Beyond Dr. Mario: Gamifying health care for the tech-savvy generation

Gamification, that is, integrating concepts usually found in games like score-keeping and competition to other activities to engage users, is a growing trend in this wired and smartphone-ready landscape. Among those testing the waters of gamification is the healthcare industry.

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It’s still in relatively early days, admittedly, but there have been many examples of healthcare apps that have shown promise in helping people take better care of their bodies by combining fun with self-monitoring and wellness.

With more doctors advocating disease prevention these days, exercise and step tracking apps, which are more than just high-tech pedometers are becoming popular.

“Gym Pact,” for instance, has users make a “pact” with other users to adhere to specific exercise and nutrition plans. And then there’s with the zombie apocalypse in “Zombies, Run!,” by developer Six to Start, where runners listen to audio adventure where they’re being chased by hordes of the undead. There’s also the “7-minute Superhero Workout,” a motion-tracking workout program built for training the perfect “superhero.”

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Meanwhile, to help patients remember to take their medications and manage their health, there are iOs and Android apps like “Mango Health” and “Asthma Hero.” The former’s rewards include gift cards while the latter is unique in that it’s connected to an inhaler strap that is synced with the patient’s smartphones, so they see their usage.

Video games have also been developed to aid health care. Reflexion Health’s “Vera” for Xbox Kinect tracks patient adherence to their physical therapy exercises while Nintendo’s Wii Sports have also been used by occupational and rehab therapy.

Of course, while gamification can be for everyone, the fun aspect of it is definitely perfect for children. Getting pricked by needles is not fun, so to help young diabetics become more enthusiastic about monitoring their blood sugar, Bayer Diabetes Care released the “Didget” blood glucose meter that connects to the Nintendo DS so kids can receive points, rewards, and play games. Similarly, for young cancer patients, there are HopeLab’s “Re-Mission” games that encourage treatment adherence and positivity through the difficult time.

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The connection between games and wellness has certainly taken strides since the days of “Dr. Mario,” especially since people can now expect real life results from their games and apps when used correctly. Based on the current trend, it is without a doubt that the medical and healthcare industry can only expect more apps that combine fun and health care.

As the administrative director at Vanderbilt University Medical Center, Candis Kinkus likes to stay attuned with the latest in healthcare technology in order to provide their patients with the best care. Follow this Facebook page for more updates on healthcare trends .

Behind the curtain: How hospital administrators can help save lives

Thanks to television shows like “ER,” “House,” and “Grey’s Anatomy,” and of course, to real-life interactions, most people are familiar with how doctors take the lead at saving lives. But while doctors and nurses are akin to frontline troops in the war against illness, to win the battles, they also need planning and support.

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This is where hospital and clinic administrators come in. Although they might not get as much screen time as doctors and nurses, these people who do much of the work behind the scenes have a critical role in connecting patients with the best possible health care.

To put it briefly, the hospital or clinic administrator’s role is to make sure that the healthcare institution is running efficiently. To be able to the job correctly, the minimum requirement is a master’s degree, and a strong background in both management and health care, to ensure that the potential administrator is familiar with the issues that one may face running a clinic and be able to deal with them.

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It is the healthcare manager’s responsibility to keep up with industry standards and laws and guarantee that the institution conforms to those. They also set budgets in order to acquire the relevant technology and medication for treating patients and to hire and retain the staff who can attend to the different requirements around the hospital. One of the administrator’s primary goals is to turn a profit, but this comes hand-in-hand with securing an environment that is conducive to providing high-quality health care and wellness.

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Clinical administrators have much to do with how patients can receive the care and treatment they need by making sure the facilities, staff, logistics, and medications are all on-the-ready. It might not be instantly obvious, but that is how healthcare managers are able to save lives from behind the curtain.

With more than 25 years of clinical management experience, Vanderbilt University Medical Center’s administrative director Candis Kinkus has gained herself a stellar reputation in the healthcare industry, as well as the respect of her peers. Follow this Facebook page for updates on healthcare technology and trends.

REPOST: Health Care Management Association Draws the Future of Healthcare Management

Students seeking a fulfilling career in healthcare management are presented with an array of opportunities; they, however, should decide conscientiously which ones to foray into. Read the article below to know how some of the most accomplished professionals in the field designed their own blueprint toward attaining success.

