A Push For Diversity In Medical School Is Slowly Paying Off
Currently students of color are underrepresented in medical schools, but their numbers are slowly growing.
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In 2009, the body that accredits medical schools issued a new requirement: All medical schools must implement policies that help them attract and retain more diverse students. Failure to do so can lead to citations from this body, the Liaison Committee on Medical Education, and can affect their status as accredited institutions.
This effort appears to be working. In a research letter published today in JAMA, researchers examine the changing demographics of medical students from 2002 to 2017. They found an increase in diversity in enrollment, especially since 2012, which the researchers think may be the first year new standards could be expected to have an effect.
But the rate of change, some medical educators say, is too slow. Medical student bodies were still 58.9 percent white in 2017.
“We see the trend going up, but it’s going up very slowly,” says Dr. Dowin Boatright, an assistant professor of emergency medicine at Yale University and coauthor of the study. “If we’re trying to get some degree of representation that matches the proportion of black people in the population as a whole … We’re talking 20 to 50 years.”
The pattern of change over the period studied is noteworthy, Boatright says. Between 2002 and 2012, the proportion of female and black students decreased each year.
In that same time period, the percentage of Latino and Asian students increased. White students were the majority of medical school enrollees throughout that time period.
In 2012, the percentage of female and black students starting medical school began a steady, albeit slow, increase.
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By 2017, 7.3 percent of new medical students identified as black, up from 6.8 percent in 2002. Students identifying as female made up 50.4 of matriculants, up from 49 percent in 2002.
Hispanics represented 8.9 percent of students, up from 5.4 percent in 2002 and Asian students were 24.6 percent of students, up from 20.8 percent.
Boatright hypothesizes that the improved numbers reflect that the new requirement that schools have formal programs to attract diverse students.
“I think there’s a strong incentive now to have at least some kind of benchmark to promote diversity,” Boatright says. “Programs actually are being held accountable.”
Many medical schools have hired dean-level administrators who focus on attracting and retaining minority students.
“When you tell people they should do something, they’re like, ‘Oh, we don’t have to do something,’ ” says Dr. John Paul Sanchez, the associate dean for diversity and inclusion at Rutgers New Jersey Medical School. “It makes people think differently when you say you must do something … People have more concrete direction.”
The Liaison Committee on Medical Education also requires that medical schools develop programs to improve the “pipeline” of minority applicants, which usually take the form of science education and mentorship programs for minority college and high school students.
Representatives of the Liaison Committee on Medical Education don’t interpret the data the same way Sanchez and Boatright do. The organization’s co-secretary, Dr. Veronica M. Catanese, said in a written statement that the organization has explicitly promoted diversity in its standards for “more than two decades” and while the organization’s expectations may encourage medical schools to pay attention to diversity, “it likely does not account for the correlation suggested by the authors of the letter.”
This trend the study identified is confirmed by the latest medical school enrollment data also released today by the Association of American Medical Colleges.
In 2018, 8.6 percent of first-year medical students are black, and more women than men started medical school: 51.7 percent identified as female.
The number of black men enrolling in medical school in 2018 — a group that has been significantly underrepresented compared to the general population — increased by 7.3 percent in 2018. Black men made up about 3.4 percent of first-year medical students this year.
This latest data differs from the data the JAMA study authors presented. To assess the effect of the new accreditation requirement, the authors excluded historically Black medical schools and all schools in Puerto Rico because they felt felt the new diversity standards would not affect them in the same way as predominantly white schools.
Sanchez says he thinks the accreditation standards are important, and encourage medical schools to devote money and time to supporting minority students. Still, he says, there’s a difference between meeting the standards and developing long-lasting programs that help minority students feel welcome in medical school.
“That takes decades to build. You can’t train someone to be passionate,” Sanchez says. “But you can hire them and bring them together to serve as faculty at the medical school.”
Mara Gordon is a family physician in Washington, D.C., and a health and media fellow at NPR and Georgetown University School of Medicine.
