Federal Workers: Performance, Pay, and Firing
Chris Edwards
Americans are concerned about the performance of the federal bureaucracy. Many people think that federal workers are overpaid and underworked. Some recent news stories provide fresh input to the debate.
A story yesterday at GovExec.com regards pay and performance. The federal pay structure is less efficient than private pay structures because it is generally based on seniority, not job performance. But GovExec.com finds that attempts to introduce federal performance pay have not worked very well either:
Most federal agencies are not making meaningful distinctions in performance ratings and bonuses for senior...
Source: Cato-at-liberty - February 25, 2015 Category: American Health Authors: Chris Edwards Source Type: blogs
Timing Discharges to Maximize Revenue - "Corruption" of Corporate Long-Term Hospitals?
A recent Wall Street Journal article that focused on a quirk in US Medicare payment rules that may be gamed by long-term hospitals also revealed the plight of physicians employed by such hospitals, and worse, the danger posed by such gaming to patients.Discharging Patients at Particular Times Maximizes Hospital RevenueHere is how the rule works: Under Medicare rules, long-term acute-care hospitals like Kindred’s typically receive smaller payments for what is considered a short stay, until a patient hits a threshold. After that threshold, payment jumps to a lump sum meant to cover the full course of long-term treatment.Th...
Source: Health Care Renewal - February 23, 2015 Category: Health Management Tags: corporate physician health care corruption Kindred Health mission-hostile management Select Medical Source Type: blogs
Bipartisan Baloney About Top 1 Percent Income Gains
Alan Reynolds
In the State of the Union address on January 20, President Obama said, “those at the top have never done better… Inequality has deepened.” The following day, Fox News anchor Brett Baier said, “According to the work of Emmanuel Saez, a professor at the University of California, Berkeley, during the post-recession years of 2009-2012, top earners snagged a greater share of total income growth than during the boom years of 2002-2007. In other words, income inequality has become more pronounced since the Bush administration, not less.”
Senator Bernie Sanders agrees that “in recent year...
Source: Cato-at-liberty - February 19, 2015 Category: American Health Authors: Alan Reynolds Source Type: blogs
Failing to Clean Up the VA
Nicole Kaeding
The Department of Veterans Affairs (VA) has a long history of mismanagement. Last year, the public became aware of a wait-time scandal at the VA hospital in Phoenix. Veterans were forced to wait months for appointments, even as the hospital was reporting no delays in service and allowing its management to receive performance bonuses. Over 1,700 veterans were not placed on the official wait lists to hide the length of actual waits. The VA Inspector General suggested that the Phoenix VA was not the only center to modify its wait lists in this fashion.
In response to the crisis, Congress passed a law tha...
Source: Cato-at-liberty - February 18, 2015 Category: American Health Authors: Nicole Kaeding Source Type: blogs
Pay 'em When They're Up, Pay 'em When They're Down - CEO Value Extraction Even at Small Non-Profit Hospitals
To the tune of "Dirty Laundry," by Don Henley, some more of health care's dirty laundry...We have frequently discussed the seemingly unstoppable rise of compensation given to top hired managers of health care organizations. Their compensation seems to rise regardless of the financial status of their organizations, much less how well their organizations are caring for patients or otherwise fulfilling the mission. Top hired managers of other organizations, particularly big for-profit corporations, have seen similar enhancements of their personal wealth, leading to the charge that they are acting as "value extract...
Source: Health Care Renewal - February 17, 2015 Category: Health Management Tags: executive compensation hospital systems hospitals St Luke ' s Health System West Georgia Health Source Type: blogs
The $5.3 Million a Year Government Bureaucrat - The Top Administrator, or CEO of a "Government Entity," Charlotte-Mecklenburg Hospital Authority, "Doing Business as" Carolinas Healthcare Gets a Raise
The pay given to top managers of health care organizations continues its seemingly inexorable rise, and the justifications for it seem to be increasingly perfunctory. However, a closer look at individual cases can generate even more questions about how we got to this pass. Our latest example arises from a recent news article about the compensation of top managers at Carolinas Healthcare. CEO Pay Levitating Since 2009 In 2011, we started following executive compensation at the hospital system now known as Carolinas Healthcare. Our posts in 2011, 2012, and 2013 all fit the same pattern.The total compensati...
Source: Health Care Renewal - February 12, 2015 Category: Health Management Tags: Carolinas HealthCare Charlotte-Mecklenburg Hospital Authority executive compensation government managers ' coup d etat public hospitals Source Type: blogs
Outsize Compensation for "Teflon-Coated" Executives - After Many Lawsuits and Negative News Stories, Norton Healthcare Executives Still Get Millions
In an earlier era of chemistry, politicians who continued to acquire votes while shedding doubts, criticisms, and allegations were called "Teflon-coated." Teflon may be outdated now, but there certainly seems to be some health care executives who have unique non-stick coatings.The Executives' Compensation Our latest example comes from the Louisville (KY) Courier-Journal, which just published an article about the compensation received by top executives of one of the region's major hospital systems. The essentials were:From 2011 to 2013, the three most recent years available, tax records show the chief executive...
Source: Health Care Renewal - February 5, 2015 Category: Health Management Tags: conflicts of interest cross fire executive compensation Medtronic Norton Healthcare public relations spine surgeons Source Type: blogs
This is, or at least may be, a BFD
I have discussed initiatives in the Affordable Care Act that encourage experimentation with new ways of reimbursing health care providers --Accountable Care Organizations being the most noteworthy. These are capitated (i.e. paid a lump sum per year per patient, with some adjustments) multi-specialty provider entities that get bonuses for patient satisfaction and good outcomes and get their pay docked for bad outcomes. But, these are just experiments that will only have a few takers.But now the Administration has announced a major change in Medicare. By then, 30% of payments will be under ACO-like alternative pay models. A ...
