Interesting News Article from 2002... Still Holds True.

MEDICINE'S MIDDLEMEN

Hospitals Sometimes Lose Money by Using a Supply Buying Group

By MARY WILLIAMS WALSH and BARRY MEIER

Two groups that dominate the purchasing of medical products for about half the nation's nonprofit hospitals have long said they exist to save money, pooling the influence of thousands of hospitals to negotiate a good price on the best products. But some hospitals are finding otherwise. They have learned that they can do better on their own, and are now raising questions about the need for the huge buying groups, which negotiated contracts last year for $34 billion in supplies. A new, preliminary study by the research arm of Congress, the General Accounting Office, is also challenging the buying groups' claims. In the study, a copy of which was obtained by The New York Times, the G.A.O. found that using a big buying group "did not guarantee that the hospital saved money." In fact, prices negotiated by buying groups "were often higher than prices paid by hospitals negotiating directly with vendors" — in some cases "at least 25 percent higher," the G.A.O. said. At issue are hundreds of millions, if not billions, of dollars in annual health care costs, much of it paid indirectly by taxpayers through programs like Medicare and Medicaid and by private insurers. The G.A.O. report is to be presented today at the first Congressional hearing on the operations of these buying groups. The hearing will be held by the antitrust subcommittee of the Senate Judiciary Committee. The subcommittee is headed by Herb Kohl, Democrat of Wisconsin. The report comes a day after one of the largest buying groups, Premier Inc., took out a full-page ad in Roll Call, a newspaper covering Capitol Hill. In the ad, Premier took credit for "holding down the costs of health care for American businesses, taxpayers, and consumers." The G.A.O. cautioned that its initial report was limited in scope and said it planned a broader inquiry. Government auditors surveyed hospitals in only one city for the prices they paid for two categories of products: pacemakers and hypodermic needles with safety features to prevent accidental sticks. Some of the hospitals surveyed bought such products through contracts negotiated by buying groups, while others made their own deals. Officials of the two biggest buying groups, Premier and Novation, which together negotiate contracts on behalf of about half of nonprofit hospitals, said they had not seen the study. Told of its findings, they disputed its methods and results. Jody Hatcher, vice president for marketing for Novation, based in Irving, Tex., said the findings were skewed because the study looked at only two products rather than a wider range of supplies. "I think you have a flawed study," he said. He and Premier officials said that if hospitals could really save money on their own they would be leaving buying groups in droves. But the G.A.O. survey, even with its limitations, adds to the growing debate about whether groups like Premier and Novation really lower the cost of medical products for the hospitals that own the groups or buy through them. Some hospital executives said in interviews that the groups did save them money, while others said they saved many millions of dollars by going it alone. Unlike other purchasing agents, the groups buying supplies for hospitals are financed by the products' manufacturers and distributors, which pay the groups' fees based on a percentage of sales. That arrangement has led to questions about whose interests the buying groups really serve. Hospitals that have broken away from buying groups cite several reasons for getting lower prices than they would have through the groups. One is the ability to negotiate with a larger number of manufacturers. Another is shorter contracts that allow hospitals to take advantage of falling prices. A third is that manufacturers freed of the need to pay fees to the buying groups will pass on the savings to hospitals. Two years ago, for example, executives of a 10-hospital chain in Iowa decided to end their relationship with Premier. Officials of the Iowa Health System said they found that each time they renegotiated a supply contract, they beat the buying group's price by 12 percent to 14 percent. They are already saving $7 million a year, and expect that figure to grow as more contracts are redone. Duncan Gallagher, executive vice president of Iowa Health, said that for years the common wisdom was that hospitals that tried to buy on their own would pay more. He expects that his system may eventually save 30 percent to 40 percent. "The people who are saying it is impossible are wrong," Mr. Gallagher said. Nicholas C. Toscano, who oversees purchasing for the Virtua Health chain of hospitals in New Jersey, said administrative fees and incentive payments that suppliers pay buying groups for handling their contracts can also raise prices for hospitals. Virtua studied the benefits and costs of buying through a large group and decided it could do better on its own. "If the administrative fee is 3 percent, we normally save, right off the top, 3 percent," Mr. Toscano said. Another factor driving up buying-group prices, Mr. Toscano said, is contract language that allows manufacturers to lock in price increases over several years, even at times when the price of the products is falling on the open market. He said that by writing contracts for shorter periods, Virtua has found opportunities to take advantage of falling prices. But Premier officials say they also renegotiate prices on contracts and some hospitals add that the size of the big buying groups can command better prices. "It is very simple economics," said Keith Callahan, a vice president of Catholic Healthcare West, a large hospital system based in San Francisco that belongs to Premier. The G.A.O. review is a rare effort to examine independently the impact of buying groups on hospital prices. In the case of pacemakers, it found that while some hospitals using buying-group contracts got better prices on some models, they got much worse prices on others. The G.A.O. also found that big groups like Premier and Novation often did not get better prices for the products under study than did smaller purchasing groups. "This lack of consistent price savings is contrary to what would be expected for large" buying groups, the study found. The survey also found that large hospitals — those with more than 500 beds — often got lower prices on their own than by using a buying group. By contrast, small and medium hospitals tended to do better using a buying group. But even in that group, government auditors found, the experience of hospitals differed.

