Press Releases

Renowned economist Reinhardt advocates reforming health system
Other CATCH '09 experts discuss art & science of new cardiac treatments

By Daniel Axelrod
CATCH '09 Correspondent

World renowned economist Uwe Reinhardt recently told Northeast Pennsylvania medical leaders that real health care reform isn't possible without an individual mandate, community rating and guaranteed-issue coverage.

The remarks came during the second annual Convergence Around Technologies Cardiovascular Health Conference, held in late October at the Radisson Lackawanna Station Hotel in Scranton.

The CATCH '09 Conference - presented by the Community Medical Center, Mercy Hospital, Moses Taylor Hospital and the Commonwealth Medical College as educational partners - has quickly become a major local gathering for health care and community leaders, said Dr. Russell Stahl, an event organizer and CMC's chief of cardiothoracic surgery. Blue Cross of Northeastern Pennsylvania was a major sponsor for the event.

This year's conference focused on treatment of advanced congestive heart failure, particularly in the elderly, as well as palliative care and health care reform. Reinhardt, who teaches at Princeton University, gave the keynote speech before answering questions in a breakout session.

"CATCH '09 really focused on health policy, greater collaboration and technological convergence in the U.S. health care system and locally," Stahl said. "Health care reform is taking us toward global payment reform and an integrated delivery system model with new payment methods."

Next year's conference will discuss local convergence when it comes to how doctors can collaborate to avoid the duplication of services and promote high quality care, Stahl added.

In this year's keynote speech, Reinhardt stressed that the federal government must reform America's health care delivery system soon or risk skyrocketing health care costs that threaten to harm the middle class.

He thinks reforms will fail if they don't include a mandate for all individuals to carry health insurance and public subsidies to allow those who can't afford coverage to buy it.

Plus, he said the government should institute a guaranteed-issue requirement for insurers to cover everyone and a community rating provision so premiums aren't based on health history.

Rather than slapping negative labels on health reform initiatives and dismissing them, Reinhardt said providers, payers, pharmaceutical companies and patients must all collaborate for success.

"We shouldn't default to clichés," Reinhardt said. "We shouldn't just say ‘It's socialized medicine, so let's not accept it.'"

If the medical community doesn't work together, "at least a decade of fierce insurgent war among tribal chiefs" will hamper reforms, he said. That's already a likely scenario, said Reinhardt, because any reforms to save the health system money will inevitably come from the bottom-line of one of the medical community's stakeholders.

At the current trajectory of rising health care costs, Reinhardt estimated that health care spending as a percentage of gross domestic product - which currently totals 16 percent - will grow to 40 percent by 2050. Rising health costs aren't primarily spurred by heart disease, the elderly, Baby Boomers consuming more care or "the myth of Medicaid bankrupting the system," said Reinhardt.

Instead, the 6 percent annual growth is driven by all Americans receiving ever more sophisticated and pricey tests and treatments, which represents our "passionate, promiscuous and illicit love affair" with medical care. Americans must now turn their relationship with medical consumption into a "mature" and "stable marriage," he added.

At the same time, health care spending is not a bad thing per se, said Reinhardt, because it's the "economic locomotive for America now." But he doesn't think we should lead industrialized nations in our rate of health care spending growth.

That's because the U.S. medical community can generate savings by installing electronic health systems and educating Americans to take better care of themselves from a young age, Reinhardt said. Other ways to reduce health system costs include using the most cost effective and appropriate treatments, lowering administrative costs, lowering profits, creating integrated medical delivery systems and cutting mistakes, Reinhardt added.

Until health care reforms are enacted, the 5 percent to 8 percent of Americans who buy individual health plans will continue to shoulder a disproportionate share of rising insurance costs, Reinhardt said. And the dwindling spending-power of the middle class will keep eroding precipitously, which ultimately will harm America, Reinhardt added.

Reinhardt's remarks dovetailed in part with the palliative care message of Dr. Eric Cassell. Though Cassell mostly stayed away from talk of money, the former Cornell University professor of public health stressed that resources devoted to palliative care are often the best spent. That's because doctors commonly focus on helping failing patients survive in pain rather than finding ways for them live in comfort as their lives end, Cassell said.

Cassell described a medical system in which doctors often think of very sick patients "in the language of disease." Such doctors see patients less as people and more as a set of vital signs that need to be improved at any cost. Yet, patients should be considered in the language of "well being, goals and functions," Cassell added. Cassell raised the proverbial question: at what point does the suffering a person is enduring to feel well cease to be worth it given the likelihood of recovery? That occurs, he said, "when a patient hasn't gotten better in the average time it takes for a patient to get better" given their age, condition, medical history and all the resources a doctor has expended.

For his part, Dr. John Boehmer, a cardiac transplant specialist at Penn State College of Medicine, outlined technological advances in ventricular assist devices that may improve the cost/benefit ratio of treating sick patients. Most of the expensive pulsatile and nonpulsatile devices require more research and refinement before they become mainstream treatments. But more surgeons are using them as destination therapies, Boehmer said.

