Cleveland Clinic should be commended for expanding its free employee wellness and health programs to more than 35,000 dependents.
This simple, common sense move is exactly the far-sighted, cost-effective, proactive action needed to address many of the preventable chronic illnesses that otherwise drive healthcare costs beyond control.
The fact that a high-profile healthcare institution like Cleveland Clinic is aggressively expanding wellness benefits is another sign that wellness programs work.
Since Jan. 1, Cleveland Clinic dependents who participate in its corporate employee health plan have had access to weight loss support services, memberships to fitness facilities, and smoking cessation treatment and medication, all at no cost to the employees.
Cleveland Clinic CEO Toby Cosgrove, MD, said the expansion is the latest step in the employee wellness campaign launched in the summer of 2008. Since then, more than 10,000 employees enrolled and participated in smoking cessation, weight management, and fitness programs. Collectively, Cleveland Clinic says 5,000 weight management program participants have lost more than 88,000 pounds–an average of 17 pounds per employee.
"Our nearly 40,000 employees and their families represent a crucial part of our community, both locally and around the world," Cosgrove said. "By giving them access to wellness and prevention programs at no cost, we can make a significant impact on the health and wellness of our community."
Cleveland Clinic banned tobacco use from its campus on July 4, 2005. In September, 2007, the hospital said it would no longer hire smokers. It has since banned trans fats from its cafeteria, and inpatient menus.
The clinic opened a Wellness Institute nearly three years ago to promote healthy lifestyle choices among employees. Chief Wellness Officer Michael F. Roizen, MD, said that extending the wellness benefits to employees' families will decrease chances that they will become one of the 30 million Americans affected by chronic illness. "Lifestyle choices that include smoking, poor nutrition and lack of physical activity are key contributors to the increased rate of chronic disease affecting our families and neighborhoods," he said.
Expanding free wellness programs to include dependents is a smart move for several reasons. From the employee productivity side, healthier families mean fewer sick days for employees, and fewer employees missing work to provide dependent care, and obviously, lower healthcare costs.
For recruiting, this will do nothing but enhance Cleveland Clinic's status. Taking proactive and progressive actions to improve the quality of life for employees is a powerful draw, and sends a strong message that management cares about the employees. Quality people want to belong to vanguard institutions.
Most importantly, it makes wellness not just an employee benefit, but a family benefit. This changes not just the behaviors at work, but the more-crucial behaviors at home. Now, mother, father and even the children can go together to the health club, or they can join Weight Watchers or smoking cessation programs, and support each other at home to meet – and maintain – health goals.
We will only reduce our nation's healthcare costs when we as individuals take personal control of our own health. Cleveland Clinic and other businesses that recognize the importance of promoting wellness for the entire family are providing the tools to do it.
Note: You can sign up to receiveHealthLeaders Media HR, a free weekly e-newsletter that provides up-to-date information on effective HR strategies, recruitment and compensation, physician staffing, and ongoing organizational development.
Nine in 10 hospitals use social media to some degree, but most of them say they're having little luck attracting new patients with it, and only one in three has a formal social media plan in place, a new study by Greystone.Net shows.
"It is impossible to ignore the effect that social media is having on the Internet in general, and on hospitals and health systems specifically," said Mike Schneider, executive vice president of Greystone.Net. "Organizations that have a formal plan to manage their social media interactions are more likely to be successful, and we expect more and more hospital Web departments to embrace this strategy moving forward."
The research, conducted over two months using Greystone.Net's research panel of more than 100 hospital marketers, also showed that budgeting for social media, including hiring social media employees, is still relatively rare among hospitals. However, many respondents told Greystone.Net that that is likely to change in the near future.
Other key research findings include:
Monitoring social media is handled by relatively few people within a hospital's Web department—70% report they have three or fewer people monitoring.
Twitter, YouTube, and Facebook are the most popular social media for hospitals, and also the most effective in terms of driving traffic to the Web site.
Despite the fact that 92% of respondents originally got involved with social media to attract new patients, only 12.5% said they had had some success.
Hospitals are struggling to find success with other goals of social media, with only small numbers reporting that they have been successful improving community relations (16.7%), customer service (8.7%), employee engagement (8.7%), and crisis management (4.5%).
The staff at a Lorton, VA family physician practice thought they were dealing with a malfunctioning heating duct when they heard what sounded like a small explosion in a vacant examination room Monday night.
"We didn't know what it was. We left the room as it was and went home. We thought we would deal with it in the morning," says Kathy Ciampi, RN, with Williamsburg Square Family Practice. "We just had the heating system tweaked, and I thought something probably blew up in the system. We'll call the repairman in the morning."
