As stated below ---what was 3/4 of Americans with strong private health are is now almost 3/4 of Americans with Medicaid. Medicare citizens who are low-income are being pushed into Medicaid level care as are veterans and public employees. These few decades coming will see that 3/4 rise to over 95% of Americans on gutted of funding Medicaid for All.
'What can I do to help rural Americans?
Families USA’s recent infographic shows the 24 states that have not yet decided to expand Medicaid'.
Mining for Medicaid gold: Health plans' latest profit ...www.amednews.com/article/20101206/business/312069965/4 With enrollment in employer-sponsored health insurance steadily declining and more Americans falling into the Medicaid safety net, health insurance companies are ...
MOVING OUR FEDERAL HEALTH PROGRAMS INTO PRIVATE HEALTH SYSTEMS IS FOLLOWED BY A WORLD HEALTH ORGANIZATION FUNDING OF OF THESE ONE WORLD PREVENTATIVE CARE ONLY LOWER TIERS OF HEALTH ACCESS.
'Almost three-quarters of the population obtained coverage through private insurance and one-quarter through public programs in 1991'.
'But Kentucky, a state controlled by a Republican governor that nonetheless built its own marketplace and did expand Medicaid, Medicaid enrollment has increased 76 percent since the ACA, the largest gain in the country'.
Below we see a right wing political group FAMILIES USA-----pretending that fighting to get Americans on GUTTED OF FUNDING MEDICAID is a good thing. They are not fighting the dismantlement of our strong, developed nation public health structure allowing most people access to hospitals and medical procedures--they are fighting to push more and more citizens onto MEDICAID. So, now we have that GAP where we need to fund programs just to move citizens to a MEDICAID LEVEL OF CARE. That was the goal of Affordable Care Act.
Many African-Americans Fall Into a Health 'Coverage Gap'
- January 26, 2015
- By Teresa Wiltz
Get Covered America volunteers Cynae Derose (L) and Jalisa Hinkle talk with Shirese Davis about the Affordable Care Act (ACA) while canvassing a Chicago neighborhood. A disproportionate number of low-income African-Americans are caught in a “coverage gap”: They make too much to qualify for Medicaid, but not enough to qualify for subsidized insurance on the ACA exchanges. (AP)
Thanks to the Affordable Care Act, the percentage of people of color who do not have health insurance is projected to fall dramatically by 2016, greatly narrowing the historic disparities in coverage between whites and nonwhites.
FOLKS, PLEASE DON'T THINK GETTING ON A MEDICAID PLAN IS A STEP UP-----IT IS NOT. IT'S NOT JUST ANY HEALTH PLAN.
But one minority group is likely to benefit less than others: African-Americans.
Fifty-five percent of all African-Americans reside in the 23 states that have not expanded Medicaid eligibility under the ACA. By comparison, 42 percent of whites, 38 percent of Latinos and 23 percent of Asians live in nonexpansion states, according to the Urban Institute.
In those nonexpansion states, a disproportionate number of blacks don't qualify for the narrower Medicaid program in place now. Medicaid typically covers pregnant women, young children, and disabled and elderly adults. Relatively few able-bodied adults with children qualify in those states, and only at incomes well below the federal poverty level. (Childless adults do not qualify.)
Even if they meet the other eligibility requirements, many African-Americans in nonexpansion states earn too much to qualify for Medicaid, but not enough to qualify for subsidized insurance on the federal health care exchanges (which exist in all states), leaving them caught in a “coverage gap.”
Before a June 2012 Supreme Court ruling made Medicaid expansion optional, the ACA anticipated that all states would expand the program. Since the assumption was that people below the federal poverty level ($11,670 for an individual) would be covered by Medicaid, only people making between that amount and four times that amount qualify for federal aid to buy insurance on the exchanges.
More than a quarter—1.4 million—of the 4 million Americans in the coverage gap are black. According to Jessica Stephens, a senior policy analyst with the Kaiser Family Foundation, a large number of Latinos also are caught in the coverage gap. But because they live largely in states that have expanded Medicaid, they are not represented in such disproportionate numbers.
“If the other states that have so far refused Medicaid expansion expanded it, the black/white (disparity) would drop dramatically,” said Lisa Clemans-Cope, a health economist at the Urban Institute and the author of a new report on coverage rates under the ACA. “Where you live matters.”
Some Republican-dominated states have refused to expand Medicaid to express their opposition to the broader health care law, but others cite fiscal concerns. The federal government will pick up 100 percent of the costs of expansion through next year. But starting in 2017, the federal share will gradually decline until it reaches 90 percent in 2020, where it will remain. Some states worry that the 10 percent share may be too much for them to afford, or that the federal government will scale back its contribution sometime in the future.
A disproportionate percentage of blacks live in the South, and that is where resistance to expansion remains strongest. Roughly half the states that have not expanded Medicaid are located in that region.
Southern states also have the strictest eligibility requirements for their current Medicaid programs. In Mississippi, for example, the parent/caretaker in a family of three would be ineligible for Medicaid if he or she earned more than $384 a month. About 86 percent of people in the coverage gap reside in the South, according to Stephens from the Kaiser Family Foundation.
Living in the Gap
Under the ACA, the divide in coverage between whites and blacks dropped from a 6.5 percentage-point gap to a 5 percentage-point gap, Clemans-Cope said. But if all states expanded Medicaid coverage, then the divide in coverage between whites and African-Americans would drop to 2.6 percentage points, she said.
Expanding Medicaid would be a big help for African-Americans in the coverage gap, according to Katherine Howitt, senior policy analyst at Community Catalyst, a national nonprofit group that advocates for affordable health care. Without insurance, Howitt said, poor working people don't have many options beyond relying on emergency rooms or the few community health care centers that offer free or discounted health services.
The majority of people caught in the coverage gap are employed. They're the working poor, paying the bills with a part-time gig or punching the clock with an employer who doesn't offer insurance. They may be juggling multiple jobs to make ends meet, or they may be in school full time.
“Closing the coverage gap can really give them a chance to get ahead,” Howitt said. “Right now, the coverage gap is politicized, tied in many legislators' minds to the ACA or Obamacare. There are lots of challenges in overcoming those political hurdles.”
Even with Medicaid expansion and subsidies on the exchanges, some people will still remain uninsured. This is because some will always decide not to pick up insurance because they believe it is unaffordable, even when they qualify for Medicaid or would only have to pay a very small premium on the exchanges. Many don't know that they qualify for assistance.
“Securing health coverage is part of the larger conversation about securing and stabilizing our community,” said Derrick Harkins, national director for Faith Initiatives and African-American Engagement for Enroll America. “You're talking about economic stability, social stability, family stability; all those things are connected. (Health care) doesn't stand apart from those.”
A Litany of Disparities
African-Americans face a litany of health disparities. According to the U.S. Department of Health and Human Services, blacks are more likely to die from cancer than any other racial or ethnic group, are diagnosed with AIDS at nine times the rate of whites and are much more likely to rely on the emergency room for their health care than are whites. They are also 40 percent more likely to have high blood pressure and twice as likely to be diagnosed with diabetes. Black women are 40 percent more likely to die from breast cancer. The mortality rate among African-American infants is more than twice that of non-Hispanic white infants.
Research shows that people with insurance tend to be healthier than those without, so the relatively high percentage of African-Americans without coverage contributes to those gaps.
Before the implementation of the ACA, 19.6 percent of blacks were uninsured, compared to 13.1 percent of whites, according to Clemans-Cope. If no additional states expanded Medicaid, 11.1 million whites are projected to gain coverage by 2016, a 52 percent reduction in the number of uninsured whites. About 2.9 million African-Americans are projected to gain coverage, a 42 percent reduction in the number of uninsured blacks.
