Kaiser hits $1 billion operating gain in Q1

Kaiser Permanente Monday posted a record $1 billion operating gain in its first quarter, just days after holding its largest-ever bond offering.The Oakland, Calif.-based health plan and hospital giant eclipsed the $1 billion barrier on revenue of $18.1 billion. That compared with an operating gain of $701 million on revenue of $16.3 billion in the year-earlier quarter.The 5.5% operating margin in the first quarter beat the strong 4.3% operating margin from the year-earlier period.Not-for-profit Kaiser is the nation’s largest integrated health system with 11.7 million health plan members and 39 hospitals.

Breaking it down

Operating revenue in Q1, at $16.3 billion, was $1.3 billion more than the comparable 2015 total of $15 billion. But operating income dipped 5.4 percent, from $741 million to $701 million, and Kaiser sustained a net non-operating loss of $197 million compared to a $301 million operating profit in 2015.

That was a hefty $498 million swing from one year to the next on the investment front.

Last year, Kaiser’s net income fell 39 percent, to $1.9 billion, even though operating revenue jumped nearly 8 percent, to $60.7 billion.

But senior officials told me last month that keeping premium rates “affordable” and growing Kaiser’s footprint is more important that squeezing out the highest possible profit margin, once the organization has earned enough to cover the costs of major capital programs.

World Obesity Federation confirms “Obesity Is a Chronic Disease”

EMBARGO 10.00am EST Wednesday May 10th.

In a statement published today in the leading journal Obesity Reviews, the World Obesity Federation confirms its support for defining obesity as a chronic, relapsing disease. The statement was prepared by a scientific committee of the Federation which concluded that obesity fits the epidemiological model of a disease process except that the toxic or pathological agent is diet-related rather than a microbe.

The question of whether obesity should be called a ‘disease’ has sparked controversy for most of the last century.In their Obesity Reviews position statement, Dr George Bray and his colleagues examine how an abundance of food, low physical activity, and several other environmental factors interact with genetic susceptibility. They draw parallels to chronic diseases, noting that the magnitude of obesity and its adverse effects in individuals may relate to the virulence or toxicity of the environment and its interaction with the host.

“Accepting the concept that obesity is a chronic disease process is important for several reasons,” said Dr. Bray. “First, it removes the feeling that patients alone are responsible for their excess weight. It also focuses attention on the ways in which this disease process can be tackled. And finally, it shows that if we can successfully treat obesity, many of its associated diseases will be eliminated.”

In an accompanying letter to the editor, the Federation’s policy experts suggest that declaring obesity to be a disease could benefit those people who are suffering with obesity and wish to have access to medical advice and support, “whilst also strengthening the call for dealing with the social determinants, obesogenic environments and systemic causes of individual weight gain.” They note that obesity is a normal response to an obesogenic environment, but is not in itself a biologically normal or healthy condition. They also note that recognizing obesity as a disease may reduce individuals’ internalized stigma, change the public discourse about blame for the condition, and have benefits in countries where health service costs are funded from insurance schemes that limit payments for non-disease conditions or risk factors.


As EHR vendors jockey for ‘mindshare,’ Epic holds slight lead among healthcare C-Suite

According to a new Reaction Research Cloud study of senior healthcare executives at hospitals, health systems and physician group practices, of those planning to buy inpatient EHRs in 2017, 40 percent will choose Epic, 39 percent want Cerner and 31 percent are looking at MEDITECH . The story is the same for outpatient EHRs: Epic at 45 percent, Cerner at 32 percent and MEDITECH at 31 percent.

The buying trend report found provider organizations are focusing their IT purchasing on telemedicine and EHRs for the most part, but tools aimed at MACRA implementation are also gaining in interest.

Reaction found 33 percent of respondents named telemedicine a buying priority, 32 percent picked inpatient EHRs, 20 percent said MACRA tools and another 20 percent are focused on patient engagement tech. Only 8 percent said they plan to buy nothing.

The vendors with the most mindshare in MACRA implementation include Premier at 22 percent, Advisory Board (Crimson) at 19 percent and Optum at 16 percent, the study found. For patient engagement it’s Epic at 37 percent, Press Ganey at 29 percent and Cerner at 24 percent. And for cybersecurity it’s Cisco at 61 percent, VMware at 34 percent and McAfee at 32 percent.

The vendors most likely to win new business for data analytics include Epic at 33 percent, IBM at 25 percent, Cerner at 21 percent and MediTech at 21 percent, the study said. And for population health management technology it’s Cerner at 35 percent, Epic at 31 percent and Allscripts at 21 percent.

In the Reaction Data study, entitled “Big Mega HIT Purchasing,” 47 percent of respondents were from standalone hospitals, 38 percent health systems, 10 percent hospital-owned physician group practices and 5 percent independent physician group practices.

Top 25 COOs

Take a look at 2017 top 25 Chief operating officers (COO) in Healthcare.  These individuals have a broad and diverse set of roles and responsibilities. Their job description varies based on the size and sector of the healthcare organization.  COOs also serve a broad range of constituencies, including governing board members, C-suite leaders, the organization’s entire workforce and, of course, the patients.

This article is a curtisey of Modern Health:





Toby Cosgrove, M.D., Announces His Decision to Transition from President, CEO Role

Source: Newsroom Cleveland Clinic

After nearly 13 years as president and CEO of Cleveland Clinic ­– which has grown into an $8 billion health system with multiple locations in Ohio, Florida, Nevada, Canada, Abu Dhabi, and, in 2020, London – Toby Cosgrove, M.D., announced at a staff meeting today that he has decided to begin a succession process to transition out of the top executive role later this year.  The Governance Committee has asked Dr. Cosgrove to continue on in an advisory role.

