“With a liberal supermajority in Washington increasingly possible,” the pharmaceutical industry is “trying to buy up protection in the hopes that Democrats will go easier on them,” a Wall Street Journal editorial states, adding, “Money follows power, and obviously the drugmakers believe they need to reposition themselves politically with the prospect of a Democratic Congress and [Democratic presidential nominee Sen. Barack Obama (Ill.)] in the White House.”

“Most notable” are television advertisements funded by Pharmaceutical Research and Manufacturers of America that “salute” politicians who supported last year’s unsuccessful attempt to renew and expand SCHIP; many of the lawmakers targeted in the ads are up for re-election this year and all but three are Democrats, the editorial continues. In addition, while campaign contributions from the industry over the past six election cycles favored Republican candidates, now contributions to the two parties are about even, according to the editorial.

The Journal writes, “Big Pharma needs to ensure that government programs remain generous, and perhaps this explains the support for SCHIP expansion.” It adds, “The faster” the share of health care spending by government programs increases, “the faster drugmakers become giant government contractors with federal dollars filling their book of business.” However, “such short-term self-interest is a long-run threat” because Congress “will use its purchasing power, or sheer coercion, to force greater pricing conformity,” the Journal writes, adding, “These trends will only accelerate if Mr. Obama succeeds in enacting a government-financed public option like Medicare, open to everyone.” The editorial states, “The pharma lobby is only speeding up the likely arrival of federal price controls and formulary restrictions,” which is “a death sentence when pharmaceutical innovation already has a 10- to 20-year investment horizon” (Wall Street Journal, 10/29).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation.В  All rights reserved.

The New York Times on Sunday examined South Korea’s inclusion on the growing list of countries that engage in medical tourism. The South Korean government, along with clinics, is trying to attract medical tourists in an effort to provide needed income for some hospitals. In South Korea, medical fees for the country’s residents are determined by the government, but hospitals can negotiate fees with foreign patients on their own. In addition, the government hopes medical tourism will boost the economy by having patients vacation in the country post-procedure. South Korea has revised its immigration policies to allow foreign patients and their families to obtain long-term medical visas and also has changed its laws to permit local hospitals to join in ventures with foreign hospitals.

Although no government records indicate how many medical tourists come to South Korea hospitals, a survey of 29 hospitals in the country found that 38,822 uninsured foreign patients were treated between January and August, compared with 15,680 in 2007, according to the Korea Health Industry Development Institute. The survey also found that 25% of the patients were from the U.S. and 10% came from both China and Japan.

Yoon Dae-hyun, a psychiatrist at the Healthcare System Gangnam Center at Seoul National University Hospital, said some Koreans are worried that social inequality will result from medical resources and skilled workers migrating from public health care to better jobs assisting foreigners. However, he said that the effort to attract foreigners could inspire local hospitals to improve their services. “There isn’t much of a gap anymore between the good hospitals in Asia and the United States,” he said.

The article also profiled several medical tourists to South Korea and some of the country’s medical institutions (Sang-Hun, New York Times, 11/16).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

The Center for Healthcare Supply Chain Research and Wyeth Pharmaceuticals honored Ken Couch, President of Smith Drug Company, with the 2008 NEXUS Award for Lifetime Achievement at the recent HDMA 2008 Annual Leadership Forum in National Harbor, Maryland. The NEXUS Award is the industry’s highest honor, recognizing leadership, exemplary service and professional excellence in the healthcare industry and the community.

Over the past decade, Couch has been actively involved with HDMA and the Center, serving a previous term as Chairman of HDMA’s Board of Directors and a term as Chairman of HDMA’s Government and Public Policy Council. He also has been an engaged participant on several HDMA Committees, including the Executive Committee, the Federal Government Affairs Committee and the Investment Committee.

“Ken’s leadership, experience, knowledge and enthusiasm have been tremendous assets to the healthcare industry,” said John M. Gray, HDMA President and CEO, and the Center for Healthcare Supply Chain Research President. “The numerous accolades and awards he has received throughout his life for his work and dedication to excellence on behalf of patients, trading partners, employees, family and friends, further demonstrate why he is the recipient of this year’s NEXUS Award.”

