Moore, OK needs more prayers

It’s ironic, in a terrible sort of way, that I post this blog on the two-year anniversary of the tragic tornado that claimed over 160 lives in Joplin. Just two days ago an even bigger and stronger tornado devastated Moore, Oklahoma.

Fortunately the Moore Tornado did not claim as many lives as the Joplin Tornado but almost half of the lives lost in Moore were children. Any event involving the loss of life of a child is horrific and it seems to increase the magnitude. No life is worth more than another but the life of a child is precious and I can’t, and hope to never, begin to understand what the parents of the children who died in Moore are going through.

Oklahoma is no stranger to tornadoes and when residents of Oklahoma refer to a tornado as The Tornado, you know it was devastating. That’s how the events of May 3, 1999 have been remembered – at least until now. The tornado that hit Moore two days ago was even bigger and stronger than The Tornado from May 3, 1999. Early indications are that it was even bigger and stronger than the tornado that hit Joplin two years ago today.

People in Oklahoma grow up around storms and live most spring days under a watch or warning of some sort. But even when you know disaster can strike, you don’t expect it to and you for sure don’t expect one of the largest and strongest tornadoes in history to strike. You for sure don’t expect that tornado to plow into an elementary school.

I don’t really know what else to say other than this, the next time you hug your child be sure you cherish the moment. Hug him or her a little tighter, hold him or her a little closer and say a prayer for the parents in Moore who would give anything to have one more chance to hug their child.

The charge confusion – let me simplify

A couple of weeks ago CMS unveiled charges and reimbursements data for about 3,000 hospitals across the country.  The information demonstrated a dramatic variation between hospitals treating similar patients in different parts of the country.  The information created a media feeding frenzy and a lot of political banter.  Hospitals are taking heat and blame but is it justified?

There are two major problems with CMS’s report.  First, the “costs” they were reporting came from hospitals’ chargemasters, which is not a true or accurate reflection of “cost”.  Second, the “charges” that were reported have little to do with what hospitals are actually paid by Medicare.

Health care finance and reimbursement is difficult to understand so let me simplify. 

Pretend for a moment that you (Shoppper A) stop by the grocery store after work to pick up a gallon of milk.  The price tag on the milk is $87.42, you go to the register, the clerk rings up the sale and you pay $3.42.  You only have to pay $3.42 because that’s the rate set by The Dairy Farmer’s of America* for a gallon of milk and the store can not ask you or force you to pay a penny more (*disclaimer – I mean no offense at all to The Dairy Farmers of America by comparing them to CMS). 

The person behind you (Shopper B) in line also has a gallon of milk but that person participates in a group grocery plan through their work and their plan promises to send business to the store in exchange for a discount on certain goods so they agree to pay the store 20% of what ever the charge is so that person pays $17.54 for the gallon of milk.

The person behind them (Shopper C) is buying a gallon of milk as well but that person doesn’t have a group plan through their work nor do they get any love from The Dairy Farmers of America (again dairy farmers I apologize and I know you love everyone).  The price for their gallon of milk is $87.42 like everyone else but this individual reaches into his pocket and realizes that he left his wallet at home but the store lets him have the milk anyway because he looks really thirsty.

The stores “cost”for each gallon of milk is $7.15 so the three gallons of milk cost the store $21.45.  Shopper A paid $3.42, Shopper B $17.54, Shopper C $0.00 for a grand total of $20.96 which is $0.49 less than the stores cost so the store lost on average $0.16 per customer.

The store won’t stay in business very long if it losses $0.16 on every gallon of milk it sells so what does it do….it starts to charge everyone a little more in hopes that Shopper B, the only shopper it has any ability to get a little more money out of, will cover the loss from Shopper A and Shopper C.  Overtime as more of Shopper A and Shopper C’s friends visit the store Shopper B is charged more and more to cover the loss and charges go up and up and up.