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The Cal State L.A. Healthcare Management Association held an event on Monday, March 2nd, in which they gathered alumni speakers working in the healthcare field to share their pathway to their successful career.

The night was open to both undergraduate and graduate students who were curious to learn from the alumni’s experiences and was held in the Golden Eagle Ballroom.

One notable speaker of the night was Shweta Sharma, a Cal State L.A. alumnus who currently works at Cedars Sinai Medical Center as a business analyst.

Sharma spoke about the importance of ‘selling yourself,’ a skill she claims ultimately landed her numerous internships that led to employment.

While Sharma admits that she applied to various internships throughout her journey, even if she wasn’t exactly sure what employers were looking for, she made sure to tell them that, “I am ready to learn. I have this background (in healthcare) and I can apply what I know.”

Sharma also emphasized the importance of being seen. “I made sure to take up every opportunity I could. Every team meeting, I would go even if they were at 7:30a.m. in the morning. I wanted to make sure they knew I was willing to work.”

The night proved to be a success, as undergrad and grad students got the opportunity to expand their network of both collegiate and professional contacts.

Jessa Caños, senior Public Health major and executive administrator of the Healthcare Management Association, got the chance to network with aforementioned Sharma. “I approached Dr. Sharma because her story was really inspiring. She showed how persistent and driven she was to get into the field,” Caños shared and continued, “She gave me her contact info and invited me to contact her at any time to help jumpstart my healthcare career.”

One of the notable aspects of the event was the unique opportunity to join a prominent health organization, for free. Normally, the healthcare organization offers membership for about a whopping, 100 dollars a year.

Candis Kinkus is an acclaimed healthcare manager with considerable experience directing clinical operations, managing operating budgets, and implementing new programs. Follow this Twitter page for updates in healthcare.

Healthcare digitization: Strengths, weaknesses, opportunities

The digitization of medical files into Electronic Health Records (EHRs), or Electronic Medical Records (EMRs) aims to improve the overall efficiency and quality of patient care at a reasonable cost. EHRs are crucial for strengthening healthcare delivery. In facilitating the meaningful and purposeful use of data, they are specifically meant to get patients empowered to play active roles in care, and to give doctors easy access to information relevant to medical interventions and ongoing treatment.

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Technology has been driving transformations in healthcare recently, and the resulting impacts, though in the developmental stage, are marked by drawbacks. With the threat of penalties to eligible professionals failing to maximize digitized medical records, and with the growing barriers associated with usage and user errors, divided attention between process and patient, and conflicting computer systems, medical practitioners and professionals are faced with complications directly affecting care delivered to patients.

A recent news report from USA Today demonstrates the actual use of digitized medical records and discusses the features, uses, and perceived challenges of EHRs/EMRs.

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Current systems and health information exchange platforms are diverse, fragmented, and have limited interoperability. With the wide variety of EHR systems flooding the market, instead of allowing user independence and flexibility, editable functions are limited to creating additional fields rather than aligning parameters to a doctor’s specific practice and operational goals.

Experts still agree, however, that EHR systems could provide user-friendly interfaces that are truly customized according to the ways each doctor treats patients, approaches his/her field, and manages the practice in a cost-effective package that does not require a huge up-front investment. It is then necessary for developers of EHR systems to prioritize the doctors’ needs first, rather than create a feature where doctors would squeeze themselves into pre-defined structure, often constraining their individuality, professional approach and expertise.

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Candis Kinkus is a respected name in the healthcare industry. Add this Google+ page to your circles for updates on technological innovation in the healthcare.

REPOST: The 7 Biggest Innovations in Health Care Technology in 2014

Brian Honigman of Referral MD lists some of the best technological developments for health care that debuted in the previous year.

This year we’ve witnessed amazing innovations in technology with everything from wearable tech like Google Glass or Nike+ to the recent introduction of Coin, one card that stores all your credit cards, debit cards, personal accounts, business accounts and other cards typically filling your wallet. The healthcare industry was no exception to the rise in disruptive technology changing the way people are impacted. What are some of the most influential healthcare technologies you’ve seen appear this year?

Without a doubt the pace at which new technology is impacting our everyday lives is increasing at lightning speeds. As of today, 29% of Americans say their phone is the first thing and last thing they look at everyday which is a telling sign of how connected we are becoming to technology.

