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Dr. Donald Berwick

One of the great minds and motivators behind the national movement to improve health care quality is slated to become the next administrator of the federal Centers for Medicare & Medicaid Services (CMS).  In anticipation of his nomination by President Obama (not yet official, but confirmed to multiple major media outlets by administration officials), Iowa hospital leaders are pleased with the thought of Dr. Donald Berwick running these important programs. 

They should be.  Much of what is right about Iowa health care – low-cost, high-quality, patient-centered and primary-care based – is what Dr. Berwick would like to see happening in the rest of the country.  If Dr. Berwick is confirmed to the post (something that probably won’t happen quickly, given the tumult surrounding the recently passed health care reform legislation), it wouldn’t be surprising to hear him talking about Iowa early on and often. 

As many Iowa health care providers know, Dr. Berwick runs the Institute for Healthcare Improvement (IHI), which focuses on “cultivating promising concepts for improving patient care and turning those ideas into action.”  One of IHI’s recent initiatives was “How Do They Do That?,” which provided regional case studies of high-value care.  

Out of hundreds of hospital referral regions (HRRs) around the country, 70 met IHI’s selection criteria.  With all eight of its HRRs meeting the criteria, only one other state had more representation than Iowa among the final 70 (California, which has two dozen HRRs, had nine that met the criteria).  One of the 10 HRRs selected to share their How Do They Do That? story was Cedar Rapids, and the CEOs of both of the city’s hospitals are excited about the prospect of Dr. Berwick leading CMS. 

“The selection of Dr. Berwick by President Obama to lead CMS is an inspired choice, particularly at a time of unprecedented rethinking of health care in our nation,” said Tim Charles, CEO at Mercy Medical Center-Cedar Rapids. “In 2003, our hospital joined with IHI because of Dr. Berwick’s commitment to the triple aims of improving patient experience, per capita cost and population health. I am certain these principles will act as his ‘true north’ as he guides CMS. 

“I have come to know Dr. Berwick more personally this past year and respect his commitment to our health care system. His identification of Cedar Rapids as a model suggests he would bring to his new role the recognition that our community is well down the road to achieving both its potential and promise as a provider of high-quality, low-cost care. We look forward to working with him.”

 “CMS could not be in more capable hands if Dr. Berwick is appointed its director,” said Ted Townsend, St. Luke’s Hospital president and CEO.  “I had the privilege of getting to know Don on a personal level after he invited a contingent of health care leaders from Cedar Rapids to IHI’s National Conference last year to talk about how Cedar Rapids provides high-quality, low-cost care.  Additionally, in his role at IHI, Don has worked with St. Luke’s and countless of other hospitals across the county to reduce errors, waste and preventable deaths. He is the perfect person to engage hospitals, doctors and health care providers to constantly strive to provide high-quality, low-cost and safe care.” 

Other hospital leaders have also spoken up in support of Dr. Berwick. IHA will share their thoughts in an upcoming post.

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Featuring hospital and health care headlines from the media and Web.

Iowa News

Iowa facilities named to top hospital list
Health care information provider Thomson Reuters named The Finley Hospital in Dubuque as one of the nation’s top hospitals in the recent report, “100 Top Hospitals: National Benchmarks.” St. Luke’s in Cedar Rapids was also included on the list. (Dubuque Telegraph Herald)

Health care reform could decrease use of UI’s student plans
Health care reform could mean fewer University of Iowa students using the university’s student insurance plans, said Richard Saunders, a senior associate director of UI Human Resources. Namely, the law could affect students covered by the UI’s health-insurance plan and recent graduates who find themselves without benefits. (University of Iowa Daily Iowan)

Winners, losers from the 2010 legislative session
Winners in the session included hospitals, which will get a fresh influx of cash through a new provider tax that the state will use to tap extra federal matching money. Then about 75 percent of the additional money will go right back to the hospitals via higher payments for care for low-income Iowans on Medicaid. (Des Moines Register)

AARP praises 2010 Iowa General Assembly for improving health care
AARP Iowa applauds the great steps this General Assembly took to improve health care in Iowa. AARP supported three passed bills, which will improve different components of our Iowa health system. (IowaPolitics)

U.S. News

The last piece in place
President Obama signed the budget reconciliation bill containing a package of revisions to the big health care legislation after giving a speech at Northern Virginia Community College, a setting aimed at drawing attention to the education component of the bill. (New York Times)