The impact of Medicaid expansion is evident in several metropolitan areas that encompass multiple states.
The St. Louis area, which includes parts of Missouri and Illinois, is one example. Missouri opted not to expand Medicaid and nearly 15 percent of black Missourians living in or near St. Louis are projected to be uninsured in 2016. Illinois did expand, and only 5.3 percent of black Illinoisans living in the St. Louis area are projected to be uninsured. If Missouri expanded Medicaid, the number of uninsured black Missourians living in or near St. Louis would drop to 7.5 percent.
Similarly, in the Washington, D.C., metropolitan area, which includes parts of Maryland and Virginia, both the District and Maryland have expanded Medicaid, while Virginia has not. (Gov. Terry McAuliffe, a Democrat, has pushed for expansion, but the legislature has balked.) According to the Urban Institute, in 2016 the uninsured rate for blacks is projected to fall to 3.9 percent in the District, 6.4 percent in the Maryland suburbs, and 10.4 percent in the Virginia suburbs. If Virginia expanded Medicaid, the uninsured rate among African-Americans living in the Virginia suburbs of the District would drop to 6.2 percent.
“This is a chance to help the working poor and the backbone of the economy in these states,” Howitt said.
Indeed, our international labor unions backing global Wall Street Clinton neo-liberals since 1990s knowing these far-right Wall Street pols were going to bust all labor wages and benefits have our labor union members as the biggest health care losers. As stated below these unions stand against Federal health plans because it takes away from the unions' power in negotiating labor benefits.
COME ON LABOR UNION LEADERS-----YOUR GOALS SHOULD BE SEEING TO THE WELFARE OF MEMBERS!
So international labor unions have supported privatization of health care------it supported global health systems----and then it shouted against the fact that its union membership are heading to GUTTED OF FUNDING MEDICAID FOR ALL. That 5% to the 1% labor union leader KNEW union health benefits were going to be gutted.
'Government health care harms unions
What a lot of people may not realize is that for much of our history, labor unions opposed universal coverage. “Unions…derive some advantage of good will, power, or profit from serving as a financial intermediary in health care,” writes Paul Starr in his Pulitzer Prize-winning history of the American health-care system, The Social Transformation of American Medicine'.
This is why our international labor unions will not support an EXPANDED AND IMPROVED MEDICARE FOR ALL----instead they support the global Wall Street players knowing they will give labor the least in wages and health benefits. US workers MOVING FORWARD to global labor pool ONE WORLD ONE THIRD WORLD HEALTH CARE.
Jul 15, 2013 @ 10:12 AM 428,953 Sell In May & Walk Away: 6 Stocks to Dump
Labor Unions: Obamacare Will 'Shatter' Our Health Benefits, Cause 'Nightmare Scenarios'
Insights into health care and entitlement reform.
Opinions expressed by Forbes Contributors are their own.
Avik Roy, Forbes Staff
Teamsters Union President James Hoffa in Detroit, 2011. (Image credit: Getty Images via @daylife)
Labor unions are among the key institutions responsible for the passage of Obamacare. They spent tons of money electing Democrats to Congress in 2006 and 2008, and fought hard to push the health law through the legislature in 2009 and 2010. But now, unions are waking up to the fact that Obamacare is heavily disruptive to the health benefits of their members.
Last Thursday, representatives of three of the nation’s largest unions fired off a letter to Harry Reid and Nancy Pelosi, warning that Obamacare would “shatter not only our hard-earned health benefits, but destroy the foundation of the 40 hour work week that is the backbone of the American middle class.”
The letter was penned by James P. Hoffa, general president of the International Brotherhood of Teamsters; Joseph Hansen, international president of the United Food and Commercial Workers International Union; and Donald “D.” Taylor, president of UNITE-HERE, a union representing hotel, airport, food service, gaming, and textile workers.
“When you and the President sought our support for the Affordable Care Act,” they begin, “you pledged that if we liked the health plans we have now, we could keep them. Sadly, that promise is under threat…We have been strong supporters of the notion that all Americans should have access to quality, affordable health care. We have also been strong supporters of you. In campaign after campaign we have put boots on the ground, gone door-to-door to get out the vote, run phone banks and raised money to secure this vision. Now this vision has come back to haunt us.”
‘Unintended consequences’ causing ‘nightmare scenarios’
IT IS NOT UNINTENDED CONSEQUENCES---IT IS MOVING FORWARD PROFITEERING HEALTH CARE.
The union leaders are concerned that Obamacare’s employer mandate incentivizes smaller companies to shift their workers to part-time status, because employers are not required to provide health coverage to part-time workers. “We have a problem,” they write, and “you need to fix it.”
“The unintended consequences of the ACA are severe,” they continue. “Perverse incentives are causing nightmare scenarios. First, the law creates an incentive for employers to keep employees’ work hours below 30 hours a week. Numerous employers have begun to cut workers’ hours to avoid this obligation, and many of them are doing so openly. The impact is two-fold: fewer hours means less pay while also losing our current health benefits.”
What surprises me about this is that union leaders are pretty strategic when it comes to employee benefits. It was obvious in 2009 that Obamacare’s employer mandate would incentivize this shift. Why didn’t labor unions fight it back then?
Regulations will ‘destroy the very health and wellbeing of our members’
The labor bosses are also unhappy, because of the way Obamacare affects multi-employer health plans. Multi-employer plans, also called Taft-Hartley plans, are health insurance benefits typically arranged between a labor union in a particular industry, such as restaurants, and small employers in that industry. About 20 million workers are covered by these plans; 800,000 of Joseph Hansen’s 1.3 million UFCW members are covered this way.
Taft-Hartley plans, they write, “have been built over decades by working men and women,” but unlike plans offered on the ACA exchanges, unionized workers will not be eligible for subsidies, because workers with employer-sponsored coverage don’t qualify.
Obamacare’s regulatory changes to the small-group insurance market will drive up the cost of these plans. For example, the rules requiring plans to cover adult children up to the age of 26, the elimination of limits on annual or lifetime coverage, and the mandates that plans cover a wide range of benefits will drive premiums upward.
But the key problem is that the Taft-Hartley plans already provide generous and costly coverage; small employers now have a more financially attractive alternative, which is to drop coverage and put people on the exchanges, once the existing collective bargaining agreements are up. That gives workers less reason to join a union; a big part of why working people pay union dues is because unions play a big role in negotiating health benefits.
So the labor leaders are demanding that their workers with employer-sponsored coverage also gain eligibility for ACA subsidies. Otherwise, their workers will be “relegated to second-class status” despite being “taxed to pay for those subsidies,” a result that will “make non-profit plans like ours unsustainable” and “destroy the very health and wellbeing of our members along with millions of other hardworking Americans.”
‘The law as it stands will hurt millions of Americans’
The leaders conclude by stating that, “on behalf of the millions of working men and women we represent and the families they support, we can no longer stand silent in the face of elements of the Affordable Care Act that will destroy the very health and wellbeing of our members along with millions of other hardworking Americans.”
President Obama, of course, pledged that “if you like your plan, you can keep your plan.” But the labor leaders say that, “unless changes are made...that promise is hollow. We continue to stand behind real health care reform, but the law as it stands will hurt millions of Americans including the members of our respective unions. We are looking to you to make sure these changes are made.”
Delay of employer mandate ‘troubling’
These aren’t the only union leaders who have been critical of Obamacare. Kinsey Robinson, president of the United Union of Roofers, Waterproofers and Allied Workers, said in April that their concerns “have not been addressed, or in some instances, totally ignored,” and that “in the rush to achieve its passage, many of the act’s provisions were not fully conceived, resulting in unintended consequences that are inconsistent with the promise that those who were satisfied with their employer-sponsored coverage could keep it.”