These technologies are starting to allow healthcare practitioners to offer cheaper, faster and more efficient patient care than ever before, which is certainly a step in the right direction. The healthcare industry has long been overburdened by a slow moving innovation due to the complexity of the medical ecosystem, but due to this technology the industry has finally seen some far reaching changes.

Everything from new artificial hearts to electronic aspirin, the healthcare industry is slowly but surely becoming more agile, effective and cost-effective for patients looking for care.

Of the many disruptions reaching the masses this year, here are the some of the biggest innovations in healthcare technology with far reaching impacts:

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1. Microchips Modeling Clinical Trials

The potential to streamline, improve, and perhaps transform the current healthcare system is huge. That’s how microchip modeling clinical trials came into use because there was an open opportunity and a need to innovate on the way clinical trials are conducted.

Microchip modeling clinical trials aim to replace the use of animals in clinical trials to more accurately test the safety and efficacy of treatment for human patients and spare the lives of countless animals typically used in testing.

These microchips are smaller than a human thumb, can reconstruct the complicated interface between organs and capillaries, which is similar to the idea of microfabrication, the process of making structures on a micrometer scale.

By eliminating animal models in certain circumstances, scientists and doctors have been able to reconstruct organs like the human lungs by focusing on the use of complicated systems of microchips to emulate these bodily systems.

In many instances, animals pass as adequate human stand in’s but in many cases they do not help drive accurate results on how human’s would be affected by the same procedures, diseases and treatments. Microchips more closely resemble live tissue, cell types and realistic three-dimensional interactions occurring in the human body than do other forms of clinical testing to date.

2. Wearable Technology like Google Glass

Wearable technology is still in its infancy but has already started to have widespread influence across many industries. Dr. Rafael Grossmann was the very first surgeon to use Google Glass or wearable technology in general while performing a surgery.

As wearable technology continues to improve to better meet the needs of its users, healthcare providers continue to hope that its use will impact both the experience of patients and practitioners to better receive and administer care.

Dr. Grossmann believes that Google Glass and wearable technology of a similar nature will help improve the way healthcare providers interact with patients and a patient’s relatives, increasing the satisfaction of patients and making doctors and other providers more effective at doing their job because of the added level of communication between parties.

He sees this new technology as allowing a doctor to someday interact with a patient, while simultaneously pulling up their medical history using Google Glass. The surgery performed using Google Glass could serve as an example of real-time education for medical students and other professionals alike.

There are even telemedicine opportunities with Google Glass as well, allowing doctors and other medical professionals to provide clinical care in certain capacities from a distance. The practice is already in use by doctor’s providing medical advice via the phone or email in many instances across the United States but, it’s the technology that limits how effective this approach can be when it comes to what level of care is able to be administered.

This is so important because according to Grossmann, many don’t survive a medical condition or emergency each year because the right patient needs to be at the right place at the right time and this isn’t often the case since up to 30% of the U.S. population doesn’t live near a trauma center if they happen to live a rural area for example.

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Grossmann has used Apple’s FaceTime to discuss crucial patient crises as well as virtual examinations with patients in various locations across the country, able to severely impact the outcome of their care. He argues that with the continued adoption of wearable tech like Google Glass, more lives will be saved since communication between medical professionals and patients will continue to improve to the next level.

3. 3D Printed Biological Materials

There have been many widespread uses of 3D printers today from guns to models of the Empire State building, but the medical uses are extremely practical and overtime could really solve ongoing health issues once it’s figured out how to accurately apply them to people.

Here are seven applications of 3D printers in healthcare that could have an important impact in the future:

-Embryonic Stem Cells: These cells have already been successfully printed in a lab and could be one-day use to create tissue that could help test drugs and assist in the growth of new organs.

-Printing Skin: There have been many advances in the areas of developing skin to help burn victims and skin disease patients, 3D printers can help further jumpstart these advances with the addition of laser-printed skin cells.

-Blood Vessels & Heart Tissue: Organovo is a company that has already successfully printed blood vessels and sheets of cardiac tissue that actually beat along just like a real heart.

-Replacing Cartilage & Bone: 3D printers have also helped scientists and doctors create stem cells that could eventually develop into both bone and cartilage in the long-term.

-Studying Cancer: Printing cancer cells is a way of growing these cells on tissue in a lab to study, test drugs on and to eventually find a cure for.

