Critical Path Network: News Briefs

Demand for beds expected to increase

Bed management likely will become an even more critical issue for access managers, with demand for hospital beds expected to increase by as much as 46% in the next 25 years.

A study published recently by Solucient, a health care business research group, says the increase of an additional 238,000 beds is expected to result from long-term demographic shifts in the U.S. population, which could drive demand for inpatient acute care through 2027.

The long-term forecasts also show that total acute care admissions are projected to increase by 13 million cases during the same time frame, a 41% jump from the current number of national admissions. The aging of the baby boom generation, increased life expectancy, rising fertility rates, and continued immigration are all likely to contribute to the 25-year growth in inpatient care, according to the study. For more information, visit

Final OPPS rule increases spending

The 1,000-page final outpatient prospective payment system rule, which took effect in January, provides the congressionally mandated inflationary update and increases overall spending but still pays hospitals only 83 cents for every dollar spent on outpatient care, the Chicago-based American Hospital Association (AHA) points out.

The rule gives the mandated 3.5% increase, but the net effect of all provisions in the rule results in a 3.1% increase from last year for urban hospitals and a 6.2% increase for rural hospitals, according to a report in the on-line service AHA News Now.

The rule does not include a pro rata reduction in pass-through payments for certain new and high-cost devices, drugs, and biologicals. It lowers the outlier threshold from 3.5 to 2.75 times the ambulatory payment classifications amount, enabling hospitals to reach the outlier threshold sooner. Outlier reimbursement will drop from 50% to 45% of costs above the threshold amount, however.

Emergency care crisis indicated by AZ survey

A statewide survey of recent emergency department (ED) visitors sponsored by the Arizona Hospital and Healthcare Association points to an emerging crisis in the availability of and access to emergency treatment in the state.

The public opinion poll of 925 residents shows that 82% said nonemergency use of EDs is a problem, while 95% said many people are using hospital EDs because they have nowhere else to go for treatment.

Some 88% of those who received emergency care in an Arizona hospital in the past year reported being either very or generally satisfied with the treatment they received, regardless of whether they were rural or urban residents, or whether they were Hispanic. Of those who were dissatisfied, long waits were the most-cited reason. Also, rural residents are considerably more likely (61%) than urban dwellers (44%) to see the availability of emergency care as a problem, the study showed. To see the full report, go to

HHS issues final report on regulatory reform

The final report of the Department of Health and Human Services Advisory Committee on Regulatory Reform features 255 recommendations to improve care delivery by reducing the regulatory burden on health care providers.

The recommendations address overly burdensome, and at times unnecessary, patient assessment tools; better coordination of the release of new requirements; clarification of rules governing emergency care; and more consistency and reliability from contractors that process Medicare claims and advise hospitals.

They also urge streamlined record-keeping and reporting requirements, such as the Medicare cost report. The committee, created last year, is composed of consumers, physicians, nurses, and other health care professionals. More information is available at

CMS proposes tracking hospital referrals to HHAs

The Baltimore-based Centers for Medicare & Medicaid Services has issued a proposed rule to require the collection of information on hospital referrals to home health agencies and other entities with which the hospital has a financial interest.

The purpose of the rule is to ensure that patients have an opportunity to make an informed choice of home health agency to which they are referred.

Once collected, the information will be made available to the public.

Hospitals are required to show a list of Medicare-certified agencies that serve the patient’s geographic area. They must indicate the agencies with which there is a financial interest, and hospital personnel are not permitted to specify an agency that must provide services.

To read the full text of the proposed rule, "Nondiscrimination in Post-hospital Referral to Home Health Agencies and Other Entities," go to: Select "title" in the search terms, and enter 11/22/2002 as the search date.