Hospital-At-Home Thoughts/Worries

 

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Random charts - preparedness

Source: Global Health Security Index (324-pg PDF)

"Biological threats—natural, intentional, or accidental—in any country can pose risks to global health, international security, and the worldwide economy. Because infectious diseases know no borders, all countries must prioritize and exercise the capabilities required to prevent, detect, and rapidly respond to public health emergencies. Every country also must be transparent about its capabilities to assure neighbors it can stop an outbreak from becoming an international catastrophe. In turn, global leaders and international organizations bear a collective responsibility for developing and maintaining robust global capability to counter infectious disease threats. This capability includes ensuring that financing is available to fill gaps in epidemic and pandemic preparedness. These steps will save lives and achieve a safer and more secure world. 

 The Global Health Security (GHS) Index is the first comprehensive assessment and benchmarking of health security and related capabilities across the 195 countries that make up the States Parties to the International Health Regulations (IHR [2005])"

Note: The U.S. ranked 1st i.e. most prepared... Perhaps this might need to be reconsidered!

Random charts - provider outlook

 

Source: BDO CFO Outlook Survey: Healthcare: Treating Healthcare Distress (13-pg PDF)

Random chart - ED errors

Source: Diagnostic error in the emergency department: learning from national patient safety incident report analysis.

Random charts - healthcare

Source: Findings from the Deloitte 2019 Health Care CEO Perspectives: StudyUnique insights from industry leaders

Random charts - market concentration

 

Source: Healthy Marketplace Index 2019

"Health care spending in the United States is on the rise and accounts for nearly 18% of US economic activity. While policymakers continue to explore the contributors to this phenomenon at the national level, differing local trends add complexity—but critical detail—to the picture of how health care dollars are spent across the country..."

Random charts - health savings

Source: Reducing Specialty Drug Costs

Random charts - clinician engagement

Source: Leadership Survey: Why Clinicians Are Not Engaged, and What Leaders Must Do About It (NEJM 14-pg PDF)

Random charts - hospital pharmacy

Source: ASHP national survey of pharmacy practice in hospital settings: Workforce—2018

Random charts - healthcare deficiencies

Source: Partnering for Success: The 2019 HFAP Quality Review (60-page PDF)

"This document represents an analysis of deficiencies identified on 2018 surveys for HFAP ambulatory surgery center, acute care hospital, critical access hospital, and clinical laboratory accreditation programs..."

Random charts - hospital closures

Source: ‘Leaving billions of dollars on the table‘ Rural hospitals foundering in states that declined Obamacare

Random charts - healthcare boards

Source: AHA's 2019 National Healthcare Governance Survey Report (74-pg PDF)

Random chart - drug spend

Source: How Does Prescription Drug Spending and Use Compare Across Large Employer Plans, Medicare Part D, and Medicaid?

Random charts - hospital costs

 

Source: Prices Paid to Hospitals by Private Health Plans Are High Relative to Medicare and Vary Widely

"... Large price discrepancies exist between what private health plans pay for hospital services and what Medicare pays. RAND Corporation researchers used data from three sources — self-insured employers, state-based all-payer claims databases, and health plans — to assess $13 billion in hospital spending in terms of hospital price levels, variation, and trends from 2015 through 2017 in 25 states. In this report, prices reflect the negotiated allowed amount paid per service, including amounts from both the health plan and the patient, with adjustments for the intensity of services provided. These negotiated prices are then compared with Medicare reimbursement rates for the same procedures and facilities to determine relative prices…” 

Relative prices, including all hospitals and states in the analysis, rose from 236 percent of Medicare rates in 2015 to 241 percent of Medicare rates in 2017 

• Relative prices varied twofold among states. Some states (Michigan, Pennsylvania, New York, and Kentucky) had relative prices in the range of 150 to 200 percent of Medicare rates; other states (Colorado, Montana, Wisconsin, Maine, Wyoming, and Indiana) had relative prices in the range of 250 to 300-plus percent of Medicare rates. 
• Relative prices increased rapidly from 2015 to 2017 in Colorado and Indiana, but they fell over the same period in Michigan. 
• Among hospital systems, prices varied nearly threefold, ranging from 150 percent of Medicare rates at the low end to 350 to 400-plus percent at the high end. 

Relative prices for hospital outpatient services were 293 percent of Medicare rates on average, far higher than the average relative price for inpatient care (204 percent of Medicare rates) 

• However, eight states — Michigan, New York, Tennessee, Massachusetts, Louisiana, New Hampshire, Montana, and Maine — stand out as exceptions to this general finding, with relative prices that are roughly equal for inpatient and outpatient services.."

Random charts - culture & health care

Source: Leadership Survey: Organizational Culture Is the Key to Better Health Care (NEJM Insights)

Random charts - med devices

 

Source: The cost of medical device innovation: can we keep pace? 

"The cost of medical device innovation: can we keep pace?© 2019 Vizient, Inc. All rights reserved.The cost of medical device innovation: can we keep pace?Innovation is the hallmark of U.S. health care. Over the last decade, advances in medical device technology have had an extraordinary positive impact on patient outcomes and quality of life. In 2017, the number of first-time premarket approvals by the U.S. Food and Drug Administration (FDA) increased 28 percent from the previous year, while the number of 510(k) clearances was up 9 percent.

 While these novel devices may provide advanced treatment options, improved quality of life and extended longevity for patients, the high costs associated with the devices and procedures create challenges for hospitals. Because of high research and development costs, the expense of clinical trials and market factors, an innovative medical device almost always carries a premium price. A review of several recent innovative cardiovascular medical device introductions reveals an average 273.3 percent increase in price (range, 163 percent to 565 percent; Table 1) over the predicate medical device.."