-Patching a Broken Heart: Printing cells with a 3D printer proves useful in a recent study of rats that had previously suffered heart attacks and were given these patches of cells to help slowly help improve their heart function overtime.

-Replacement Organs: Printing new part for organs or entire organs all together will help solve an ongoing medical need and help save hundred of thousands of people every year waiting for an organ donation to come thru.

4. Optogenetics

A new technology has jump-started the technique in neuroscience known as optogenetics where neuroscientists target a single neuron in the brain of a mouse merely by turning on a light.

This is done by using a light activated gene and inserting it into the genome of a mouse to be able to easily identify when the particular neuron is firing in the brain.

Optogenetics is a hot topic amongst the medical community today, surrounded by both praise and criticism. Its purpose is to control a brain’s activity with light. This could have far reaching benefits with humans to help better understand the complex network of neurons that make up the brain. A stronger understanding could help humans better grasp how we create thoughts, emotions and behaviors.

Identifying these neurons may sometime help people detect flaws or deformities in the various neurons in the brain that cause devastating mental disorders like schizophrenia, Parkinson’s and depression. By controlling the activity of specific neurons, neuroscientists will begin to learn how each type of neuron contributes to the overall functions of the brain.

The firing of a neuron through lighting may someday be a technique to finding the answers to some of the many open questions mankind has wondered about themselves both medically and physiologically since the dawn of time or this technique may not be able to work with humans due to its invasive nature in its current applications with rats.

Time will tell as to whether this approach is effective, but nevertheless, the study of the human brain using light will help neuroscientists on the path to better understanding the neurons and how they work across this complex organ.

5. Hybrid Operating Rooms

With the addition of new technology, comes the integration with established technology and systems that either needs to be replace completely or connected with to improve their performance or build upon the brand new technology’s use.

This is a difficult task for healthcare professionals due to the complexities of the systems, technologies and operations currently in place at all healthcare facilities, hence why this industry is often the slowest moving when it comes to impactful change.

A hybrid operation room is a new innovation where a traditional OR is outfitted with advanced medical technology to improve the care delivered to patients and enhances the skill-sets of medical practitioners when it comes to administering treatment.

The Lakeland Regional Media Center is an example of a hybrid operating room, one of the first in its area, but definitely an indicator of more widespread changes to come to operating rooms around the country innovating on existing processes and technologies with traditional surgical procedures and treatment options.

Technologies used in hybrid operating rooms have typically helped reduce trauma, scarring, spurred faster rehabilitation and has helped decrease hospital stays. The technologies used at the LRMC that helped improve a patient’s experience at a hospital included advanced imaging technologies that allowed for real-time intra-operative image guidance, as well as tools to help perform high-risk minimally invasive cardiac procedures.

6. Digestible Sensors

Approved in 2011, digestible sensors will continue to provide healthcare professionals with more information about the human body and how various treatment solutions affect each system of organs.

A digestible sensor is a sensor that transmits information about a patient to medical professionals to help them customize the care to the individual as well as the care provided to other individuals experiencing similar health conditions or ailments.

This technology would eventually allow an individual to swallow a pill provided by their doctor and skip their physical because the digestible sensors, that look like regular pills, could perform all the same functions a doctor typically handles in a standard physical and then some.

Digestible sensors will monitor your bodily systems and wirelessly transmit what’s happening in your body to another device like your smartphone or computer for your own review or the review of your doctor. Latest innovations with digestible sensors don’t even require a battery source since they solely rely on the human body as an energy.

An innovation of this nature could have far reaching effects for healthcare by helping detect diseases and conditions at earlier stages in people digesting these sensors that are in turn, constantly monitored wirelessly.

For more healthcare innovations of 2013, here’s an infographic on these developments and others that drastically impact the future of healthcare for patients and professionals alike, originally from Medical Future.

Image Source: getreferralmd.com

7. Cloud-based provider relationship management software

Communication may seem like an easy technology to develop for the healthcare industry, but it has been nothing but problematic for decades costing over $250 billion to process over 30 billion transactions annually. From referrals, progress updates, and insurance authorizations; these types of communications result in huge amounts of money and time being wasted and a liability to every healthcare provider.

Patients are stuck in the middle as doctors still communicate with antiquated systems (ex. the fax machine) delaying critical care. As many as 50 percent of referrals are not received by the specialty care provider causing patients to miss treatment and healthcare providers to lose money.

