Report: Medical Errors Injure Upwards Of 488,900

By Steve Rensberry
   (RPC) - 2/19/2016 - A recent report by the Heartland Health Research Institute estimates that between 281,000 and 488,900 patients in Illinois hospitals are injured each year to do preventable medical errors or events. The estimate nationally is between 6.6 million and 11.5 million patients.
Preventable injuries occurring in Illinois hospitals.
    “If the Centers for Disease Control (CDC) were to include preventable medical errors in U.S. hospitals as a category, it would be the third leading cause of death in the United States, behind heart disease and cancer,” an HHRI press release about the report states.
   Fatalities occur in Illinois hospitals due to preventable adverse events (PAE) at an estimated rate of about 1 death for every 139 hospital admissions. By comparison, 11 patients die in hospitals from such errors for every vehicle fatality, 15 patients die for every murder committed in the state, and altogether nearly 3 percent of the state's entire population is harmed each year by PAEs. The frequency and volume translates into about one fatality every 50 minutes in the state due to such errors.
   The annual cost of such errors? The HHRI report estimates that in Illinois the annual social cost of such fatalities is about $5.2 billion. Nationally the cost is estimated between $23.1 billion and $103.4 billion. The number of injured patients annually in Illinois, based on the most common types of preventable medical errors, is as follows: adverse drug events (72,600 patients); venous thromboembolisms/, VTEs – blood clots that form within a vein (48,800); decubitus ulcers, bed soars (36,400); catheter-related urinary tract infections (17,500); falls in the hospital (16,200); nosocomial pneumonia (12,600); catheter, related bloodstream infections (6,300).  
   "Preventable medical errors in our hospitals is clearly alarming, both in the number of lives affected and in cost." Heartland Health Research Institute President David Lind stated. "Is Illinois making progress on preventable medical errors? The quick answer is, we don't really know because reporting yields a healthy dose of under-counting and under-reporting of medical errors. Without having stringently-coordinated regulations and policies that effectively hold providers accountable through transparent reporting, medical errors will continue and the public will remain in the dark. The Federal Aviation Administration has such regulations - shouldn't our safety be just as important when we enter a hospital as it is when we board an airplane? The public deserves transparency and accountability on this issue."
   A study by USA Today in 2013, using data from the National Practitioner Data Bank and other sources, point to an additional worry for potential patients – unnecessary surgeries, which the article states might account for as much as 10-20 percent of all operations in some specialties. Cites are cardiac procedures such as stents, angioplasty and pacemaker implants, spinal surgeries, hysterectomies, cesarean sections, and knee replacements.
   “Tens of thousands of times each year, patients are wheeled into the nation's operating rooms for surgery that isn't necessary,” authors Peter Eisler and Barbara Hensen write.
   What makes the size of the problem difficult to calculate is that only the worse cases are likely to become public knowledge, and if a surgery by chance takes care of a problem that could have been alleviated with lesser therapy or a non-surgical procedure, little suspicion is raised because the problem is gone.
   “Hospitals around the country do not report PAEs accurately and consistently - if at all,” the HHRI report states. “National experts acknowledge that most PAEs are either under reported or unreported. The Department of Health and Human Services Office of Inspector General issued a report in 2012 stating, 'Hospital staff did not report 86 percent of [patient harm] events to incident reporting systems, partly because of staff misperceptions about what constitutes patient harm.' This behavior reflects our culture of silence.”
   An October 27, 2015 Harvard Business Review report, written by Rebecca Wentraub, Yannis K. Valtis and Peter Bonis, claims there are many as 44,000 deaths in the Unites States each year due to preventable medical errors, with a price tag of roughly $17 billion.

