Monday, December 12, 2016

On Call by Casey Ross
Good morning and welcome to a new week! Here's the latest news on hospitals and health care. For more, follow @statnews on Twitter or like us on Facebook.

Just in: Will payment reform pass by rural providers? 

Is Washington overlooking small and rural providers in its push for performance pay?

A new report by the Government Accountability Office suggests that current regulations make it difficult for them to participate in these new Medicare payment models, which tie compensation to performance on various cost and quality measures. Among the issues flagged:

Big investment, for uncertain rewards. Required IT upgrades cost big bucks. Just making an EHR interoperable with another provider can cost $20,000. Recovering that money can take several years.

Managing patients is more difficult in rural America. If patients must travel long distances to be seen, it is harder to manage their care proactively, which can quickly skew performance numbers.

Staffing shortages. Without IT officers and teams of care coordinators, small providers are forced to choose between caring for patients and endless administrative work. Which would you choose?

The report points out a number of resources available to support the switch to performance pay. But it’s a good bet that many small and rural providers won’t be ready to participate in new payment programs set to kick off in 2017.

New poll: Steering clear of holiday calories

When it comes to the Battle of the Bulge, we are all in this fight together.

The barrage of decadent holiday foods hits caregivers as hard as their patients. With this in mind, we asked our partner, Figure 1, to poll health professionals on their strategies for preventing holiday weight gain.

Nearly 1,900 people responded. Of those, 43 percent said, “Move more, eat less.” The second most popular response is the one many of us use: “I’ll worry about it in the New Year!”

Said one registered nurse:  “Now that I work in the critical care unit, I say a silent prayer that I am stationed at the back nursing station — all the treats end up at the front nursing station.”

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A digital DSM is on the horizon, and it could mean real time edits

It took 19 years to produce the latest version of psychiatry’s most important guide, the Diagnostic and Statistical Manual of Mental Disorders (DSM). That editing process, while thorough, doesn’t keep pace with new discoveries in the field of psychiatry.

In a First Opinion for STAT, Dr. Michael B. First writes about efforts to provide real-time updates of the DSM, and what that would mean for clinicians on the front lines of care. Given the import of the manual, and the immediacy of digital publishing, properly vetting changes will be more important than ever.

Read more.

Fresh take: Closing the racial disparity in cancer research

Research into cancer-causing mutations is revolutionizing health care, but not everyone is benefiting equally. A new study by the University of Pennsylvania aims to level the playing field,

The researchers found that African-American women have a higher prevalence of mutations than white women in the gene TP53, which is linked to breast and ovarian cancer, but a lower rate of mutations in the gene CHEK2. This could mean TP53 might be a marker of those cancers in African-American women.

Mutations of the BRCA1 and 2 genes — most commonly linked to breast cancer and tested for regularly — were similarly prevalent in white and African-American women, according to the study. The study, which examined the DNA of 736 women of both races, also found that more African-American women have mutations for which cancer implications are unknown.

"This study is a first step towards being able to zero in on the mutations that are more prevalent in African American patients,” said the study’s lead author, Dr. Payal D. Shah,  “but future research is needed to better understand the patterns of genetic mutations across patient populations."


  • MedPAC pushes pay hikes for doctors and hospitals, excludes other caregivers. (Modern Healthcare)
  • Coming in 2017: Onsite HIPAA audits. (FierceHealthcare)
  • Liver cancer is a growing scourge in poor countries. (NPR)

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