tufts medical center


Marathon Medical Update: Shrapnel Abounds, Leg Amputations For Some

WBUR’s Martha Bebinger reports that the number of patients being treated for Marathon bomb-related injuries is now up to 187. At least 24 people are in critical condition at 14 area hospitals. Many have been treated and released. Three people have died.

Doctors at several hospitals are reporting that based on injuries, it appears that the bombs were packed with shrapnel.

Bebinger quotes Dr. Stephen Epstein, at Beth Israel Deaconess Medical Center saying: “What we were seeing looked like BBs,” consistent “with the explosive devices.”

WBUR’s Asma Khalid was at Massachusetts General Hospital for a news conference this morning. She said doctors have treated 31 patients; 12 were admitted, 8 are in serious condition and 4 required amputations of lower extremities, according to Dr. George Velmahos, Chief of Trauma Services at MGH. They are more optimistic than yesterday, Khalid said; “everyone who was in the ICU is alive and stable.”

Khalid was also at Tufts Medical Center and reports that doctors saw 14 disaster-related patients; 10 are still in the hospital. She reports that there have been no amputations so far. She said Bill Mackey, chief of surgery at Tufts, described injuries in the lower extremities and included open fractures, nerve damage and muscle damage. Most injuries were between the knee and ankle. She said the medical team detected small shards of metal, and small metallic fragments, ranging from 1 centimeter to a few millimeters.

A man in the crowd following the explosion. (AP Photo/The Daily Free Press, Kenshin Okubo)

A man in the crowd following the explosion. (AP Photo/The Daily Free Press, Kenshin Okubo)

As of this morning, seven of the 10 kids treated at Children’s Hospital Boston have been released, according to the hospital. Three pediatric patients remain, with two of them in critical condition in the Medical/Surgical ICU and one on a surgical unit. Here’s the official update:

Our latest patients included:

— 2-year-old boy with a head injury in good condition.

— 10-year-old boy with multiple leg injuries in critical condition.

— 9-year-old female with leg injury in critical condition. Continue reading

Tufts, Vanguard To Launch New Health Insurance Program


WBUR’s Martha Bebinger reports:

Tufts Medical Center, its physicians, and the for-profit Vanguard Health Systems are sponsoring the first member-run health insurance plan in Massachusetts.

Tufts and its partners won federal approval and $88.5 million dollars to launch a new health insurance option — Minuteman Health — around lower cost hospitals and providers with benefits designed by the members. And members will decide how to spend surpluses or profits, says Minuteman Health board chair Ellen Zane.

“The surpluses will either go back to reducing the cost of the premiums or enhancing the benefits in the products. That is a major difference for this kind of product in the market,” Zane said.

Organizers are working with the Massachusetts Division of Insurance to meet state regulations. They hope to have the plan up and running in at the beginning of 2014. The federal investment will help build initial reserves for the program.

Eric Beyer, president and CEO of Tufts Medical Center, says 17 hospitals in MA have expressed interest in joining the Minuteman Network.

“This is an interesting and exciting development that could shake up the health insurance market for individuals and small employers,” says Nancy Turnbull, Senior Lecturer on Health Policy and Associate Dean for Educational Programs at the Harvard School of Public Health. “The key to success will be whether the plan offers products that are more affordable and have an attractive provider network. The coop model is new to Massachusetts but will, I think, resonate with many consumers who would relish being part of a health plan in which they have a real voice.”

Here’s the full press release from Tufts:

Tufts Medical Center, its New England Quality Care Alliance (NEQCA) physicians network and Vanguard Health Systems (NYSE: VHS) are proud to sponsor the Minuteman Health Initiative, which has received an $88.5 million loan from the Centers for Medicare and Medicaid Services (CMS). This new member-governed, non-profit health insurance option for Massachusetts residents intends to offer consumers and employers lower-cost, high-quality care with unprecedented transparency, as well as increased efficiency and satisfaction for physicians, patients and employers alike. Plan members will ultimately govern this health plan via Minuteman’s unique ownership structure. Continue reading

How Your Kidneys Could Signal Trouble Ahead For Your Brain

New research finds links between the humble kidney and our brains. Shown here is the kidney of an embryonic mouse, genetically altered to glow green.

The last time Dr. Julie Lin went for her annual check-up, she asked for tests of her kidney function that her primary care doctor would not otherwise have ordered.

It was not just that Dr. Lin is a Brigham and Women’s Hospital nephrologist — a kidney specialist — and often sees patients who, by the time their disease has been detected and they have been referred to her, are verging on total kidney failure.

It was that she had found in her own research — which is just out in a leading nephrology journal — that tests of your kidney function can apparently yield surprisingly telltale insights into the health of your brain, and possibly other organs as well.

The research looked at more than 1700 women over age 70 in the long-running Nurses’ Health Study, following them for up to six years. It found that in women whose urine tests indicated the very beginnings of kidney dysfunction, their cognitive abilities — higher-order brain functions like memory and verbal fluency — declined two to seven times faster than normal.