As it happens, the explosion was caused by a grapefruit-sized meteorite that punched through the shingled dormer roof, insulation, and ceiling tiles on the one-story building, and came to rest in three large pieces on the concrete floor.
"It looked like it was fired out of something. It did a lot of devastation to the room. Everything was scattered everywhere," Ciampi says. "It was about 300 grams, the size of a grapefruit, a light gray concrete color on the inside, but the outside was dark and streaked and shiny. Our office manager's husband is a geologist. She described it to him. He drove an hour to get here and said 'you've got a meteorite.' We didn't believe him."
Ciampi thought the mysterious object more likely fell off an airplane or a helicopter from nearby Ft. Belvoir.
"We're doctors and nurses. Nobody's thinking meteorite. So we went on the Internet to look up meteorite, got a magnet to see if it was magnetized. It was magnetized," she says. "In the meantime, we called the Fairfax County police because we weren't sure if it came out of an airplane. The policeman was rolling his eyes when we told him. 'Yeah sure it's a meteorite.' And when it magnetized, his eyes got really big and then all the TV stations started calling."
The extraterrestrial rock was donated to the Smithsonian Institution, which has named it Meteorite Lorton.
"We have had a lot of people coming out of the woodwork. It's been a circus here," Ciampi says. "Yesterday was very difficult for the doctors because we had people with cameras in the waiting rooms, and we were trying to maintain patient privacy. They hung in there, but we had a tough day."
The happy ending for Ciampi is that nobody was hurt by the one-in-a-billion shot.
"We were very fortunate nobody was in the room. Our two physicians were about eight to 10 feet away. One doctor had a patient scheduled for that room who had cancelled."
After the last few days of media attention, Ciampi says everyone at the two-physician practice is ready for a return to normal. "We are just a doctors' office," she says. "We need to take care of our patients."
Grassley said that his 11-question survey is a response to complaints he's heard from providers about administrative complications, formatting and usability issues, errors, and interoperability roadblocks.
"Given the taxpayer investment and the investment of the healthcare system overall in the information technology industry, the more Congress and others overseeing implementation of this program dig into the problems and work to get them sorted out now, the better," Grassley said in a media release.
The ranking member of the Senate Finance Committee said providers have cited instances where software produced incorrect medication dosages because it miscalculated body weights by interchanging kilograms and pounds. Grassley said providers have also complained that their concerns and questions about software snafus are being "ignored or dismissed" by vendors and hospital administrators.
"Some sources recount difficulties in approaching the HIT vendor with problems and the lack of venue to discuss these issues either with the vendor or peer organizations," Grassley said. "Often this is attributed to alleged ‘gag orders' or non-disclosure clauses in the HIT contract that prohibit healthcare providers and their facilities from sharing information outside of their facilities regarding product defects and other HIT product-related concerns."
Grassley said some HIT products do not have to meet reporting requirements for adverse events under the FDA's Manufacturer and User Facility Experience database. "Thus, problems with these products may go without remedy thereby inhibiting the ability of the healthcare professional to provide quality care and potentially impacting patient safety," he said. "Furthermore, contractual restrictions on the sharing of experiences and information related to specific vendor products limit a healthcare facility's ability to make informed decisions about HIT adoption and implementation."
Hospitals that were sent the query include: Banner Health, Brigham & Women's Hospital Case Western Reserve University Hospital Health System, Catholic Healthcare West, Geisinger Medical Center, Kaiser Permanente System, Mayo Clinics, and the University of Pittsburgh Medical Center. Grassley has asked the hospitals to complete and return his survey by Feb. 16.
Last fall, Grassley wrote a similar letter to 10 major HIT vendors relaying those issues and concerns. His office is still examining those responses.
Louis Wenzlow, director of HIT at the Rural Wisconsin Health Cooperative, says Grassley's new letter underscores the myriad challenges involved in implementing HIT on such a massive scale.
"What makes the incentive program a potential disaster isn't the fact that providers will face these challenges, but the fact that they are not being given the time or the flexibility to implement [electronic health records] systems in a way that will mitigate these challenges and meet the quality and efficiency goals of the incentive program," Wenzlow says.
"Rural providers, who are much farther behind non-rural providers in their EHR adoption efforts, will be particularly hard pressed to meet the implementation deadlines," Wenzlow says. "The result will be that hospitals that already have EHRs will be getting the vast majority of the incentives; and hospitals without EHRs—those most in need of funding—will be largely excluded from the incentive program."
Charles E. Christian, CIO at Good Samaritan Hospital in Vincennes, IN, says some problems should be expected considering the size of the undertaking.
