Online job ads for healthcare practitioners and technicians grew by 3,300 listing in April for a total of 630,000 listings, a level of demand not seen since the recession began two years ago, the Conference Board reports.
Overall, online job ads in most employment sectors across the economy—in most parts of the nation—surged by 222,700 listings in April, continuing a prolonged upswing that has seen 870,000 new listings in the past six months, with a total of 4.1 million job listings in April, according to The Conference Board Help Wanted OnLine report.
"In a welcome sign for the job market, employers began the spring hiring season with a large 223,000 increase in demand for workers," said June Shelp, vice president at The Conference Board. "Providing evidence of the strengthening economy, labor demand in April rose in practically every state and a wide variety of occupations from management positions to office workers and sales help. Improved job prospects also contributed to the April rise in The Conference Board Consumer Confidence Index to its highest level since September 2008. The gap is beginning to narrow, but the number of unemployed continues to outnumber advertised vacancies by 3.82 to 1."
The report, which tracks more than 1,000 online job boards across the United States, also notes that the demand for healthcare support occupations has remained relatively strong throughout the recession and grew by 2,400 listings in April, to 128,700 listings, the highest monthly level since the HWOL series began in May 2005. Increases in this field reflect the continued strong demand for workers in occupations like occupational and physical therapists and nursing aids, the report said.
Demand in the healthcare labor market varies substantially from the higher-paying practitioner and technical jobs to the lower-paying support occupations. In April, advertised vacancies for healthcare practitioners or technical occupations outnumbered the unemployed looking for work in this field by 4 to 1, and the average wage in these occupations is $32.64/hour, the report said. The average wage for healthcare support occupations is $12.66/hour and there were more than two unemployed people looking for work in the field for every advertised vacancy, the report said.
Many non-profit hospitals don't do enough to tell needy patients they may qualify for charity care programs, or how to apply for help, according to a report released today by The Access Project and Community Catalyst.
The report, Best Kept Secrets, examines whether non-profit hospitals are meeting the voluntary guidelines established by the American Hospital Association for billing and collections for uninsured and underinsured patients.
AHA guidelines call on hospitals to have clear, written policies to help patients determine if they qualify for charity care and to make these policies available to patients and the public.
Best Kept Secrets is based on a 2009 national survey of 99 randomly selected non-profit hospitals that was conducted by The Access Project. The survey found that while most hospitals mentioned their charity care programs on their Web sites or over the telephone, only 25% provided eligibility information. Less than half provided a charity care application form, and less than 1 in 10 hospitals listed discounts for income levels on their Web sites.
"This report illustrates that voluntary guidelines are ineffective," said Access Project director Mark Rukavina. "Given the state of our economy and the insecurity Americans feel regarding healthcare costs, hospital charity care is and will continue to be an important part of our healthcare safety net. Both federal and state governments must ensure that hospitals receiving tax breaks are also fulfilling their charitable obligations."
The federal healthcare reform law requires tax-exempt hospitals to establish and publicize financial assistance policies that clearly specify eligibility criteria. They are also banned from taking extraordinary collection actions before making a reasonable effort to determine if patients qualify for financial assistance.
Jessica Curtis, director of the Hospital Accountability Project at Community Catalyst, called the report "surprising and disappointing given that hospital billing and collection practices have been closely scrutinized over the last decade by Congress and many state governments."
"It will be important for the federal government to develop regulations that establish very clear standards for tax-exempt hospitals and then monitor hospital behavior to ensure that they comply with the new requirements," Curtis said.
Hospitals take their mission of caring for the uninsured and underinsured "very seriously," the AHA said in a statement repsonding to The Access Project's report.
"Today's report is out of sync with field practices and the health reform legislation, which we supported," AHA officials said in the statement. "The legislation includes provisions similar to AHA's voluntary guidelines. From conversations with our members, we know that there is a great deal of time and energy dedicated to helping the uninsured and that hospitals are constantly developing new and better ways to communicate with the uninsured and underinsured."