Candis Kinkus specializes in improving the management and operation of healthcare facilities. Subscribe to this blog for more on recent developments in the field of healthcare management.

REPOST: Challenge of keeping frontline Ebola healthcare workers alive

Health workers at the front line of combatting the dreaded Ebola virus count as among the world’s modern day heroes. Despite putting themselves at foremost risk of contracting the fatal disease, they carry on with their mission without any misgivings. The least that the health sector can do, asserts The Guardian’s health editor Sarah Boseley, is to ensure sophisticated systems are in place to allow deployed physicians and nurses to work under the safest possible conditions, so that cases of Thomas Eric Duncan and other previously infected health workers will be averted.

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Health workers on the Ebola frontline are and always have been at the highest risk of contracting the disease. Ebola becomes more contagious the sicker patients get. By the time they are in the care of doctors and nurses, patients have become a serious danger to the lives of those treating, washing and attempting to rehydrate them.

But in countries such as the US and Spain, which have sophisticated healthcare systems and well-equipped hospitals, healthcare workers should be safe. It is shocking that workers in Spain and now Texas have contracted Ebola from patients they were treating.

As Médecins sans Frontières has proved, it is possible to keep health workers safe even in the difficult setting of west Africa, where an isolation ward can be no more than an area behind a canvas tent flap. The vital elements are vigilance and strict adherence to the rules.

The Texas health worker was reportedly wearing full protective gear – gown, gloves, mask and shield – while providing care for the patient who later died. Either that equipment failed or correct procedures were not followed.

Dr Tom Frieden, head of the US Centers for Disease Control and Prevention, suggested on Sunday that there had been a breach in protocol, saying that one focus of the investigation will be the possibility that the health worker took off protective gear incorrectly.

Personal protective suits keep the virus off the body but removing them safely is a skill in itself. It is possible to transfer the virus from the outside of the suit on to the hands. From there it takes a moment’s thoughtlessness to touch the face. The virus enters the body through eyes, nose or mouth or any abrasion on the skin.

In Africa it is so much harder to be safe. The suits are hot, there are not enough available, and doctors and nurses are hard-pressed because there are too few of them to cope with the soaring number of cases. In Liberia there was a critical health worker shortage even before Ebola broke out. Fear over dangerous working conditions was as strong a motivation for recent strikes as very low pay. The government in June doubled the pay of nurses because of the hazard, but was told by the World Bank to rescind the offer, which would have busted the health budget.

Better conditions for health workers in Africa are vital. That is going to have to involve increasing their number and improving training. There will still be, for a while, a shortage of experienced people to supervise and ensure procedures are followed. West Africa needs a great deal of help from the west.

Candis Kinkus, administrative director of Vanderbilt University Medical Center, advocates the safety and welfare of health workers both in hospitals and in the field. Subscribe to this blog for the more news and insights on healthcare management.

The diagnosis for HealthCare.gov: Not a disease for the Obama administration

Around this time last year, the launch of HealthCare.gov, an Obama initiative dovetailed with the President’s other plans for American healthcare, flubbed. What would have been the official website of Obamacare looked more ill than millions of Americans still awaiting medical insurance.

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The dismal attempt of the Obama administration to pack in affordable care in an accessible platform prompted a relaunch, which is ongoing as of writing. This time around, the bugs are getting cleaned out for a faster-loading page that won’t crumble under heavy site traffic. As millions of Americans go after health security, Healthcare.gov should be absorbing online insurance applications with speed and ease. No apologetic page timeouts would be tolerated. And first of all, the menu of affordable services should load rapidly to apprise Americans of their healthcare entitlements.

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HealthCare.gov CEO Kevin Counihan is inaugurating the enrollment on Nov. 15. Meanwhile, the IT experts behind the site are subjecting it to the ultimate stress test: the security breach, or the dreaded hack. To fend off attacks, government officials are introducing into the website a vaccine in the form of simulated hacking, performed on a weekly basis. These measures promise a website immune to Murphy’s Law in a high-expectations season that flips at the slightest glitch. It is estimated that twice as many Americans who signed up last year (only 12, if you consider the previous successful enrollments on the first day—yes, it was that bad) will be staking either their doubts or their faiths on Obamacare by actually signing up.