"Software is software. Even Microsoft has problems getting the code written, and these are not simplistic systems," says Christian, who sits on the steering committee of the College of Healthcare Information Management Executives.
Christian says hospitals must be careful not to rush to meet the meaningful use deadline. They need to get the technology in place properly and take the necessary time to make sure the systems are working correctly.
Christian says it's imperative that providers understand the abilities and limitations of the systems they're buying. "A lot of the systems being purchased these days are flexible enough to let you bend and twist them in ways that meet your work flows and work practices. But if you aren't careful and don't test them appropriately you could create self-inflicted wounds that could have unintentional outcomes," he says.
Whatever new systems are installed must be tested vigorously.
"Sometimes, the protective measures we take drive people crazy," Christian says. "But I'd rather make sure it fails in the testing environment than when I put that in live productive use and have the potential to harm the patient."
It's needed now more than ever, as the CDC reports that 34% of adults, and 17% of kids are obese. If we want to reduce healthcare costs by any significant measure, getting people to take responsibility for their health is the single most important component.
However, when we create the incentives for healthier living that are at the heart of wellness programs, we must also understand that not everybody will be able to take full advantage of those incentives.
We have to account for people who can't afford the snazzy health club, or they work a second job, or they don't live in a nice part of town with leafy green parks and safe streets that provide for enjoyable walks, or they've got a chronic illness like arthritis that makes movement painful and difficult.
The House and Senate healthcare reform bills each contain incentives to expand workplace wellness programs. The bill that passes must ensure that the motivation for people to maintain their health does not come in the form of shame, veiled threats, or economic hardship.
A recent essay in the the New England Journal of Medicine frames those concerns succintly. The essay warns that some of the "carrots" in wellness incentives are just orange-colored sticks designed to punish and weed out employees who aren't improving personal health metrics, like weight loss, or reducing blood pressure and cholesterol levels.
"Attainment incentives provide welcome rewards for employees who manage to comply but may be unfair for those who struggle, particularly if they fail," write the essay's authors, Harald Schmidt, Kristin Voigt, and Daniel Wikler, with the Harvard School of Public Health, and the Harvard University Program in Ethics and Health.
"The law demands the provision of alternative standards for those who cannot or should not participate because of medical conditions, but those categories are narrowly defined. For all others, the implicit assumption is that they can achieve targets if they try. This assumption is hard to reconcile with what we know about lifestyle change."
The Harvard researchers correctly note that this is also about money and class. Many workers on the lower end of the socio-economic ladder — the ones who could most benefit from reduced healthcare costs — are also more likely to be overweight, or to suffer from other chronic health problems that wellness programs are supposed to address.
Will these also be the people who are more likely to be punished with higher premiums if they don't meet their metrics?
We're touching upon a key friction point in the wellness movement. If people make conscientious and disciplined decision to take better care of themselves, exercise, watch what they eat, why shouldn't they be rewarded with lower healthcare costs? On the other hand, if we reward people for improving health metrics, are we then discriminating against coworkers who don't?
The wellness movement could be the perfect tonic for a graying, fat nation. But it's based on individual initiative, responsibility, and reward. Without incentives, the wellness movement could resemble a warm-and-fuzzy soccer tournament where even the last-place team gets a trophy.
On the other hand, if the incentives are too rigid, the people who would most likely benefit will also be penalized if they don't succeed. Their poor health will remain an growing expense that everyone else will share. That's not a good cost containment strategy.
Note: You can sign up to receiveHealthLeaders Media HR, a free weekly e-newsletter that provides up-to-date information on effective HR strategies, recruitment and compensation, physician staffing, and ongoing organizational development.
St. David's South Austin (TX) Hospital will begin a $72 million renovation and expansion project in April that will add three floors, more than 100,000 square feet, and 25% more beds. Effective immediately, the hospital has been renamed St. David's South Austin Medical Center.
"This renovation highlights three of the hospital's top priorities—providing the highest quality healthcare, ensuring hospital stays are comfortable and convenient for patients and their families, and offering resources for the community," said interim CEO Brett Matens, in a media release. "Our new name will better identify the hospital's current and future services to the community."
The project, scheduled for completion in April 2012, will include:
Expansion: A three-story patient tower, with one floor of universal beds for critical care; an expanded women's services area, including a new nursery and Level II nursery; renovated surgical suites, including new operating rooms for general surgery, neurosurgery, and orthopedic surgery; and a new post-anesthesia care unit.
Hospitality renovations: A new family waiting area outside of the nurseries, more parking, and additional larger-sized rooms for extended stays or patients with large families.
Community resource renovations: An auditorium and community center; a renovated chapel; and a remodeled dining area and food court.