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Managing Diabetes During the Holidays

Having diabetes shouldn't stop you from enjoying holiday celebrations and travel. With some planning and a little work, you can stay healthy on the road and at holiday gatherings with friends and family.

The most important step in managing diabetes during holiday travel and festivities is preparing. Know what you'll be eating, how to enjoy a few traditional favorites while sticking with a healthy meal plan, and how to pack necessary supplies for a trip, and you're all set to celebrate!

Feasts and Parties

Before you go, take these steps to make sure you stick to your healthy meal plan.

• Eat a healthy snack to avoid overeating at the party.
• Ask what food will be served, so you can see how it fits into your meal plan.
• Bring a nutritious snack or dish for yourself and others.

You don't have to give up all of your holiday favorites if you make healthy choices and limit portion sizes. At a party or holiday gathering, follow these tips to avoid overeating and to choose healthy foods.

• If you're at a buffet, fix your plate and move to another room away from the food, if possible.
• Choose smaller portions.
• Choose low-calorie drinks such as sparkling water, unsweetened tea or diet beverages. If you select an alcoholic beverage, limit it to one drink a day for women, two for men, and drink only with a meal.
• Watch out for heavy holiday favorites such as hams coated with a honey glaze, turkey swimming in gravy and side dishes loaded with butter, sour cream, cheese or mayonnaise. Instead, choose turkey without gravy and trim off the skin, or other lean meats.
• Look for side dishes and vegetables that are light on butter, dressing and other extra fats and sugars, such as marshmallows or fried vegetable toppings.
• Watch the salt. Some holiday favorites are made with prepared foods high in sodium. Choose fresh or frozen vegetables that are low in sodium.
• Select fruit instead of pies, cakes and other desserts high in fat, cholesterol and sugar.
• Focus on friends, family and activities instead of food. Take a walk after a meal, or join in the dancing at a party.

Traveling for the Holidays

Leaving home to visit friends and family means changing routines. Make sure you remember to take care of your diabetes while traveling. Check blood glucose (sugar) more often than usual, because a changing schedule can affect levels.

Remember Your Medication

• Pack twice the amount of diabetes supplies you expect to need, in case of travel delays.
• Keep snacks, glucose gel, or tablets with you in case your blood glucose drops.
• Make sure you keep your medical insurance card and emergency phone numbers handy, including your doctor's name and phone number.
• Carry medical identification that says you have diabetes.
• Keep time zone changes in mind so you'll know when to take medication.
• If you use insulin, make sure you also pack a glucagon emergency kit.
• Keep your insulin cool by packing it in an insulated bag with refrigerated gel packs.

