At the Hospitals: May 11, 2014

Sunday, May 11, 2014
Dartmouth Researchers 
Find Savings in Cancer Care

Lebanon — Researchers from The Dartmouth Institute for Health Policy & Clinical Practice report that savings in the cost of cancer care may be found in accountable care organizations through reductions in hospitalizations.

Approximately 10 percent of Medicare spending is for cancer care, and Medicare spending is nearly four times higher for beneficiaries with cancer than for those without the disease, the institute said in a recent news release. “Little is known about how to curb spending growth while maintaining or improving quality of care for those high-risk, high-cost patients.”

The analysis, published in the December issue of the journal Healthcare, provides the first empirical evidence on how the shared savings ACO model may affect the cost and experience of care for cancer patients.

The researchers looked at the Physician Group Practice Demonstration, which ran from 2005 to 2010 in 10 physician groups, for the best current evidence on the likely effectiveness of accountable care organizations for Medicare beneficiaries. Under an ACO contract, a group of physicians is eligible to share in savings they create if they meet quality standards.

The researchers report that a reduction of $721 annually per patient could be found in Medicare spending, a 3.9 percent decrease, with no adverse consequence for survival. The savings were associated with fewer admissions for inpatient care among beneficiaries with prevalent cancer due to better management of acute care, especially in beneficiaries eligible for both Medicare and Medicaid. However, there were no reductions in cancer-specific treatments, such as chemotherapy or surgical procedures.

There was no significant change of proportions of deaths occurring in the hospital, reductions in hospice use, hospital discharges or ICU days. But there was an improvement in mortality.

“This could be viewed optimistically,” said Carrie Colla, principal investigator in the study. “This payment reform was not associated with stinting on cancer-specific treatment.”

Disappointingly, the demonstration group did not make changes in services more likely to be discretionary (such as imaging), which are both expensive and common in cancer treatment, Colla said. The researchers noted that as more expensive chemotherapy agents and new procedures are introduced into the market, payments for inpatient care may be dwarfed by spending on cancer treatments.

Physician Assistant 
Joins Valley Regional Hospital

Claremont — A new primary care provider has joined the Internal Medicine clinic at Valley Regional Hospital.

MacKenzie Monahan is a nationally accredited and board certified physician assistant. He earned his undergraduate degree from the University of Connecticut in Storrs-Mansfield and his master’s degree at Franklin Pierce University in West Lebanon. He completed an internship in internal medicine at Barre (Vt.) Internal Medicine, as well as internships in family medicine, emergency medicine, pediatrics and general surgery at various facilities throughout Vermont. Before pursuing his degree and coming to Valley Regional Hospital, he worked at Fletcher Allen Health Care in Burlington as a clinical microbiologist in the Department of Pathology and Laboratory Medicine.

Nurse-Midwife Joins Gifford

Randolph — April Vanderveer, a certified nurse-midwife and women’s health nurse practitioner, has joined Gifford. She will divide her time between Gifford Ob/Gyn and Midwifery in Randolph and the Gifford Health Center at Berlin.

Vanderveer is an experienced birthing center nurse who went on to nurse midwifery school at Georgetown University in Washington, D.C. She also has a bachelor’s degree from the University of Vermont and a bachelor’s degree in nursing from the Medical University of South Carolina in Charleston.

She worked for 11 years at Copley Hospital in Morrisville, Vt., as a birthing center nurse before and while in midwifery school. As part of her schooling, she did nine months of clinical training at Gifford.

Vanderveer is board certified by the American Midwifery Certification Board.

Kearsarge Students 
Complete Health Care Program

New London — Four students from Kearsarge Regional High School recently completed the Caring Student Intern Program at New London Hospital.

Leah Bowman, Ben Esmaili, Devon Fortier and Devin Taves took the four-day course, designed to help high school students explore the health care industry and related career opportunities.

The students, eight in all, visited several areas in the hospital, including the emergency department, radiology, laboratory, physical therapy and the William P. Clough Center, an extended nursing care facility.

They also took part in hands-on classes and learned about infection control, proper hand washing procedures, application and interview skills, quality improvement, and patient safety. Some of the students earned their initial CPR certifications, and others received CPR recertifications. — Compiled by Aimee Caruso