Couch is an active business and civic leader in Spartanburg, South Carolina, and he believes strongly in giving back to his community and to the industry. Most recently, he was awarded the honorary Doctor of Humane Letters from Wingate University. Additionally, he received the Morgan Award from the United Way of Piedmont for his civic contributions.

During his impressive career, he has held positions as a pharmacist, Computer Systems Manager, Marketing Director and currently, President of Smith Drug Company, a division of JM Smith Corporation. Couch brings an invaluable perspective to the healthcare industry as a result of his diverse background.

“The Center and the NEXUS Award supporter, Wyeth Pharmaceuticals, Inc., are pleased to recognize Ken for this lifetime achievement award,” said Karen Ribler, Executive Vice President and COO, Center for Healthcare Supply Chain Research. “Ken truly defines the essence of this award – and we are delighted to spotlight his leadership, passion, service, and commitment to excellence in his profession and in our community.

About the Center for Healthcare Supply Chain Research

The Center for Healthcare Supply Chain Research, formerly the HDMA Research and Education Foundation, is a 501(c)(3) non-profit charitable organization that serves as the knowledge partner of the Healthcare Distribution Management Association (HDMA).The Center is committed to serving the healthcare industry by providing research and education specifically focused on priority healthcare supply chain issues. The Center’s mission is twofold: To conduct research and disseminate information that will enhance the knowledgebase, efficiency and effectiveness of the total healthcare supply chain; and to provide thought leadership to further enhance the safety and security of the healthcare supply chain through future focused study and programming.

About HDMA

The Healthcare Distribution Management Association (HDMA) is the national association representing primary, full-service healthcare distributors. Each day, the member companies of HDMA are responsible for ensuring that more than eight million prescription medicines and healthcare products are safely delivered to 145,000 pharmacies, hospitals, nursing homes, physician offices, clinics, government and other providers in all 50 states. This essential public health function is provided with tremendous efficiency, saving the nation’s healthcare system nearly $34 billion each year. HDMA and its members are the vital link in the healthcare system, working daily to provide value, remove costs and develop innovative solutions to deliver care safely and effectively.

Healthcare Distribution Management Association

A study presented Tuesday at the American Public Health Association’s annual meeting in San Diego looked at whether doctors subconsciously prefer white patients over black patients, which could explain some racial health disparities, Reuters reports. Previous research has shown that blacks receive poorer health care than whites, even when income, education level and insurance status are the same. Blacks also have disproportionate rates of some conditions, and reasons for the disparities have not fully been explained, according to Reuters.

The study, by researchers from the University of Washington, is based on results of more than 400,000 people who between 2004 and 2006 took an online test about their attitudes on race (Reuters, 10/28). The test, called the Implicit Association Test, was developed more than a decade ago by a UW professor to measure subconscious bias (Ho, Seattle Post-Intelligencer, 10/28). The study looks for subconscious signs of bias by asking the test-taker to complete a series of questions and tasks, such as having to quickly state whether photos of blacks and whites were positive or negative. Anthony Greenwald of the UW who created the test and helped with the study said, “We don’t call what these test show prejudice. We talk about it as hidden bias or unconscious bias, something that most people are unaware they even possess.”

Of the participants, about 2,500 identified themselves as doctors. Researchers found that most doctors in all racial and ethnic groups showed an “implicit preference over whites than blacks,” with the exception of black doctors who showed no preference for either race, Reuters reports (Reuters, 10/28). The preference for whites was more significant in male doctors than female doctors, and the bias was similar among the rest of the test-takers, who had a more than 70% unconscious preference for whites over blacks (Seattle Post-Intelligencer, 10/28).

Janice Sabin, the UW researcher who presented the study, said, “This supports speculation that subtle race bias may affect health care, but does not imply that it will,” adding that it is too early to determine whether there is a direct link between physician bias and the quality of care black patients receive. She added, “But we have to remember people are not racist if they hold an implicit bias,” noting, “People who report they have a medical education are not different from other people, and this kind of unconscious bias is a common phenomenon” (Reuters, 10/28).


An abstract of the study is available online.