Matens says the medical center will have to hire more nurses within the medical surgical areas and critical care departments, and support staff in all ancillary areas.
In 2005, St. David's South Austin Hospital completed a $50 million expansion project that included 34 new medical surgical beds, a cardiovascular center, an ICU observation unit, and a 360-space parking garage. St. David's South Austin Medical Center, owned by St. David's HealthCare, is an acute-care facility with 252 beds.
Architectural plans and interior design for the tower will be led by Nashville-based Gould Turner Group, Inc. The garage expansion will be led by Nashville-based Earl Swensson Associates, Inc. The general contractor has not yet been named.
Johnson & Johnson and two of its subsidiaries have been named in a kickback scheme that allegedly paid millions of dollars to Omnicare Inc., for dispensing J&J drugs to nursing home patients, the Department of Justice announced today.
In a civil False Claims Act complaint against J&J subsidiaries Ortho-McNeil-Janssen Pharmaceuticals Inc., and Johnson & Johnson Health Care Systems Inc., the federal government alleges that the kickbacks were designed to induce Omnicare's nursing home pharmacy company to purchase and recommend J&J drugs, including the anti-psychotic drug Risperdal.
"We will pursue those who break the law to take advantage of the elderly and the poor," said Tony West, assistant attorney general for DOJ's Civil Division. "Kickbacks such as those alleged here distort the judgments of healthcare professionals and put profits ahead of sound medical treatment."
According to the complaint, J&J knew that Omnicare's pharmacists reviewed nursing home patients' charts at least monthly and made recommendations to physicians on what drugs should be prescribed for those patients. The government further alleges that J&J knew that physicians accepted the Omnicare pharmacists' recommendations more than 80% of the time, and that J&J viewed such pharmacists as an "extension of [J&J's] sales force."
Johnson & Johnson issued a brief statement Friday afternoon defending its conduct. "We are reviewing the complaint filed today and will address the government's lawsuit in court," said Carol Goodrich, director of Corporate Media Relations at J&J. "We believe airing the facts will confirm that our conduct, including rebating programs like those the government now challenges, was lawful and appropriate. We look forward to the opportunity to present our evidence in court."
In November, the federal government, several states, and Omnicare entered into a $98 million settlement agreement that resolved Omnicare's civil liability under the False Claims Act for taking kickbacks from J&J.
In a statement Friday, Omnicare said, "As announced on November 3, 2009, Omnicare reached a voluntary civil settlement with the U.S. Attorney's Office, District of Massachusetts, the Departments of Justice and Health and Human Services, as well as various of the states in which the Company does business. The settlement related to the previously disclosed investigation with respect to qui tam complaints filed against the Company.
"The Settlement Agreement did not include any finding of wrongdoing or any admission of liability by Omnicare. The Company denies the contentions of the federal government and the qui tam relators as set forth in the complaints and further denies any liability related to those contentions. The Company chose to settle the matter to avoid expensive and time-consuming litigation and to focus on its mission of providing high-quality pharmaceutical care for the frail elderly," according to Omnicare.
The federal complaint alleges that J&J paid the kickbacks to Omnicare in several ways:
First, J&J allegedly increased the amount of the rebates as long as Omnicare implemented specific programs to increase the prescriptions of J&J drugs, said the Department of Justice.
Second, J&J allegedly paid Omnicare millions of dollars for "data," much of which Omnicare never provided. The true purpose of these payments was to induce Omnicare to recommend J&J drugs, according to the federal government.
Third, J&J allegedly made various other kickback payments to Omnicare in the form of "grants" and "educational funding," even though their true purpose was to induce Omnicare to recommend J&J drugs, said the Department of Justice.
DOJ filed its complaint in two consolidated whistleblower lawsuits already on file in federal court in Massachusetts.
The demand for healthcare workers appears to be accelerating in most areas of the nation, a new study shows.
Labor trends in 30 markets tracked by the consulting firm Health Workforce Solutions LLC found demand growing fastest in Sacramento, Riverside/San Bernardino, Pittsburgh, Cleveland, and Dallas for the fourth quarter of 2009. The New York/Northern New Jersey area ranked at the bottom of the 30 markets tracked.
"After several slow quarters, we are now seeing notable movement across a number of markets as healthcare employers begin to ramp up again," said David Cherner, managing partner of San Francisco-based HWS. "With the healthcare reform picture finally becoming clearer, many forward-thinking organizations appear to be refocusing back on their hiring needs at an opportune time before the competition for key clinical and ancillary personnel undoubtedly returns."