Over Dr. Cosgrove’s tenure, Cleveland Clinic’s expansion locally, nationally, and internationally has positioned the institution for a strong future as its revenues have grown from $3.7 billion in 2004 to $8.5 billion in 2016. It has become Ohio’s largest employer with over 50,000 caregivers and a global leader in clinical outcomes, patient experience, innovation and wellness, ranking No. 2 in the nation last year by U.S. News & World Report.

“It is an honor and a privilege to be a part of an extraordinary and forward-thinking organization that puts patients at the center of everything we do,” Dr. Cosgrove said. “Cleveland Clinic’s world-class reputation of clinical excellence, innovation, medical education and research was created and will be maintained by the truly dedicated caregivers who work tirelessly to provide the best care to our patients.”

By making leadership development a top priority, Cleveland Clinic has developed a deep, talented pool of physician-leaders who are ready to take on executive roles such as hospital presidents, executive administrative roles, leaders of major initiatives across the enterprise, and more.

“The goal of any leader is to leave an institution better than you found it. Without a doubt, Toby has done that,” said Cleveland Clinic Board of Directors chairman Bob Rich. “Our world-class reputation has only grown over the past 13 years, as he has led Cleveland Clinic through a period of dramatic growth and worldwide expansion.”

His successor will be jointly selected by the Board of Directors and Board of Governors and that process is expected to be concluded in 2017. The Governance Committee has asked Dr. Cosgrove to continue on in an advisory role.

In keeping with its model as a physician-led institution, Cleveland Clinic’s new president and CEO will be a practicing physician.

Before becoming CEO in 2004, Dr. Cosgrove was a cardiac surgeon for nearly 30 years, performing 22,000 operations and earning an international reputation for expertise in valve repair. As president and CEO, Dr. Cosgrove has driven major initiatives that have gained international recognition, created best practices in healthcare, focused on patient outcomes and promoted patient experience.

Cleveland Clinic has grown steadily between 2004 and 2016: the number of physician-scientists has doubled from 1,800 to 3,400; total visits increased from 2.8 million to 7.1 million; research funding grew from $121 million to $260 million; and construction has changed the face of Cleveland Clinic’s main campus, with the addition of the Miller Family Heart & Vascular Institute, the Glickman Urological & Kidney Institute, the Cleveland Clinic Taussig Cancer Center, the Tomsich Pathology & Laboratory Medicine Institute and, currently under construction, a health education campus in collaboration with Case Western Reserve University.

Dr. Cosgrove’s leadership has emphasized patient care and patient experience, including the re-organization of clinical services into a patient-centered model of care designed around organs and diseases rather than doctors. He coined the phrase “Patients First” to be the guiding principle for all caregivers and hired the first Chief Patient Experience Officer to focus on the experiential, physical and emotional aspects of patient care, now a growing norm in hospitals today. Cleveland Clinic is considered one of the country’s “Best Workplaces in Health Care” in Fortune and a “World’s Most Ethical Company” by the Ethisphere Institute.

Dr. Cosgrove has launched major wellness initiatives for patients, employees and communities, including: banning smoking on all Cleveland Clinic campuses; adopting a policy to not hire smokers; offering employees free memberships to Weight Watchers and gyms; ridding the cafeteria of fried foods; opening weekly farmer’s markets in the summer and fall; and creating an employee health insurance program that offers discounts for physical activity or for enrollment in a disease management program.

Anchored in Cleveland on its 165-acre main campus, Cleveland Clinic’s name is well known around the world for its clinical excellence. Cleveland Clinic Abu Dhabi opened in May 2015; Cleveland Clinic Toronto just celebrated its tenth year; and Cleveland Clinic London is expected to begin seeing patients in 2020. Locally, Cleveland Clinic recently opened a new state-of-the-art hospital in Avon. And in Weston, Fla., Cleveland Clinic Florida is constructing a new five-story tower.

Under Dr. Cosgrove’s innovative leadership, he also envisioned “same-day” medical appointments that opened access to 1.5 million same-day appointments for patients in 2016. He also is committed to new ways to allow patients to access care anytime, anywhere, with walk-in appointments, virtual visits by phone or tablet, and more.

Dr. Cosgrove received his medical degree from the University of Virginia School of Medicine in Charlottesville, completing his clinical training at Massachusetts General Hospital, Boston Children’s Hospital, and Brook General Hospital in London. His undergraduate work was at Williams College in Williamstown, Mass.

He was a surgeon in the U.S. Air Force and served in Da Nang, Republic of Vietnam, as the Chief of U.S. Air Force Casualty Staging Flight. He was awarded the Bronze Star and the Republic of Vietnam Commendation Medal.

Joining Cleveland Clinic in 1975, Dr. Cosgrove was named chairman of the Department of Thoracic and Cardiovascular surgery in 1989. Under his leadership, Cleveland Clinic’s heart program was ranked No. 1 in America for 10 years in a row by U.S. News & World Report, a distinction that has remained for 22 successive years. He has published nearly 450 journal articles, book chapters, authored “The Cleveland Clinic Way” and developed 17 training and continuing medical education films. As an innovator, Dr. Cosgrove has 30 patents filed for developing medical and clinical products used in surgical environments.

Dr. Cosgrove is a 2016 Fortune Businessperson of the Year (#14), has topped Inside Business’s “Power 100” listing for Northeast Ohio, is highly ranked among Modern Healthcare’s “100 most powerful people in healthcare” and “most powerful physician executives,” and is an inductee of the Cleveland Medical Hall of Fame.

Dr. Cosgrove has been consulted by successive presidential administrations, serving on the Veterans Administration Commission on Care (2015) and the current White House Strategic and Policy Forum