May 17, 2020

$4.1 billion Recovered from Healthcare Fraud in 2011

Health
healthcare
Medicare
Medicaid
Admin
2 min
Nearly 10% of Medicare claims are fraudulent
On Monday government officials announced the largest recovery of fraudulent healthcare payments on record was secured in fiscal 2011, amounting to $4.1...

On Monday government officials announced the largest recovery of fraudulent healthcare payments on record was secured in fiscal 2011, amounting to $4.1 billion. Backing the sum is the largest number of defendants to be charged in a year for healthcare fraud-related crimes: 1,430.

The Justice Department and Department of Health and Human Services (HHS) reported a 50% percent increase in reclaimed funds was observed from 2009 to 2011, comprised of settlements related to fraudulently-obtained Medicare and Medicaid. Of the 1,430 charged, 734 defendants were convicted during the year.

The striking increase has been credited to the Medicare Fraud Strike Force teams and the Health Care Fraud Prevention & Enforcement Team (HEAT). HEAT is a task force that was created in 2009 to address healthcare fraud.

"Our historic effort to take on the criminals who steal from Medicare and Medicaid is paying off: We are gaining the upper hand in our fight against healthcare fraud," Health and Human Services Secretary Kathleen Sebelius said in a released statement. 

Data analysis was used to help the teams identify high billing levels in known healthcare “fraud hot spots.” Detroit and Miami joined the list, bringing the total to nine. Other cities that made the list include Los Angeles, Brooklyn, Houston, Tampa and Baton Rouge.

Nearly 10% of all received Medicare payments fund fraudulent claims, a 2011 government report found.

"Fighting fraud is one of our top priorities and we have recovered an unprecedented number of taxpayer dollars," said Sebelius. "Our efforts strengthen the integrity of our healthcare programs and meet the president's call for a return to American values that ensure everyone gets a fair shot, everyone does their fair share, and everyone plays by the same rules."

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May 6, 2021

Women leading in healthcare means better patient outcomes

womeninhealthcare
Leadership
medicaldevices
hearthealth
Julie Tyler
5 min
Women leading in healthcare means better patient outcomes
Julie Tyler, Divisional Vice President at Abbott’s Vascular Business, tells us why women leading in healthcare means better patient outcomes...

I know I’m pointing out the obvious, but women are different to men. In the context of healthcare—a woman’s physiology, symptoms and sometimes even treatment options are different from a man's. We have witnessed this in cardiovascular health, where there is ample research and evidence that women’s symptoms are often different to men’s. We also know that heart disease is responsible for 1 in 3 deaths in women annually—it is the number one killer.

The fact is women do not always get the treatment they need. A lot of that has to do with who is treating them, how they are being treated by their physicians and the healthcare systems that are designed to support patient needs. 

The proof is in the research at the care level; a 2017 study of hospitalised patients over the age of 65, examined differences in outcomes based on the gender of the treating physician. The results of the study concluded that patients treated by female physicians had lower mortality and readmission rates compared with those cared for by male physicians. 

Gender equity starts at the top

I believe that gender equity in healthcare starts at the top with the leaders who set expectations around workplace culture, and that trickles down to the workforce. 

You might think gender has nothing to do with how patients are treated—a patient is a patient, regardless of age, ethnicity, religion, creed, color or gender. But I believe there is a correlation between female leadership in healthcare and better patient outcomes—for men and women. Despite a predominantly female workforce in healthcare (65% of healthcare workers are women), only 13% of healthcare CEOs are women.

The disparity in the number of women in the healthcare C-suite is irrefutable, but I believe the more diversity we have at the boardroom table in hospitals and health systems— and that includes women—the more perspectives we bring to the decisions that ultimately impact patients and their families.

Female healthcare leaders are also caregivers

Many women are still the primary caregivers at home. The responsibility of grocery shopping and meal planning, making doctor and dentist appointments for children and elderly parents, and everything in between still tends to fall to women.  

This lived experience gives women the ability to think about innovations and solutions from the perspective of the caregiver—not just the patient. The fact is when someone is sick in the family, it affects the whole family.

As a woman, I often think about solutions and technologies that facilitate holistic healing and health that support the whole family. Bringing the mentality of inclusion to healthcare leadership means programs like the American Heart Association’s Go Red for Women campaign, will ensure research and treatment for cardiovascular disease in women will get the attention it deserves and ultimately, better outcomes for patients.

The bottom line and meaningful work are equally important

A 2019 study found that public companies with a female CEO were more profitable than their competitors with men at the helm, but that didn’t come at the cost of job fulfillment.

Women who lead companies and organisations can influence their workforce by rallying around a common cause. Having meaningful work and the opportunity to make a difference in the world is powerful motivation that doesn’t have to come at the cost of profitability. 

The work we do at Abbott is a good example—I consistently reinforce the good that comes from the research and development of the products we make with my team. Clinical trials, like the current LIFE-BTK trial, is consciously recruiting female principal investigators who work with underserved populations to enroll patients from communities of color and women. Knowing the work we do has a social impact on society might be difficult to quantify, but in my opinion, it’s priceless and could lead to meaningful treatment options that improve patient outcomes in the long-term.

Emotional intelligence and empathy are not soft skills

Interpersonal skills, problem-solving and self-awareness are considered “soft skills”—skills that might not be required to do the job, but in leadership positions, they are no longer “nice to haves,” they are “need to haves” if you are going to inspire high-performing teams. 

Research suggests women tend to score higher on social and emotional competencies than men. In the words of Joanne Conroy, the CEO and President of Dartmouth-Hitchcock Health in New Hampshire, “Diverse representation at the table changes the conversation. It becomes more collaborative; there is more listening and less interrupting. We have better conversations about how we are functioning as a team and we create a safe space when people can be honest with their feedback to all members of the team, including the leader.” 

I’m not suggesting women have a monopoly on soft skills, however having gender diversity around the boardroom table means a diversity of skills. Being aware of your team’s morale and what motivates them is equally important as managing your supply chain.

When it comes to health, we know that patients want more personalised care. The emergence of artificial intelligence (AI) has the potential to generate data that is tailored to the health needs of women and ultimately lead to better treatment options and outcomes. But the data insights generated by AI are only as good as the patients’ data available for analysis. To maximize the potential of AI—and meet the expectation of personalised care for patients—healthcare leaders need to be aware of who is and isn’t being included in studies and clinical trials, like women, and telegraph the need for greater inclusion to their teams. 

These ideas are just the tip of the iceberg. Sure, we have come a long way since Elizabeth Blackwell—the first female physician in the United States—founded New York Presbyterian Hospital. Sure, there is still plenty of work to do, but I do hope my contribution is paving the way for more women to take on leadership roles in healthcare and make a positive impact on lives of all patients and their families.

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