Is your visit to the "ER" driving up health care costs?

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In Houston, your closest Emergency Room is pretty darn close.

It's part of a hot national trend of building freestanding ERs. They are more convenient and usually speedier than the traditional ER that is attached to a hospital. They also cost more.

Houston already has a bunch, according to a recent piece in Kaiser Heath News (KHN).

Nowhere is the trend hotter than in the Houston metropolitan area, with 41 freestanding ERs and 10 more under development. Counting the freestanding ERs and traditional hospital-based ERs, greater Houston has 150 emergency rooms — twice the number as Greater Miami — even though its population is only slightly bigger, according to a KHN analysis.

These facilities are often co-owned by physicians and are "often located near high-end shopping centers, … target consumers with private insurance [and] bill like regular emergency rooms." 

The KHN piece analyzes the costs to the health care system associated with these new facilities. They can "charge insurers double or triple the amount per patient as an urgent care center or doctor's office." Some patients are using them for routine care that would cost less in their physician's office.

Why?

Insurers have little power to stop patients from using the facilities because by state law, they must pay for ER coverage anytime a patient perceives they have an emergency, regardless of whether that turns out to be the case. For that reason, the freestanding ERs have no need to contract with insurers and offer discounts.
The main reason they are more costly than urgent care is that they charge a "facility fee" on top of a fee for the physician's time—just like traditional ERs. The facility fee was originally intended as a way to help hospitals recoup overhead costs including 24-hour staffing, administration and equipment. 

Price and cost are considerations every health care consumer will sooner or later need to address. 

If the Affordable Care Act is going to make care, well, "affordable," health systems and physicians will need to be more assertive in educating patients about using the right facility at the right time to receive the right care.

That way, everyone can win.

Original source: Columbia Journalism Review

 

Learn how to take care of kids

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"This is not how Mom does it."

A new PSA video on "Babsitting Basics" from the American Red Cross shows just what can go wrong when the babysitter is, well, clueless.

The PSA promotes an online course that covers safety, health care and how to talk to parents when something goes wrong.

Lots of hospitals offer Babysitting 101 courses. It's a great community-building opportunity — and a great way to build confident young babysitters and put anxious parents at ease.

Do you know how to calm a crying baby? Or how to handle a conflict between two children? How about what to do if a child has a tummy ache? You can learn how to help kids have fun, while keeping them safe and following household rules with Babysitting Basics online course and Babysitter's Training classroom course from the Red Cross.

Source: Adweek

 

"I miss the intensity of life"

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Alzheimer's is a powerful and emotional disease. You are forced to watch a loved one literally fade away.

A video profile of Stephen Hume, created by my good friends at First Priority Media, shows that Alzheimer's is not just an old age disease. Very poetically and poignantly, Hume describes how his world is changing, shrinking and losing its "intensity."

"[Our doctor told us] your world will progressively shrink until it becomes the size of the chair you're sitting in."

Realizing he will eventually lose his ability to connect with his wife, he pays it forward with praise, appreciation, respect and love for those who will be tasked with looking after him.

"As caregivers, please know how important what you do is and how truly lonely this disease would be without you."

This line alone illuminates the power and importance of an engaged patient as well as their family and friends. Taking care of our health and medical conditions is a team sport. Having someone by your side — as your coach and advocate — can mean the difference between living and simply surviving.

The film, "The Intensity of Life," was part of the American Brain Foundation's 2013 Neuro Film Festival that aims to raise awareness about funding for brain research. It was done for the Alzheimer's Association of Rhode Island.

 

This film has been entered into the 2013 Neuro Film Festival from the American Brain Foundation at www.NeuroFilmFestival. com. Let's put our brains together to cure brain disease. Visit CureBrainDisease.org.

We're No. 1 (or at least No. something)

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The rankings are out.

Forget the AP's Top 25 college football poll. The big money ranking is the 2013-14 best hospitals list from U.S. News & World Report.

With their new U.S. News numbers in hand, hospitals are clamoring to splash the good news in ads, banners and articles (of course some are trying to explain why they dropped a spot or two). 

Elisabeth Rosenthal has a great piece in The New York Times ("The Hype Over Hospital Rankings," July 27, 2013) that examines what the rankings mean to patients and the cost of health care.

“Nearly every hospital has a banner out front saying they’re a ‘top hospital’ for something in some rating system,” said Dr. Nicholas Osborne, a Robert Wood Johnson Clinical Scholar at the University of Michigan. “Those ratings have become more important for hospital marketing than for actually helping patients find the best care.”

Every patient wants the best care from the best doctor at the best hospital. But what they really expect is the best care they can get from the best doctor available at the best hospital that is close to home. And they want it right now.

Indeed, with thousands of good hospitals across the nation, the best selling point for routine medical care may simply be convenience: some studies show that patients prefer nearby hospitals with worse results over ones with better outcomes farther away.

Health care is expensive. Dollars are hard to come by. Health care marketing should be educating patients and their families to help them become more active and engaged in their care. Because a more active and engaged patient will ultimately be a healthier patient — and that will drive down costs. 

Awards make hospital administrators and boards happy (and marketers, too, because they get a little more money to run ads). Great, compassionate care makes patients happy.

And convenience will win almost every time.