Richard Trumka, head of the AFL-CIO, is unhappy with the White House’s one-year delay of the employer mandate, calling it “troubling.” Hoffa, Hansen, and Taylor note that "this is especially stinging [and] most disconcerting" because the administration has responded to the concerns of businesses, but not those of labor.
DID ANYONE REALLY THINK GLOBAL WALL STREET CLINTON NEO-LIBERALS WERE GOING TO INSTALL AN EMPLOYER MANDATE?
But it’s the employer mandate which is responsible for all of the disruptions that Trumka’s labor brothers are complaining about. If we repealed the employer mandate, we’d get rid of the incentive that restaurants and other employers have to cut the hours of part-time employees.
Government health care harms unions
What a lot of people may not realize is that for much of our history, labor unions opposed universal coverage. “Unions…derive some advantage of good will, power, or profit from serving as a financial intermediary in health care,” writes Paul Starr in his Pulitzer Prize-winning history of the American health-care system, The Social Transformation of American Medicine.
If unions’ role in negotiating health coverage is taken over by the government, unions lose a big chunk of their utility. “Employers and unions had both tried to use medical care to strengthen their hand in the battle for workers’ allegiances,” Starr continues.
Labor unions opposed FDR’s half-hearted attempt at universal coverage, and split on Truman’s related proposal. Unions were fine with Medicare and Medicaid, because health benefits for retirees and poor people weren’t as relevant to their interests. It wasn’t until the 1970s that the goals of progressives and labor unions became closely aligned on national health care.
Now, my primary concern isn’t the power and influence of labor unions—rather, it’s the ability of Americans to have access to good jobs and affordable health insurance. And those latter goals are best achieved in a system where people buy health coverage for themselves, instead of getting it through their employers or the government.
That Obamacare encourages more people to buy insurance on their own, in part by incentivizing employers to drop health coverage, is one of the law’s few salutary qualities. It’s unsurprising that this outcome makes labor unions unhappy. But they had every opportunity to take the bill in a different direction in 2009. That they didn’t is no one’s fault but their own.
Do we have PUBLIC HEALTH if our first responders are privatized to global security and emergency corporations? If our community planners are global Wall Street Baltimore Development and their 'labor and justice' organizations? Do we have social workers, public health doctors and nurses if our public health department is outsourced to global Johns Hopkins and its corporate non-profits? Do we have public policy-makers if global health corporation executive committees are writing that health policy? If we have record outbreaks of public health disease vectors because no health inspections or ordinary sanitation has been dismantled?
OF COURSE NOT-----THAT WAS OUR AMERICAN, FIRST WORLD DEVELOPED NATION QUALITY OF LIFE-----THIRD WORLD FOREIGN ECONOMIC ZONES DON'T HAVE CITIZENS WITH RIGHTS TO THESE HEALTH PROTECTIONS!
Public Health is...
Some examples of the many fields of public health:
Scientists and researchers
Public health physicians
Public health nurses
Occupational health and safety professionals
Here is an article telling WE THE PEOPLE the US has no PUBLIC HEALTH protections whether in our communities our in our health facilities from predatory medical procedures to complete absence of accountability and all this stems from CLINTON/BUSH/OBAMA dismantling our our Federal Health and Human Services enforcement of Federal health protections and patient's bill of rights. We are at this point because of the global Wall Street health executives that are now the national health committee members writing all our public health policy. We will no longer get an honest assessment of performance because these health institutions like global Johns Hopkins are simply being allowed to SELF EVALUATE-----ergo, juke the stats.
Our once public scientists and researchers are now tied to global corporate R and D facilities----product patenting mills---not public health scientists.
When we say AFFORDABLE CARE ACT didn't do all that---this existed before----yes, it existed during CLINTON/BUSH/OBAMA because Federal agencies were not enforcing laws---it will soar now because Affordable Care Act officially wrote into law these deregulated and profit-driven conditions.
Patient safety: A public health crisis for a nation of patients
By Stephen E. Littlejohn
April 10, 2017
The United States is a nation of patients. More than 300 million Americans -- 95 percent of us — encounter the nation’s health care system at least once in the space of five years. It’s essential that every health care encounter is safe and free from harm. Sadly, that isn’t the case.
Our daughter, Meredith, died not from the cancer she had been so bravely fighting but from a health care-associated infection that should have been preventable and for which there was no effective antibiotic. Meredith isn’t an exception. The Centers for Disease Control and Prevention estimate that nearly three-quarters of a million Americans develop health care-associated infections each year, 75,000 of whom die during that hospitalization.
Other patients get the wrong medications, endure mistakes in surgery, experience falls in the hospital, receive treatments meant for someone else, develop pressure ulcers, and more. More than 12 million patients each year experience a diagnostic error in outpatient care, half of which could cause harm. One-third of Medicare beneficiaries in skilled nursing facilities experience adverse events.
“Crossing the Quality Chasm,” an influential report from the Institute of Medicine (now the National Academy of Medicine), says that “tens of thousands of Americans die each year from errors in their care, and hundreds of thousands suffer or barely escape from nonfatal injuries that a truly high-quality care system would largely prevent.”
There have been improvements in patient safety in recent years, but they have been limited and inconsistent. New safety systems, like surgical checklists and medication barcoding, have taken hold in some places. But they have inexplicably failed to gain traction elsewhere.
My daughter’s death compelled me to help find ways to make American health care safer. I’m now on the Advisory Board of the National Patient Safety Foundation (NPSF), which recently released a Call to Action that reframes the challenge of preventing health care harm as a public health crisis and proposes a national coordinated response.
The Call to Action looks to earlier efforts to tackle serious public health problems like smoking, highway accidents, and drunk driving. They had in common strong leadership, an actively engaged public, and new cultural norms. They have also paid off. Since 1965, the smoking rate has declined from 42% to 17%, the motor vehicle fatality rate decreased by half and the alcohol-related share of motor vehicle fatalities dropped from one-half to one-third.
The Call to Action aims to help improve patient safety by embracing the powerful combination of leadership, coordinated and clearly defined messages, and public engagement that has provided the foundation of successful public health campaigns. It stresses the need for collaboration among all stakeholders, especially patients and families.
The NPSF wants patients and families to share decision-making with their physicians and to play active roles when medical teams visit hospitalized patients at the bedside The foundation also calls for removing limits on family visiting hours, making available patient-activated rapid response teams, and participating in root cause analyses when harm or mistakes occur.
Here are a few other things that patients and family members can do to make each health care encounter safer.
- Wash your hands to prevent infection and don’t be shy about reminding others, especially the medical staff, to do the same thing.
- Ask questions about the risks and benefits of any treatment or procedure.
- Don’t go alone – bring a trusted ally with you whenever possible.
- Know your medications and why you’re taking them.
- Repeat back to your clinicians what you think they’ve told you.
- And understand your care plan by asking the NPSF Ask Me 3 questions: What is my main problem? What do I need to do? Why is it important for me to do this?
As a nation of patients, we must make patient safety a priority. Each of us should put the “public” in public health and work to prevent health care harm in every way possible.
'Evergreen was created by former Howard County health chief Dr. Peter Beilenson as a consumer-run health insurance co-op. The federal Affordable Care Act established a loan program to encourage new private, consumer-run insurance companies that could increase competition among insurers and hopefully drive down prices. Evergreen received a $65 million loan through the health reform law before the loan program was shut down during budget negotiations'.
