Daily Rounds: ERs Deny Care; Medicare 'Costly Waste'; Mass. Kids Less Fat

Three Mass. ERs cited for denial of care (The Boston Globe) - "Health officials cited three Massachusetts hospitals in the past six months for wrongly sending away patients from their emergency rooms, in one case resulting in the death of a patient while en route to another facility. In that episode, caregivers at Charlton Memorial Hospital in Fall River failed to provide needed medical treatment before transferring the patient, who was unstable and in respiratory distress, state investigators concluded. In a case at St. Vincent Hospital in Worcester, an on-call surgeon refused to come in late at night to perform an emergency operation on a patient with flesh-eating bacteria, investigators found."

GAO calls test project by Medicare costly waste (The New York Times) - "Medicare is wasting more than $8 billion on an experimental program that rewards providers of mediocre health care and is unlikely to produce useful results, federal investigators say in a new report. The report, to be issued Monday by the Government Accountability Office, a nonpartisan investigative arm of Congress, urges the Obama administration to cancel the program, which pays bonuses to health insurance companies caring for millions of Medicare beneficiaries."

More physicians calling the shots in latest round of ACOs (amednews.com) - "Even in some of the new ACOs that involve hospitals, physicians say they still are playing a major leadership role in care coordination. Plymouth Bay Medical Associates, Jordan Physician Associates and a number of specialty physicians from Jordan Hospital joined to form Jordan Community ACO in Plymouth, Mass. Physicians in the network will coordinate care for more than 6,000 Medicare patients. The ACO is structured so that physicians and the hospital have an equal say in how the organization will operate and share in any savings."

Obesity rates dropping among Mass. infants, toddlers (The Boston Globe) - "After a three-decade tripling in childhood obesity rates, the trend has leveled off and, for the first time, appears to be on a substantial decline - at least among Massachusetts infants and preschoolers, according to a study published Monday in the journal Pediatrics. Researchers at the Harvard Pilgrim Health Care Institute found that the percentage of obese girls under age 6 dropped from 9 percent to slightly more than 6 percent from 2004 to 2008; the percentage of obese boys under age 6 fell from nearly 11 percent to just under 9 percent during the same time period."

And more on denial of care:
Despite tax breaks, some NC hospitals deny care to poor (NewsObserver.com) - "The newspapers found that:
• About a third of North Carolina hospitals spent less than 2 percent of their budgets on charity care in 2010. Most of these are small hospitals in rural areas, and many report that they are losing money.
• At some hospitals, profits far exceed charity care spending. In 2010, the most recent year broadly available, Duke’s three hospitals provided $64.1 million in charity care, or 3.3 percent of the budget. That year, Duke had an operating profit of $316 million, or 14 percent.
• In North Carolina, where nearly one in five residents under 65 lacks health insurance, some of the least charitable hospitals are located in counties where the needs are highest. Duplin General Hospital serves a high-poverty county in Eastern North Carolina where one in four people lacks health insurance. Its charity care spending is less than 1 percent of its budget.