More than half a million Americans are in ‘end-stage’ kidney disease, and among them, 88,000 die each year.

The cognitive experts working on the study were “really struck by how strong an association there was, how much faster a decline this very small amount of protein in the urine is signaling,” Dr. Lin said.

The study mainly raises the possibility of an easy, non-invasive urine screening test that could provide a useful window into brain health. But it also has potential implications for a medical-emotional conundrum: Over 20 million Americans are afflicted by chronic kidney disease; more than half a million are in its ominous “end stage,” and among them, 88,000 die each year. So why, oh why, don’t you care more about your kidneys?

Continue reading

Breaking: Blue Cross, Tufts Medical Center Reach Agreement

This just in:

New Contract Agreement Reached between Blue Cross Blue Shield of Massachusetts, Tufts Medical Center and New England Quality Care Alliance

BCBSMA Members Can Continue to Seek Care at Tufts Medical Center and from its Community Physician Network

December 7, 2011 – Boston, MA – Blue Cross Blue Shield of Massachusetts (BCBSMA), Tufts Medical Center and New England Quality Care Alliance (NEQCA) announced today that they have agreed to a new three-year contract. The agreement ensures that BCBSMA members who receive care at Tufts Medical Center, Floating Hospital for Children or from a NEQCA community physician can continue to do so without any interruption. BCBSMA members who would like to be new patients of NEQCA, Tufts MC and Floating can receive care as well.

Under the agreement, the Tufts Medical Center and NEQCA network will receive an annual network-wide average increase of 3 percent. Continue reading

What You Need To Know About New DNA Down Syndrome Tests

The news recently broke that prenatal testing is entering a new era: DNA tests able to detect Down syndrome in a fetus just by testing the mother’s blood are now hitting the market.

Below you’ll find a nuts-and-bolts Q&A with a leading researcher on such tests: What’s the state of the science? Who should get one? How much are they?

But first, a brief editorial: This is good news for the great many parents-to-be who want the chance to know in advance if a fetus has Down syndrome. As an older mother, I would have been overjoyed to have a near-definitive, non-invasive test. If the women who come after me have that chance, and it looks like they will, I’ll consider it quite a boon of the genomic era.

Much of the coverage has struck me as oddly “balanced.” If you search on nytimes.com, for example, the headline says the new type of test “raises hopes and questions.” Questions? Well, sure, it’s a new technology: Will it live up to its initial promise? But the Times story also cites concerns “that use of such tests early will lead to more abortion of fetuses with minor abnormalities, the wrong sex or an undesired father.” It quotes Dr. Brian Skotko of the Down syndrome program at Children’s Hospital Boston, whose sister has Down syndrome. He “pointed out that these tests could encourage more people to end their pregnancies, causing a decline in the numbers of people with the condition and leading to diminished support for them.”

I remember it as: ‘Do I want to avoid Down syndrome badly enough to risk this whole precious pregnancy?’

We’re all entitled to our points of view. But let’s look at the tests from the perspective of the parents-to-be.

These DNA tests could bring about the end of the heart-wrenching pregnancy decision on whether to get an invasive test like an amniocentesis despite the small risk of miscarriage. (I remember it as: “Do I want to avoid Down syndrome badly enough to risk this whole precious pregnancy?”) Continue reading

Tufts, Blue Cross, Giving Patients A Voice And Re-Imagining The Pie

Scene from another negotiation, US-Russian arms talks in Geneva

Yesterday, the news broke that contract talks have broken down between Blue Cross Blue Shield of Massachusetts and Tufts Medical Center, and if nothing changes, tens of thousands of patients may have to switch doctors or insurance plans next year. This seemed like the perfect moment to turn to Harvard’s Program for Health Care Negotiation and Conflict Resolution — and to Leonard Marcus, Barry Dorn and Eric McNulty, co-authors of the new edition of “Renegotiating Health Care: Resolving Conflict to Build Collaboration.”

Q: So how do you see this Blue Cross-Tufts situation?

Lenny: I see this as once again a partial negotiation where the insurance company and a provider are trying to figure out a business arrangement without including the full range of stakeholders — which would include the patients. Patients have an economic stake in health care just as insurers and providers do. So, it would be interesting to imagine, if the patients were at the table, what might they add to this negotiation?

Imagine if Blue Cross wound up paying less to Tufts than they do to Partners and they took that savings, passed it along to patients, and said, ‘If you are on a tight budget and want a lower-cost plan, we have it for you — if you go to Tufts providers. If you prefer to go to Partners providers, you pay more. Blue Cross would achieve cost savings it wants, Partners would get the premium price it wants, and Tufts would get some competitive advantage through a lower-priced offering. The economics would be transparent and consumers could exercise choice. If many of them chose the lower-cost Tufts option, it could cause Partners to rethink its model – and possibly result in reductions of overall system costs.