In each state when Affordable Care Act directed private health systems be built those global health systems already in place like global Johns Hopkins simply solidified the consolidation with other global private health institutions like global PHARMA and global health insurance corporations while the lower-tier health system for what was to become GUTTED OF FUNDING MEDICAID FOR ALL was allowed to PRETEND to be corporate non-profits LIKE MARYLAND'S EVERGREEN HEALTH. We shouted loudly this was a back-door give-away to what is a Johns Hopkins operative and state health insurance insider BEILENSON------and here it is---not several years after it registered as a non-profit geared to provide affordable health care for Marylanders ----it is petitioning to become private and it will win that petition and is merging with a global LIFE BRIDGE. Now, Evergreen Health could not recruit any consumers other than public health employees, MEDICAID AND MEDICARE citizens. The entire reason for its existence was to consolidate all lower-tier health consumers into one major outlet and then hand them to a global corporation.
Remember, BEILENSON was able to grab all kinds of subsidy in building this lower-tiered health corporation as a non-profit now he sells it as though it was a for-profit-----WINNERS AND LOSERS IN THIS HEALTH CARE PRIVATIZATION OF ALL THAT IS PUBLIC HEALTH.
'The stock purchase agreement is pending Evergreen's final transition to a for-profit company, which the Maryland Insurance Administration is expected to consider in June'.
Just about ANYONE can start a business with $ 65 million in subsidy and the state moving all its public health business to a CO-OP HEALTH NON-PROFIT-------------THIS IS CRIMINAL
Investor Group Agrees to Acquisition of Evergreen Health
News provided by
Evergreen Health 01 May, 2017, 09:42 ET
BALTIMORE, May 1, 2017 /PRNewswire/ -- A group of investors, comprised of JARS Health Investments, Anne Arundel Health System and LifeBridge Health, today announced that it has formally agreed to acquire Evergreen Health.
The stock purchase agreement is pending Evergreen's final transition to a for-profit company, which the Maryland Insurance Administration is expected to consider in June.
"This agreement with some of Maryland's most respected health care organizations will ensure Evergreen's success for many years to come," said Dr. Peter Beilenson, CEO of Evergreen Health. "I am especially pleased that our new partners share Evergreen's abiding goal: to provide Maryland residents with the highest-quality services at the most affordable prices."
"We are proud to be partnering with Evergreen Health and are excited about the Company's future. Evergreen is poised to become a leading health insurance provider in Maryland. Evergreen now has the finances and partners to compete in the Maryland insurance market. The combined strength of the investors will make Evergreen a new powerhouse that brings competition to the marketplace," said Dr. Scott Rifkin, one of JARS's principals.
"The ability to offer insurance products has been a strategic imperative for Anne Arundel Medical Center for more than a decade, as it is an important factor in access to care and leads to improved health status and outcomes for the communities we serve," said Maulik Joshi, DrPH, Executive Vice President and Chief Operating Officer of Anne Arundel Health System.
"At LifeBridge Health, we believe in the power of partnership to improve the health of people in the communities we serve. We are eager to work with JARS and Anne Arundel Health System to build on what Evergreen has started and to add to the diverse portfolio of health and health-related services that LifeBridge Health provides," said Neil Meltzer, President and CEO of LifeBridge Health.
JARS is an investment group formed and funded by some of Maryland's top healthcare executives specifically to support Evergreen Health's mission of providing health insurance to Maryland residents.
Anne Arundel Health System includes a 380-bed not-for-profit hospital (Anne Arundel Medical Center), a medical group, imaging services, a substance use treatment center, and health enterprises. In addition to a 95-acre Annapolis campus, Anne Arundel Medical Center has outpatient pavilions in Bowie, Kent Island, Odenton, Pasadena and Waugh Chapel.
LifeBridge Health is one of the largest, most comprehensive providers of health services in Maryland. LifeBridge Health includes Sinai Hospital, Northwest Hospital, Carroll Hospital, Levindale Hebrew Geriatric Center and Hospital, and related subsidiaries and affiliates.
Evergreen Health was represented by Funk and Bolton. The investors were represented by Nemphos Braue LLC, Neuberger Quinn Gielen Rubin Gibber P.A. and Epstein Becker Green P.C.
Funny----Goggle EVERGREEN HEALTH and you see chains of this brand name all over the nation-------if this was independent why are no other EVERGREEN HEALTH corporations suing for brand name infringement? As with MEDSTAR being national they tout these subsidiaries as STARTUPS
'In September 2012, after two years of planning by an advisory board, the Centers for Medicare and Medicaid Services (CMS), an agency under the U.S. Department of Health and Human Services (HHS), allowed Evergreen Health Co-op Inc. to become the 22nd co-op in the nation'.
Call me skeptical but we see this brand all over the nation tied to Medicare and Medicaid patients and rehabilitation and we think EVERGREEN has more to do with the MEDICAL TERM EVERGREEN meaning
Evergreening is any of various legal, business and technological strategies by which producers extend their patents over products that are about to expire, in order to retain royalties from them, by either taking out new patents (for example over associated delivery systems, or new pharmaceutical mixtures), or by buying out, or frustrating competitors, for longer periods of time than would normally be permissible under the law.
It looks to me that this START UP in Maryland has ties to what would make a national consolidation of PHARMA, HOSPITAL, HEALTH INSURANCE, and HOME/SENIOR CARE facilities. By merging with SINAI HOSPITAL et al it brings that national health system monopoly opposite Johns Hopkins.
THIS IS HAPPENING IN YOUR NECK OF THE WOODS---IT MATTERS BECAUSE WHAT USED TO BE OUR FEDERAL MEDICARE AND MEDICAID IS BEING DISTRIBUTED TO THESE PRIVATE HEALTH SYSTEMS.
EVERGREEN PHARMACEUTICAL INC
EVERGREEN PHARMACEUTICAL INC
> Get Phone Number & Directions
11933 NE GLENN WIDING DR PORTLAND, OR 97220
Evergreen Health Center
1130 N Westfield St, Oshkosh, WI 54902
Get Map & Directions
Evergreen Health Center, the federal provider number is 525647, is a nursing home in Oshkosh WI. This nursing home accepts patients covered by medicare and medicaid and is registered as a non profit - corporation. Evergreen Health Center has a 95% occupancy rate with 76 residents using its 80 beds.
Evergreen Health & Rehabilitation Center
139 Moran Lake Road, Ne, Rome, GA 30161
Get Map & Directions
Evergreen Health & Rehabilitation Center, the federal provider number is 115720, is a nursing home in Rome GA. This nursing home accepts patients covered by medicare and medicaid and is registered as a for profit - corporation. Evergreen Health & Rehabilitation Center has a 86% occupancy rate with 86 residents using its 100 beds.
Evergreen Family Health
is committed to acting on your behalf as your medical home. The medical home concept, also known as a Patient Centered Medical Home (PCMH), uses a team approach of coordinating care between the primary care pracitioner, specialists, other providers such as therapists and home health care, and community resources. It also creates a central location where all your medical history is collected and available whenever it is needed for your healthcare.
We, as your primary care practitioners, serve as the main organizer of your medical home. One major benefit of a medical home is that you receive care from a practitioner who knows you and understands your medical history. Your primary care practitioner oversees your care, coordinates specialists who may treat your various medical conditions, and develops a relationship with you to understand various factors that might be important to your health.
28 Park Ave, Williston, VT 05495
Excellence in Rehab Care with Comfort and Compassion
At Evergreen Health and Rehab in Winchester, VA, you’ll find a comfortable, inviting atmosphere with caring, compassionate therapists, clinicians and staff. Whether patients are here for short-term rehab or long-term care, they receive the highest quality of care, state-of-the-art therapy, expert services and programming.
Welcome to Evergreen Home Healthcare,
your one-stop source for all home health care needs. We offer premier home health care services when they are medically necessary to help restore, rehabilitate or maintain a patient in their home. Our services are carefully designed to offer patients quality home health care including skilled nursing, home health aide services and other therapeutic services.