Cost issues remain despite healthcare reforms
The issue is particularly important in South Florida, with its high rates of uninsured coupled with healthcare costs that are the highest in the nation or close to it. Any attempt to control costs will have huge effects here — perhaps including reductions in the number of expensive tests and visits to specialists. (Miami Herald)

Firms say part of health law will cost them millions
Although President Obama’s newly minted health care overhaul doesn’t take effect for some time, its impact is already being felt by some American companies. They’re warning that they stand to lose millions of dollars because of a single passage in the law. (National Public Radio)

Small businesses fret over details of health law
Small-business owner Joe Ascioti says Massachusetts’ 2006 health care law has left him facing $15,000 in fines since it took effect. Now, he’s worried the nation’s new health care overhaul could bring similar woes to employers nationwide. (Washington Post)

US system may be next for health innovator
Donald Berwick has never run anything larger than his 110-employee Cambridge consulting firm and think tank and has never worked in Washington. But people who know him say he has the intellect and judgment to run the agency, which touches the lives of one in three Americans. (Boston Globe)

Nurses strike at Temple University Hospital
Several hundred striking nurses and other health professionals rallied outside Temple University Hospital this afternoon, blocking traffic on Broad Street as the crowd spilled into the roadway. The protest came five hours after the workers walked off the job in a contract dispute. (Philadelphia Inquirer)

Ranks of homeless rising in Minnesota
Homelessness in Minnesota rose 22 percent in the past three years, reaching the highest level in at least two decades, according to initial findings from a statewide survey by Wilder Research of St. Paul. Analysts blamed the weak economy. (Minneapolis Star Tribune)

Pediatric ER turns fun and games into effective care
Provena St. Joseph Medical Center this month opened a 5,000-square-foot addition in Joliet dedicated to treating the area’s sick children. The new addition centers on being kid-friendly –– from smaller beds to appropriately sized blood-pressure cuffs to cartoons playing on the in-room televisions. Even the staff is specially trained to treat children. (Chicago Tribune)

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Featuring hospital and health care headlines from the media and Web.

Iowa News

Q-C hospitals beef up fight against infections
Both Genesis Health System and Trinity Regional Health System have beefed up hand hygiene programs, required influenza vaccinations and established procedures to encourage employees to check and challenge each other in regards to cleanliness. (Quad-City Times)

Local health providers respond to bill
Kurt Carlson, M.D., chief medical officer with Winneshiek Medical Center said, “One of the reasons the current model of health care is not sustainable, is because the incentive for physicians to focus on quality and value is missing. If reimbursement was outcome-based, health-care organizations would find ways to improve their quality outcomes to benefit from higher reimbursement.” (Decorah Journal)

Agency works to prevent Medicare fraud
Shirley Merner greets news of big Medicare fraud crackdowns in big cities across the nation with mixed feelings. She’s thrilled that a new federal program is busting up crime rings and saving millions of dollars in federal money. But she fears that could drive con artists out of Los Angeles, Houston, Miami and Detroit and in to Iowa. (Waterloo-Cedar Falls Courier)

Weekend fundraisers a rousing success
As a result of the generosity of area businesses and patrons who attended both events, Avera Holy Family Health will be able to add much-needed equipment, improving quality care for its patients and the Emmet County Nature Center Foundation will be able to pay down the debt of the Nature Center, saving taxpayers money. (Estherville Daily News)

U.S. News

Health law does little to curb overuse of care
To truly change the nation’s chronic overuse of medical care, there will have to be a substantial change in the way patients think about health care, how medicine is practiced and how it is paid for, economists and doctors say. The legislation does little to help in those areas. (New York Times)

Stimulus stumbles hold lessons for health care sell
As President Barack Obama prepares to roll out the health care reform plan, he can look to one recent case study in how not to do it — the economic stimulus package. Health reform is a chance for voters to see if the White House can learn from its mistakes. Here are the lessons from the stimulus Democrats hope to apply to selling health reform. (Politico)

Companies push to repeal provision of health law
The American Benefits Council said the provision — which reduces the tax deductions for companies with drug coverage for their retired employees — would deal a significant blow to corporate profits and would discourage companies from hiring more workers. (New York Times)

Insurance industry agrees to fix kids coverage gap
The insurance industry says it won’t fight President Barack Obama over fixing a coverage gap for kids in the new health care law. In a letter Monday to Health and Human Services Secretary Kathleen Sebelius, the industry’s top lobbyist says insurers will accept new regulations to dispel uncertainty over a much publicized guarantee that children with pre-existing medical problems can get coverage starting this year. (Associated Press)