Urban Meyer Will Retire As Ohio State's Football Coach, After Scandal-Marred Season
Ohio State Buckeyes coach Urban Meyer is retiring, the school said on Tuesday. He’s shown with his wife, Shelley Meyer, after defeating the Northwestern Wildcats in the Big Ten conference championship game at Lucas Oil Stadium in Indianapolis.
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Ohio State football coach Urban Meyer is retiring, the school said on Tuesday. Meyer will depart OSU after a season in which he was suspended for three games over his handling of domestic abuse allegations against an assistant coach. His last game will be in the Rose Bowl on New Year’s Day.
Meyer will be replaced by offensive coordinator Ryan Day — who led the team when the head coach served his suspension for the first three games of the 2018 season.
In addition to the domestic abuse scandal, Meyer “has been slowed by headaches caused by a cyst,” member station WOSU reports, adding, “The chatter increased after he looked more distressed and beleaguered than usual on the sideline during the 49-20 loss to unranked Purdue on Oct. 20.”
Meyer, 54, has won three national titles — two at Florida and one at Ohio State. With one game left to play this season, he has an overall win-loss record of 186-32.
This season, Ohio State is 12-1 and won the Big Ten conference title, but it did not make it into the final four of the College Football Playoff, which will decide the national champion. Currently ranked No. 6, the Buckeyes will face Washington in the Rose Bowl.
Ohio State’s athletic department says it will hold a news conference to announce the coaching transition from Meyer to Day at 2 p.m. ET.
Meyer has been Ohio State’s head coach since 2012, amassing an 82-9 record — and never losing to the school’s arch-rival, Michigan. But both the coach and his university were criticized earlier this year for their response to domestic abuse allegations against longtime assistant Zach Smith by his ex-wife, Courtney Smith.
As NPR’s James Doubek reported, “Meyer fired Zach Smith, an assistant coach, on July 23 after learning of reports that … Courtney Smith had been given a domestic violence civil protection order against him a few days before.”
At that time, Meyer said he and his staff had not previously known about the allegation. But that immediately drew skepticism, along with questions about how long Meyer had known about the accusations — and whether he had reported them, as required by Title IX.
Ohio State’s inquiry revealed that Meyer had known about domestic abuse allegations against Smith since at least 2015, when police investigated the case — and when, according to Courtney Smith, she told Meyer’s wife about it. After a months-long investigation from 2015-16, no charges were filed. The Smiths divorced in 2016.
OSU said the lack of charges led Meyer and the school’s athletic director, Gene Smith, to believe they were not required to report the situation or take disciplinary action. It suspended both men over their lack of action.
Amid the scrutiny on Meyer’s program, it also emerged that Zach Smith’s treatment of his wife had drawn police scrutiny nearly 10 years ago — shortly after Meyer first took him on as a graduate assistant at the University of Florida.
As The Tampa Bay Times reported earlier this year, “Smith was arrested in 2009 for allegedly jamming his pregnant wife into a wall.”
When he left Florida, Meyer cited health concerns as the main reason. He had been hospitalized after a high-profile loss to Alabama. But as ESPN reported in 2015, the coach also left “myriad off-field issues,” including more than 30 arrests of players during Meyer’s six-year tenure.
Born in Toledo, Ohio, Meyer started his coaching career with a two-year stint at Bowling Green State. He followed that with another two years at Utah, where he cemented his reputation for developing high-powered offenses.
Blind Swimming Coach Demonstrates He's More Than Capable
Being a collegiate coach is tough — coaching while blind is even more difficult. The only person to do it in NCAA swimming is Tharon Drake, an assistant coach at Catawba College in North Carolina.
STEVE INSKEEP, HOST:
Coaching at the collegiate level is tough. Imagine how hard it must be to coach at that elite level when you’re blind. That is the challenge facing the nation’s only blind swimming coach at Catawba College in North Carolina. From member station WFAE in Charlotte, Cole Del Charco brings us this profile.
UNIDENTIFIED PERSON: Take your mark.
(SOUNDBITE OF SWIMMERS DIVING INTO POOL)
COLE DEL CHARCO, BYLINE: Swim practice at Catawba College is noisy, nonstop and muggy. Assistant coach Tharon Drake walks the edge of the pool barking instructions. He doesn’t need to see his swimmers to know when they’re doing something wrong. He can hear it.