“‘Us against them’ battling over a fixed pie where each side is trying to get the biggest piece of the pie”

But under the current rubrick, patients pay the same for Blue Cross Blue Shield coverage no matter where they go. So, one could assume that whatever money Blue Cross is extracting from this will go straight to their bottom line.

So if you were advising Blue Cross and Tufts right now about how to get their negotiations back on track, what would you say? Continue reading

Brain Surgery Patient To Tufts, Blue Cross: ‘Guys…Work It Out’

Here, Martha Bebinger tracks down a brain surgery patient (who happens to be an anchor at WBUR) to illustrate what’s at stake after contract talks between Tufts Medical Center and Blue Cross Blue Shield of Massachusetts broke down last night.

Due to the impasse, Blue Cross members who see doctors at Tufts Medical Center may have to find a new physician in January. The state’s largest insurer sent letters today warning patients about what this might mean for them.

To get a first hand view on the Tufts, Blue Cross dispute, Martha walked into one of our glass walled studios where a colleague had just finished a newscast:

Mr Faneuf?

Dave Faneuf, an anchor at WBUR, is a Blue Cross member who had surgery this summer to remove a brain tumor. Now he’s receiving radiation.

“If this reoccurs, if it comes back, radiation will not be an option again,” Faneuf said. “So the only option is more surgery. And the team that performed the surgery is at Tufts. They’re the one’s who’ve been in there, they’re the ones who’ve written the notes, they’re the ones, if I have to go back, they’re the ones I want doing it.” Continue reading

Talks Break Down Between Blue Cross and Tufts Medical, Patients May Need New Docs

A contract dispute between Blue Cross and Tufts Medical Center could leave at least 88,000 patients in search of a new primary care doctor, reports WBUR’s Martha Bebinger.

Blue Cross is alerting employers (whose employees have Blue Cross health plans) in letters today that they may no longer be able to go to Tufts.

But Tufts Medical Center CEO Eric Beyer says he hopes negotiations will continue. Continue reading

New CEO At Tufts Medical Center

Eric J. Beyer

Here’s the news release from Tufts Medical Center:

BOSTON (July 22, 2011) – Tufts Medical Center announced today that Eric J. Beyer has been selected as its next President and Chief Executive Officer – assuming leadership of the hospital October 1 as outgoing President and CEO Ellen Zane retires. Beyer has been President and CEO of the Tufts Medical Center Physicians Organization since 2005, and in this role he has been a key architect of the hospital’s strategy throughout his tenure.

“This is a very exciting time for Tufts Medical Center. Our Board of Trustees and search committee worked diligently to determine the best candidate for this important position and determined that Eric Beyer, one of our own, was the president and CEO we wanted for the future,” said Tom Hollister, Chairman of the Tufts Medical Center Board of Trustees. “Eric is an experienced, talented and driven leader with extensive knowledge of this dynamic health care market and Tufts Medical Center’s strong position. He is highly respected throughout the region and is exactly the leader the Medical Center needs to guide it during this time of great change in the health care environment.” Continue reading

Tufts Medical Center CEO: Give Us A Uniform Rulebook, No More ‘Bags Of Cash’

Outgoing Tufts Medical Center CEO Ellen Zane

Last week at the state cost-trend hearings, outgoing Tufts Medical Center CEO Ellen Zane proposed a radical idea: a “common fee schedule across all health plans.” We asked her to expand on it, and she does so below, clearly and with some deliciously frank turns of phrase, such as: “There should be no more special deals outside of the base fee schedule, which I have always described as ‘bags of cash’ funneled through to hand-picked providers through various schemes.”

The hearings on providers, payers and costs last week were enlightening for what they showed about the attitudes of different participants in the market. Overall, I think providers showed they are willing to lead major changes in how they provide care and how they are paid for it.

I would like to see a similar willingness to change on the part of insurers, and in my testimony at the hearing I briefly touched on what I think some of those changes should be. I believe these changes could eliminate millions of dollars in administrative costs. If all insurers could agree to – or were required to – apply one set of rules to the way they pay providers, we would have millions more available for patient care or reducing premiums.

Let’s start by examining the premise that insurance companies always put forward: that only 10 percent of the health care dollar goes to administrative costs. That only looks at insurers’ administrative costs – it ignores the millions upon millions that providers pay to interpret the myriad insurance rules that determine how much we are paid for each service.

Imagine a sport in which players were expected to adapt to a totally different rulebook every time they played in a different stadium – and that over the course of a season they played in tens, if not hundreds, of different stadiums. On top of that, imagine the referees are entitled to change the rules in the middle of a game. That’s what it’s like for providers trying to interpret how to bill insurers. To keep up with all this takes football fields of billing folks (just to extend the sports analogy) at my hospital, and at every other hospital in the state.

So how do we create a more level playing field? First of all, I proposed the establishment of a base fee schedule for all of the many services provided by doctors and hospitals. Continue reading