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While it is good that millions of Americans don’t have to line up for medical insurance, and that affordable care, despite the drawbacks of the past, still remains a priority, the law has to be implemented neatly. Otherwise, the Obama administration will risk the ire of the many Affordable Care Act naysayers, who, as things look up this year, might be giving it a shot.

The job of administering health care is not confined to practitioners. As demonstrated by the rollout of the Affordable Care Act’s provisions, the approach to healthcare services determines a population’s receptivity to measures that intend to improve access and service. Visit this Candis Kinkus blog for an informative take on managing medical services.

REPOST: Smart Moves for Controlling Health Care Costs in Retirement

Of the millions of Americans building a nest egg for their retirement, very few understand that regular health care spending later in life typically and significantly increases. This article stresses the importance of insurance and financial planning using service systems such as Medicare or Social Security to accommodate the health expenses that come with old age.

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Planning for later-life medical costs is essential. These steps can keep you healthy longer and ease your worries.

It’s clear that planning for later-life health care costs is essential for a secure retirement—but figuring out what to do about them is a lot less clear. Out-of-pocket health expenses are not only a big-ticket item but are not predictable or controllable. No wonder few of us build financial strategies for future health needs, preferring the ever-popular ostrich plan: Place head in sand and hope for the best.

“Less than one out of six pre-retirees has ever attempted to estimate how much money they might need for health care and long-term care in retirement,” according to a report by Merrill Lynch and Age Wave, a consulting firm. Knowledge about Medicare is abysmal, the survey found, even among those already enrolled in the program.

And a recent health benefits survey by the Employee Benefits Research Institute, a non-profit retirement industry think tank, found that while nearly half of workers were confident about their ability to get the treatments they need today, only 30% were confident about that ability during the next 10 years, and just 19% are confident once they are eligible for Medicare.

Having a plan is a good way to build confidence. So start by taking a look at the mirror and asking yourself: How long do you think you’ll live and how healthy will you be in your later years?

“A 65-year-old male in excellent health can expect to live to age 87, while the same male in poor health has a life expectancy at age 65 of approximately 81 years,” said a recent study from the Insured Retirement Institute, a trade group that pushes annuity investments. A 65-year-old female in excellent health has a life expectancy of 89, or 84 in poor health. An average couple age 65 has a 40% chance that one or both will live to age 95.

While living to an old age may be better than what’s behind Door Number Two, it may prove costly. Old-age health expenses tend to be loaded into the last few years of life, often to deal with chronic illnesses, especially Alzheimer’s.

Average out-of-pocket health care expenses for that 65-year-old male will be an estimated $246,000 for the rest of his life if he is in poor health and dies at 81, the IRI study said. The lifetime bill rises to $345,000 for the healthy man who survives to an average age of 87.

Adopting healthy lifestyle habits may significantly reduce older-age health expenses. Just as important, it’s the best investment you can make in a higher quality of life during your later years.

The Merrill Lynch-Age Wave study recommends these proactive planning steps:

Map out future out-of-pocket health expenses, including estimating future Medicare premiums and co-pays.
Learn how Medicare and long-term insurance work.
Develop contingency plans, for you and other family members, should illness cause lost income from an extended work disability.
Broaden your planning to include those family members most likely to comprise your caregiving and financial support network.

The IRI report, not surprisingly, sings the virtues of using annuities to provide guaranteed lifetime streams of income to deal with long-running health care expenses. Many financial advisers prefer other investments. But you should at least look at annuity options as part of your long-term financial planning anyway.

If you’re especially worried about running out of money in your 80s— and, God willing, your 90s—then you should explore deferred annuities. Often called longevity insurance, a deferred annuity can be designed to not begin payouts until old age. If you buy one of these products in your 50s or 60s, the insurance company will provide very attractive payment terms. And it should, of course, because it will have the use of your annuity purchase money for 20 or even 30 years, with a good chance you’ll die before they have to pay you a cent.

The other insurance product worth a close look is long-term care insurance. Increasingly, this product is being linked with annuities to provide purchasers with choices—receive annuity payments or use the money for a qualifying long-term care needs. Generally, such hybrid products provide less bang for the buck than a pure annuity or long-term care policy. Also, keep in mind that your goal here should be to protect you and your family from ruinous health care bills. This is primarily an insurance product, not an investment.

Finally, the best annuity around is Social Security. It offers lifetime payments, annual inflation protection and government payment guarantees. That’s why I pound the drum of deferring Social Security until age 70, if it makes sense for your financial, family and longevity profile.

