Varying Hospital Readmission Rates Not Explained By Socioeconomic Status
According to new research reported at Modern Healthcare, some of the issues "often" blamed for poor readmission rates to hospitals actually aren't correlated: Socioeconomic status, care access and insurance coverage differences can't explain why some hospitals have higher rates.
Modern Healthcare:
Socioeconomic Status Only Modestly Influences Readmissions, Yale Study Finds
The factors often blamed for poor hospital readmission rates—socioeconomic status, access to care and insurance coverage—do not account for why readmissions are higher at some hospitals than others or why Medicare-Medicaid dual eligibles are readmitted more often, new research shows. Yale University researchers led a team that compared readmissions among patients diagnosed with three major acute conditions who covered by both Medicare and Medicaid to those with Medicare alone for an article published in JAMA Health Forum on Friday. (Gillespie, 1/28)
In news about health insurers —
Georgia Health News:
Judge Extends Order, Keeping Northside Patients In Anthem Network Till Spring
A Fulton County judge Friday extended a reprieve in the contract dispute between Northside Hospital and Anthem until April 15, delaying for a second time the need for thousands of patients to switch doctors. Northside patients who have Anthem insurance have been caught in the middle of the battle between the insurer and hospital system for months. They were facing the risk that their in-network insurance coverage for Northside hospitals and doctors would end at midnight Monday. The decision by Judge Rachelle Carnesale extends the temporary restraining order put in place earlier this month and includes a provision that Anthem and Northside have a “judicially hosted” settlement conference by Feb. 25. (Miller, 1/29)
Modern Healthcare:
Aetna Wrongfully Denied Proton Therapy Claims, Court Rules
Aetna wrongfully denied coverage of cancer patients' proton therapy after the insurer tried to prove that the treatment was experimental and investigational, a federal judge ruled. Aetna's ambiguous definition of "medically necessary" failed to justify its exclusion of proton therapy for treating non-metastatic breast or prostate cancer in adults, Judge Kenneth Marra ruled in a summary judgment from the U.S. District Court for the Southern District of Florida on Thursday. The lawsuit will now proceed to class certification that could expose Aetna to liability for a group of patients with similar complaints. (Kacik, 1/28)
Modern Healthcare:
BCBSA Invests In Digital Health Savings Account Startup
Digital benefits startup First Dollar raised $14 million led by Blue Cross Blue Shield Association's venture arm, with participation from Next Coast Ventures and Meridian Street Capital, the company announced on Thursday. First Dollar, which offers a digital wallet consumers can use to spend tax-advantaged cash like Health Savings Accounts, adds the Series A round to cash from angel investors Firefly Health CEO Fay Rotenberg, Bright Health Group chief technology officer Brian Gambs, RPM Ventures Managing Director Marc Weiser and more. The Austin-based company said it has raised $19 million in total venture funding. (Tepper, 1/28)
In other health care industry news —
Modern Healthcare:
ThedaCare Scraps Lawsuit To Prevent Employees From Leaving For Ascension
ThedaCare has halted its attempt to get a court to block seven employees from leaving to work at a competitor, the Neenah, Wisconsin-based health system announced Friday. The case against Ascension Northeast Wisconsin faced an uphill battle after a judge lifted an temporary order blocking the workers from quitting ThedaCare's flagship hospital for the same positions less than seven miles away at St. Louis-based Ascension's Appleton facility. ThedaCare's attorney filed a voluntary dismissal notice in Outagamie County Circuit Court on Friday. (Bannow, 1/28)
Philadelphia Inquirer:
Home Health Care Shortages Have Families Struggling
A survey this month of 122 members of the Pennsylvania Home Care Association found that their nonmedical care worker staffs have declined by a quarter since the beginning of 2020 and skilled medical care workers by 20%. More than 90% of providers surveyed said they had declined requests for care since 2020 due to staff shortages. Some home health workers have found more lucrative jobs and may never return, said Denise Tyler, an expert on aging policy and long-term care with the nonprofit research institute RTI International. (Laughlin, 1/31)