Evergreen Home Healthcare is a full-service Home Healthcare Agency certified under Medicare serving Boone Cook, DuPage, Kane, Lake, McHenry, Will, and Winnebago Counties
The Affordable Care Act was about consolidation and expanding US health care into global health systems and that is what we see with EVERGREEN HEALTH and below we see this as well with our next largest University of Maryland Medical System. Johns Hopkins has over these few decades been taking over all Baltimore public health hospitals and clinics so it is already well anchored in Greater Baltimore and expanded to Washington beltway. It merged with CA Kaiser to expand nationally and as we see below University of Maryland Medical System is really deeply partnered already with Johns Hopkins so a merger in the near future is FORESEEABLE.
That creates a top tier only for the global 1% and 2% Baltimore City center medical with the EVERGREEN merger group servicing that 99% of gutted of funding MEDICAID FOR ALL.
University of Maryland and St. Agnes to partner - Baltimore Sun
www.baltimoresun.com/health/bs-hs-stagnes-umms-merger-20160106-story.html Jan 6, 2016 ... The University of Maryland Medical System and St. Agnes Healthcare ... doctors and other resources that hospital executives say will enable them to provide ... Partnerships and mergers can also give smaller hospitals that affiliate ... Tinglong Dai, an assistant professor at the Johns Hopkins University Carey ...
University of Maryland Medical System Completes Merger with ...umms.org/newsreleases/2013/upper-cheaspeake-merger Dec 9, 2013 ... UMMS also operates Mt. Washington Pediatric Hospital as a joint venture with Johns Hopkins. The University of Maryland Medical Center ...
University of Maryland Medical System to Acquire Riverside Health...umms.org/newsreleases/2015/agreement-to-acquire-riverside-health May 14, 2015 ... The University of Maryland Medical System (UMMS) announced ... Mt. Washington Pediatric Hospital as a joint venture with Johns Hopkins.
JHU-UMD Diabetes Research Center | Johns Hopkins Medicinewww.hopkinsmedicine.org/diabetes-research-center/ Investigators from Johns Hopkins University and University of Maryland have joined together to create the Johns Hopkins University - University of Maryland ...
Maryland General Hospital gets new name as part of rebranding...
www.bizjournals.com/baltimore/news/2013/04/25/university-of-maryland-medical-midtown.html Apr 25, 2013 ... The University of Maryland Medical System unveiled plans Thursday to ... the hospital as a companion to UMMC, similar to Johns Hopkins ...
Maryland General Hospital gets new name as part of rebranding effort
Apr 25, 2013, 4:30pm EDT
Kevin Litten Reporter Baltimore Business Journal The University of Maryland Medical System unveiled plans Thursday to rebrand Maryland General Hospital as the University of Maryland Medical Center Midtown Campus in a bid to give the hospital a higher academic profile.
UMMS officials said they will change the name in June and plan to draw more academic professionals to the hospital. As much as half of the hospital’s operations will focus on academic pursuits when the change is fully realized, said Mark L. Wasserman, the senior vice president of external affairs and development for the University of Maryland Medical System.
Enlarge Maryland General Hospital sits on Baltimore's west side.
University of Maryland Medical System
“Acute health care is undergoing a sea change without precedent,” Wasserman said. “The way to save this hospital is to bring academic talent there.”
Wasserman’s comments came during a city Urban Design and Architecture Review Panel presentation on a new $50 million ambulatory care center the hospital is planning.
The new ambulatory care center could house some preventive and primary care services, such as a diabetes center, UMMS CEO Robert Chrencik told the Business Journal in January.
UMMS has attempted to build an ambulatory care center before, but disputes between the School of Medicine, the medical system and administrators killed the project.
The project could be part of an effort to expand access to primary care services at Maryland General, Chrencik has said, with a special focus on addressing the health care needs of the West Baltimore community.
Chrencik said in January that UMMS wants to more closely associate Maryland General with the University of Maryland Medical Center through a rebranding effort. UMMS acquired the struggling Maryland General Hospital in 1999 and has since tried to turn it around. Community members feared the 200-bed hospital would close.
Chrencik said he envisions the hospital as a companion to UMMC, similar to Johns Hopkins Hospital’s relationship with Johns Hopkins Bayview. Just as Bayview focuses largely on the local East Baltimore community, Maryland would focus on its West Baltimore neighborhood.
What we described today happening in Maryland and Baltimore is just what this article states-----AHCs------ACADEMIC HEALTH CENTERS----when we speak of US cities deemed Foreign Economic Zones and tie that with global health systems and tourism ----we see GREATER BALTIMORE as a global health tourism designation and global technology is a must in building this global economic structure. None of this has anything to do with what is good for WE THE PEOPLE. It is all based on what generates the most profit for those global 1% connected to US Foreign Economic Zones like Baltimore. This article states that MARYLAND is positioning itself as a regional leader in global health care ergo all the consolidation into global health monopolies.
Whereas before our Federal and State health agencies were tied to building public hospitals and public clinics and all the public health infrastructure that kept WE THE PEOPLE safe and healthy ---Federal funding built this system and state funding helped maintain this system-----global Wall Street is throwing that model away and saying---we don't need to worry about public health for the 99%----we need to maximize profits from health industry and global health tourism with global market rates for designer medicine is that model.
This is why Baltimore has allowed its health care to become predatory and eliminated DO NO HARM in its race for medical patent mills.
'What Is Alignment and Why Is It So Important?
Alignment is the degree to which component parts of AHCs work together. In fully aligned AHCs, medical school, practice plan, and university hospital leaders closely align their governance, strategies, management, and economics (Figure 1). AHCs can achieve significant alignment by optimizing at least two of these four dimensions; optimizing only one is insufficient to achieve significant institutional alignment'.
What has changed during these few decades of CLINTON/BUSH/OBAMA is realignment of our government agencies from a voter-driven elected assembly working to maintain economy, public safety, and public services for taxpayer citizens----to aligning structures that will become globally competitive to maximize profits and wealth for that global 1% tied to these US Foreign Economic Zones..
Fully Aligned Academic Health Centers: A Model for 21st-Century Job Creation and Sustainable Economic Growth
E. Albert Reece, MD, PhD, MBA, vice president for medical affairs, Robert A. Chrencik, MBA, CPA, president and chief executive officer, and Edward D. Miller, MD, chief executive officer
The publisher's final edited version of this article is available at Acad Med
See other articles in PMC that cite the published article.
Alignment is the degree to which component parts of academic health centers (AHCs) work cohesively. Full alignment allows AHCs to act quickly and cohesively toward common goals and to take advantage of opportunities that present themselves, particularly where collaboration is essential. Maryland’s two major AHCs—University of Maryland Medicine (UMM) and Johns Hopkins Medicine (JHM)—have experienced periods of significant misalignment during each of their histories. Their most recent periods of misalignment caused significant negative economic and academic impacts. However, the process of realigning their clinical and research missions has not only given them a renewed economic vigor but has also paid significant dividends for the state of Maryland, helping it weather the current recession much better than other regions of the country. The two AHCs’ continued economic success during the recession has led Maryland lawmakers to increasingly seek out their expertise in attempts to stimulate economic development. Indeed, UMM, JHM, and other fully aligned AHCs have shown that they can be powerful economic engines and offer a model of job growth and economic development in the 21st century.
During the recession that began in 2007, approximately 8.4 million Americans lost their jobs during the initial year.1 Although the U.S. economy began improving somewhat in 2011 and 2012, as of spring 2012 the current national unemployment rate is still above 8%,2 and the long-term economic forecast remains murky.3 The state of Maryland suffered significantly fewer job losses compared to other regions of the country and, recently, has added thousands of jobs while many other states’ economies have remained stagnant. Maryland’s unemployment rate stood at 6.5% as of February 2012,4 which is almost 20% below the national average. Furthermore, Maryland consistently has been ahead of the curve in terms of economic recovery.5
One major reason Maryland fared better during this recession compared to the rest of the nation is its close proximity to Washington, DC. Nonmilitary federal jobs generate $11.4 billion in total wages annually in Maryland.6 However, University of Maryland Medicine (UMM) and Johns Hopkins Medicine (JHM), Maryland’s two major academic health centers (AHCs), generate roughly the same amount ($11.5 billion) of economic activity annually for the state.7,8 Indeed, we are two of the largest nonfederal employers in Maryland.