Candis Kinkus is the administrative director of Vanderbilt University Medical Center, where she leads her multiple departments of over 370 hospital employees and staff in providing high quality health care and medical treatment to patients and families in Nashville, Tennessee. For more articles and news on health care and the hospital industry, visit this blog.

REPOST: Expanding profits: Medicaid ‘expansion’ boom for hospitals

If hospital administrators have been reluctant to expand Medicaid eligibility for patients, this latest development might help them make a decision faster. This article reports on dramatic revenue increases for medical institutions who have chosen to broaden their Medicaid coverage.

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Medicaid expansion is expanding profits for a bunch of hospitals.

A new analysis of major for-profit health systems found that hospitals in states that expanded Medicaid eligibility under Obamacare are seeing far fewer uninsured patients, a large rise in paying patients and more revenue as a consequence—which stands in stark contrast to hospitals in nonexpansion states.

For example, there was about a 47 percent decrease in the rate of admissions of uninsured or self-paying patients at the hospitals in expansion states in the first half of 2014. Yet, hospitals in nonexpansion states either saw a slight reduction in such admissions or no decreases at all, according to the PricewaterhouseCoopers Health Research Institute.

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The report issued Wednesday, looked at quarterly earnings reports filed by health systems with the Securities and Exchange Commission.

Hospitals in expansion states also saw double-digit increases in Medicaid admissions, while Medicaid admissions at hospitals in nonexpansion states were modest, at most, according to the PwC report.

As a result, “for-profit health systems, operating more than 500 hospitals in the U.S., report far better financial returns through the first half of the year than expected, owed in large part to expanded Medicaid.”

The report comes as Medicaid expansion is even being eyed by Republican governors who oppose Obamacare, because of the billions of dollars in federal money that can be untapped for hospitals and other medical providers in states that increase the pool of potential Medicaid recipients. As of now, 24 states do not have Medicaid expansion, although Pennsylvania’s plan to expand eligibility in 2015 was approved last week.

“In states that have expanded Medicaid, an influx of newly insured patients has helped reverse long-running hospital trends such as declining admissions and a rise in uncompensated care,” the report found.

“Given the emerging picture of health system haves and have notes, it is understandable why many hospital executives continue to urge state lawmakers to expand Medicaid where they haven’t already.”

The report looked at the five biggest for-profit health systems in the U.S., which operate in 35 states, some of which have expanded Medicaid eligibility to include nearly all poor adults, and some that haven’t. The systems were HCA Holdings, LifePoint Hospitals, Tenet Healthcare, Community Health Systems and Universal Health Services.

Ceci Connolly, managing director of the Health Research Institute, said the findings were “striking,” particularly given the fact that health-care trends normally can take several years or more to become significant.

“Even though we expected this sort of distinction between the expansion states and the nonexpansion, we did not expect it to be this significant and this fast,” she said. “This one we saw in the first quarter, second quarter, boom, boom boom, and that’s pretty striking to us.”

“For hospitals and those systems that worry about the bottom line every quarter, every year, this is worth paying attention to,” she said.

Connolly noted that even as hospitals in expansion states are reaping the benefits of treating more people with government-sponsored insurance, hospitals in every state are dealing with a decrease in disproportionate share payments from the federal government.

Those payments traditionally were used to offset the costs hospitals incurred from treating the indigent. But Obamacare is reducing those payments by about $17 billion through 2020 because of the ability of states to expand Medicaid, and thereby reduce a hospital’s liability to care for the uninsured.

To deal with those reduced payments, and to take advantage of Medicaid expansion, hospitals have been reaching out to prospective patients to make them aware how they could obtain health coverage.

PwC’s report noted that Tenet HealthCare “held more than 350 events to raise awareness of health plans and new Medicaid thresholds,” which Tenet CEO Trevor Fetter said lead to “tens of thousands” of new Medicaid enrollees.

Tenet, which operates in five Medicaid expansion states, had its uninsured and charity admissions drop 46 percent at the same time that its Medicaid admissions in those states rose nearly 21 percent.

“In the second quarter alone, Tenet saw a $78 million reduction in unpaid care,” the report said.

The difference in the experience of health systems in expansion and nonexpansion states was underscored by HCA Holdings. In expansion states, HCA saw a 48 percent plunge in uninsured admissions, and a 32 percent rise in Medicaid admissions.

