2014 was a big year in healthcare. ICD-10 was delayed—again—and the United States got its first surgeon general in, oh, a year. The Pioneer ACO program took a couple of huge hits, there was at least one big IT vendor acquisition and in the category of very, very bad news, data hacks, Ebola and hospital violence were front-of-mind for many administrators.
So what were the biggest stories of 2014? What were execs talking about—and what are the implications going into 2015?
ICD-10 delayed... again
Hospitals who had spent a good chunk of change for the planned transition to the new code set had a moment of silence on October 1. And although some physician groups pushed to have the new deadline, October 1, 2015, pushed back even further, there was no language in the $1.1-trillion spending bill passed by Congress on Saturday that suggested that this is likely. Hospitals, for their part, have urged lawmakers to keep the deadline in place.
Despite the controversy surrounding ICD-10, there is one universally agreed-upon upside to the hyper-specific coding system: Weird and obscure codes that stand for bizarre medical injuries. By a country mile, Healthcare Dive's most popular story in 2014 was this one: The 16 most absurd ICD-10 codes.
Cerner acquires Siemens health IT division for $1.3B
Fulfilling ongoing industry rumors, EHR giant Cerner announced acquisition of the IT division of German corporation Siemens in a deal worth $1.3B in August. The acquisition increased Cerner's annual revenue from about $3 billion last year to more than $4.5 billion in annual revenue this year. This makes Cerner the number-one vendor in revenue, over a billion dollars larger than previous industry leader McKesson, according to Vince Ciotti on HIStalk. Epic is now in third place, with $1.7B in revenue.
Providers continue to struggle with EHR adoption and meaningful use attestation, struggles that many hospitals say are a direct result of vendor challenges—in fact, legal suits against IT vendors on the rise and likely to keep rising (think Cerner's $106 million settlement this spring). In July, Healthcare Dive took a look at the top 10 EHR vendors by MU attestations.
Patients are willing to pay NPs and PAs but Medicare still isn't
A recent online study of more than 1,500 US adults conducted by Harris Poll on behalf of the American Academy of Physician Assistants found that 93% of Americans who have interacted with a PA—including those who have accompanied a loved one to see a PA—in the last year agree that PAs are going to be part of the solution to address a shortage of healthcare providers.
However, there are still some legislative and regulatory barriers that limit NPs and PAs' ability to practice medicine. One of Healthcare Dive's most popular features in 2014 looked at how much longer federal laws will prevent them from practicing to the full scope of their abilities.
Another one bites the dust in the Pioneer ACO program
San Diego-based Sharp HealthCare, which operates five hospitals, announced in its Q3 earnings report that it has dropped out of the Medicare Pioneer accountable care organization program, and shortly thereafter, three more ACOs followed: Franciscan Alliance, Genesys PHO and Renaissance Health Network. Nineteen now remain in the program, although some have transferred to the less-risky shared savings program.
According to Sharp, fundamental flaws in the program itself prompted the system's departure: "Because the Pioneer financial model is based on national financial trend factors that are not adjusted for specific conditions that an ACO is facing in a particular region (e.g., San Diego), the model was financially detrimental to Sharp ACO despite favorable underlying utilization and quality performance," Sharp said in its disclosure.
Healthcare Dive was ahead of this particular trend. In May, we took a look at how one insurer exposed Medicare ACOs' biggest flaw.
Hospitals hire actors to fake Ebola symptoms
The Ebola outbreak in West Africa has killed 6,841 people as of Monday, and hospitals in the United States haven't been immune from the crisis. While some have lambasted the public response as hysteria, the first patient diagnosed on US soil wasn't diagnosed when he first visited the hospital and subsequently died.
Hospitals have worked to prepare themselves in a variety of ways, including the acquisition of protective gear that has caused a spike in business amongst suppliers. Health experts say that the domestic risk associated with the crisis in West Africa has shined a limelight on infection control procedures.
Many hospitals have also prepared their staff through training, including one hospital that tested its staff by hiring actors to fake Ebola-like symptoms in the ER.
Community Health Systems announces massive data hack
In August, Franklin, TN-based Community Health Systems announced that it was the victim of a massive theft of the personal data of 4.5 million people. The hack likely occurred in April or June and included patient names, addresses, social security numbers and other HIPAA-protected data.
CHS is one of the largest hospital operators in the country, managing 206 hospitals in 29 states. This was a high-profile breach, and it came directly in the wake of the FBI's warning to the healthcare industry that it needs to shape up its data security efforts: In April, the FBI issued a private industry notification (PIN) to the healthcare industry, warning providers that their security is insufficient to meet the risk of cyberattacks.
Healthcare Dive took a look at 4 ways providers can avoid data breaches and how to deal with those breaches that come from the inside.
Physician shoots gunman at Philadelphia hospital
A psychiatric patient opened fire at Mercy Fitzgerald Wellness Center in Philadelphia in July, killing his caseworker before psychiatrist Lee Silverman returned fire with his open weapon and critically wounded the shooter. The shooting raised serious questions about hospital safety, particularly in facilities like Mercy, and how staff should be trained to respond in the face of patient violence.
"I believe that if the doctor did not have a firearm, [and] the doctor did not utilize the firearm, he'd be dead today, and I believe that other people in that facility would also be dead," said Delaware County District Attorney Jack Whelan.
Following the incident, Healthcare Dive spoke to a hospital security expert to discuss this highly-read feature: Active shooters and other violence: How hospitals should prepare.
The shooting had other implications for healthcare as the Senate debated the president's appointee for surgeon general, a post that until December 15 had been empty for a year and a half as legislators wrangled over gun control issues. At the 11th hour, the Senate confirmed internal medicine physician Dr. Vivek H. Murthy for the role, but not without plenty of angst about Murthy's position on fire arms.
Other talking points
Both are expanding their affiliate networks, but neither anticipates unrestricted growth. Affiliated hospitals enjoy national branding and other benefits, but will they remain independent?
The new 100-bed hospital isn't affiliated with a health system in any way—and its entrepreneurial, specialist-driven model is setting it apart in an incredibly competitive market.
Uber held a somewhat unsuccessful one-day flu shot campaign. Is healthcare ready to be this mobile?
These words are popular at conferences and in opinion columns, but what do they really mean?
Both ran healthcare companies brought down by accusations of massive financial fraud, but only one ended up taking any blame for the mess.