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ER visits rising despite Affordable Care Act

Source:
By
Michael Sandler  | January 17, 2015
Modern Healthcare

Patient emergency room visits rose sharply at hospitals with the highest ER use in 2013, the last year before the Affordable Care Act's insurance expansion kicked in, according to Modern Healthcare magazine's latest By The Numbers. And many of the hospitals with the busiest ERs in 2013 are reporting even higher volumes in 2014 despite the nation's declining uninsured rate.
“We're seeing a failure of access to care,” said Dr. Howard Mell, a practicing ER physician in northeast Ohio and spokesman for the American College of Emergency Physicians.

Millions of Americans now have medical coverage, but because primary-care doctors are closing their offices and not accepting Medicare patients, even mild health crises are being pointed toward the ER, Mell said. “Obamacare isn't failing, but we knew it wouldn't handle ER visits,” he said. The nation's 24 busiest emergency rooms reported 18.7% more visits in 2013 over 2012, according to data supplied by the American Hospital Association for the By The Numbers list. And it appears that number will continue to rise in 2014.

At Lakeland (Fla.) Regional Health Medical Center, for instance, more than 200,000 people visited its emergency room in 2014, nearly 7% more than the 187,425 in 2013, when it ranked 16th on the BTN list.Florida did not expand Medicaid. And Polk County—the region served by Lakeland—had a 27.2% uninsured rate in 2012.“These factors make it difficult to isolate and statistically correlate the impact of the ACA,” said Janet Fansler, Lakeland's chief operating officer. To meet high demand, the hospital has reorganized its ER from two service areas (critical and noncritical) to nine care pods: one for triage, one for children, six for adults and one for fast-track patients, Fansler said. The hospital now also uses a registered nurse “bed-traffic controller” and pod nurse supervisors to keep patient care moving.

Even some hospitals on the busiest ER list that saw ER visits fall in 2013 are reporting an uptick in 2014. Children's Medical Center in Dallas, ranked 24th, saw its ER visits drop by 5.5% to 163,630 in 2013. But visits rebounded 5.6% to 172,839 in 2014, according to COO Doug Hock. He blamed timing and the flu season's severity for the decline in 2013, and noted the ACA has had little effect on Texas in 2014. The state also failed to expand Medicaid.

Analysts say that trend of rising ER visits across the nation will continue until the newly insured become more familiar with the process. “More people have insurance, but the cultural norm has been to wait until they're sick to seek care,” said Dr. Mitchell Morris, a provider consultant at Deloitte Consulting. “As they get educated, ER use will go down over a period of years.”

Follow Michael Sandler on Twitter: @MHmsandler

CHS to Participate in the J.P. Morgan Healthcare Conference


Community Health Systems to Participate in the J.P. Morgan Healthcare Conference

Franklin, Tenn.--(Business wire)-- Jan. 6, 2015-- Community Health System, Inc. (NYSE: CYH) today announced that management will participate in the 33rd Annual J.P. Morgan Healthcare Conference to be held January 12-15, 2015, at the West St. Francis Hotel in San Francisco.

The investor presentation will begin at 4:30 p.m. Pacific time, 6:30p.m. Central time, on Tuesday, January 13, 2015, and will be available to investors via a live audio webcast. A link to the broadcast can be found at the investor relations section of the Company’s website, www.chs.net, and a replay will be available for 30 days using the same link.
www.chs.net.

Community Health Systems, Inc. is one of the largest publicly-traded hospital companies in the United States and a leading operator of general acute care hospitals in communities across the country. Through its subsidiaries, the Company currently owns, leases or operates 206 affiliated hospitals in 29 states with an aggregate of approximately 31,000 licensed beds. The Company’s headquarters are located in Franklin, Tennessee, a suburb south of Nashville. Shares in Community Health Systems, Inc. are traded on the New York Stock Exchange under the symbol “CYH.” More information about the Company can be found on its website at
CT
Source: Community Health Systems, Inc.
Community Health Systems, Inc.
W. Larry Cash, 615-465-7000
President of Financial Services and Chief Financial Officer
or
Michael J. Culotta, 615-465-7037
Vice President - Investor Relations

Franklin, Tenn.--(Business wire)-- Jan. 6, 2015-- Community Health System, Inc. (NYSE: CYH) today announced that management will participate in the 33rd Annual J.P. Morgan Healthcare Conference to be held January 12-15, 2015, at the West St. Francis Hotel in San Francisco.