Directors in hospital-owned practices in emergency medicine earned $20,000 per year while their counterparts in nonhospital-owned practices earned $60,000, according to the Medical Group Management Association Medical Directorship and On-Call Compensation Survey: 2010 Report Based on 2009 Data.
Family practitioners in hospital-owned practices earned $23,250 and their counterparts in nonhospital-owned practices earned $8,400 annually. Surgical subspecialist directors received $40,000 in both hospital and nonhospital-owned practices, MGMA said.
"Physicians may be expected to take on directorship responsibilities or on-call coverage as part of their employment terms as employees of the hospital," said Jason Whitmer, senior manager at Crowe Horwath LLP, and a MGMA survey advisory committee member. "Each employment arrangement is unique and determines whether a current employee will provide directorship support or if the hospital will need to acquire help externally for these services. Compensation for directorship duties may already be built into the salaries physicians receive."
Compensation for medical directors varied widely across specialties, with the greatest annualized compensation—$90,000—reported for anatomic and clinical pathology. Three other specialties—nephrology, neonatal pediatrics, and cardiovascular surgery—reported median compensation greater than $50,000. Most medical practices reported median compensation of less than $50,000. Hourly rate compensation was more consistent across specialties and indicated how workloads differed among respondents.
Medical directors who trained as surgical subspecialists reported the $40,000 in annualized compensation, followed by nonsurgical subspecialists at $31,200. Directors who trained as primary care physicians received less than $24,000.
Compensation variations also were attributed to directors’ responsibilities and hours worked per week. Directors responsible for attending meetings reported dramatically lower compensation levels than directors without this responsibility. Nonsurgical specialist directors who attended meetings were compensated $28,800 while their counterparts without this responsibility earned $50,000. Responsibilities such as documentation and care planning, physician behavior and impairment, physician education and recruitment saw differences in annual compensation.
The Medical Center at Bowling Green (KY) is notifying 5,418 patients of a breach of personal health information after the theft of a computer hard drive from the hospital's mammography unit. The hard drive contained data on patients who underwent bone density testing at The Medical Center between 1997 and 2009.
"We have no reason at this point to believe the device was stolen for the information on it or that any personal information has been released or used," the hospital said in a statement posted on its Web site.
The personal information on the hard drive was not encrypted, the hospital said.
The Medical Center staff discovered the theft on April 1, launched an internal investigation, and reported the theft to local police. Information in the hard drive includes each patient's full name, date of birth, address, medical record number, and physician name. Some patients' records also include Social Security numbers, weight, height, and menopause age.
"As a result of this breach, steps are underway to further strengthen the security of patient information," the hospital statement read. "We will now archive data to a secure network, which will allow us to eliminate the need for use of a hard drive like the one that was stolen. Additionally, we will ensure that we do not have any other equipment configurations that utilize a portable hard drive containing non-encrypted data."
The hospital is urging affected patients to monitor accounts and bank statements each month and check credit reports on a regular basis, and has notified the Department of Health and Human Services about the breach.
What can your hospital learn about safety from a coal mine? Quite a bit, actually.
The New York Timesrecently ran an in-depth piece comparing the allegedly checkered safety record and procedures at the now-infamous Upper Big Branch Mine—the Massey Energy Co. coal mine in Montcoal, WV, where 29 men lost their lives following an April 5 explosion—against the E3-1 coal mine in Hazard, KY, that is run by TECO Coal Corp., a company with an impressive safety record. Both mines are nonunion, but the Times report suggests that that is nearly all they have in common.
Despite emitting 25% more methane gas than the Upper Big Branch Mine, for example, E3-1 hasn't had a fatality since it opened in July 2004, the Times reports, nor has it accumulated anywhere near the dozens of safety citations the Upper Big Branch has received. TECO, the Times reports, routinely surpasses minimum state and federal safety standards in critical safety areas like mineshaft ventilation and air quality, and worker emergency training.