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

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According to a new analysis from the Canadian Institute for Health Information (CIHI), 99% of the 103 Ontario hospitals participating in a 2008 patient safety survey reported that they had a formal hand hygiene policy in place, and just more than one-third of these (38%) established an auditing process to ensure that proper handwashing procedures are being followed. Hand hygiene is recognized in Canada and internationally as a top patient safety priority measure in preventing the spread of infections, and auditing is a key component in ensuring observance of hand hygiene policies.

Community hospitals were the most likely facility type to have a formal mechanism in place for auditing hand hygiene practices (47%), followed by teaching hospitals (35%) and small hospitals (19%). Among hospitals without formal inspection procedures, more than half (59%) reported that one will be developed in 2008, with full implementation planned for 2009.

“In recent years, limiting the spread of hospital-acquired infection has become a major focus of patient safety campaigns across the country,” says Dr. Michael Gardam, Medical Director at the University Health Network in Toronto. “The results of this survey offer a rare chance to see how these campaigns are changing the culture of Ontario’s hospitals and creating a safer environment for patients.”

Appointing experts in creating safe surroundings

Many Ontario hospitals have implemented hospital infection control programs, appointing professionals with infection prevention and control training and expertise. These professionals work with an organization to prevent health care – acquired infections by educating staff, planning and implementing infection control practices and evaluating existing policies and procedures. In 2008, 80% of hospitals reported having either a certified infection control practitioner (ICP) or a physician/doctoral professional trained in infection control as part of
their infection control program. Successful programs emphasize the importance of having both, and the survey showed this was the case in 42% of participating hospitals.

The presence of infection control experts varied by hospital type; all teaching hospitals reported that their program included a physician or doctoral professional trained in infection control, compared to 56% of community hospitals and 26% of small hospitals. A greater proportion of teaching hospitals reported that they have an ICP certified by the Certification Board of Infection Control as part of their infection control program compared to community and small hospitals.

Infection surveillance programs

Many studies show that active surveillance of hospital-acquired infections can help contain their spread. Of hospitals participating in the survey, 98% reported that they routinely track cases of nosocomial (hospital-acquired) infections within their hospital. Approximately three out of four hospitals (74%) reported that they most commonly use hospital-wide surveillance to routinely monitor the incidence of nosocomial infections, compared to targeted surveillance of specific areas of the hospital. These results varied by hospital type: small and community hospitals largely use hospital-wide surveillance (84% and 78%, respectively), whereas teaching
hospitals use hospital-wide (47%) and targeted surveillance (53%) equally.

Almost all hospitals indicated that they reported the incidence of “super-bug” infections,
either internally or publicly. At the time the survey was completed, 96% of hospitals indicated reporting for methicillin-resistant Staphylococcus aureus (MRSA), 95% for vancomycin-resistant enterococci (VRE) and 95% for Clostridium difficile (C-difficile). New mandatory reporting legislation enacted by the Ontario Ministry of Health and Long-Term Care means that as of September 26, 2008, public reporting of all C-difficile cases is mandatory in Ontario
health care facilities. VRE and MRSA cases will be reported publicly by December 30, 2008.

“Nobody wants patients to become more unwell while being treated in hospital,” says Dr. Indra Pulcins, Director of Health Reports and Analysis at CIHI. “Better information on current infection control practices and policies, as well as information about the incidence of hospital-acquired infections, will provide further direction for the development of new procedures into the future.”

Reusing single use medical devices

The appropriate use of reusable medical equipment can be critical in preventing hospital-acquired infections. Medical devices labelled by the manufacturer as single use are meant to be discarded after one use. In Ontario, some single use medical devices are allowed to be used more than once if reprocessing (sterilization) is done by a licensed operator. While the majority of Ontario acute care hospitals (87%) do not reuse these devices, the survey found that of the hospitals that permit reuse of the devices following sterilization, teaching hospitals are the most likely to do so (29%) compared to community hospitals (12%) and small hospitals (4%).

About CIHI

The Canadian Institute for Health Information (CIHI) collects and analyzes information on health and health care in Canada and makes it publicly available. Canada’s federal, provincial and territorial governments created CIHI as a not-for-profit, independent organization dedicated to forging a common approach to Canadian health information. CIHI’s goal: to provide timely, accurate and comparable information. CIHI’s data and reports inform health policies, support the effective delivery of health services and raise awareness among Canadians of the factors that contribute to good health.