In nonexpansion states, HCA saw just a 2 percent drop in its uninsured admission rate.

The positive effect of its business in expansion states was reflected over the summer, when HCA revised its earnings outlook to reflect what it said would be a bigger-than-expected windfall from Medicaid expansion and private insurance plans sold through the health-care exchange.

PwC’s report found Medicaid expansion has “had a similar effect on doctors,” with primary care physicians and others seeing a higher percentage of Medicaid patients in the first quarter of this year than their counterparts in nonexpansion states.

The report comes amid continued debate over Medicaid expansion and as 7.2 million people have signed up for Medicaid since last fall. Not all of those newly enrolled were newly eligible, but the expansion of Medicaid and the rollout of the Affordable Care Act have been credited with a big boost in the enrollment rate in expansion states.

The ACA originally mandated that every state and the District of Columbia expand their Medicaid programs to cover nearly all adults who earn up to 138 percent of the federal poverty level, or about $16,105 for an individual and $32,913 for a family of four. Traditional Medicaid programs, which are jointly run by state and federal governments, often do not cover adults without children, or cap eligibility for benefits at very low incomes for adults with dependent children.

The expansion of Medicaid was supposed to work in concert with another aspect of Obamacare, which makes subsidies available to people who earn between 100 to 400 percent of the federal poverty level, and who buy private insurance plans through state health-care exchanges as well as
HealthCare.gov.

But the 2012 Supreme Court decision that upheld the ACA requirement that nearly all Americans obtain health coverage this year or pay a penalty also found that Medicaid expansion would be decided on a state-by-state basis.

So far, Medicaid expansion has been adopted by 26 states and the District of Columbia.

Pennsylvania’s version of expansion was approved last week, and will begin Jan. 1 Governors of five other states are making moves to expand or are seriously discussing that prospect.

Unlike traditional Medicaid, where state and federal governments split the costs, the federal government is footing 100 percent of the costs of covering the newly eligible under Medicaid expansion through 2016. After that, the federal government’s share of the costs will decrease gradually, but are set to level out at 90 percent—much higher than its share under traditional Medicaid in any state.

Aaron Albright, a spokesman for the Centers of Medicare and Medicaid Services, said, “Medicaid expansion is helping millions of Americans access health coverage, many for the very first time. Increased coverage reduces hospitals’ uncompensated care and lowers cost shifting to businesses and everyday Americans that see higher health insurance premiums when those costs are passed on to them.”

Vanderbilt University Medical Center administrative director Candis Kinkus manages over 350 employees united in their professional commitment to provide world-class healthcare to all patients and visitors. For more about health systems and laboratory management, visit this blog.

Hopes and Desires

Everyone wants the results milliseconds after a Google search clarifies things once and for all. After looking back subjectively, curiosity merited far more adulation than it does now.

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Technology has nevertheless systemized an era where digitization is an omnipresent way of life. No matter the immediacy and accessibility of what lies easily within our devices, nothing matches the personal, tangible, and face-to-face experiences awaiting our need for actual contact. In no other industry is transparency and compassion appreciated more than within the health care field: the immediate contrast between a wifi connection and an inviting smile are no comparison.

There are so many who have devoted their entire lifestyle to retaining a personal touch in wellness, which is understandably expected from our health care providers. In order to meet this overwhelming desire, experts in the medical field lay their framework within the administrative branch to coordinate, strategize, and manage the backbone of their operations: they turn to industry specialists like Candice Kinkus.

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Candice Kinkus first earned her undergraduate degree in Science and later still an MBA in Marketing and Finance from the University of Pittsburgh. She followed this up with a postgraduate degree in Health Management Systems from Carnegie-Mellon University.

After an illustrious an education, Ms. Kinkus went on to direct and manage numerous departments within some of the most frequented and well-known medical establishments and health care providers, including Highmark Blue Cross Blue Shield, Magee-Womens Hospital, Gateway Medical Group, and the Pennsylvania Medical College & Allegheny General Hospital.

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Ms. Kinkus is one of those behind-the-scenes orchestrators who makes sure than when your health needs are put under the microscope, proper hands are there to spot, identify, and deliver solutions that gets you back on the track your lifestyle deserves.

To learn more about Candice Kinkus, visit her website to see what happens behind the curtain.