The investor presentation will begin at 4:30 p.m. Pacific time, 6:30p.m. Central time, on Tuesday, January 13, 2015, and will be available to investors via a live audio webcast. A link to the broadcast can be found at the investor relations section of the Company’s website, www.chs.net, and a replay will be available for 30 days using the same link.

U.S. Has A Surgeon General, For The First Time In 17 Months

Source:
MPR News
Bill Chappell
NPR
December 15, 2014
mprnews.org

A job that's been open in President Obama's administration since July of 2013 was finally filled Monday, as the Senate voted to confirm Vivek Murthy as America's new surgeon general.
The tally was 51-43, ending a confirmation process that began after Obama nominated Murthy to the post in November of 2013 — yes, that's one year ago. "Dr. Vivek Murthy is an MD and an MBA," NPR's Tamara Keith reported in March. "He practices and teaches at Brigham and Women's Hospital and teaches at Harvard Medical School. He co-founded a clinical trials company, an HIV education organization and Doctors for America, formerly known as Doctors for Obama. And he isn't even 40 yet." But the National Rifle Association was unhappy with the choice of Murthy, citing tweets he had written criticizing both guns and the NRA. "The NRA told lawmakers a vote for Murthy would be scored against them," Keith reported. "It seems the fact that question could even be asked was enough to put Murthy's nomination on ice." The NRA also viewed Doctors for America as being against guns.
"The group advocated for the president's health care law, but that's not what got Murthy hung up in the Senate," NPR's Mara Liasson reports today for All Things Considered. "Doctors for America also supports stricter gun control laws, including background checks, mandatory safety training and banning certain semiautomatic weapons." Murthy has said he plans to target obesity, not guns, if he were to be confirmed. And his colleagues, including Dr. Chris Lillis, the Virginia state director for Doctors for America, have also defended him.
"Dr. Murthy's views that he expressed many years ago is in complete congruence with the American College of Emergency Physicians, the American College of Physicians, the American College of Surgeons, and the American Academy of Pediatrics," Lillis tells Liasson. "He said nothing different than what the rest of the public heath establishment has said." As Liasson notes, Murthy's confirmation was also endangered because during the run-up to last month's midterm elections, "too many Democrats up for reelection in red states... said they would join Republicans and vote no." Two things changed for Murthy to be confirmed. First, with Congress now in a lame-duck session, he got more support from Democrats. "Murthy also got an unexpected assist from conservative Republican Sen. Ted Cruz," Liasson says, "whose last-minute unsuccessful gambit to stop President Obama's executive actions on immigration gave outgoing Senate Majority Leader Harry Reid a parliamentary opening to push through a bunch of stalled nominations, including Murthy's." Since former Surgeon General Regina M. Benjamin left the post in the summer of 2013, it's been filled on an interim basis by Rear Admiral Boris D. Lushniak.
Update at 6:57 p.m. ET: White House Statement:
We've received this statement from President Obama on Murthy's confirmation:
"I applaud the Senate for confirming Vivek Murthy to be our country's next Surgeon General. As 'America's Doctor,' Vivek will hit the ground running to make sure every American has the information they need to keep themselves and their families safe. He'll bring his lifetime of experience promoting public health to bear on priorities ranging from stopping new diseases to helping our kids grow up healthy and strong. Vivek will also help us build on the progress we've made combatting Ebola, both in our country and at its source. Combined with the crucial support for fighting Ebola included in the bill to fund our government next year, Vivek's confirmation makes us better positioned to save lives around the world and protect the American people here at home."
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