Politics makes strange bedfellows in fight against nonprofit hospitals
Sen. Chuck Grassley (R-Iowa) and Rep. Bobby Rush (D-Ill.) have formed an unusual alliance to ensure that tax-exempt hospitals treat patients without insurance. Nonprofit hospitals receive tens of billions of dollars in tax benefits each year to offer medical assistance to patients who lack proper coverage. But some have curtailed this care to boost their bottom line. (The Hill)

Hospitals giving more charity care
“Government must not back away from its role in the partnership that provides tax exemptions to hospitals. Taxing hospitals, many of which are struggling to survive, would destabilize the health-care delivery system and the health care safety net that they provide their communities,” said the CEO of the Illinois Hospital Association.  (Chicago Sun-Times)

New worries about H1N1 influenza
Although H1N1 flu activity is still low in most of the country, flu-related hospitalizations in Georgia have, since the beginning of February, been higher than they were in October at the height of the second wave of the flu, said Dr. Anne Schuchat, director of the Centers for Disease Control and Prevention’s National Center for Immunization and Respiratory Diseases. A CDC team was sent March 6 to assist state officials investigating the outbreak, but its members have found nothing unusual. (Los Angeles Times)

Increase in number of ‘observation cases’ costly to hospitals
During the past year, Medicare and commercial insurers increasingly have labeled patients as “observation cases,” saying they’re not sick enough to be hospitalized — but not well enough to go home. Doctors, hospitals and consumer advocates say the trend is costing patients and hospitals. They say the practice is particularly harmful to Medicare patients. If they are discharged without a record of a three-day inpatient stay, Medicare recipients are denied coverage for skilled nursing home care. (Pittsburgh Tribune-Review)

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Featuring hospital and health care headlines from the media and Web.

Iowa News

A healthy boost for competition?
Doctors walking around some hospitals own the place, a trend that’s sparking calls of unfair competition in Nebraska and across the country. Hospital groups say doctor-owned facilities are plucking the most profitable patients, like those with heart problems, and customers with the best insurance. Such patients are essential because they help to pay for services that typically break even or lose money, such as emergency departments and mental health. (Omaha World Herald)

U.S. News

Health overhaul likely to strain doctor shortage
Better beat the crowd and find a doctor. Primary care physicians already are in short supply in parts of the country, and the landmark health overhaul that will bring them millions more newly insured patients in the next few years promises extra strain. (Associated Press)

Health care overhaul Q & A
Last week, President Obama signed into law the most sweeping health care overhaul in generations. This article looks at how the new health law could affect you, and how soon. (Los Angeles Times)

Health-care overhaul leaves Democrats in stable condition
Shifts among core constituencies suggest that President Obama and House Speaker Nancy Pelosi (Calif.) may have reaped some benefit from the legislation’s passage, but the public’s take on the Democratic Party has not budged, and Senate Majority Leader Harry M. Reid (Nev.) appears to be losing popularity. None of the central players in passing health-care reform appears to be winning favor with the bill’s opponents. (Washington Post)

New law deals setback to malpractice foes
The health-care legislation has dealt another blow to a movement seeking to limit the amount doctors have to pay in medical-malpractice suits. As a result, tort-overhaul advocates, who battle the well-organized lobby of plaintiffs’ lawyers, are struggling to find ways to fight back. (Wall Street Journal)

New Medicare chief’s hearing may re-ignite overhaul debate
Donald M. Berwick, a Harvard University scholar and long-time critic of U.S. health care, will be thrust into the political fight over the overhaul law as President Barack Obama’s choice to run Medicare and Medicaid. The pick, requiring Senate confirmation, follows last week’s approval of the biggest revamp of the U.S. system since the 1960s, without support from a single Republican. (BusinessWeek)

Analysis: Economy, not health care, will be focus
Losers in a brutal struggle with President Barack Obama, Republicans now hope voter anger over newly enacted health care legislation will propel them to victory in midterm elections this fall. Forget about it. No matter the impact of health care, the economy still matters most — unemployment in particular — in a country struggling to emerge from the deepest recession in decades. (Associated Press)

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On this week’s Iowa Journal on Iowa Public Television, host Paul Yeager discussed the new health care laws with representatives of Iowa insurance, business, Medicaid and hospitals.

IHA President and CEO Kirk Norris joined Jim Swift, Chairman and CEO of Holmes Murphy and Associates, an insurance brokerage firm with more than 500 employees and Jennifer Vermeer, Director of Iowa Medicaid, which is the third largest provider of insurance in Iowa.

Watch the video here.

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