U.S. Health Insurers Eye Bigger Profits In 2016

By Steve Rensberry
   (RPC) - 2/12/2016 - The Affordable Care Act not withstanding, health insurance companies across the United States have been seeking to raise their rates. Some companies, such as Blue Cross and Blue Shield of Minnesota, have sought increases of more than 50 percent in recent months. (1)
   In a Jan. 26 commentary written by CIGNA executive Wendell Porter and published by the Center for Public Integrity, that author notes that the nation's largest health insurer, UnitedHeathCare, posted profits of $10.3 billion in 2014, against revenues of $130.5 billion -- pushing its share price to $113.85. This is in sharp contract to a price of $30.40 in March of 2010.
   UnitedHealthCare isn't alone.
   “Every one of the big six saw their shares reach or come close to reaching historic highs. Although they haven’t done quite as well as United, the other five have seen the price of their stock more than double or triple. Health Net’s share price has increased 224 percent since March 2010. Anthem’s is up 238 percent over the same time period. Aetna’s 290 percent. Cigna’s 305 percent. And Humana’s 309 percent,” Porter writes. He cites the industry practice of purging unprofitable accounts--in particular small business accounts--as a contributing factor. (2)
   A Jan. 21 story by Paul R. La Monica, published by CNN and entitled “Thanks, Obamacare! Health insurer stocks soar,” cites the same record highs. “Many health care companies have yields that are significantly higher than the puny yields investors get from buying long-term U.S. Treasury bonds,” La Monica writes. (3)
   Kevin McCoy of USA Today suggests in a February 2 story that Aetna's fourth-quarter profits beat Wall Street forecasts, in part, because of an increase in the number of Medicare and Medicaid health plans it sells. (4)
   “The company said net income for the October -December quarter rose 38 percent to $320.8 million, or 91 cents a share,” McCoy writes. “That was up from $232 million, or 65 cents a share, for the same period last year.”
   New profits from Cigna Corp, meanwhile, were down 9 percent in the first quarter of 2015 (Mara Lee, Hartford Courant, Feb. 4), with the company citing higher costs associated with individual health insurance plans as one reason for the drop. A $48 million purchase by Anthem, announced last summer, is pending.
   Bob Herman, writing for Modern Healthcare, highlights other movements in the industry after years of uncertainty toward government programs and other types of investments, apart from traditional health plans. He cites data from Securities and Exchange Commission filings which show the percentage of UnitedHealthCare revenue from Medicare and Medicaid in 2009 at 49 percent, and it's share of commercial plan revenue at 50 percent, compared to 2014 revenues of 59 percent and 36 percent respectively. Aetna derived 24 percent of its profits from Medicare and Medicaid in 2009, and 76 percent from commercial accounts, compared to 42 percent and 58 percent in 2014 respectively. (5)
   “Federal spending on healthcare surpassed Social Security for the first time in 2015, thanks in large part to Medicaid expansion and the ACA's public exchanges, according to the Congressional Budget Office. Investor-owned HMOs that focus almost exclusively on outsourced Medicaid—such as Centene Corp. and Molina Healthcare—have thrived,” Heman states. “Medicare Advantage, perhaps more than any other federal program, has attracted the most interest because of the substantial revenue prospects from the growing numbers of baby boomers becoming Medicare-eligible. Almost 18 million people have a private Medicare Advantage plan, up from 10.5 million in 2009.”
   An analysis of 2016 premium changes and insurer participation in the Affordable Care Act's Health Insurance Marketplace, conducted by the Kaiser Family Foundation, looked at changes in the two lowest-priced Silver Plans for 11 major metropolitan areas and found an average, pre-tax credit increase of 4.4 percent. Those cities were: Portland, Oregon; Albuquerque, New Mexico; Richmond, Virginia; Burlington, Vermont; Baltimore, Maryland; Portland, Maine; Washington D.C.; Hartford, Connecticut; New York City, NY; Detroit, Michigan; and Seattle, Washington.
   “Our analysis is based on the 10 states plus the District of Columbia where we were able to find comprehensive filings or other information about the rates of the lowest-cost plans. Other states have released summary information, but not sufficient detail to identify the lowest-cost silver plans. In many cases, premiums are still under review by insurance departments and may change prior to the start of open enrollment,” the KFF report stated.