Irvine-based Monarch HealthCare, A Medical Group Inc., and HealthCare Partners Medical Group, a Torrance group that serves Orange County, are participating in a new federal healthcare project aimed at reining in medical costs.
They’ll join 30 other health systems in 18 states to partner with Medicare on an accountable-care initiative. Accountable-care organizations are intended to help doctors, hospitals and insurers streamline care without reducing quality.
Hospitals that participate in the initiative will be eligible to receive bonus payments based on a savings goal of as much as $1.1 billion for Medicare over five years.
“If you’re a hospital executive, you’re rewarded for keeping your beds full,” said John Rother, chief executive of the Washington, D.C.-based National Coalition on Health Care, who recently spoke on behalf of the businesses, unions and hospitals that make up the coalition in an interview with Bloomberg. “That’s going to change.”
The program launched Jan. 1 and could cover about 860,000 Medicare recipients in California and 17 other states, according to the federal estimates.
Federal healthcare reform passed in 2010 envisioned networks of doctors, hospitals and health insurers pooling their services and getting paid by hitting certain quality milestones and based on how much money they save.
Monarch—no stranger to accountable-care organizations—has been tapped by Medicare to test the effectiveness of several types of healthcare delivery and payment. The medical group previously was picked by the Brookings Institution’s Engelberg Center for Health Care Reform and the Dartmouth Institute for Health Policy and Clinical Practice to participate in a separate accountable-care project.
Breast Implants
Women who’ve received breast implants should understand that they will need a lifetime of care, according to a recent Reuters report.
Breast implants are now the flashpoint of an overseas health scare because of recent reports of implants from Poly Implant Prothese, a now-defunct French device maker, having an abnormally high rupture rate.
The article also noted that the Food and Drug Administration had said that most women who have the implants were likely to need additional surgery within 10 years to address possible complications such as ruptures or leakage.
Reuters suggested that costs for breast enhancement surgery, which is not covered by insurance, were likely to add up over the years. Breast implant surgeries with either silicone or saline implants can cost $5,000 to $8,000 on average in the U.S. “Revision” breast surgeries are often more expensive because of existing scar tissue and a need to remove or adjust the original implants.
After a raft of controversies in the early 1990s, the FDA ordered silicone breast implants off the domestic due to questions about their safety.
In 2006, U.S. silicone breast implant sales resumed after the FDA cleared implants sold by Irvine-based Allergan Inc. and Mentor Corp., which is now a business unit of Johnson & Johnson. The approval came with the condition that the companies would follow a sample of 40,000 women for 10 years to look at safety issues.
“Breast implants do not last a lifetime, they will need replacing at some point in the future,” the British Implant Information Society told Reuters.
ICU-Hospira
San Clemente medical-device maker ICU Medical Inc. has extended a pair of distribution agreements with longstanding core customer Hospira Inc. through 2018. ICU makes needleless intravenous connectors and other medical devices intended to protect healthcare workers.
One deal calls for ICU to make all new custom infusion sets that are sold by Lake Forest, Ill.-based Hospira, which was previously part of Abbott Laboratories, and the companies jointly promote the devices under the name of SetSource. The other—initially struck in 1995—is a supply and distribution agreement under which Hospira primarily buys ICU’s Clave and oncology devices.
Both deals maintain Hospira’s rights to distribute ICU’s products worldwide with terms that previously extended to 2014.
Bits and Pieces
Newport Beach-based Alliance HealthCare Services Inc. said it expects full-year 2012 revenue of $470 million to $500 million, compared to analysts’ expectations of $482.5 million. Alliance, which provides mobile and fixed-site imaging services, did not give a net profit estimate. Instead, it said it expected adjusted earnings before interest, taxes, depreciation and amortization of $140 million to $150 million. Company executives say that adjusted EBITDA is a good indicator of Alliance’s performance. … MP Biomedicals LLC, a maker of medical testing and research products based in Santa Ana, hired Todd Nelson as chief executive. Nelson was most recently chief executive of eBioscience Corp. in San Diego. Milan Panic, MP Biomedicals’ founder, remains chairman. Panic is best-known for founding ICN Pharmaceuticals Inc., a predecessor of Canada’s Valeant Pharmaceuticals International.