THARON DRAKE: I’m going to show Joao in a second. I’m going to put my left hand in the position I want him. And we’ve talked about this so he’ll know it. Left hand. Watch his hand. Yup. There he goes.
DEL CHARCO: Drake’s been hounding freshman Joao Miranda all season about the way his hand hits the water.
DRAKE: What finger goes first?
JOAO MIRANDA: The middle finger.
DRAKE: Middle finger entry. Middle finger entry.
MIRANDA: Yeah. And sometimes I use my thumb first and I splash a lot of water.
(SOUNDBITE OF WATER SPLASHING)
DEL CHARCO: For Drake, it’s not hard at all to figure out when a swimmer uses bad form.
DRAKE: Everything has a different pitch, just like it would on a piano. Don’t ask me what pitch it makes. It just makes a different noise.
DEL CHARCO: His swimmers at Catawba College didn’t know what to think of having a blind coach at first. But not any longer. Drake has hand motions, yells and paces the pool deck, all without a white cane.
DRAKE: Pick it up. Pick it up.
DEL CHARCO: And when swimmers like junior Federico Borrego are swimming…
FEDERICO BORREGO: What you see outside the pool is going to be the same when you’re racing and you come out and see – you actually see him doing, like, the hand signs, or to tell you to go faster or screaming at you. That is really, really neat ’cause any coach does that.
DEL CHARCO: Drake says his perspective gives him an edge over other coaches. They can only see problems.
DRAKE: Being able to tell the water different, being able to hear the breathing gives me so much more feedback than your typical coach is going to get. So I have more – I have more details. And if this was a math problem, I know more variables.
DEL CHARCO: Drake’s an accomplished swimmer. In blind swimming divisions, he’s reigning world champion and medaled in the Paralympics. But he wasn’t always sure he could coach. Then one day, at the Paralympics in Rio de Janeiro in 2016, he wanted to try something. Sitting by a fellow swimmer, he tested his theory that he could hear the difference between good and bad form. He could. But identifying specific issues took a lot of trial and error. Now he says it’s easy to identify each of the 28 swimmers on this team by their sound.
DRAKE: I think of it like anything else. You know what someone looks like, their facial characteristics. I just have to memorize what their sound characteristics are. Everyone’s arms hit the water a little bit different. Everyone’s got a little bit different of a pattern, and you just learn where they normally will be and then what their little pattern is.
DEL CHARCO: When starting out, Drake took inspiration from some blind people who use a kind of echolocation to know their surroundings and do things like ride bikes.
DRAKE: And if we’re being honest, they don’t probably tell their story about how many times they ran their head into a wall trying to learn that skill. It’s not like one day they woke up and, bam, they had it perfect. They had to work for it.
DEL CHARCO: So has Drake. He wants to show people that just because someone says you can’t do something doesn’t mean you have to listen.
(SOUNDBITE OF WATER SPLASHING)
DEL CHARCO: For NPR News, I’m Cole del Charco in Salisbury, N.C.
Copyright © 2018 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.
NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.
NFL Faces More Backlash Over Kareem Hunt Video
There’s more fallout in the NFL after a video surfaced of former Kansas City running back Kareem Hunt getting into an altercation with a woman. Many believe the league didn’t investigate enough.
Paul Sherwen, Renowned Cycling Commentator, Dies At 62
Cycling commentator Paul Sherwen, pictured at the 2013 Tour Down Under, died on Sunday at the age of 62.
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Paul Sherwen, one of the best-known pro-cycling commentators who is widely credited with introducing the English speaking world to the sport, died on Sunday at his home in Uganda. He was 62.
Sherwen’s voice became almost inextricable from the Tour de France and other major cycling events after a stellar career as a competitor. He rode in the Tour seven times during the 1970s and 1980s, twice becoming the British national champion. But the British cyclist is best known for his 33 years commentating on the world’s most famous and grueling cycling competition — many with co-commentator, Phil Liggett.
Over more than three decades, Sherwen spread his passion for cycling across British, Australian and American television and radio to new generations of fans. He covered the sport during five Olympic Games as an analyst for NBC Sports.