What happens next, well the media begins a negative firestorm about how the store charges way too much for a gallon of milk and how milk is unaffordable.  But is it really unaffordable.  Shopper A’s price is set and never changes, Shopper C doesn’t have to pay anything so milk seems affordable to Shopper A and Shopper C to me.  Shopper B, well Shopper B decides that the cost of milk is difficult to justify so he encourages his employer to negotiate a greater discount and says “hey I will pay a little more each month if you can keep my cost of milk where it is”.

Shopper B’s employer negotiates a new group deal with the store and now the group only has to pay %18 of the price tag on the milk so you know what happens next – you guessed it, the store raises the price of milk – AGAIN….

And that is how charges get inflated.  It’s easy to point a finger at the store but don’t forget, milk does a body good and everyone needs milk at some point in their life!

500

This is the 500th blog I’ve posted so it’s a milestone of some sort.  Let me share with you a few of the things I’ve learned from blogging. 

You never really know what people might find interesting.  I’m amazed at the feedback I get about blogs that I think people won’t care about and I’m amazed at the feedback I get about blogs that I don’t care about.

Blogging exposes a person to due criticism and to undue accolades.  If you’re going to write something and post it for the world to see on the world-wide web you’re obviously opening yourself up to criticism and I’m good with that.  I wrote it, I’ll take the heat for it.  I make it a point not to be too controversial I also make it a point to proof read, at least once, every blog I post.  When you post a typo you hear about it.  Sometimes I hink i will post a log wit a fuw typos just to see if anyone is peying attntion.  Most of the blogs I post are about someone or something else so I don’t really deserve any accolade but I get them by default.

It doesn’t take as much time as I thought to maintain a blog.  When Tammy Woirhaye challenged me to start this deal I was worried that I didn’t have the time but its like anything else, if its worthwhile you make the time.  It does take commitment and as long as people continue to read I will stay committed to posting on a regular basis.

I’m amazed at the people who read this blog.  I have been stopped by strangers in the community who have commented on the something they’ve read.  They say thank you or they want additional information – that’s really cool.

It really isn’t hard to come up with topics.  There are no rules and there are no guidelines which makes it easier.  I can post a blog about an important hospital topic or a random post about doing 500 blogs.

A picture really is worth a thousand words.  No matter how many keys I peck or how descriptive my writing is I can never describe something that’s better seen.  Blogs with pictures get the most hits.

Speaking of hits, this blog gets on average 160 hits a day, the most hits on any one day was 484, so if you want to sell your old couch with flower pattern print let me blog about it but be sure you send me a picture because a picture is worth a thousand words and if you’re willing to admit that you have a flower pattern print couch for sale I promise I will post the picture and write a story about it.  (Remember that day that got 484 hits, it had this picture)

People really enjoy the stories I post about my son (soon to be sons).  I have two theories as to why.  First, I usually post the funny stuff.  Their usually stories about him being a boy, me trying to be a Dad, something he’s done wrong or something I’ve actually done right.  My second theory is that those stories are humanizing.  Most everyone who reads this blog can relate to those stories.  Those stories remind you of something in your past, present or future and those stories are real.  When I talk about things like Medicaid Expansion, expense as a percent of net revenue, Accountable Care Organizations, the Affordable Care Act, etcetera, etcetera, etcetera it’s easy to overlook how those things really matter and I get that because to some extent they don’t.

Now I realize I’ve just committed blasphemy for a hospital administrator to say some of the things shaping the health care landscape of our country don’t really matter but the truth is there are things that matter more to the people reading.  What truly matters are the patients you care for, the people you work with, the family you love and the balance you strike between those things that are most important.  In the end we’re a hospital, we’re here to provide care and regardless of the external environment hospitals save and improve lives every day and that will never change.

Health care workers have the most difficult jobs in the world but the reason they’re great at their jobs is because their committed and the reason 500 blogs isn’t that big of a deal is because it just takes a little commitment.