Canadian Institute for Health Information

President Bush’s “efforts to reduce HIV infection and mortality rates through the President’s Emergency Plan for AIDS Relief have made the first real dent in Africa’s HIV/AIDS plight,” and the program’s success “should illustrate for the next administration the benefits that would come from creating a similar program to battle the rise of HIV infections in America’s inner cities,” Robert Gallo, director of the University of Maryland’s Institute of Human Virology, writes in a Washington Post opinion piece. According to Gallo, although PEPFAR has extended antiretroviral treatment to more than 1.7 million people around the world and helped HIV-positive women give birth to nearly 200,000 HIV-negative infants, in 2008, “some places in the United States, chiefly poor urban areas, are home to the same rising HIV/AIDS statistics as those of some Third World countries.”

Gallo writes that in light of recent CDC data about HIV/AIDS in the U.S., a “PEPFAR plan for America’s inner cities would help to neutralize and diminish the number of people contracting HIV and the number dying of AIDS.” He adds, “It would provide access to prescribed care and medical therapies so patients with HIV can live a normal lifespan.” Furthermore, an “effort to help these Americans, among our country’s poorest, could also strengthen U.S. international relations, sending a message to the world that America recognizes that it is not different from other countries and that we, too, have an HIV/AIDS pandemic.”

According to Gallo, a domestic strategy for HIV/AIDS similar to PEPFAR also would assist in the construction of clinical infrastructures for diagnosis and treatment in inner cities. He writes, “Federal and state officials have already allocated enormous sums to fight bioterrorism. But in the past seven years, more Americans have been the victims of HIV/AIDS than have been affected or killed by any bioterrorist attack.” Gallo adds that education “is the key to managing and preventing HIV infection” and that the U.S. “needs a program that can teach people about prevention and early detection.” He writes, “As long as adverse socioeconomic conditions prevail, those living in HIV/AIDS ‘hot spots’ without education about the disease and facing other life challenges — such as mental illness, drug abuse, homelessness and lack of health insurance — will be at risk even if we do develop an AIDS vaccine.”

Regardless of when such a vaccine is developed, Gallo writes that “we must actively address the growing HIV/AIDS pandemic in the United States.” He adds, “When an AIDS vaccine does become available, a program to reduce HIV infection in inner cities would ensure that our nation is educated and positioned to readily distribute the medicine, helping to put an end to this terrible disease. In the meantime, the program would help stabilize a growing HIV pandemic and stop the spread of HIV.”

Gallo writes, “Unless we develop a program to fight HIV infection in America’s inner cities, our urban centers will continue to face an even more daunting pandemic.” He concludes, “To improve the health of millions of Americans and reduce HIV infection rates, the next administration should craft and implement a PEPFAR plan targeting our inner cities” (Gallo, Washington Post, 11/16).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

That photo of your smiling kids on the refrigerator door might do more than just make you feel good; you might make healthier food choices after looking at it. A new study in the Journal of Consumer Research shows that positive moods can increase our ability to understand the big picture.

“A positive mood enhances efforts to attain future well-being, encourages broader and flexible thinking, and increases openness to information,” write the study’s authors Aparna A. Labroo (University of Chicago) and Vanessa M. Patrick (University of Georgia).

The researchers investigated the scientific basis for the simple practice of surrounding oneself with positive things. The first study presented identical statements to study participants. The statements in each set were preceded by either a smiley face or a frowny face.”The results revealed that simply associating a smiley with a statement resulted in the statement being construed at a higher, more abstract level.”

In follow-up studies, the authors induced positive and negative moods by asking participants to describe either the happiest or unhappiest days in their lives. They then filled out three different questionnaires to determine the level of abstract versus concrete thinking. All three questionnaires showed that people in a good mood thought more abstractly.

The authors explain that being in a good mood allows people to step back emotionally. “The research demonstrates that by signaling that a situation is benign, a positive mood allows people to psychologically distance themselves from the situation,” the authors write.

“Those in a positive mood not only adopt higher-order future goals and work harder toward attaining them, but also reduce their efforts when goals are proximal or concrete,” they conclude.

###

Source: Mary-Ann Twist

University of Chicago Press Journals

Health chiefs have been able to see first-hand how more than ВЈ2m of funding for the East of England Ambulance Service is helping to further shape patient services. Health chiefs have been able to see first-hand how more than ВЈ2m of funding for the East of England Ambulance Service is helping to further shape patient services.