HWS' Labor Market Pulse Index also found that:
Much of the growth is being fueled by newly announced expansion plans and larger facility openings at organizations, such as Mercy San Juan Medical Center in Sacramento, the University of Pittsburgh Medical Center, the Cleveland Clinic and University Hospitals in Cleveland, and Texas Health Resources in Dallas.
Of the 30 major markets tracked, the slowest area for the quarter, the New York metro/Northern New Jersey area, remained relatively flat, dropping 4% from the prior quarter.
The Labor Market Pulse Index composite index, a representative basket of the 30 largest markets, posted a 19.5% increase in the fourth quarter of 2009 from the third quarter of 2009 and was up 17.3% compared to the fourth quarter of 2008.
For the fourth quarter of 2009, 21 markets of the 30 tracked by the LMPI showed signs of accelerated demand, up from 16 in the third quarter.
With a 21% Medicare reimbursement cut for physicians looming on March 1, the American Medical Association this weekend began airing tv ads that call on the Senate to permanently fix what has become an annual sideshow. The ads are airing in 10 states through the end of January.
"Time is running out for the Senate to act on this important issue for seniors, military families and physicians," said AMA President J. James Rohack, MD, in a media release. "Our new TV ad expresses the urgency of the issue, as physicians will be forced to make tough practice decisions if Congress does not fix the issue once and for all before March 1."
In 1997, Congress mandated Medicare spending cuts that were scheduled to begin in 2001. Those cuts have never taken effect, because each year the AMA, and other healthcare lobbying groups, push Congress to delay the cuts for another year. With each annual Band-Aid fix, however, the next year's cuts get deeper.
In October, AMA lobbied unsuccessfully for a bill that would have reset the sustainable growth rate formula for physicians back to zero to eliminate around $245 billion debt that has accumulated during the past six years as a result of Congress' annual fixes. The bill mustered only 47 of the 60 votes needed to bring it to the Senate floor.
The latest AMA ad focuses on seniors, veterans, and active military families, which are groups the AMA says will be hurt by physician payment cuts. A voice-over in the ad says: "Physicians who care for Medicare and TRICARE patients face a 21% cut, and seniors and military families will pay the price with fewer doctors and less access to the care they've earned."
"This ad is the opening salvo in our two-month campaign to urge the Senate to take immediate action to repeal the current Medicare physician payment formula and replace it with one that reflects the cost of providing care," Rohack said. "Congress can no longer put a Band-Aid on the problem by passing yet another short-term fix that creates instability in the system for seniors and their physicians. A permanent fix is crucial to building a solid foundation for health reform."
Five healthcare facilities in two counties near New York City have agreed to immediately stop dumping pharmaceutical waste into the city's watershed, the New York Attorney General's Office announced this week.
The five Putnam and Delaware county facilities named in the settlements are: O'Connor Hospital in Delhi; Margaretville Memorial Hospital; Mountainside Residential Care Center in Margaretville; Countryside Care Center in Delhi; and Putnam Nursing and Rehabilitation Center in Holmes.
Prosecutors say all five facilities cooperated with the investigation, and that the resulting agreements are the first to require the sources of pharmaceutical waste releases to end the risky disposal practice.
The five facilities are located within the New York City Watershed, an almost 2,000 square-mile area that drains into reservoirs and lakes providing drinking water to 8 million New York City residents and 1 million people in Westchester, Putnam, Ulster, and Orange counties.
Flushing waste pharmaceuticals allows for the release of painkillers, antibiotics, anti-depressants, hormones, and other waste drugs into the watershed—the drinking water supply for almost half the state's residents. State officials say that so far, only trace amounts of pharmaceuticals have been found in the New York City drinking water supply.
"Changing disposal practices begins with educating our healthcare workers, providing safe disposal options and enforcement of the law," said Adrienne Esposito, executive Director of Citizens Campaign for the Environment, which lauded the agreement. "When we fix our morning coffee, it should include sugar and milk, not Ritalin and antibiotics."
The settlements require that each of the healthcare facilities send their pharmaceutical waste to appropriate waste facilities. Each facility is required to take other specific steps to ensure safe disposal of pharmaceutical and other wastes in the watershed, including:
Ensuring that waste management practices, including those related to pharmaceutical waste, comply fully with all New York and federal laws and regulations related to waste management and clean water.
Paying civil penalties for past violations of law and costs incurred by the state in the investigation.
Implementing pharmaceutical "take back programs" to ensure the collection and proper disposal of pharmaceutical wastes generated by area households.
The AG's investigation found that the facilities' handling of pharmaceutical wastes and other wastes violated various provisions of the federal Resource Conservation and Recovery Act, and the federal Clean Water Act, according to the AG.