"Dr. Boehmer reinforced the need for this technology and the fact it is evolving to the point it might become commonplace," said Dr. Richard Abramowitz, who heads Wilkes-Barre General Hospital's cardiology department. "Dr. Cassell discussed knowing when the need isn't there to implement the technology - that's the art of medicine."

In a separate conference breakout session, Dr. Stahl screened a film of his patient Charlie Flynn, now 83, who underwent valve replacement surgery. Flynn's strong will to live and his health history made the surgery possible even for an older patient in failing health. Yet, Flynn's story represented one of the tough choices doctors face daily about whether to continue treatment.

"CATCH '09 was successful because it really probed the questions surrounding when a doctor should intervene with cutting-edge technology and when it's time to stop and just make the patient comfortable," said Dr. Christopher Dressel, director of Mercy Hospital's cardiac cath lab. "This year's speakers provided their fascinating take on these questions amid the backdrop of Uwe Reinhardt's broader discussion on health care reform."

Community Medical Center receives American Heart Association’s Get With The Guidelines Gold Performance Achievement Award

For Immediate Release
Contact: Jane Gaul
Phone: 570-969-7002
j.gaul@cmchealthsys.org

SCRANTON, PA, October, 29, 2009 — Community Medical Center recently received the American Heart Association’s Get With The Guidelines – Coronary Artery Disease Gold Performance Achievement Award for the second year in a row for sustained performance. The award recognizes Community Medical Center's commitment and success in implementing a higher standard of cardiac care that effectively improves treatment of patients hospitalized with coronary artery disease. Stephen J. Voyce, MD, CMC Cardiologist and GWTG Physicians Champion stated, "This confirms CMC’s commitment to evidence based treatments which have been established to improve cardiac patient outcomes."

Under the Get With The Guidelines – CAD program, patients are started on aggressive risk reduction therapies such as cholesterol-lowering drugs, aspirin, ACE inhibitors and beta-blockers in the hospital and receive smoking cessation/weight management counseling as well as referrals for cardiac rehabilitation before they are discharged. Hospitals that receive the Get With The Guidelines - CAD Gold Performance Achievement Award have demonstrated for 36 consecutive months that at least 85 percent of its eligible coronary patients (without contraindications) are discharged following the American Heart Association's recommended treatment guidelines.

"The American Heart Association applauds Community Medical Center for its success in implementing the appropriate evidence-based care and protocols to reduce the number of recurrent events and deaths in cardiovascular disease patients," said Gregg C Fonarow, M.D., National Chairman of the Get With The Guidelines Steering Committee and Director of Ahmanson-UCLA Cardiomyopathy Center. "Community Medical Center has achieved a high level of performance in terms of implementing these life-prolonging treatments."

"Community Medical Center is dedicated to making our cardiac unit among the best in the country, and the American Heart Association’s Get With The Guidelines program is helping us accomplish that by making it easier for our professionals to improve the long-term outcomes of our cardiac patients," said John Nilsson, CEO and President of Community Medical Center. "We are pleased to be recognized for our dedication and achievements in cardiac care."

The American Heart Association’s Get With The Guidelines – CAD program helps hospitals increase the use of and adherence to the association’s secondary prevention guidelines for coronary artery disease. Developed to assist healthcare professionals follow proven standards and procedures before patients are discharged, Get With The Guidelines – CAD can help Community Medical Center reduce the risk of recurrent heart attacks and death in treated patients. The program, which works by mobilizing teams in acute care hospitals to implement American Heart Association/American College of Cardiology secondary prevention guidelines.

According to the American Heart Association, approximately 610,000 people suffer a new heart attack and 325,000 experience a recurrent heart attack each year. Statistics also show 1.26 million individuals are affected by CAD* each year. Additionally, one in five deaths in the United States is caused by CAD.

*CAD data was taken from 2009 AHA CHD Statistical Update

Geisinger and Community Medical Center to explore working together

SCRANTON, PA, August 24, 2009 — Geisinger Health System (GHS) and Community Medical Center Healthcare System (CMC) in Scranton have announced the signing of a non-binding letter of intent to explore ways the healthcare organizations can work together to benefit healthcare in the Lackawanna County and surrounding area.

"Geisinger is continually interested in improving healthcare and working to best meet the needs of the community," said Geisinger President and Chief Executive Officer Glenn Steele, Jr., MD. "We have had productive talks with CMC regarding ways we could potentially work together to advance patient care. With the signing of this letter of intent, we are able to involve more people from each organization and investigate the possibilities in greater detail."

"Our goal at CMC has been and always will be doing what is right for patients," added John Nilsson, CMC President and Chief Executive Officer. "Exploring synergies with Geisinger in our patient care missions is an appropriate approach to ensuring the people of Lackawanna County and the northeast continue to enjoy high quality medical services."

Both organizations stressed they are in the early stages of studying each health system’s offerings and capabilities, and comparing that information with community need. No timetable has been set regarding determination on joint programs or other potential areas where CMC and Geisinger could work together.

