In the months since the Patient Protection and Affordable Care Act (PPACA) was enacted, organizations have been inundated with law and consulting firm client advisories, articles and seminars—all focused on summarizing the new health care reform law. But to what extent have those articles and seminars provided a clear plan of action.  Well I think I found a document that was worth the read.  It’s an implementation checklist for hospitals from McDermott Will & Emery and you can find it here.

I found this to be a well assembled document and was intrigued by the first section that tackled an issue of Tax Exempt Status and the new Section 501(R) which imposes additional requirements that hospitals and other organizations whose operations include hospital operations must satisfy in order to continue to meet the standards for tax exemption under Section 501(c)(3). The additional requirements imposed on a hospital by new IRC Section 501(r) include those relating to (a) periodic conduct of a “Community Health Needs Assessment.”

Did you know that MCHC recently conducted a market wide Community Needs Assessment and that our program offers hospitals the ability to drill down by zip code?  Contact Mike Dermont to learn more at mdermont@mchc.com.

Chitra Mohla’s blog, Health IT: Coming Soon to a Class Near You, is just one example of the new career opportunities available in health care. The health care delivery system that is evolving today and the jobs needed to support it is certainly different than the jobs I first encountered when I began my health care career 33 years ago. One of my first jobs in health care was to write job descriptions. To do so, I had to observe and interview health care workers about their jobs. It was a great way for me to learn the health care delivery system.

As I look at the jobs listed in Chitra’s blog, I’m not totally sure what some of those are. But I must admit I’m still trying to absorb what I learned in a meeting this morning.

Together with about 35 senior IT executives from our member hospitals, I listened to a two hour presentation from a potential vendor for our Metro Chicago Health Information Exchange (HIE). The HIE, when hopefully launched early next year, will allow for the seamless transmission of  a patient’s health information, no matter who provided the care - a hospital, physician(s), pharmacy, skilled nursing facility, etc or what type of computer system, hardware and software each has implemented. The implications of having this type of information available at the clinician’s and patient’s fingertips is staggering! This certainly supports our Vision - High quality accessible healthcare for all communities.

This effort will create hundreds (if not thousands) of new, well paying jobs just in the metro Chicago area alone.

So if you like technology and are interesting in working in a great career area, think about health care!

These figures were quite alarming when I read them. I found the non-business hour carve out statistic an interesting view of how the resources of emergency departments (ED) are used. When I first saw it I was thinking wow, people are afraid to leave their work day to take care of their health and most doctor office are closed after 5:00 pm. Then I realized that the data is from 2007 and this is when the economy was booming. Another statistic that supports our view that hospitals are the safety net to the uninsured is demonstrated by the significant difference in utilization rates of the homeless persons. See below:

A new report on 2007 ED visits found:

· There were 116.8 million ED visits or 39.4 visits per 100 persons

· The age group with highest annual ED visit rate was infants under 12 months old (88.5 visits per 100 U.S. infants)

· For 64.7% of visits, patients arrived in EDs during nonbusiness hours (5:00 p.m. to 8:00 a.m. Monday through Friday, and on the weekends)

· The visit rate for homeless persons was almost twice that of those living in private residences (71.8 compared with 35.9 visits per 100 persons)

· The annual number of visits to EDs has increased by 23% since 1997

Source: “National Hospital Ambulatory Medical Care Survey: 2007 Emergency Department Summary,” National Health Statistics Reports No. 26, August 6, 2010,

How do these rates compare to your facility? Join in on the discussion.

Yesterday we had the unique opportunity to host the Special American Business Internship Training (SABIT) Program in Hospital Administration for the United States Department of Commerce.

The SABIT Hospital Administration program is designed to train 18 mid- to senior-level health care executives from Eurasia (Armenia, Azerbaijan, Georgia, Kazakhstan, Kyrgyz Republic, Moldova, Tajikistan, and Ukraine). These delegates, screened and selected by the U.S. Department of Commerce, represent health care leaders in their respective countries who are seeking information in order to improve the delivery of  health care in their home countries. This is our third year hosting the SABIT Program.

For more than two hours we had a lively discussion (through interpreters) on a variety of health care matters. Our team presented information on many of our Clinical Services programs and the work of the Illinois Poison Center which is a program of MCHC. Read More

This week, the Deputy Administrator was at the Metropolitan Chicago Healthcare Council (MCHC) offices and we heard a lot about the Centers for Medicare and Medicaid Services’ strategy for the future. Some of my peers have done a great job highlighting what was discussed amongst members in this meeting. What I heard loud and clear as a financial leader, is that we can expect extraordinary pressures on reimbursement. To that end, I am happy that we at MCHC have invested in the new Wage Index Navigator tool.  Making sure that the markets Wage Index is as appropriate as possible is even more essential than ever.

Thanks to the work and effort of the participating hospitals in the MCHC Wage Index Program, in Federal Fiscal Year 2011, the Chicago market will receive an estimated $21.6 million in additional inpatient reimbursement solely attributed to the wage index. The non-participating hospitals will benefit from this additional reimbursement as well but it could have been more for all. If all hospitals in the Core Based Statistical Area (CBSA) had participated in our FFY 2011 Wage Index Program and had similar results as the participating hospitals, the entire CBSA would have received an additional $30.6m in inpatient reimbursement. So have we left monies on the table, sure we did! For this reason, it is important that all MCHC hospitals recognize their importance of  participating in this organized wage index program. We are all in this one together.

The Wage Index Navigator tool eliminates reasons to not participate in the MCHC Wage Index Program. It is cost effective, easy to use and saves staff time. To learn more about this tool join us on a Webinar on August 5th.

Do you have any additional ideas on how we can preserve the resources needed to deliver care to Chicagoans?  Let me know by posting your thoughts.