25-09-2012 17:04 Health care has been changing in New Jersey with new laws, an aging population and talk of a potential doctor shortage. One of the factors for health care in New Jersey is the state's college merger, which includes UMDNJ. Dr. Thomas Cavalieri, dean of the UMDNJ School of Osteopathic Medicine, told NJ Today Managing Editor Mike Schneider that he's optimistic about the merger and believes it will improve health care in the state. For more New Jersey news, visit NJ Today online at

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UMDNJ Dean Hopeful Merger Will Make School Stronger - Video

On 9/27/12, Health Care REIT Inc.'s 6.50% Series J Cumulative Redeemable Preferred Stock (NYSE: HCN.PRJ) will trade ex-dividend, for its quarterly dividend of $0.4062, payable on 10/15/12. As a percentage of HCN.PRJ's recent share price of $27.04, this dividend works out to approximately 1.50%, so look for shares of HCN.PRJ to trade 1.50% lower ? all else being equal ? when HCN.PRJ shares open ...

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Health Care REIT's Series J Preferred Stock Goes Ex-Dividend Soon

President Barack Obama's health care overhaul has never been popular in Arkansas, a state where even most Democrats regard the law as politically toxic.

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Arkansas governor changes course on health care

Group health care spending in the United States accelerated last year, according to a new analysis.For those covered by employer plans, spending on health care services increased by 4.6% to $4,547 per plan enrollee. By contrast, in 2010, costs rose an average of 3.8%, according to the Health Care

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Group health care spending up in 2011: Analysis

By Robert Weisman, Globe Staff

UMass Memorial Health Care is stepping up its restructuring efforts, telling employees Tuesday that it plans to pare another 140 full-time jobs at its flagship hospital in Worcester.

In a letter to the systems 13,200 employees, chief executive John G. OBrien blamed declines in health insurance payments and the number of patients it treats. He said the latest cuts will come on top of about the 150 positions that have been eliminated at UMass Memorial Medical Center in Worcester since February. The system also operates four community hospitals in central Massachusetts.

OBrien said UMass Memorial Health Care has completed the sale of its home health and hospice division to VNA Care Network & Hospice for an undisclosed price, shedding another 144 jobs from the systems payroll in the process. UMass Memorial has also put its hospital labs unit up for sale.

Despite the steps to reduce expenses, OBrien warned that cost challenges remain.

While significant expense savings and revenue enhancement efforts were implemented in February, significant volume declines in our inpatient services such as cardiology medicine and womens services -- coupled with declining reimbursements -- continue to threaten our ability to end this fiscal year with an operating margin that breaks even, he wrote.

Other hospitals also have disclosed plans recently to trim staffing in the face of rising cost pressures. Last week, Boston Childrens Hospital said a plan to eliminate 255 positions would include 45 layoffs. Jordan Hospital in Plymouth last month said it was doing away with more than 60 jobs.

In an interview, OBrien said in-patient volume at UMass hospitals had dropped 4 percent from a year ago, partly because more health care procedures can be done on an outpatient basis. He also said health insurers are channeling members to lower-cost treatment facilities, making it harder for teaching and safety-net hospitals such as UMass Memorial Medical Center to compete. The hospital is affiliated with the adjoining University of Massachusetts Medical School.

Some of what were doing right now is looking to the future, said OBrien, who is retiring in January. Because when payment reform is implemented in Massachusetts, its going to be very challenging to the academic medical centers. With the tremendous pressure across the country to get health care costs down, I see this pressure for the foreseeable future.

UMass Memorial, --which also operates Clinton Hospital, Health Alliance Hospital in Fitchburg and Leominster, Marlborough Hospital --and Wing Memorial Hospital in Palmer, posted a $56.1 million profit for the 2011 fiscal year, according to data from the state Division of Health Care Finance and Policy. OBrien said much of that profit stemmed from investment income.

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UMass Memorial Medical Center to do away with another 140 full-time jobs

Freshmen interested in medicine were challenged Tuesday night to learn more about the American health care system and work for change in the future.

Dr. Bill Roper, dean of the School of Medicine and CEO of the UNC Health Care system, presented The Future of Medicine as part of the First Year Fellows lecture series.

Roper emphasized the need for medical students to understand government policy in order to excel in the field of medicine.

I hope that those of you interested in medicine are not perturbed (by these issues), Roper said.

Rather, I hope you see this as an opportunity to pursue medicine and get involved in these wider issues of national and public policy that are so important.

Roper said a false perception about American health care is that people eventually get all of the care they need.

He said individuals without health insurance are slower in seeking care and are ultimately worse off when they receive treatment.

Given these problems, Roper said that it is the substantial changes the way the system is organized, doctors are paid and services are rendered that need to be focused on.

We are not going to have sweeping change in health care, he said.

Rather, we are going to have incremental changes year after year that I hope will take us in the right direction in order to fix the problems I am trying to highlight.

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UNC School of Medicine Dean Bill Roper stresses medical policy

They may not like it, but they don't see it going away. About 7 in 10 Americans think President Barack Obama's health care law will go fully into effect with some changes, ranging from minor to major alterations, an Associated Press-GfK poll finds.

