Dr. Niran Al-Agba

A Hospital With No Beds Cannot Stand

The evidence is now clear CON laws not only increase costs, but also restrict access for the underserved, especially in rural areas. Hospital bed access is expressed in the number of beds/1,000 population; on average, there are 3.62 beds/1,000 people in the United States. Recent studies by Strattman and Russ found states with CON laws have 1.31 fewer beds/1,000 overall. Kaiser Foundation found Washington and Oregon have the lowest bed ratios in the nation, at 1.7 beds/1,000, with Kitsap County having a woefully inadequate ration of 1.30 beds/1,000. In short, the evidence supports the fact that CON regulations worsen access for rural residents.

Niran Al-Agba2020-05-14T03:56:26+00:00August 15, 2017|Categories: Patient, Policy|Tags: Certificate of Need, CHI, CON laws, Corporatization, Franciscan, Health Policy, Hospitals, Rural Care, Washington State|

Is the KentuckyOne Health Experience a Road Map for Kitsap County?

The Pacific Northwest hospital group may be considered the “golden child” for now, but what happens if profit margins decline and further cutting costs is not feasible? The Jewish Hospital merger experience should serve as a cautionary tale for Kitsap County. Will our beloved community hospital be sold off five years from now or can we escape the same fate by devising a viable alternative for healthcare in our community?

Niran Al-Agba2020-05-26T01:29:47+00:00June 13, 2017|Categories: Patient, Policy|Tags: ACA, Affordable Care, CHI, Consolidation, Corporatization, Franciscan, Hospitals, Obamacare, Physician Autonomy, Surprise Billing, Transparency|

What is the Cost of a Single Hospital Bed in Kitsap County? $225 Million

May 1st, the Washington State Department of Health will rule on the Certificate of Need (CON); whether or not CHI closes hospital operations in Bremerton and moves all services to Silverdale. CHI will invest $680 million to expand campus size and build a state-of-the-art facility; they will save $9 million annually in improved efficiency. It will take just 75.5 years to recoup the cost.

Niran Al-Agba2020-05-14T03:41:39+00:00May 2, 2017|Categories: Patient, Policy|Tags: Affordable Care, CHI, Franciscan Health, Health Policy, Healthcare Workers, Hospitals, Patient Advocacy, Transparency|

Non-Profit Hospitals are a Fairy Tale

An article published in Health Affairs found seven of the nation’s 10 most profitable hospitals were of the non-profit variety, each earning more than $163 million from patient care services. Revoking their property tax-exempt status for not functioning as a charitable entity could return billions in healthcare dollars to local government, communities, and citizens, struggling to afford quality health care.

Niran Al-Agba2020-05-14T03:39:30+00:00April 25, 2017|Categories: Patient, Policy|Tags: Affordable Care, Health Policy, Hospitals, Patient Advocacy, Surprise Billing, Transparency|

You’ve Got Facility Fees!

Studies continually show small clinics provide better quality care for lower cost, have fewer hospital admissions, and keep patients healthier than the hospital-based clinics. We must eliminate the onerous facility fee to level the playing field, eliminate the incentive for hospitals to create monopolies, and save Americans 100s of billions of dollars per year.

Niran Al-Agba2020-05-14T03:35:12+00:00April 11, 2017|Categories: Patient, Policy|Tags: Affordable Care, Consolidation, Corporatization, Health Policy, Hospitals, Patient Advocacy, Surprise Billing, Transparency|

“Let Obamacare Explode”

Physicians care deeply about our patients and our communities. Physicians must ensure they have input on the next healthcare go-around. Meaningful healthcare reform will require pragmatism, diligence, compromise, and patience. Working across the aisle is vital to developing better health care legislation for the American people.

Niran Al-Agba2020-05-14T03:34:06+00:00April 4, 2017|Categories: Patient, Policy|Tags: ACA, Affordable Care, Consolidation, Corporate Medicine, Corporatization, Hospitals, Obamacare, Transparency|

Dr. Noseworthy and the AHCA: A Tipping Point

The CEO of the Mayo Clinic, Dr. Noseworthy, was last heard recommending patients fire their physicians suffering from burnout. While he does not have truckloads of compassion or empathy for colleagues; he is, at least, honest. Dr. Noseworthy recently confessed “We’re asking…if the patient has commercial insurance, or they’re Medicaid or Medicare patients and they’re equal that we prioritize the commercial insured patients enough so… We can be financially strong at the end of the year to continue to advance our mission.” The ‘ailing’ nonprofit generated a paltry $475 million last year.

Niran Al-Agba2020-05-14T03:32:56+00:00March 28, 2017|Categories: Policy|Tags: ACA, Affordable Care, Corporatization, Government Medicine, Hospitals, Obamacare, Transparency|

Price Transparency and All Its Warts

Legislators in more than 30 states have proposed legislation to promote price transparency, with most efforts focused around publishing average or median prices for hospital services. Some states already have price transparency policies in place. California requires hospitals to give patients cost estimates for the 25 most common outpatient procedures. Texas requires providers to disclose price information to patients upon request. Ohio passed price transparency legislation last year; however a lawsuit filed by the Ohio Hospital Association has delayed implementation. The cost of a knee replacement is $15,500 at the Surgery Center of Oklahoma, whereas the national average is $49,500.

Niran Al-Agba2020-05-14T03:31:16+00:00March 14, 2017|Categories: Patient, Policy|Tags: ACA, Affordable Care, Corporatization, Hospitals, Obamacare, Transparency|

Costs of a Hospital Monopoly in Underserved Counties

There is a growing body of evidence that hospital mergers lead to higher prices for consumers, employers, insurance, and government overall. It is imperative to educate patients and lawmakers as to how the consolidation of hospitals and medical practices raise costs, decrease access, eliminate jobs, and ultimately reduce care quality as a result. Lawmakers should focus on this “first pillar” of cost control as they go back to the drawing board.

Niran Al-Agba2020-05-14T03:30:18+00:00March 7, 2017|Categories: Policy|Tags: ACA, Affordable Care, CHI, Corporatization, Franciscan Health, Hospitals, Rural Care, Surprise Billing, Transparency|

Blood, Guts, and MACRA

DR-Exit: Sean MacStiofain said “most revolutions are caused… by the stupidity and brutality of governments.” Regulation without legitimacy, predictability and fairness always leads to backlash instead of compliance. If something is not done to stop MACRA implementation, more physicians will opt-out of Medicare and Medicaid than is fathomable. Once DRexit begins, there will be no turning back.

Niran Al-Agba2020-05-14T03:29:09+00:00February 28, 2017|Categories: Policy|Tags: Affordable Care, Consolidation, DRexit, Hospitals, MACRA, MIPS, Physician Autonomy, Rural Care|