates, North Dakota.

Auditors considered the amount of opioids each hospital dispensed and the percentage increase over three years when deciding which ones to review. They looked at 30 patient records at each hospital, visited the facilities and interviewed staff.

They found the hospitals strayed from the Indian Health Manual in reviewing treatment for patients and their causes of pain every three months. Patients also must sign a written consent form and an agreement to treat chronic pain with opioids so they know the risks and benefits, as well as the requirement for drug screenings. More than 100 patient records didn’t have informed consent, and dozens didn’t have evidence that providers adequately educated patients.

The Centers for Disease Control recommends that patients be prescribed no more than 90 morphine milligram equivalents per day, a measure used to compare an opioid dose with morphine. The audit found that each hospital met or exceeded that amount at times. At the Shiprock hospital, the daily dosage was more than four times as high. The auditors also found some patients were prescribed opioids and benzodiazepines — commonly used to treat anxiety and insomnia —at the same time, which “puts patients at a greater risk of a potentially fatal overdose.”

The Indian Health Service said it implemented a tool to track the dosages, and all of its facilities reported data in the first quarter of 2019.

Among the report’s other findings:

—More than two dozen records showed no evidence patients were screened for drugs with a urine test when they started opioid treatment and periodically after. Providers didn’t have an alert system to know when patients were due. The Phoenix hospital has since implemented one.

—Pharmacists are supposed to review patients’ files before filling prescriptions from an outside provider, but that wasn’t being done at four of the hospitals. In one case, Fort Yates filled a prescription from an outside provider despite the hospital discontinuing treatment because the patient violated a pain management agreement. The Indian Health Service said it would issue a directive in December for prescribers to track that information.

—Only the Lawton hospital had opioids secured in a storage cabinet that requires employee authentication to access. One photo attached to the report showed the combination to a safe on the safe itself. The Indian Health Service said it has revised its manual to require opioids awaiting pickup to be locked up.

—Agreements with their states require that hospitals report daily on opioid prescriptions that are filled so patients don’t seek the drugs from multiple providers at the same time. Fort Yates and Phoenix now are complying. The Indian Health Service said the reporting would be automated by June 2020.

At all hospitals, auditors noted that providers didn’t always review the data before seeing new patients or during the time they were taking opioids for chronic pain.

“Part of it is to ensure the holistic approach of providing care,” Lewis said.

Hospital officials and providers often said they were overwhelmed by the number of patients or couldn’t control how regularly they came in — sometimes due to the long distances between patients’ homes and the hospitals.

Lewis said auditors try to be reasonable in their requests. “We try to make recommendations that are going to be actionable and cost-effective for an organization,” she said.

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