Tuesday, August 18, 2015

Hospital wait times, noise levels and other information posted online through Yelp

See the Washington Post article: "You can now look up ER wait times, hospital noise levels and nursing home fines on Yelp" by Lena Sun (August 5, 2015).

The article reports on the emphasis being put on healthcare services by Yelp, with the help of ProPublica, a nonprofit news organization based in New York.

ProPublica compiled the information from its own research and the Centers for Medicare and Medicaid Services. The data is for 4,600 hospitals, 15,000 nursing homes, and 6,300 dialysis clinics in the United States, and it will be updated quarterly.

What's the big deal?  According to the article: "Much of the information about hospitals, for example, is available on Medicare's Hospital Compare Web page. But Yelp executives say the information is sometimes difficult to find and hard to sift through."

This data will be in addition to the Yelp star rating system based on consumer reviews: "Consumers have always been able to review medical businesses using Yelp's star-rating system. Those ratings will continue to be based on consumer reviews. What's different now is the additional data that will pop up."

How are hospitals reacting?  Let us know your thoughts.

See the Washington Post article: "How hospitals hope to boost ratings on Yelp, HealthGrades, ZocDoc and Vitals" by Lena Sun (June 3, 2015).

See how one "reputations manager" is addressing the online data, "after several months of reviewing comments in real time on nearly a dozen Web sites, including Healthgrades.com, ZocDoc.com and Google Plus, as well as Facebook and Twitter".

So to answer the question What's the big deal? consider this point about expectations:

"But putting hospitals and doctors into the online rating world is fraught with possible problems. For one, patients and doctors have widely differing expectations."

"When patients are asked to rate how doctor quality should be measured, clinical outcomes, such as getting cured of a disease, rarely come up, said Lisa Suennen, who advises health-care companies. Patients talk about whether a doctor or nurse was kind to them, or whether their experience was fast and convenient. It’s assumed that the doctor is going to treat their illness or condition."

"Physicians, on the other hand, go straight to the clinical. The cancer is gone. Or the person can walk again. They don’t even talk about the other stuff, Suennen said. The two groups “are really disconnected.”

Consider this: The healthcare system featured in the Washington Post article reported about two negative reviews a day. (A score of 3 or lower, out of 5). Some days there would be none. Then there was a week with seven negative reviews, all for doctors who hadn’t been rated before.

"One scored 1.9 out of 5 because the patient waited more than 45 minutes and had only a few minutes with the doctor. Another review complained about a rude receptionist. Most negative ratings have to do with wait times and scheduling."

The article discussed how a system may push out positive comments and how the Cleveland Clinic has developed its own rating system in addition to the patient satisfaction survey required by Medicare.

"Even the Cleveland Clinic, one of the country’s most prominent medical centers, felt the digital pressure. It rolled out its own doctor rating site in April for more than 1,550 doctors. Responses are drawn from a patient satisfaction survey required by Medicare, which many hospitals use internally to target areas for improvement."

"Unlike some sites that rely on one or two reviews, Cleveland Clinic displays only ratings for doctors who have been reviewed by at least 30 patients. Ratings — one to five stars — are updated weekly and include negative as well as positive comments."

And consider this strategy of creating 37 categories, including office staff and bedside manner. “If someone writes that ‘Dr. Smith seems very smart but he only spent 3 minutes with me,’ ” the doctor scores a 5 for competency but maybe 3 on beside manner.

Monday, August 3, 2015

Notice Act presented to President - written notice to be required for observation status of more than 24 hours

The Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act, introduced as H.R. 876 on February 11 of this year, made a quick run through the legislative process, having passed the House on March 16 after committee consideration and passing the Senate on July 27.  It is now waiting the President's signature. This action follows close on the heels of the CMS proposed changes to the two-midnight rule.

Becker's Hospital Review posted "9 things to know about the Notice Act on July 29".  Follow the link to the original article written by Erin Marshall.  The text follows:

1. The legislation calls for hospitals to provide written notice to patients who are in the hospital under observation status for more than 24 hours. Hospitals would need to provide notification no later than 36 hours after the time observation status begins.

2. The written notice must include why the patient was not admitted to the hospital and the financial implications of observation status, including subsequent eligibility for coverage for a skilled nursing facility.

3. Medicare does not cover skilled nursing facility stays unless the patient was admitted as an inpatient for a minimum of three nights. In some cases, physicians reclassify people as inpatients when more than observation is needed. Medicare patients who are not reclassified have to either forgo SNF care or pay for it themselves, regardless of the length of their hospitalization.

4. Medicare Part A pays for inpatient stays. If you are hospitalized on observation status, payment by Medicare is under Part B, which covers physician and outpatient services. Patients without Part B coverage are often left with the bill for observation status, even though there was not a perceptible difference in the type or level of care they received in the hospital.

5. If the NOTICE Act is signed into law by President Obama, hospitals across the nation will have to comply within 12 months.

6. A number of states, including Connecticut, Maryland, New York, Pennsylvania and Virginia, already require hospitals to give patients notice about observation care.

7. There were an estimated 1.5 million observation stays among Medicare beneficiaries in 2012. The number of observation stays increased 100 percent from 2001 to 2009, likely because of financial pressure on hospitals to reduce potentially preventable readmissions of inpatients within 30 days.

8. Under the NOTICE Act, hospitals would be required to notify patients about observation status, but patients can only change that status by swaying a physician or the hospital to do so. Yale-New Haven (Conn.) Hospital CEO Marna Borgstrom noticed that after learning they were under observation care, many patients left the hospital against medical advice.

9. The NOTICE Act is separate from CMS' two-midnight rule, for which it recently proposed updates as part of the 2016 Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System proposed payment rule.