On the Road and in the Air

• Get an influenza vaccination before traveling, unless your medical provider instructs otherwise. Get the flu shot, not the nasal spray.
• Wash hands often with soap and water. Try to avoid contact with sick people.
• Reduce your risk for blood clots by moving around every hour or two.
• Pack a small cooler of foods that may be difficult to find while traveling, such as fresh fruit, sliced raw vegetables, and fat-free or low-fat yogurt.
• Bring a few bottles of water instead of sweetened soda or juice.
• Pack dried fruit, nuts, and seeds as snacks. Since these foods can be high in calories, measure out small portions (¼ cup) in advance.
• If you're flying and do not want to walk through the metal detector with your insulin pump, tell a security officer that you are wearing an insulin pump and ask them to visually inspect the pump and do a full-body pat-down.
• Place all diabetes supplies in carry-on luggage. Keep medications and snacks at your seat for easy access. Don't store them in overhead bins.
• Have all syringes and insulin delivery systems (including vials of insulin) clearly marked with the pharmaceutical preprinted label that identifies the medications. Keep it in the original pharmacy labeled packaging.
• If a meal will be served during your flight, call ahead for a diabetic, low fat, or low cholesterol meal. Wait until your food is about to be served before you take your insulin.
• If the airline doesn't offer a meal, bring a nutritious meal yourself. Make sure to pack snacks in case of flight delays.
• When drawing up your dose of insulin, don't inject air into the bottle (the air on your plane will probably be pressurized).
• Stick with your routine for staying active. Make sure to get at least 150 minutes of physical activity every week. Ten minutes at a time is fine.

FDA Launches Website on Safe Disposal of Used Needles and Other Sharps

The Food and Drug Administration has launched a new website for patients and caregivers on the safe disposal of needles and other sharps that are used at home, at work and while traveling. The website will help people understand the public health risks created by improperly disposing of used sharps and how users should safely dispose of them.

Sharps is a term for medical devices with sharp points or edges that can puncture or cut the skin. Such medical devices include hypodermic needles and syringes used to administer medication; lancets or fingerstick devices to collect blood for testing; needle and tubing systems for infusing intravenous and subcutaneous medicines; and connection needles used for home hemodialysis.

After being used, many sharps end up in home and public trash cans or flushed down toilets. This kind of improper disposal puts people, such as sanitation workers, sewage treatment workers, janitors, housekeepers, family members and children at risk for needle stick injuries or infection with viruses such as Hepatitis B and C and Human Immunodeficiency Virus (HIV).

“Safe disposal of used needles and other sharps is a public health priority,” says Jeffrey Shuren, MD, director of the FDA’s Center for Devices and Radiological Health. “This website provides information about how to keep used sharps from ending up in places where they could harm people.”

With more diseases and conditions such as diabetes, cancer, allergies, arthritis and HIV being managed outside of hospitals and doctors’ offices, the number of sharps used in homes and work offices is increasing. In addition, pets are being treated in homes and livestock are being treated on farms, which are also contributing to the increased number of sharps outside of veterinary hospitals.

The Environmental Protection Agency estimates that more than 3 billion needles and other sharps are used in homes in the United States each year.

Sharps disposal guidelines and programs vary by jurisdiction. For example, in 2008, California passed legislation banning throwing needles in household trash. Florida, New Jersey and New York have established community drop off programs at hospitals and other health care facilities. People using sharps at home or work or while traveling should check with their local trash removal services or health department to find out about disposal methods available in their area.

