News briefs: JCAHO hospital standards; advance directives; medical costs; ANA loses two states
News briefs
JCAHO to rework hospital standards
The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) announced its decision to rework outdated hospital standards, after the results of an American Hospital Association study found that in some hospital departments an hour of patient care translated into an hour of paperwork. Up to 85% of the standards that hospitals must meet in order to be accredited have not been revamped in seven years. JCAHO’s best intentions may be difficult to implement, however, as roughly half of its standards were written to comply with Medicare’s condition of participation, and accordingly, JCAHO standards will have limited room for reworking and require government approval for substantial change.
Few home care patients have advance directives
A study conducted and sponsored by the Rochester (NY) Individual Practice Association and Blue Cross found that less than 10% of home care patients with chronic diseases such as heart failure have advance directives, and that in general, people are not be referred to hospice care early enough. Results showed that 40% of referred patients died within one week of admission. The survey also found that the majority of institutions ask patients at the onset of care about advance directives. The Rochester Community End-of-Life survey sampled 72 area hospitals, home care agencies, hospices, diseases management programs and skilled nursing facilities on such matters as advance directives, hospital referrals, and pain management.
Hospitals forcing medical costs up
Thanks to hospitals’ demands for dramatically higher payments from insurers, Americans are seeing some of the most rapid surges in medical costs in recent years. In the first quarter of last year, consumers saw a 10% to 15% increase in medical costs as insurance companies attempt to pass along their costs to consumers. Up until recently, the average annual increase over the past 10 years averaged between 5% and 6%. As more hospitals are becoming increasing powerful within a region, thanks to an industry-wide pattern of mergers and acquisitions, they are using their newfound power to demand higher payments from insurance companies and dropping those who refuse to pay.
Some NY hospitals have won double-digit increases in payments, while those in certain part of WI have asked for 40% to 60% payment increases for some services. Meanwhile, hospitals in Chicago, Portland, OR, and Orange County, CA, have severed ties with insurance carriers that refused to meet the new price scale. Hospitals are blaming a payment hike freezes for their now-sudden increases. Escalating the problem is a rising cost in prescription medications that rose nearly 19% last year, and more widespread use of costly diagnostic treatment and equipment.
Check caller ID, advises JCAHO
Several home care organizations have received calls from an individual falsely claiming to be affiliated with the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). The individual is asking organizations for information on hourly rates, productivity levels, and the number of revisits and admissions. Please be advised that the caller is not affiliated with JCAHO.
ME, MA leave ANA
The Maine and Massachusetts nurses’ associations have voted to leave the American Nurses Association (ANA), saying that the national group is too moderate. They are the first two state nurses associations to leave the ANA since 1995, when the California Nurses Association left. Both votes occurred in April, with the Maine group voting 259-31 to leave and the Massachusetts Nurses Association voting 3,105-656 to split. The result of the two departures will mean more than $1.1 million lost in dues.
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