Safety inspections are constant at E3-1, especially around shift changes. Workers are encouraged to speak out against safety hazards, and managers and foremen are held accountable for ensuring that equipment is working and safety procedures are followed. If there is a breakdown in safety procedures, someone gets fired.
TECO miners and managers spoke openly and on the record with the Times and said they were satisfied with their training and the safety precautions taken on their part. TECO said it rewards miners who report safety issues, and also provides an 800 number for anonymous complaints.
Massey declined to comment in the Times piece, but the Richmond, VA-based energy company disputed the allegations after the article ran.
"Clearly, something went wrong at Upper Big Branch. But we simply don't yet know what it was," Massey's statement read in part. "If there was improper conduct regarding operations and safety, there will be accountability. What we do know is this: accusations that Massey Energy is indifferent to safety could not be more wrong. Our company puts the safety of its members first—and always first."
Nice slogan: Safety First! Who could argue with that! Sadly, with 29 lives lost, it's no longer about slogans or safety. It's damage control.
Of course, the goal of a good safety program is measureable outcomes, not catchy phrases. In coal mines, safety is measured by quantifiable numbers such as a lack of fatalities, or a reduction in workplace injuries and job-related chronic diseases such as black lung. In hospitals, safety is measured in the reduction of hospital-acquired infections, medication errors, and other preventable mistakes that the Institute of Medicine once said needlessly kill about 100,000 patients each year.
Good hospitals, like good coal mines, have a deeply imbued culture of safety that goes beyond mere words. Safety culture never rests. It always strives to protect workers–and patients—from dangerous conditions. It empowers employees to speak out against hazardous conditions or practices without fear of retribution. Good managers at coal mines—and hospitals—understand that lives are at stake.
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Independence Blue Cross will offer $47 million in pay raises for primary care physicians in its southeastern Pennsylvania provider network, including $33 million to incentivize better patient outcomes, the Philadelphia-based health insurer announced today.
IBC said the added money will allow the 1,800 primary care physicians in that network to double their incentive earnings over last year's program by providing better care to IBC's commercial and Medicare Advantage HMO and Point-of Service members. The changes in reimbursement will attract and retain high-performing primary care physicians, IBC added. At the same time, IBC said it is “modifying” reimbursements for costlier, episodic, specialty care services, which the insurer said can often be avoided with regular, effective preventive care.
"IBC is a strong advocate for changing the healthcare system to enhance the affordability and quality of healthcare," IBC President/CEO Joseph A. Frick said. "Real and sustainable healthcare reform includes collaborating with our physician and hospital partners by enhancing incentives for providing safer, higher quality, and more cost-effective care—rather than just more care. That's what these changes are all about and they demonstrate our commitment to help people stay well, and encourage better coordination of care when our members become ill."
Beginning July 1, IBC's compensation for primary care physicians will include three components:
Base reimbursement. IBC will raise pay to network primary care physicians by an average of 10%—the largest pay raise IBC has given in the last five years.
Incentives for improving clinical quality outcomes while improving patients' education and access to care. The Quality Incentive Payment System will reward primary care physicians who improve the quality of care compared to national standards of quality care through proper blood sugar testing, cholesterol screening, eye exams for diabetics, and other measures such as breast, cervical, and colorectal cancer screenings, childhood and adolescent immunizations, and asthma and cardiovascular management. The incentives reward physicians' performance on process measures and quality outcomes compared to peers in the same primary care specialties. The highest performing physicians get the highest reimbursements.
Incentives for managing medical costs. The supplemental money incentivizes physicians to improve care coordination, and to take the time to discuss with patients the risks and benefits of certain procedures or treatment, and to help patients understand the value of the treatment–for example, understanding the benefits of non-invasive, conventional treatment versus a diagnostic or invasive procedure.
Johnson & Johnson subsidiaries Ortho-McNeil Pharmaceutical LLC, and Ortho-McNeil-Janssen Pharmaceuticals Inc. will pay more than $81 million to resolve criminal and civil whistleblower allegations that they promoted the off-label use of the epilepsy drug Topamax, the Justice Department announced today.