The partnership between NHS South West Essex and the ambulance service has led to an agreement in funding for new vehicles, new recruits, training and equipment.

Simon Eatherton, the ambulance service’s general manager for south Essex, was joined by NHS South West Essex’s deputy chief executive and director of quality and nursing Barbara Stuttle on Tuesday afternoon to meet some of those being trained up by the ambulance service, and some new equipment they are using.

Currently training at the St John’s Ambulance centre in Rochford are 30 student ambulance paramedics who, when they complete their initial course in December, will be deployed to parts of the area covered by the primary care trust which includes Brentwood, Basildon, Wickford, Thurrock, and Tilbury.

Also included in the ВЈ2.5m funding is a new ambulance, response cars for Basildon, Thurrock and Billericay, an urgent suport vehicle, and improvements to Basildon station including a make-ready facility for vehicles.

Simon said: “We have to hit a tough Government targets including reaching a category A patient within eight minutes 75% of the time, and a less serious incident in 19 minutes, 95% of the time. Couple that with a high call demand because of things like population density, and it’s clear what measures have to be put in place to address patient needs.

“This led to key people from both organisations meeting on a regular basis this year, to identify how south-west Essex would benefit from more resources and how we could work together to do that. What has come out of it is very positive.”

Barbara has been out on an ambulance to see the kinds of work patterns and pressures resources are under. She added:”Fundamentally, patients in south-west Essex are entitled to the best possible care, with high clinical standards and up-to-the-minute resources.

“This collaboration with the ambulance service has involved a lot of hard work and determination, and seeing for myself the outcome of this joint working is very pleasing.”

Last week (Monday 20th-Sunday 26th October, 2008), the ambulance service responded to 778 calls from the south-west Essex area.

East of England Ambulance Service NHS Trust

House Speaker Nancy Pelosi (D-Calif.) is committed to passing in the next session of Congress legislation that would require physicians nationwide to adopt health information technologies and could include negative consequences to encourage providers to do so, according to one of her senior advisers, CQ HealthBeat reports.

Wendell Primus, senior budget and health policy adviser to Pelosi, on Tuesday at the Healthcare Information and Management Systems Society public policy forum said, “She believes very strongly that it’s a prerequisite, a foundation, upon which our health care system be built.” Primus added, “We’ll have a good Democratic [health IT] bill early” in 2009 that will make sure “every physician’s office is wired as soon as possible,” he said.

According to CQ HealthBeat, Primus later added, “You can have carrots or sticks” to encourage adoption of health care IT, and one strategy could be withholding Medicare payments from providers who fail to adopt the technology. Congressional Budget Office Director Peter Orszag at a Senate Finance Committee hearing in July suggested using negative consequences to spur health IT adoption among providers. Orszag said, “If you want to get to near universal health IT in the near future, meaning the next five years, it’s got to be the stick.”

Primus said congressional staffers currently are working on the measure. He added that the legislation likely will incorporate facets of a House bill (HR 6898) introduced in September by House Ways and Means Health Subcommittee Chair Pete Stark (D-Calif.), which includes penalties for providers who do not adopt the technology, and another House bill (HR 6357) introduced by Energy and Commerce Committee Chair John Dingell (D-Mich.) that does not include such penalties. Primus said that Pelosi will support health IT legislation moving forward whether it includes the penalties or not.

Predicting the Future
It is unclear when and how health IT legislation will be addressed in the next Congress because of the doubt surrounding a new administration and whether lawmakers will address larger health care reform, according to Primus (Weyl, CQ HealthBeat, 10/28). It still is unclear if health IT legislation next year will be a free-standing measure or part of a health care reform omnibus. Primus said that the main health care issues will be “access, cost-value and quality” and that they all could be addressed together. According to Primus, Pelosi believes health IT is an integral part of addressing all three (Noyes, CongressDaily, 10/28).

He said health IT “could move alone very early” but, “are we going to do health care legislation in one big bill or … incrementally?” (CQ HealthBeat, 10/28). Before they take up health IT legislation, Primus said that congressional leadership first must draft an economic stimulus package and address appropriations before the continuing resolution runs out in March (CongressDaily, 10/28). Primus said, “The health care agenda is going to be very difficult in a world with $700, $800 billion deficits” (CQ HealthBeat, 10/28).