"Prudent healthcare organizations today regularly talk with other providers on such issues," Nilsson said. "We will provide additional information should our discussions with Geisinger lead to anything definitive."

"At times, discussions with other organizations lead to concrete results, while at other times they do not," Steele said. "With two quality organizations like CMC and Geisinger, we can assure you we will carefully consider the possibilities."

Community Medical Center Healthcare System is a leading provider of quality healthcare services in Northeastern Pennsylvania. A not-for-profit corporation located in Scranton, CMC offers a complete continuum of educational, diagnostic, therapeutic and rehabilitative services and programs. The partners of the CMC Healthcare System include Mountain View Care Center, a 180-bed long term care facility; as well as Abington Physical Therapy and Green Ridge Physical Therapy. For more information, visit www.cmchealthsys.org.

Founded in 1915, Geisinger Health System (Danville, PA) is one of the nation’s largest integrated health services organizations. Serving more than two million residents throughout central and northeastern Pennsylvania, the physician-led organization is at the forefront of the country's rapidly emerging electronic health records movement. Geisinger is comprised of two medical centers, a 720-member group practice, a not-for-profit health insurance company, an alcohol and chemical dependency treatment center, and the Geisinger Center for Health Research—dedicated to creating innovative new models for patient care, satisfaction and clinical outcomes. For more information, visit www.geisinger.org.

Community Medical Center Surpasses State Standards in Cardiac Readmissions

For Immediate Release
Contact: Jane Gaul
Phone: 570-969-7002
j.gaul@cmchealthsys.org

SCRANTON, PA, August 14, 2009 — According to a new report released by the Pennsylvania Health Care Cost Containment Council (PHC4), Cardiac Surgery in Pennsylvania 2006-2007, Community Medical Center outperformed all other hospitals in the surrounding areas for 7-day and 30-day readmission for patients undergoing Coronary artery bypass graft, (CABG) surgery, as well as 7-day readmission of patients having valve replacement combined with CABG surgery.

Coronary artery bypass graft (CABG) surgery is a surgical procedure used to treat patients with blockages in the coronary arteries. According to PHC4 data, the most common reasons for readmission following these procedures are infections and congestive heart failure. We have minimized these and other adverse outcomes, leading to improved overall results from open heart surgery.

"CMC results regularly surpass many providers in our area, as well as some top academic centers in Pennsylvania," states Dr. Russell Stahl. "There is a notable consistency to our product. CMC and its physicians have always been marked as 'expected' or 'better than expected' in PHC4 analyses.”

We invite anyone to visit and see why we provide excellent cardiac surgical care in NEPA, and will do so for years to come. For more information on Community Medical Center and the PHC4 report, visit: www.phc4.org.

Community Medical Center Receives Award from VHA Inc. for Clinical Excellence

For Immediate Release
Contact: Noelle Snyder
Phone: 570-969-8985
noelle.snyder@cmchealthsys.org

Irving, Texas (October 1, 2008) – Community Medical Center Healthcare Systems has received the Achieving Patient Care Excellence (APEX) Award from VHA Pennsylvania, the regional arm of VHA Inc., the national health care alliance. Community Medical Center won the award for its work to improve surgical care and prevent surgical infections.

The award recognizes Community Medical Center for meeting or exceeding national standards for care in this area. As of Oct. 1, 2008, the Centers for Medicare and Medicaid Services will no longer pay hospitals for the cost of treating many of these conditions.

“Community Medical Center’s goal is to promote and provide the best practice outcomes for our patients.” stated, John Nilsson, Interim CEO and President of Community Medical Center.

“VHA works with dozens of hospitals across Pennsylvania, and our mission is to help them become leading performers. We’re proud to say that many members have certainly demonstrated clinical excellence” said Steve Johnson, chief executive officer of Susquehanna Health and VHA Pennsylvania Board Chair. “VHA supports hospitals as they work to improve clinical care by providing Web tools to help them assess their current performance and clinical blueprints that guide better performance. Regional collaboratives and action planning meetings offer member networking opportunities to help accelerate the pace of internal change.”

Cliff Shannon, consultant with Pittsburgh Regional Healthcare Initiative, states “Public expectations, payer demands, and government mandates are pushing hospitals to provide better care. By recognizing these select hospitals with clinical quality awards, VHA is demonstrating that hospitals can overcome many obstacles that often stand in the way of achieving clinical excellence. They are to be congratulated for their fine work.”

VHA has 16 regional offices across the nation. Each office serves as a hub for the delivery and development of programs and services that help hospitals improve their operational and clinical performance.

VHA Inc., based in Irving, Texas, is a national alliance that provides industry-leading supply chain management services and supports the formation of regional and national networks to help members improve their clinical and economic performance. With 16 offices across the U.S., VHA has a track record of proven results in serving more than 1,400 not-for-profit hospitals and more than 23,000 non-acute care organizations nationwide.

CLICK to view APEX program.

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