Whereas federal jobs in the state and the rest of the nation are projected to shrink dramatically in the coming years,10 our two enterprises are growing and annually adding thousands of new jobs throughout the state and region. As a result of the economic staying power during the recent recession, Maryland lawmakers increasingly seek advice from UMM and JHM on economic development strategies for the life sciences sector. Neither of our health systems would be in economic leadership positions today, however, if it were not for steps we took in our recent histories to bring our respective health care systems into full alignment. These experiences are consistent with AHCs elsewhere that have seen significant research, clinical, and economic gains as a result of full alignment.
What Is Alignment and Why Is It So Important?
Alignment is the degree to which component parts of AHCs work together. In fully aligned AHCs, medical school, practice plan, and university hospital leaders closely align their governance, strategies, management, and economics (Figure 1). AHCs can achieve significant alignment by optimizing at least two of these four dimensions; optimizing only one is insufficient to achieve significant institutional alignment.12
Optimal academic health center alignment, as achieved by integrating the organization to the greatest extent possible in four key areas. Modified with permission from Levin S, Maddrey G, Bagnell A. Achieving Optimal Alignment in Academic Health Centers. ...Full alignment allows AHCs to act quickly and cohesively toward common goals12 and to take advantage of opportunities that present themselves, particularly where collaboration is essential.13 A recent study by Souba and colleagues14 found that AHCs with strong alignment between their medical school deans and clinical department chairs were significantly more successful in competing for National Institutes of Health (NIH) research grants compared to lesser-aligned AHCs. The University of Pittsburgh Medical Center and the University of Pennsylvania Medical System, two separate and privately owned AHCs residing in separate regions of Pennsylvania, are examples of two AHCs whose leaders credit full alignment between their research and clinical missions as a major reason for their clinical and economic success.11 Combined, they generate more than $26 billion in economic activity and more than 90,000 jobs for the state of Pennsylvania.
The UMM Story
The University of Maryland School of Medicine (UMSOM) was founded in 1807 as the nation’s first public medical school. In 1823, UMSOM’s faculty used their own funds to build the first hospital in Baltimore, which was also the nation’s first teaching hospital and AHC.17 However, the hospital was on shaky financial footing for much of its history because of constant internal squabbling, poor business practices, and bad relationships with its physicians and state legislators.17 Nevertheless, it was generally successful until the mid-1980s, when a drastically changing health care landscape and a weak revenue flow pushed it to the brink of insolvency.
Maryland’s then governor, Harry R. Hughes, stepped in and freed the hospital from state management so that it could be more competitive with other hospitals in the region. He also created an independent, 21-member board of directors made up of former medical school alumni and current faculty to oversee the operation of the hospital, which was renamed the University of Maryland Medical Center (UMMC). Simultaneously, the Maryland legislature passed a bill creating the University of Maryland Medical System (UMMS), with UMMC as its flagship hospital. The legislation also stipulated that UMSOM must recruit and supply all of the faculty physicians providing care at UMMC.
IN OTHER WORDS THIS IS WHEN OUR UMMS WAS MADE A QUASI-GOVERNMENTAL AGENCY----CORPORATIZED NOT PUBLIC--THE 1980s WAS OF COURSE REAGAN'S PUSH TO CORPORATIZE PUBLIC UNIVERSITIES.
UMMS thrived under this new governance system, expanding to a six-hospital system with annual revenue increasing from $165 million to $1 billion by the year 2000.17 In the mid-2000s, however, an unprecedented rate of growth in the medical school and its physicians’ clinical practice, coupled with a change in leadership at the medical system, created another period of significant misalignment that resulted in the cancellation of a $350 million clinical expansion project17 and a dramatic drop in UMMS’ operating margins for several years (Figure 2).
University of Maryland Medical System’s (UMMS’s) operating margins, 2005–2011. Excludes certain one-time revenue and expense items. In fiscal year 2008, operating margins dipped almost 75% from fiscal year 2005 during UMMS’s ...In 2008, Maryland’s current governor, Martin O’Malley, intervened to correct this misalignment by reconstituting the UMMS board of directors. The UMMS board then appointed a new chief executive officer, previously UMMS’s chief financial officer and already well known to the leadership of the medical school and faculty practice plan.18,19 The leadership of UMMS and UMSOM then immediately sought to realign themselves through the steps outlined below, which not only restored UMMS profit margins to healthy levels (Figure 2) but also ensured its ability to reinvest in new facilities and research programs that could produce additional profits.
UMM’s realignment approach
UMM’s first realignment step was to significantly change how all joint initiatives and programs were planned and led. Rather than alternating leadership between UMSOM and UMMS on major planning and recruitment committees, as in the past, we made UMSOM and UMMS representatives equal cochairs on all joint committees. We also fully integrated our longer-range planning processes. For example, when UMSOM developed its most recent strategic plan, it included leadership and staff from UMMS and the faculty physician practice plan in all phases of the process.
UMMS likewise facilitated realignment by including UMSOM leadership and faculty in all of its expansion plans, including planning for mergers, acquisitions, and clinical services expansion. UMSOM’s dean and senior staff also began participating in all UMMS board meetings and retreats.
In addition, all UMM leaders heavily promoted their renewed partnership and commitment to collaboration internally and externally by publishing joint annual reports,7,20 which hadn’t been done in more than a decade, and holding joint town-hall-style meetings for faculty, staff, and supporters. UMSOM promoted the collaborative partnership and interdependence of the medical school and health system during its annual state of the school address,21 which every year includes an audience of local, state, and national legislators, major donors, the public, members of the board of visitors, and UMMS leadership and staff. Thus, it was made clear to all of UMM constituents and supporters that the health system and medical school are equal partners, and one cannot truly succeed without the other.
The benefits of better alignment for UMM
These steps have resulted in a common set of visions and goals and in the joint planning and execution of major programs and projects throughout the region. Moreover, they put UMM on sound financial footing and gave it the ability to respond quickly and aggressively to new opportunities and new sources of funding. Indeed, UMSOM currently is one of the fastest-growing research enterprises in the country, as measured by federal grants and contracts.
UMSOM’s internationally recognized basic science and clinical research capacity, in turn, has helped fuel UMMS rapid growth and clinical achievements. Today, UMMS is a 12-hospital system with 15,000 employees, approximately 2,300 licensed beds, 115,000 annual patient admissions, and gross patient revenues of nearly $2.5 billion annually.7 One UMMS hospital is jointly owned with JHM. Recently, the Leapfrog Group, which rates hospitals for health care quality and patient safety, named UMMC as one of the two “Hospitals of the Decade” for health care quality and patient safety.22 UMMC also has recently has been consistently ranked by U.S. News & World Report as one of the nation’s top hospitals.
The JHM Story
On his death in 1889, Baltimore entrepreneur Johns Hopkins bequeathed $7 million to createThe Johns Hopkins Hospital and the Johns Hopkins University (JHU) as separate entities, with separate presidents and boards of trustees. JHU founded a school of medicine in 1893, with its own separate governing board. It quickly grew to become a nationally recognized leader in medical education and biomedical research.