For the safe disposal of needles and other sharps used outside of the health care setting, the FDA recommends the following:

DO:

- Immediately place used sharps in an FDA-cleared sharps disposal container to reduce the risk of needle-sticks, cuts or punctures from loose sharps. (A list of products and companies with FDA-cleared sharps disposal containers is available on the FDA website. Although the products on the list have received FDA clearance, all products may not be currently available on the market.)
- If an FDA-cleared container is not available, some associations and community guidelines recommend using a heavy-duty plastic household container as an alternative. The container should be leak-resistant, remain upright during use and have a tight fitting, puncture-resistant lid, such as a plastic laundry detergent container.
- Keep sharps and sharps disposal containers out of reach of children and pets.
Call your local trash or public health department in your phone book to find out about sharps disposal programs in your area.
- Follow your community guidelines for getting rid of your sharps disposal container.
DO NOT:

- Throw loose sharps into the trash.
- Flush sharps down the toilet.
- Put sharps in a recycling bin; they are not recyclable.
- Try to remove, bend, break or recap sharps used by another person.
- Attempt to remove a needle without a needle clipper device.

Blood Pressure Drop During Dialysis May Raise Clot Risk

Low BP occurs in about 25% of these treatment sessions in kidney-failure patients, researchers say



FRIDAY, July 29 (HealthDay News) -- Low blood pressure while undergoing dialysis puts patients at increased risk for clots where their blood vessels are connected to the dialysis machine, a new study says.

Previous research had found that a sudden drop in blood pressure during dialysis can lead to short-term gastrointestinal, muscular and neurologic symptoms, and long-term problems such as stroke, seizure, heart damage and death.

This new study, led by researchers at Stanford University School of Medicine, examined data collected between 1995 and 2000 from 1,426 dialysis patients who took part in a clinical trial sponsored by the U.S. National Institutes of Health.

Dialysis is a treatment for kidney-failure patients that uses a machine to cleanse their blood. Many patients are attached to the dialysis machine through a fistula, a surgically created vascular access point in the body that's connected to the tubes that take and return blood to the dialysis machine.

The analysis revealed that patients who experienced low blood pressure most often while undergoing dialysis were two times more likely to have a clotted fistula than those who had the fewest episodes of low blood pressure.

"Our analysis shows another adverse consequence associated with a fall in blood pressure during dialysis for patients," lead author and nephrologist Dr. Tara Chang said in a Stanford news release. "Vascular access is their lifeline. It's required for dialysis and without dialysis, they'll die."

Because low blood pressure occurs in about one-quarter of dialysis sessions, "physicians already try to avoid low blood pressure during dialysis through various means," Chang said. "This is just one more good reason to continue these efforts."

The study is published in the July 29 online edition of the Journal of the American Society of Nephrology.

The National Kidney Foundation has more about dialysis.

-- Robert Preidt


SOURCE: Stanford University, news release, July 29, 2011

Fourth of July...

AOSS Medical Supply
will be closed, Monday, July 4th, in observance
of "Independence Day" and will resume business
on Tuesday, July 5th.

 

Have an enjoyable and safe holiday!

As a reminder...

AOSS Medical Supply wishes to say "Happy Father's Day" to all of the dad's and those soon to be!  Have a restful and safe weekend...

And here are several viewpoints on the Day to ponder:

Red Buttons


Never raise your hand to your kids. It leaves your groin unprotected.


Jimmy Piersal, on How to Diaper a Baby

Spread the diaper in the position of the diamond with you at bat. Then, fold second base down to home and set the baby on the pitcher's mound. Put first base and third together, bring up home plate and pin the three together. Of course, in case of rain, you gotta call the game and start all over again.


Ernest Hemingway

To be a successful father, there's one absolute rule: when you have a kid, don't look at it for the first two years.


Bill Cosby

If the new American father feels bewildered and even defeated, let him take comfort from the fact that whatever he does in any fathering situation has a fifty percent chance of being right.


Phyllis McGinley

The thing to remember about fathers is... they're men. A girl has to keep it in mind: They are dragon-seekers, bent on improbable rescues. Scratch any father, you find someone chock-full of qualms and romantic terrors, believing change is a threat, like your first shoes with heels on, like your first bicycle...


