Nikhil Verma M.D.’s Post

Here’s a shocker…..private equity firms in healthcare lead to worse outcomes! “Private equity acquisition was associated with increased hospital-acquired adverse events, including falls and central line–associated bloodstream infections, along with a larger but less statistically precise increase in surgical site infections. Shifts in patient mix toward younger and fewer dually eligible beneficiaries admitted and increased transfers to other hospitals may explain the small decrease in in-hospital mortality at private equity hospitals relative to the control hospitals, which was no longer evident 30 days after discharge. These findings heighten concerns about the implications of private equity on health care delivery.”

Does it matter who is the owner? With acquisitions in the medical sector happening quickly within all specialities, do we know if healthcare will suffer from it? In this recent study specifically regarding hospital acquisitions the statistics showed a negative impact. Ultimately the end goal is to make sure "care" and "health" is IN the system. "Private equity acquisition was associated with increased hospital-acquired adverse events, including falls and central line–associated bloodstream infections, along with a larger but less statistically precise increase in surgical site infections. Shifts in patient mix toward younger and fewer dually eligible beneficiaries admitted and increased transfers to other hospitals may explain the small decrease in in-hospital mortality at private equity hospitals relative to the control hospitals, which was no longer evident 30 days after discharge. These findings heighten concerns about the implications of private equity on health care delivery." https://lnkd.in/eC7HxHrm Kannan S, Bruch JD, Song Z. Changes in Hospital Adverse Events and Patient Outcomes Associated With Private Equity Acquisition. JAMA. 2023;330(24):2365–2375. doi:10.1001/jama.2023.23147 #regulations #healthcare #prevention #policymaking

"The data are clear: Value-based care works. As our report shows, this smarter health care model improves outcomes for Medicare Advantage members and allows primary care physicians to practice medicine at the top of their license and develop meaningful relationships with patients," says Kate Goodrich. Based on the findings, VBC facilitates a more team-based approach to whole-patient care, with PCPs empowered by multidisciplinary teams to ensure patients receive high-quality, holistic care. It allows us to refocus our perspective on what really matters: the patient. #VBC #ValueBasedCare #Healthcare #Patients #Medicine #Relationships

Does the quality of patient care change when a private equity firm acquires a hospital? That is a question that researchers sought to answer. Their conclusion: The acquisition of a hospital by a private equity firm was linked with a 25% increase in hospital-acquired adverse conditions. These conditions included falls and bloodstream infections. This study suggests that profit-driven ventures are likely to cut corners and leave patients more vulnerable to substandard care. #hospitals #healthcare #privateequity #patientcare #Medicare

Hospitals should increase and improve their care transition activities (CTAs) in order to improve patient outcomes and lower spending, according to a new study in the American Journal of Managed Care.   The study involved more than 400,000 hospitalized Medicare fee-for-service beneficiaries discharged to the community in 2017 and examined the association between hospital-reported CTAs and beneficiaries’ transitional care management (TCM) claims. It found TCM was associated with significantly lower spending, ED visits, hospitalizations, readmissions and 90-day mortality. Significant utilization reductions were estimated for beneficiaries attributed to high-CTA hospitals.     Read the study here: https://bit.ly/3BvpoJu I #ACO #CareTransition AJMC - The American Journal of Managed Care

Is private equity bad for healthcare? Recent research indicates that hospitals acquired by private equity firms experience an increase in adverse events, even though they typically admit lower-risk patients. Specifically, within three years post-acquisition, there was a 27% rise in falls, a 38% increase in central line-associated infections, and approximately twice as many surgical site infections compared to control hospitals. Key findings: 1. A 25% higher rate of hospital-acquired adverse events occurred after private equity takeovers. 2. Younger patients with less dual eligibility for Medicare and Medicaid were affected. 3. The study concludes that these hospitals are providing "poorer quality inpatient care." #Healthcare #PrivateEquity #PatientSafety

Based on the findings, value-based care (VBC) facilitates a more team-based approach to whole-patient care, with PCPs empowered by multidisciplinary teams to ensure patients receive high-quality, holistic care. In 2022, 85% of patients in value-based arrangements saw their primary care provider (PCP) at least once, whereas 75% of those not in VBC arrangements saw their PCP at least once. Regarding preventive care, value-based arrangements saw a 14.6% higher rate of completed preventive screenings compared with MA members who were not in value-based arrangements. Patients treated in VBC arrangements also saw 30.1% fewer in-patient admissions compared with Original Medicare beneficiaries.

A well-timed study published in JAMA with the news that General Catalyst is acquiring Summa Health. “PE acquisition of hospitals, on average, was associated with increased hospital-acquired adverse events despite a likely lower-risk pool of admitted Medicare beneficiaries, suggesting poorer quality of inpatient care. In a difference-in-differences examination of 662,095 hospitalizations at 51 PE–acquired hospitals and 4,160,720 hospitalizations at 259 matched control hospitals using Medicare Part A claims data, PE acquisition was associated with a 25.4% increase in hospital-acquired conditions (HACs), which was driven by falls and central line–associated bloodstream infections. Medicare beneficiaries at PE hospitals were modestly younger, less likely to be dual eligibility, and transferred more to other acute care hospitals relative to control, likely reflecting a lower-risk population of admitted beneficiaries. This potentially explained a small relative reduction for in-hospital mortality that dissipated by 30 days after hospital discharge.”

Key takeaways from a recent JAMA study on the hospital-at-home concept (and thanks to Modern Healthcare for publishing this story): • About 47% of 1,134 people surveyed said they would choose hospital-level care at home. • About 40% of respondents thought hospital-at-home can be as good as in-facility care, while roughly a quarter said it was not.  • Nearly two-thirds of the adults surveyed said they would feel safe being treated at home. • Respondents also said they would be willing to assist in providing medical care to a loved one getting hospital care at home.  • About 82% said they would be able to manage medication on a schedule. • More than two-thirds said they would provide wound care to a patient and nearly half said they would change a catheter. Hospital-at-home programs that enable patients to receive acute care at home have proven effective in reducing complications while cutting the cost of care by 30 percent or more, according to the Commonwealth Fund. At UC Davis Health, we're building and innovating on this extraordinary front – our patients and their access to quality care, where, how and when they want it, is top-of-mind, always!

10 Year look back on #VBC from Humana. VBC is growing, but still #valuebasedcare by percentages ~40% VBC, ~20% FFS (with some VBC component), and 40% still straight FFS payments. Highlights from Humana: * 30.1% fewer inpatient admissions * 23.2% reduction in medical costs * 14.6% increase in VBC patients receiving preventative screenings vs. non-VBC Medicare Advantage patients Here is the full report: https://lnkd.in/enxhWWhi