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AP-GfK Poll: Most see health law being implemented

WASHINGTON, Sept. 25, 2012 /PRNewswire/ -- Patients want more meaningful discussions with their care providers when making health care decisions, according to a new discussion paper released today by the Institute of Medicine. The survey found that 8 in 10 people want their health care provider to listen to them, but just 6 in 10 reported that it actually happens, and fewer than 4 in 10 say their provider clearly explains the latest medical evidence. Additionally, less than half of people surveyed reported that their provider asks about their goals and concerns for their health and health care.

"Simply stated, engaging patients in their own medical decisions leads to better health outcomes," concluded the authors, participants in the IOM's Evidence Communication Innovation Collaborative on behalf of its Roundtable on Value & Science-Driven Health Care. The paper is based on fresh qualitative and quantitative research, as well as an extensive review of relevant research on evidence- and medical-decision making, all commissioned by the collaborative.

Several authors discuss the research further in a just-released "Viewpoint" in the Journal of the American Medical Association, "Recognizing an Opinion: Findings from the IOM Evidence Communication Innovation Collaborative."

"The gap between what people want and what they are getting leads to poor medical decision-making, but it also represents an opportunity to do better," said George Halvorson, chairman and chief executive officer of Kaiser Permanente and co-chair of the IOM collaborative. "We know how to get it right; with shared decision-making between patients and clinicians that produces informed decisions."

The authors say there are three essential elements to an informed decision based on shared decision-making. First, people must have timely access to the best available medical evidence. Second, providers must provide sound, unbiased counsel based on their clinical expertise. Third, patients' and families' goals and concerns must be actively elicited and fully honored.

In the context of shared decision-making, the public does not view evidence as an indicator of cook-book medicine. Rather, a survey of 1,068 patients conducted by Consumer Reports National Research Center in the spring of 2012 for the IOM collaborative found that patients view evidence about what works for their condition as more important than either their provider's opinion or their personal goals and values.

"Doctors take note: People want and deserve meaningful engagement in conversations about their care, and they value it when rating their experience of care," said contributor John Santa, MD, director of the Consumer Reports Health Ratings Center. "They do not want their practitioner to make decisions for them or offer only some of the options."

The collaborative's goal is to accelerate the routine use of the best available evidence in medical decision-making. Bill Novelli, a professor in the McDonough School of Business at Georgetown University, former CEO of AARP and co-chair of the collaborative said the call to action is clear for the people who pay for care and provide care. "We need to make it easy to do the right thing by encouraging, empowering and motivating clinicians to facilitate informed medical decisions whenever and wherever they practice. Policy can foster this by changing the way we pay for care, by promoting high-quality tools to help clinicians inform patients, and by educating clinicians about best practices for communicating with patients."

The Evidence Communication Innovation Collaborative (ECIC) of the Institute of Medicine (IOM) Roundtable on Value & Science-Driven Health Care seeks to improve public understanding, appreciation, and evidence-based discussion of the nature and use of evidence to guide clinical choices. The collaborative includes communication experts, decision scientists, patient advocates, health system leaders and providers.

This research was led and conducted by MSL Washington, GYMR Public Relations, Lake Research and Consumer Reports National Research Center on behalf of the collaborative.

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Options and Evidence: It's What Patients Want

Copyright 2012 The Associated Press. Produced by NewsOK.com All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

I paid two medical bills last week: $306 toward an ultrasound and $126 for lab tests.

First, I called my health insurer, Blue Cross Blue Shield, to make sure I owed that much. The bills seemed steep, given that I have medical insurance. What's more, the ultrasound and labs were ordered in conjunction with my annual women's health screening, which I understood with the passage of health care reform should carry no co-payments or deductibles because it's recommended by the U.S. Preventive Services Task Force.

The phone rep told me the extended tests weren't coded by my doctor as preventive. I accepted that. But when I asked about the percentage I owed, I got confused. I assumed 20 percent, after my $500 deductible was met. But I learned my responsibility was 30 to 40 percent, depending on the federal tax ID of providers and whether they fell in the Blue Choice, Blue Preferred or Blue whatever networks. I have Blue Options, but it doesn't feel like I have options. Surely, there's a simpler way.

A new Oklahoma City-based startup aspires to offer physician, specialty and surgical care on a prepaid, monthly retainer basis. Meanwhile, even the state's SoonerCare Medicaid state-federal system which provides health care to largely low-income women and children moved from managed care to fee-for-service years ago to more efficiently provide care.

The Patient Protection and Affordable Care Act is like rearranging deck chairs on the Titanic, David Rothwell, a primary care physician and partner in the new company Salerno Health (salernohealth.com), told me last week. When it fully takes effect in January 2014, the legislation mandates health care for more uninsured Americans, but Rothwell said the nation is short some 225,000 doctors to care for the influx of patients. Moreover, he said, the act does nothing to control skyrocketing medical costs.

Insurance was meant to cover major medical and not preventive care, he said. Asking health insurance to cover X-rays, most blood tests, routine procedures and physician visits is equivalent to asking your car insurance to pay for a portion of new windshield wipers or an oil change, he said.

Launched June 1 with a dozen investors and six primary care providers in the greater Oklahoma City area, Salerno for $49 a month provides 85 percent of the health services the average person needs, Rothwell said. My ultrasound or an MRI or colonoscopy would have cost me $50 over their retainer, he said. For an additional $69 a month, or $118 total, people starting Oct. 1 can have specialty and surgical care, including cardiology and orthopedics.

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Health care choices lack simple answers