Despite their separate governance, JHU, its medical school, and Johns Hopkins Hospital coexisted peacefully for more than a century and shared a common clinical vision.24 However, by the mid-1990s, the separate boards and their leadership had developed different visions. Those differences led to frequent internal clashes among the leadership of all three organizations as well as between their boards.24 Media reports of their frequent feuds made fundraising for the school of medicine and the hospital difficult, at a time when the medical school was running budget deficits as the result of constructing, equipping, and financing a new research building, all requiring an internal loan of $30 million to pay its expenses.
By 1996, members of all JHU boards recognized the damage their infighting was inflicting not only on the reputation of their AHC but also on the morale of its faculty and staff. They also recognized the urgent need to put the medical school on better financial footing so that it would be able to adapt to a changing health care landscape.24 The JHU boards of trustees, therefore, held a number of emergency meetings and ultimately created a framework for greater unity and integration of decision making and strategic planning between the hospital system and the medical school.
JHM’s realignment approach
To achieve realignment, JHU created a 10-member coordinating group— with equal representation from the university, hospital, and health system boards—to completely overhaul the century-old system by which the school of medicine and The Johns Hopkins Hospital interacted and operated. That coordinating group then created a “virtual corporation,” the Johns Hopkins Health System Corporation, which was to be overseen by a 40- to 45-member board made up of university and health system trustees and a 16-member executive committee chaired by JHU’s president.26 The coordinating group also created a unified leadership position, or combined dean/CEO, to run JHM, as the combined medical school and hospital system officially became known. The first dean/CEO of JHM and vice president for medicine of the Johns Hopkins Health System Corporation, who previously was a respected member of the JHU faculty, was appointed on January 15, 1997.
The benefits of better alignment for JHM
The unified governance of JHM allowed the new dean/CEO to immediately begin strengthening the practice plan, one of the most important source of revenues for the medical school, but which had been losing money. Control of the practice plan was restored to the school of medicine, and by 2001 it was profitable again, with a 75% to 80% improvement in collected billings over previous years.24 In addition, all of JHM’s fundraising was integrated so that there was no longer competition between the health system and medical school.
These steps then allowed JHM also to begin rapidly expanding its clinical services by acquiring other hospitals and merging with other health care systems. Today, JHM operates 6 academic and community hospitals, 4 suburban health care and surgery centers, and more than 30 primary health care outpatient sites, and it has more than 2.6 million outpatient encounters.
Realignment also allowed the medical school to remain the number one recipient of NIH research funding and to continue to be ranked among the top research-oriented medical schools in the nation by U.S. News & World Report.29 The Johns Hopkins Hospital likewise has continued to take the top spot in annual rankings.
Economic Benefits of Alignment to the State of Maryland
UMM and JHM generate a combined $11.5 billion ($5 billion and $6.5 billion, respectively)7,8 in direct economic output for Maryland. Furthermore, our two AHCs are both experiencing a period of rapid growth and expansion, which means potentially thousands more new jobs for the region.
In 2011, JHM completed the most expensive building project in Baltimore’s history30—a $1.1 billion hospital construction project that added more than 2.6 million square feet of clinical and research space and created thousands of jobs for Baltimore (Table 1). In addition, UMM recently completed or is in the midst of major construction projects at six separate locations across the state. These projects are creating thousands of construction jobs and many more health care system jobs for Maryland (Table 1).
Recent or Ongoing Major Construction Projects at University of Maryland Medicine (UMM) and Johns Hopkins Medicine (JHM) Academic Health Centers, as of 2012The Maryland General Assembly recently allocated funding for the design phase of UMM’s newest health sciences facility, a 332,000-square-foot, $284 million, state-of-the-art research building to be located on the University of Maryland Baltimore campus.31 This project will increase economic activity in Maryland by an estimated $410 million and create roughly 3,000 jobs over its multiyear construction period.
UMM and JHM also have spurred a growing commercial life sciences hub in Baltimore by building a biotechnology park near each campus. Thanks largely to these two bioparks, which required roughly similar investments, as of 2012 Baltimore is home to almost one-quarter of Maryland’s biotechnology companies and 41% of its private life sciences jobs.33 Since their establishment, these two bioparks have added almost 1,000 high-paying jobs to the Baltimore economy (Table 2), which have offset losses in other parts of the state.34 They have also attracted a variety of new businesses and ventures, which will help create more jobs in the future.
University of Maryland Medicine (UMM) and Johns Hopkins Medicine (JHM) Biopark Square Footage, Investment, and Jobs Created, as of 2012*The state of Maryland has recognized the importance of our two health care enterprises to the health of the state’s economy. For example, Maryland’s governor, Martin O’Malley, asked the leadership of both institutions to collaborate on ways to spur economic activity and to recruit the best and brightest research and technical talent to work in Maryland.35 UMM and JHM also are two key institutional members of the Maryland Life Sciences Advisory Board, which is helping Maryland’s legislature to develop a comprehensive strategic plan for the state’s life sciences industry.36 One of the major programs conceptualized by the board is Governor O’Malley’s BIO 2020 Initiative, a comprehensive, targeted plan to leverage Maryland’s science and technology assets and highly skilled workforce to attract and grow the bioscience industry in Maryland.
Indeed, bioscience has become a major source of jobs, income, and gross state product (business sales) in Maryland. It contributes to Maryland’s coffers through the income and sales taxes generated directly and indirectly by the sector’s commercial entities, institutions, and employees.39 Combined, Maryland’s biotech companies generate $29 billion in economic output, supporting 120,000 total jobs, $11 billion in direct income, and nearly $600 million in state taxes annually.39 Maryland’s life sciences sector accounted for one-third of all state job gains between 2002 and 2010, and it generates 6%, or $17.6 billion, of the state’s gross domestic product.34 The Baltimore region, home to UMM and JHM, generated more than 40% of these new life sciences jobs.
Comments and Conclusions
Misalignment between research and clinical missions and visions at AHCs is not an uncommon occurrence. When misalignment does occur, it often results in acrimony between and among institutional leadership and governing bodies and can also negatively impact the morale and productivity of faculty and staff. The thesis that realignment can pay significant clinical and economic dividends is supported by the available research. Kirch and colleagues, for example, made a case study of a period of misalignment and realignment at the University of Pennsylvania health system and found that realignment led to significant gains in academic, research, and clinical performance almost immediately after it occurred.
Kirch et al also found a set of critical factors within Penn Medicine’s realignment approach that were associated with its successful turnaround.40 Among these factors are several that closely correlate with the steps we took to achieve realignment, including aligning corporate structure and governance to unify the academic enterprise and health system; fostering collaboration and accountability; and articulating a succinct, highly focused, and compelling vision and strategic plan internally and externally.
During UMM’s and JHM’s most recent periods of misalignment, JHM chose a unified leadership approach to affect realignment, whereas UMM chose a “separate but equal” leadership approach. There are few data to recommend one leadership structure over the other.41 However, the data do suggest that whatever the structure, leadership qualities are critical to maintaining proper alignment. UMM and JHM both chose new leaders who were already well known within their organizations and who knew its inner workings to help bring about realignment. Case studies of AHCs support the notion that autocratic leaders and trustees are not as successful in maintaining alignment as are leaders with a democratic leadership style who govern by consensus rather than decree.42,43 Balancing the makeup of governing boards44 also is a critical factor in bringing AHCs back into proper alignment.
UMM and JHM have both faced serious economic challenges of our own before and during the recent recession, operating on razor-thin margins for years. Now we face an even more uncertain future with the specter of sequestration of the federal budget in January 2013, possible additional state funding cuts, decreased endowment recovery, market uncertainty caused by health care reform, and fundraising challenges coupled with increased pressure on institutional resources for research. Nevertheless, because of the ability to act collaboratively and in a coordinated fashion, we believe that we and other fully aligned AHCs will be in a better position to weather these vicissitudes than less aligned AHCs.