U.S. Meeting EHR Order
In related news, HHS Deputy Secretary Tevi Troy in an interview with CongressDaily said the U.S. is “well on the way” to meeting a goal of providing at least half of the U.S. population access to electronic health records by 2014 that was part of an executive order issued by President Bush in 2004. Troy’s comments precede the final meeting of the Certification Commission for Healthcare Information Technology, a federal advisory panel established to monitor the challenges of implementing a national health IT system. CCHIT will be replaced with a $13 million public-private sector collaboration, Troy noted, which will continue the functions of CCHIT “no matter who wins the election.” He said CCHIT is “a very good model” and should be preserved by the new administration because it has been critical “to provide the right type of standards for interoperability and privacy protection” and encourage future adoption of health IT (CongressDaily, 10/28).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation.В  All rights reserved.

Some hospitals in Massachusetts receive payments from insurers that on average are about 15% to 60% more than payments for the same procedure at competing hospitals, even when there is no evidence that higher-priced care leads to better patient outcomes, according to a Boston Globe review of private insurance data. According to the Globe, an “ongoing Spotlight Team investigation of health care in [the] state found scores of payment disparities for routine procedures in which there is no obvious difference in quality.”

The Globe reports that the “payment pattern has become a driving force in the state’s galloping health care costs” and “raises hard questions about why certain hospitals and physicians receive premium pay for care that is no better than that of their competitors.” Health care executives say that the “dramatic payment gaps have emerged over the last decade as hospitals pushed, with varying levels of success, to offset federal budget cuts by boosting their income from insurance companies,” according to the Globe. The hospitals that receive the highest rates are those that “have the bargaining clout” — often “based on a powerful brand name and elite reputation” or geographical location — to “demand higher insurance payments,” the Globe reports.

The “resulting wide range of payments for the same services reflects a health care system in which deregulation and lax government oversight have allowed the hospitals with the most clout to extract big increases from insurers while everyone else falls behind,” the Globe reports. Charles Baker, president of Harvard Pilgrim Health Care, said, “The same service delivered the same way with the same outcome can vary in cost from one provider to the next by as much as 300%,” adding, “There is no other sector of the economy anywhere in this country in which that kind of price variability with no appreciable difference in service or product quality can sustain itself over time.” The growing payment disparities have not been subjected to public scrutiny because of confidentiality agreements included in contracts between insurers and hospitals.

Partners HealthCare
According to the Globe, “no company has thrived more … or has had more impact on the cost of medicine” in Massachusetts than Partners HealthCare, which in 1994 was established “to fight back against what its founders saw as the stinginess and lopsided power of insurance companies.” Partners was developed as a collaboration between two of the state’s most well-known hospitals — Brigham and Women’s Hospital and Massachusetts General Hospital — and became what some called “the ’800-pound gorilla’ of Massachusetts health care, able to bend insurers to its will,” the Globe reports.

However, while “Partners prospers, 24 Massachusetts hospitals are losing money,” the Globe reports, adding that many of those hospitals “would be profitable if they had even a fraction of Partners’ contract clout.” Massachusetts General and Brigham on average receive payments that are 30% higher than other non-pediatric state hospitals, according to data obtained by the Globe. Peter Markell, Partners CFO, said, “We were willing to take the risk of challenging payers,” adding, “If you are never willing to challenge them, of course they are going to jam it down your throat.”

National Trend
The Globe reports, “The growing dominance of Partners — and Children’s Hospital for pediatricians — is a microcosm of the national trend in the last 15 years, as government has increasingly allowed the market to decide what health care will be available and at what price.” During that period, “[h]undreds of unprofitable hospitals closed, while many others merged to gain more negotiating power with insurers, which by the mid-1990s, were aggressively denying claims and shortening hospital stays to hold down costs,” according to the Globe. Economists say that the clout of merged health care systems contributed to significant increases in medical inflation in the 1990s, and health care specialists “agree that the price run-up did not lead to a similar improvement in quality,” the Globe reports (Allen/Bombardieri, Boston Globe, 11/16).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.