In a separate whistleblower settlement also announced today, DOJ said Schwarz Pharma Inc. will pay $22 million to resolve False Claims Act allegations that the company didn’t tell the Centers for Medicare and Medicaid Services that two unapproved products did not qualify for federal reimbursements.
Ortho-McNeil will plead guilty to a misdemeanor and pay a $6.14 million criminal fine for the misbranding of Topamax in violation of the Food, Drug and Cosmetic Act. The Food and Drug Administration approved Topamax as an anti-epileptic drug, but not for psychiatric use.
The government alleged that Ortho-McNeil Pharmaceutical promoted Topamax for off-label psychiatric uses through a “Doctor-for-a-Day” program that hired outside physicians to visit other healthcare providers and encourage prescribing Topamax for unapproved uses.
Ortho-McNeil-Janssen will pay $75.4 million to resolve civil allegations that their off-label promotion of Topamax caused false claims to be submitted to government healthcare programs for psychiatric uses that were not reimbursable. The federal share is $50.6 million, and the state Medicaid share is $24.6 million. The whistleblowers will get more than $9 million from the federal share.
Ortho-McNeil-Janssen Pharmaceuticals will enter a corporate integrity agreement with the Office of Inspector General of the Department of Health and Human Services. The settlement with Schwarz, now a subsidiary of Belgium-based UCB S.A., resolves allegations that the company submitted false quarterly reports to the government about the drugs Deponit, a nitroglycerin skin patch, and Hyoscyamine Sulfate Extended Release, an antispasmodic medication for stomach, intestinal, and urinary tract disorders. Federal prosecutors said Schwarz misrepresented the regulatory status of both drugs and failed to advise CMS that these unapproved drugs did not qualify for coverage under federal healthcare programs.
The federal share of the settlement is $12.2 million, and the state Medicaid share is $9.7 million. Two whistleblowers in the settlement will get $1.8 million.
Democratic Sen. Dianne Feinstein of California called on WellPoint Inc. to drop plans for premium pay hikes of as much as 39% on policyholders in her state after the health insurer reported a Fiscal 2010 first quarter profit increase of 51%.
Indianapolis-based WellPoint reported a net income of $876.8 million, or $1.96 per share, with total revenues of $15.1 billion, as profits from its consumer segment increased by 49%, to $326 million. WellPoint credited the solid quarter on enrollment growth of 0.5% and lower benefit expenses, owing to the relatively mild flu season.
"We are pleased with our membership growth in the first quarter, which was higher than we anticipated. We have grown significantly in the National Accounts market this year, reflecting that large customers continue to be attracted to WellPoint's broad and cost-effective provider networks, leading products and initiatives, and reliable customer service," WellPoint CEO/ President Angela F. Braly said in the profits report.
Feinstein said in a media release that the profits were evidence that WellPoint is not hiking up rates on customers due to economic need, as the company claims, but as part of a coordinated strategy to drive up corporate profits. Feinstein noted that WellPoint's profit increase came two weeks after news reports revealed that Braly received a 51% increase in her compensation last year.
"At a time when so many Americans are struggling to make ends meet in a tough economy, WellPoint is reaping a 51% increase in profits while simultaneously raising premium rates on hardworking California families by up to 39%. This is unconscionable," Feinstein said. "WellPoint's actions are a textbook example of the profits-above-all-else Wall Street mentality that has caused major hardship for millions of average Americans. It's time to break the profit-hungry habit."
WellPoint Inc. is the parent company of Anthem Blue Cross of California, which announced plans in February—in the middle of the national debate on healthcare reform—to impose rate hikes of up to 39% on 800,000 policyholders. The company has twice delayed the rate hikes because of sharp criticism.
"I call on WellPoint to cancel its plans to increase premium rates on policyholders in California until the time when there is a national Health Insurance Rate Authority in place to review whether these rate hikes are justified—and to protect policyholders from unfair corporate greed," Feinstein said.