Always Ready

OK so I know we celebrated hospital week at GVMH this past week BUT this week is the true hospital week.  The link below will take you to a short (30 second video) that puts the value of hospitals into perspective.  Its worth watching!

http://www.aha.org/advocacy-issues/nhw/index.shtml?channelId=ea4975dc137a47f4852f6bd8d674e5df&channelListId&mediaId=51f0e991eb2742629ac06af6e326990b

There are consequences

Jackson Hewitt, a company specializing in tax services, released a report last month that said states opting out of the ACA face tax repercussions. Employers with 50 or more employees, according to the report, will be exposed to increased shared responsibility payments to the tune of up to $1.3 billion per year in the 22 states that have opposed or are leaning toward opposing the expansion under ACA.

Another study from the Missouri Hospital Association says that without Medicaid reform, the cost of caring for the state’s uninsured will continue to skyrocket. The cost, estimated to hit $3.5 billion annually in six years, will be paid by businesses and individuals with health insurance.

Herb Kuhn, president and CEO of the MHA, said hospitals will experience an estimated $4.2 billion in cuts between now and 2020, and without the additional Medicaid coverage, hospitals will continue to care for uninsured residents.

Various reductions in hospital payments were made in the ACA, with the expectation that hospitals “would see new revenue from patients newly covered by Medicaid and those purchasing insurance through a health insurance exchange,” according to the MHA. President Barack Obama proposed a budget earlier this month that would delay those cuts.

Crying Uncle and a special thank you

I was ready to cry uncle this past Friday. Who would have ever thought that we’d have snow on May 3! I turned the air conditioner on in my house on Tuesday and the furnace on Thursday.

I’m sooo ready for spring but I’m afraid we’re going to go from winter to summer. My son got out of bed Friday and he was thrilled to see snow on the ground – he was the only one in the house glad to see snow. It’s weird to see green grass sticking out from the snow and it’s even more weird to see flowers and shrubs covered in snow.

I heard on the radio that the last time it snowed on May 3 was 1907 and it may be another 106 years before it snows that late again so maybe I should be happy that my son got to see snow in May during his lifetime but I’m just not there yet.

The snow played havoc with plants and moods but it also interfered with a couple of events. The Annual GVMH Auxiliary Golf Tournament was to be held on May 4 but it has been postponed to July 13. The snow would have made finding a golf ball difficult for some of the players but that’s not the case for me. I will lose as many balls in July as I would on the snow-covered course in May.

Speaking of auxiliary I do want to recognize the GVMH Auxiliary. I attended the Auxiliary Awards Luncheon a couple of weeks ago and we have 89 dedicated Auxiliary Members. Our Auxiliary play a key role in patient care and we are a better organization because of them. They are just as valuable as any of our patient care staff and they are just as dedicated as our paid staff.

During the luncheon Auxiliary Members are recognized for hours of service and I’m always amazed at how much time is donated. I want to send a special thank you to Pat Kampmann. Pat is a dear friend and a great person and she has volunteered over 21,000 hours.

To put her volunteer time into perspective think about this. If you work full-time for 10 years you will be a few hours short of 21,000 hours. Pat’s dedication and commitment is admirable and greatly appreciated. Thank you Pat and thank you to all of our Auxiliary.

Hospital Week 2013

On Wednesday I posted information about Nurses Week and GVMH is also celebrating Hospital Week May 6-12 this year’s theme is Team GVMH to recognize our Behaviors of Excellence.

A hospital is more than a place where people go to heal, it is a part of the community that fosters health and represents hope. From providing treatment and comfort to the sick, to welcoming new life into the world, hospitals are central to a healthy and optimistic community.

The nation’s largest health care event, National Hospital Week dates back to 1921 when it was suggested by a magazine editor who hoped a community wide celebration would alleviate public fears about hospitals. The celebration, launched in Chicago, succeeded in promoting trust and goodwill among members of the public and eventually spread to facilities across the country.

Miracles happen in hospitals every day and as we celebrated hospital week this past week let me share what happened in hospitals across the country this past week.

This past week:

Hospitals provided emergency care to 2.4 million Americans

Hospitals delivered 73,400 babies

Hospitals performed 525,000 surgeries

Hospitals were the health care safety net for 50 million uninsured

Hospitals cared for 676,000 Americans admitted to hospitals

This past week was hospital week and it was just another average week for hospitals across the country…hospitals make miracles happen every week!