Word: lowered
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...thing the Academy knows that the public doesn't: which films placed six to 10 in the Best Picture voting this past year. If the lower five slots had all gone to artsy fare like Doubt and Revolutionary Road, you can be sure we wouldn't have heard today's announcement. So the Academy must want Oscar night to be moderately reflective of the movies that real audiences came to, saw and were conquered by. It won't be the People's Choice Awards, but it won't be the Independent Spirit Awards either. And for that...
...incomes are looking paltry: "Real median household incomes in all age groups under 55 have not increased since 2000. In fact, for the first time in at least 40 years, there is a chance that the real median household income for these age groups will be lower at the end of the decade than at the start...
...talk about dying patients in ways that might have baffled the white coats on Emanuel's cancer ward: platelets were discussed, but so were spiritual needs, family tensions, hobbies and anything else relevant to quality of life. It sounds squishy, but Mayo patients who request palliative care have 84% lower hospital costs, 53% lower overall costs and higher satisfaction. Mayo has computerized medical records that provide instant access to patient histories, improving information-sharing, reducing pharmacy errors and eliminating the hassle of tracking down charts. The staff cafeteria even gives away fruit, illustrating Mayo's apple-a-day commitment...
...Harper, a neurologist who oversees Mayo's clinical practice in Rochester. "Practicing medicine is not the same as building Toyotas, but you can still standardize. Uncertainty shouldn't be an excuse to ignore data." Mayo has teams working on evidence-based protocols to reduce the use of intensive care, lower valve-replacement costs and avoid unneeded transfusions. It's standardizing a handoff protocol that reduced errors after shift changes at its Arizona branch, as well as a program that boosted patient satisfaction by teaching doctors at its Florida branch to listen better. Mayo even has its own registry to track...
...incentives are fairly straightforward, like extra dollars for primary care, prevention and computerization; to discourage wasteful defensive medicine, he seems willing to limit malpractice lawsuits when doctors stick to best practices. But ultimately, rewarding quality rather than quantity will require daunting changes in Medicare reimbursement policies. That could mean lower patient costs and higher provider revenues for proven treatments, but when patients want more expensive options unsupported by data, they may have to pay the difference themselves...