John Aubrey

Sir Walter, being strangely surprised and put out of his countenance at so great a table, gives his son a damned blow over the face. His son, as rude as he was, would not strike his father, but strikes over the face the gentleman that sat next to him and said, "Box about: twill come to my father anon."


James Baldwin

If the relationship of father to son could really be reduced to biology, the whole earth would blaze with the glory of fathers and sons.


Helen Hayes

When Charles first saw our child Mary, he said all the proper things for a new father. He looked upon the poor little red thing and blurted, "She's more beautiful than the Brooklyn Bridge."


Peter De Vries

My father hated radio and he could not wait for television to be invented so that he could hate that too.


Robert Orben

Life was a lot simpler when what we honored was father and mother rather than all major credit cards.

Plasma Protein Therapeutics Association 2011

Our CEO and our President/COO are in attendance at this years Plasma Protein Therapeutics Association (PPTA) Conference in Reston, Virginia.

The Plasma Protein Therapeutics Association (PPTA) is the primary advocate for the world’s leading source plasma collectors and producers of plasma-based and recombinant biological therapeutics.

The medicines produced by PPTA members are used in treating life-threatening diseases and serious medical conditions including bleeding disorders, immune system deficiencies, alpha-1 antitrypsin deficiency, burns and shock.

As the global representative for the plasma collection and therapeutics industry, PPTA works cooperatively with patient groups, policymakers, regulatory agencies and other stakeholders to address critical issues, and we are there and partnered with PPTA.

http://www.pptaglobal.org/

US Department of Labor's OSHA Press Release

US Department of Labor's OSHA conducting inspections of outpatient care centers in Mississippi to reduce needlestick hazards

http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=NEWS_RELEASES&p_id=19689

ATLANTA – The U.S. Department of Labor's Occupational Safety and Health Administration is announcing a new emphasis program focused on reducing the number of needlestick and sharps injuries in Mississippi at ambulatory surgical care centers, freestanding emergency care clinics and primary care medical clinics that provide acute, chronic and emergency care on an as-needed or walk-in basis.

"Needlestick and other sharps-related injuries that expose workers to bloodborne pathogens continue to be an important public health concern," said Cindy Coe, OSHA's regional administrator in Atlanta. "Employers must take seriously their responsibility to protect workers from these health risks."

In addition to Mississippi, OSHA will be visiting a sample of health-related facilities in other southeastern states, including Alabama, Florida and Georgia, to review each establishment's processes and programs designed to protect workers from bloodborne hazards. Those inspections will focus on bloodborne pathogen hazards associated with exposure to contaminated sharps devices. Establishments of all sizes with varying numbers of workers will be inspected.

OSHA area offices also will continue to open inspections in response to complaints that include allegations of sharps/needlestick hazard exposures.

The regional emphasis program begins April 25 and will continue until Sept. 30, 2012, unless it is extended.

Under the Occupational Safety and Health Act of 1970, employers are responsible for providing safe and healthful workplaces for their employees. OSHA's role is to ensure these conditions for America's working men and women by setting and enforcing standards, and providing training, education and assistance. For more information, visit http://www.osha.gov.

AOSS Medical Supply will be closed Monday, May 30th, in honor and observance of Memorial Day and will resume business on Tuesday, May 31st.
"AOSS Medical Supply affirms its commitment to honoring those individuals who have given their lives, in order for us to have our freedom!"

During the recent days of this week, numerous communities within our Parish and our region have experienced the loss of property and loved ones, due to the severe weather, and we, the Executives and Staff of AOSS Medical Supply, wanted to extend our deepest and heartfelt thoughts and prayers to everyone affected!







Our community is very important to us and we hold each individual’s life as sacred, this is why AOSS Medical Supply is a part of the Ark-La-Miss and will continue to be for years to come…