Source: Stayin' Alive - January 27, 2015 Category: American Health Source Type: blogs
Nonprofit CEO compensation: Much ado about not much
The Sunday Boston Globe (Leading nonprofit jobs hold big perks) was as predictable as it was misguided. Here’s the juicy lead:
They are not only well-paid, but many receive an array of generous perks — housing allowances, home loans, club dues, and free travel for spouses. One was awarded a quarter-million dollars in retention bonuses. Another is reimbursed for his children’s college tuition.
Exhibit A is the president of the Museum of Science. He’s the one who’s reimbursed for his kids’ tuition. But wait, it turns out he worked for 10 years as a dean at Tufts, where free tuition is a standard...
Source: Health Business Blog - January 26, 2015 Category: Health Managers Authors: dewe67 Tags: Policy and politics Source Type: blogs
Top stories in health and medicine, January 24, 2015
From MedPage Today:
Congressman to AMA: Offer SGR Solutions Not Complaints. The American Medical Association (AMA) is doing a disservice by not weighing in on how to pay for repealing the sustainable growth rate (SGR) formula for physician reimbursement under Medicare.
Lethal Injection: A Cruel, Painful, Terrifying Execution. Physicians should abstain from discussions on how to improve lethal injection, according to one clinician who has become an outspoken critic of the execution modality.
Fall Risk Factors in RA Are Not Clear. The true rates of falls and potential fall risk factors in patients with rheumatoid arthritis...
Source: Kevin, M.D. - Medical Weblog - January 24, 2015 Category: Journals (General) Authors: MedPage Today Tags: News Rheumatology Source Type: blogs
Unpacking The Medicare Shared Savings Proposed Rule: Geography And Policy
Conclusions
Depending on one’s perspective, the early results of the MSSP are either promising or disappointing. On the one hand, nearly a quarter of qualifying ACOs achieved shared savings in the first year of performance; on the other, three-quarters either did not lower spending or did so but failed to exceed the minimum savings rate. Our analysis suggests that, using Hospital Referral Region spending as a proxy, the way medicine is practiced (or at least has been practiced) in a region is important to the ACO’s ability to generate shared savings under current benchmarking methdology. We conclude that some adjustmen...
Source: Health Affairs Blog - January 22, 2015 Category: Health Management Authors: Scott Heiser, Carrie Colla, and Elliott Fisher Tags: All Categories Health Care Costs Health Reform Hospitals Insurance Medicare Payment Policy Quality Spending Source Type: blogs
OIG Soliciting Recommendations on New Safe Harbors To The Anti-Kickback Statute; Stakeholder Comments on Developing Special Fraud Alerts
Each year the HHS Office of Inspector General (OIG) solicits recommendations for new or modified safe harbor provisions under the Anti-Kickback statute, as well as comments on developing Special Fraud Alerts. Comments to OIG’s Solicitation of New Safe Harbors and Special Fraud Alerts are due by March 2, 2015.
The Anti-Kickback statute makes it a criminal offense to “knowingly and willfully offer, pay, solicit, or receive any remuneration to induce or reward referrals of items or services reimbursable by a Federal health care program.” Remuneration under the statute includes the transfer of anything of value, directly...
Source: Policy and Medicine - January 16, 2015 Category: American Health Authors: Thomas Sullivan Source Type: blogs
Daiichi Sankyo Agrees to Pay $39 Million to Resolve Off-Label and Kickback Allegations; Enters into Corporate Integrity Agreement with OIG
Discussion programs, known as “PODs,” from Jan. 1, 2005, through March 31, 2011, as well as other speaker programs from Jan. 1, 2004, through Feb. 4, 2011.
The company allegedly made payments to physicians “when physician participants in PODs took turns ‘speaking’ on duplicative topics over Daiichi-paid dinners, the recipient spoke only to members of his or her own staff in his or her own office, or the associated dinner was so lavish that its cost exceeded Daiichi’s own internal cost limitation of $140 per person,” according to DOJ.
The complaint alleges that "[a]bsent Defendant’s unap...
Source: Policy and Medicine - January 13, 2015 Category: American Health Authors: Thomas Sullivan Source Type: blogs
Daiichi Sankyo Settlement and Corporate Integrity Agreement
Discussion programs, known as “PODs,” from Jan. 1, 2005, through March 31, 2011, as well as other speaker programs from Jan. 1, 2004, through Feb. 4, 2011.
The company allegedly made payments to physicians “when physician participants in PODs took turns ‘speaking’ on duplicative topics over Daiichi-paid dinners, the recipient spoke only to members of his or her own staff in his or her own office, or the associated dinner was so lavish that its cost exceeded Daiichi’s own internal cost limitation of $140 per person,” according to DOJ.
The complaint alleges that "[a]bsent Defendant’s unap...
Source: Policy and Medicine - January 13, 2015 Category: American Health Authors: Thomas Sullivan Source Type: blogs
Cheating bosses stain the reputation of their organisations and their junior staff
Former Enron CEO Jeff Skilling (left) and his attorney leave the courthouse in 2006When high-ranking members of an organisation break the rules, it's not just their own reputation on the line. New research from Stanford University shows that the stain of transgression sends its fingers out to every organisational member.In a series of online studies, Takuya Sawaoka and Benoît Monin presented participants with information about a hypothetical company employee involved in unethical activity such as deceptive marketing. When the culprit's position in the company was senior rather than low-ranking, participants were more like...
Source: BPS RESEARCH DIGEST - January 8, 2015 Category: Psychiatrists and Psychologists Authors: Research Digest Source Type: blogs
