Increased efforts are needed to improve care for Medicare beneficiaries, despite signs of progress, according to a report released by the Commonwealth Fund. Delivery of services targeted as national priorities, such as mammography, heart-attack care and outpatient treatment of chronic conditions, has improved (See related stories, p. 8). But wide gaps exist in screening for colorectal cancer, treatment for depression and control of high blood pressure and cholesterol, in particular, the report found. Disparities in care also exist based on race and income. For example, 96 out of every 10,000 white patients developed a blood clot in their leg or lung after surgery; 164 out of every 10,000 black patients did so. And while 51% of Medicare patients defined as poor received flu vaccinations in 2001, 69% of those defined as high-income were vaccinated.
GNYHA targets infections
The Greater New York Hospital Association and United Hospital Fund launched a campaign to prevent central-line-associated bloodstream infections, one of the most common infections in hospital care. About 40 GNYHA-member hospitals have signed on and have identified teams and profiled the intensive-care units that will participate, a GNYHA spokeswoman said. The initiative, part of the Institute for Healthcare Improvement's 100K Lives Campaign, is expected to save money as well as lives, she said. According to Allegheny General Hospital, Pittsburgh, which has a similar program, two ICUs saved $1.3 million after the first year. The GNYHA board of governors has unanimously endorsed public reporting of hospital infection rates provided the reporting is conducted through the state health department.
Gilmartin exits Merck
Raymond Gilmartin resigned as chairman, president and chief executive officer at Merck & Co., Whitehouse Station, N.J., and was immediately replaced as president and CEO by Richard Clark, president of the company's manufacturing division. Lawrence Bossidy, former chairman and CEO of Honeywell International and a current Merck board member, will serve as chairman of the board's newly structured executive committee, which is expected to be in place for up to two years, officials said. Gilmartin will stay on as a special adviser to the executive committee until March 2006, when he will retire. Merck did not state a reason for the change. The company has been struggling to recover from the voluntary withdrawal of its blockbuster arthritis drug Vioxx last September. Clark, 59, was chairman and CEO of pharmacy benefit manager Medco Health Solutions before its 2003 spinoff by Merck. Gilmartin joined Merck as president and CEO in 1994 and was named chairman the same year.
Cardinal to discontinue unit
Drug distributor Cardinal Health, Dublin, Ohio, said it is discontinuing operations of a 20-employee unit that buys and sells pharmaceuticals from secondary distributors because of declining financial results for the unit. The unit accounted for about 0.5% of Cardinal's $36 billion in drug distribution revenue in the first nine months of the company's fiscal year ending June 30, a 40% decline over the year-ago period, Cardinal spokesman James Mazzola said. The unit, based in Groveport, Ohio, has been in financial decline for more than two years, a result of stricter company procedures to prevent drug counterfeiting and exclusive agreements with pharmaceutical manufacturers, Mazzola said. New York Attorney General Eliot Spitzer reportedly is investigating the secondary wholesale market, but Mazzola said the decision to close the distribution unit was a "business decision."
Doc convicted of killing patient
A Chicago-area podiatrist was convicted of fatally shooting a former patient in 2002 to prevent her from testifying against him in a Medicare fraud case. Ronald Mikos, 56, was found guilty of one count of tampering with a witness by murder, three counts of influencing a witness, two counts of obstructing justice, 14 counts of mail fraud and five counts of healthcare fraud. Because killing a witness is a capital crime, Mikos could face the death penalty. Sentencing hearings begin May 10. Prosecutors said the former patient, Joyce Brannon, was ready to testify that Mikos had not performed more than 70 foot surgeries billed to Medicare. Mikos' defense attorney said her client had defrauded Medicare of more than $1.25 million but had not murdered Brannon.
Kaiser's profits rise in 1st quarter
Kaiser Permanente, Oakland, Calif., saw its first-quarter profits rise 27% to $552 million, up from $435 million in the year-ago quarter, fueled by renewed membership growth. Revenue rose 12% to $7.7 billion in the quarter ended March 31, and enrollment increased by 100,000 members, or 1.2%, for a total of 8.3 million. The company's operating margin expanded to 6.4% from 5.6%. The nation's largest not-for-profit HMO said the strong financial results would help it meet long-term capital goals, including a $21 billion expansion program involving the construction of 25 new or replacement hospitals. Kaiser spent $379 million on capital improvements in the first quarter, 15% more than a year ago.
N.C. hospital to offer discounts
North Carolina Baptist Hospital, Winston-Salem, said it will implement a new discount policy for some uninsured and out-of-network insured patients effective June 1 (See related story, p. 16). Patients must agree to a payment plan to receive the discounts, which will range as high as 50% with a $10,000 limit. The hospital, affiliated with Wake Forest University School of Medicine, was sued in late 2004 in Rowan County (N.C.) Court in a class-action lawsuit on behalf of uninsured patients. Plaintiffs alleged that the hospital overcharged uninsured patients compared with patients with government or private insurance. Len Preslar Jr., the hospital's president and chief executive officer, said the discount policy was not in response to the lawsuit but was prompted by an "increasingly dysfunctional and fragile private insurance system." All uninsured patients will be apprised of the hospital's discount policy and its charity-care policy, which applies to patients whose households earn up to 400% of the federal poverty limit, he said.