Here is the goal of these REALIGNMENTS of our medical university campuses and consolidation with global health corporation industries -----in maximizing profits creating this global health tourism to send 99% of gutted of funding MEDICAID FOR ALL which then will include over 90% of Medicare patients to cheapest global venue for care. Our US cities deemed Foreign Economic Zones will of course be destinations for global 1% as our health care system is #1 in world. We simply have a majority of citizens living with third world health outcomes.
This is what the Affordable Care Act had as a goal--if you are losing health access---if you are receiving predatory or abusive care----it is the deregulation and consolidation to global health systems policies causing all this.
These tierings will take 99% of Americans to third world levels of access. This is designed only for those able to pay what will become higher and higher health procedure costs with everyone else taking risks with a deregulated lower-tier of global health systems.
'Finally, the federal and state governments should lead by example by allowing Medicare and Medicaid programs to send willing patients abroad. Medicare in particular would benefit from cost savings due to its large volume of orthopedic and cardiac procedures'.
Medical Tourism: Global Competition in Health Care
Global competition is emerging in the health care industry. Wealthy patients from developing countries have long traveled to developed countries for high quality medical care. Now, a growing number of less-affluent patients from developed countries are traveling to regions once characterized as “third world.” These patients are seeking high quality medical care at affordable prices. Reports on the number of patients traveling abroad for health care are scattered, but all tell the same story. An estimated 500,000 Americans traveled abroad for treatment in 2005. A majority traveled to Mexico and other Latin American countries; but Americans were also among the estimated 250,000 foreign patients who sought care in Singapore, the 500,000 in India and as many as 1 million in Thailand.
The cost savings for patients seeking medical care abroad can be significant. For example:
- Apollo Hospital in New Delhi, India, charges $4,000 for cardiac surgery, compared to about $30,000 in the United States.
- Hospitals in Argentina, Singapore or Thailand charge $8,000 to $12,000 for a partial hip replacement — one-half the price charged in Europe or the United States.
- Hospitals in Singapore charge $18,000 and hospitals in India charge only $12,000 for a knee replacement that runs $30,000 in the United States.
- A rhinoplasty (nose reconstruction) procedure that costs only $850 in India would cost $4,500 in the United States.
In 2006, the medical tourism industry grossed about $60 billion worldwide. McKinsey & Company estimates this total will rise to $100 billion by 2012.
Patients who are not familiar with specific medical facilities abroad can coordinate their treatment through medical travel intermediaries. These services work like specialized travel agents. They investigate health care providers to ensure quality and screen customers to assess those who are physically well enough to travel. They often have doctors and nurses on staff to assess the medical efficacy of procedures and help patients select physicians and hospitals.
Prices for treatment are lower in foreign hospitals for a number of reasons. Labor costs are lower, third parties (insurance and government) are less involved or not at all involved, package pricing with price transparency is normal, there are fewer attempts to shift the cost of charity care to paying patients, there are fewer regulations limiting collaborative arrangements between health care facilities and physicians, and malpractice litigation costs are lower.
How can patients ensure the medical treatment they will receive will be of high quality?
- Foreign health care providers often have physicians with internationally respected credentials, many of them with training in the United States, Australia, Canada or Europe.
- More than 120 hospitals abroad are accredited by the Joint Commission International (JCI), an arm of the organization that accredits American hospitals participating in Medicare; another 20 are accredited through the International Standards Organization; and some countries are adopting their own accrediting standards.
- Some foreign hospitals are owned, managed or affiliated with prestigious American universities or health care systems such as the Cleveland Clinic and Johns Hopkins International.
- Several companies are building and operating hospitals in Mexico that meet American standards, largely for American (and wealthy Mexican) patients.
- Finally, patients can also use online communities to get information on the safety and quality of medical providers by reading the testimonies of other patients who have had surgery abroad.
Medical tourism is only one aspect of the way globalization is changing the U.S. health care system. Apart from patient travel, many medical tasks can be outsourced to skilled professionals abroad when the physical presence of a physician is unnecessary. This can include interpretation of diagnostic tests and long-distance international collaboration, particularly in case management and disease management programs, because of the availability of information technology.
If American health care consumers are to benefit to the fullest extent from global health care competition, federal and state policies must allow them to take advantage of the opportunities. Legal reforms policymakers should consider include recognizing licenses and board certifications from other states and countries. The federal Stark laws limiting relationships between physicians and hospitals need to be modified to let health care providers offer integrated medical services, including follow-up care for patients returning from treatment abroad. Finally, the federal and state governments should lead by example by allowing Medicare and Medicaid programs to send willing patients abroad. Medicare in particular would benefit from cost savings due to its large volume of orthopedic and cardiac procedures.
'Dr. Peter L. Beilenson, MD, MPH President & Chief Executive Officer Dr. Peter L. Beilenson, M.D., M.P.H. currently serves as the CEO and President of the Evergreen Health Cooperative, an innovative, member-oriented health care model authorized by the Affordable Care Act'.
I wanted to bring all this together locally so my friends can see the same model in their neck of the woods. We speak of global 1% and global IVY LEAGUEs as having a pathway to receiving all patented products that are geared to go global. Not all Ivy League students have this pathway of course but some OLD WORLD MERCHANT OF VENICE connection hands these patented product deals to a few. Here is Beilenson grad of Harvard and Hopkins IVY LEAGUES able to use terms sounding left social progressive HEALTH CARE FOR ALL-----CO-OP HEALTH BUSINESSES----PUBLIC HEALTH INITIATIVES FOR THE POOR. Know what? Baltimore's lead, drug, HIV, violence, mental health, poverty, housing instability has never been worse after 3 decades of having BEILENSON tied to PUBLIC HEALTH IN BALTIMORE. That is because during these few decades all Federal, state, and local funding that should have addressed all these health disparities were instead directed to expand global Johns Hopkins and global Wall Street.
THESE ARE THE 5% TO THE 1% WHO RAN AS DEMOCRATS SERVING AS FAR-RIGHT GLOBAL WALL STREET WORKING TO ENRICH THE RICHEST WHILE PRETENDING TO HELP THE POOREST.
There are those 5% Baltimore pols as PUPPETS FOR GLOBAL WALL STREET MOVING FORWARD these global empire-building goals----SCHMOKE, O'MALLEY
About the only thing Beilenson really did was push tanning parlor policies through to aid in prevention of skin cancers. Of course these directions for Johns Hopkins took hold when BLOOMBERG TOOK THE SCHOOL OF PUBLIC HEALTH.
Dr. Peter L. Beilenson, MD, MPH President & Chief Executive Officer Dr. Peter L. Beilenson, M.D., M.P.H. currently serves as the CEO and President of the Evergreen Health Cooperative, an innovative, member-oriented health care model authorized by the Affordable Care Act.
He brings 20 years of experience in public health leadership having previously served as the Health Officer of Howard County, Maryland in the administration of County Executive Ken Ulman and as the Baltimore City Health Commissioner in the administrations of Mayors Kurt Schmoke and Martin O'Malley. Dr. Beilenson received his undergraduate degree from Harvard College, Medical Doctorate from Emory University School of Medicine, and Masters in Public Health from the Johns Hopkins University Bloomberg School of Public Health. During his tenure in Baltimore City, Dr. Beilenson’s vision led to expanded drug treatment programs in Baltimore, improved immunization compliance, a wide range of extremely effective lead poisoning prevention initiatives, juvenile violence prevention, and the creation of the state-wide initiative for universal health coverage in Maryland - Health Care for All. In Howard County he launched the Healthy Howard Access Plan, a first-of-its-kind program in the country that provides comprehensive, affordable health and wellness services to the uninsured of Howard County; the Healthy Howard Initiative—which certifies healthy schools, workplaces, childcare and restaurants; and the first in the nation ban on indoor tanning for minors.