Feinstein has introduced the Health Insurance Rate Authority Act of 2010, which would empower Health and Human Services to review and reject unfair premium rate increases. Rep. Jan Schakowsky (D-IL) has introduced a companion bill in the House.
Nearly half—44%—of primary care physicians received no additional compensation for on-call coverage, according to the Medical Group Management Association’s Medical Directorship and On-Call Compensation Survey: 2010 Report Based on 2009 Data.
In addition, 49% of nonsurgical specialists who answered Englewood, CO-based MGMA’s survey reported no additional compensation for on-call coverage, while 72% of surgery specialists received additional on-call compensation. Most survey respondents said the compensation was in the form of a daily or annual stipend.
The daily rate of on-call physician compensation varied greatly among specialties. Family practitioners with and without OB/GYN earned $110 and $100, respectively, per day. Neurosurgeons earned $1,671 daily. Ophthalmologists earned $500 in additional compensation per day while general surgeons earned $905 and urologists earned $283. The holiday rate for general surgeons was $3,000, and family practitioners received $588 per day.
"For many privately owned physician practices, the trend toward payment for on-call coverage is a positive one. Hospitals are faced with staff issues regarding who should receive pay and why, and are frequently called upon to develop justifiable rationale to support their decisions," said Kenneth T. Hertz, principal, MGMA HealthCare Consulting Group. "At the same time, as the trend toward physician employment within integrated systems increases, the separate on-call payment disappears from the formula and instead, is integrated in the overall compensation package."
On-call providers reported 971 hours worked per year for their annual stipend, 720 hours worked per month for their monthly stipend and 20 hours worked per week for their weekly stipend. Those who were paid on a daily rate were expected to be on call for a full 24 hours.
A federal grand jury has indicted two former hospital executives for their alleged roles in a bid-rigging conspiracy at New York Presbyterian Hospital, the Department of Justice announced.
The four-count indictment, handed up Tuesday in U.S. District Court in New York City, charges Emilio "Tony" Figueroa, a former director of facilities operations at NYPH, and Santo Saglimbeni, a former vice president of facilities operations at NYPH, with mail fraud and wire fraud.
Also indicted on the same charges were Michael Yaron and two companies owned by him, Cambridge Environmental & Construction Corp., which does business as National Environmental Associates, an asbestos abatement company, and Oxford Construction & Development Corp.; and Moshe Buchnik, president of two asbestos abatement companies. A third company, Artech Corp., owned by a relative of Saglimbeni, was also named in the indictment.
The indictment alleges that from 2000 through January 2008, Saglimbeni awarded asbestos abatement contracts, air monitoring contracts, and general construction contracts to Yaron, Buchnik and their companies at the same time that Saglimbeni sought and received cash kickbacks from the two men. The kickbacks were funneled to Saglimbeni through Artech, a company Saglimbeni created in a family member's name to conceal kickbacks, the indictment alleges.
In addition, between June 2001 and June 2006, Saglimbeni and Figueroa allegedly awarded contracts to install and repair the heating ventilation and air conditioning systems at NYPH to a co-conspirator's company in return for cash kickbacks and other gifts. Saglimbeni and Figueroa are also charged with mail fraud, because they allegedly had NYPH mail a payment on the fraudulently-awarded contract to a co-conspirator's company in May 2005, the indictment alleges.
The mail and wire fraud charges with each carry a maximum penalty of 20 years in prison and a $1 million fine.
The charges are part of an ongoing federal antitrust investigation of bid rigging, fraud, bribery, and tax-related offenses relating to construction, maintenance, and service contracts administered by the Engineering Department of Mount Sinai Medical Center and School of Medicine and the Facilities Operations Department and the Engineering Department of NYPH. To date, eight people and three companies have pleaded guilty to charges arising out of this ongoing investigation. Three other people were indicted on related charges on March 31.