“We are saddened to offer our condolences to the friends and family of Paul Sherwen, who passed away this morning at his home in Uganda,” the news outlet said in a statement on Sunday.
“Paul was synonymous with the Tour de France in the U.S. and will be greatly missed by his legions of fans and the NBC Sports family, which was honored to be part of Paul’s 40th Tour last July,” NBC wrote. “Our thoughts are with Paul’s wife, Katherine, their children, and all of those in the cycling community who became Paul Sherwen fans over his many years calling the sport he loved.”
Members of the cycling community, including his longtime broadcasting partner, were blindsided by the news of Sherwen’s sudden death.
“I went to bed in Africa with a heavy heart last night feeling sadness like never before,” Liggett wrote on Twitter. “My team mate for 33 years was no longer with me. Your hundreds of messages showed how well @PaulSherwen was loved.”
I went to bed in Africa with a heavy heart last night feeling sadness like never before. My team mate for 33 years was no longer with me. Your hundreds of messages showed how well @PaulSherwen was loved. Let’s think of Katherine and his children with love just now.
— Phil Liggett (@PhilLiggett) December 3, 2018
British Cycling also noted the loss of the former national champion in a tweet, calling him “a great voice of our sport.”
We were truly saddened by the news of the passing of @PaulSherwen. A former national champion and a great voice of our sport, our thoughts are with his family and friends at this time.
— British Cycling (@BritishCycling) December 2, 2018
Lance Armstrong, who won the Tour seven times before being stripped of his championships amid a major doping scandal, wrote about meeting Sherwen in 1992, when he worked as a press officer for Team Motorola. “He was always a class act and a great friend,” Armstrong said.
Completely shocked and saddened to hear of Paul Sherwen’s passing. Met Paul in 1992 when he worked as our press officer for Team Motorola. He was always a class act and a great friend. My deepest condolences go out to his family. RIP Climber.
— Lance Armstrong (@lancearmstrong) December 2, 2018
“The soundtrack to our July and our sport has been silenced,” Australia’s Cycling Central wrote on Twitter. “We are too gutted for words right now.”
The soundtrack to our July and our sport has been silenced. Paul Sherwen died overnight at his home in Uganda. We are too gutted for words right now, but we tried somehttps://t.co/5x0jQZRBqY pic.twitter.com/fSjX0xdarm
— CyclingCentral (@CyclingCentral) December 2, 2018
Cycling commentator and former professional Paul Sherwen has died at age 62. I don’t know specifics, other than he was in Uganda, where he lived and had stake in mining businesses. An extremely warm guy and a true gentleman from the first time I met him to the last time I saw him pic.twitter.com/P05yiang3H
— Neal Rogers (@nealrogers) December 2, 2018
Sherwen was born in Lancashire in the U.K. and raised in Uganda since age 7, NBC Sports reported. “He helped create Paul’s Peloton, which brought bicycles to Africa, and advocated for African wildlife as a chairman of the Ugandan Conservation Foundation and supporter of the Helping Rhinos initiative.”
The cause of Sherwen’s death is not yet known.
NFL's Chiefs Cut Player Seen Attacking Woman — After Video Becomes Public
Kareem Hunt walks off the field before his last game with the Kansas City Chiefs. The Chiefs released him after the release of a video showing Hunt shoving and kicking a woman.
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Editor’s note: This article contains images of assault that some may find disturbing.
The Kansas City Chiefs cut Kareem Hunt, one of the NFL’s top running backs, on Friday, hours after the release of a video showing him attacking a woman.
Now, fans are asking a familiar set of questions: What did the NFL know about the domestic violence incident, and did it try to conceal what happened?
KC Chiefs Running Back Kareem Hunt Brutalizes and Kicks Woman in Hotel Video https://t.co/o3UZsnKM02
— TMZ Sports (@TMZ_Sports) November 30, 2018
The security camera video obtained and published by TMZ shows Hunt and a few other people in the hallway of a Cleveland apartment building. Hunt appears to argue with a woman. He shoves her several times — at one point knocking her to the ground and then kicking her — as other people try to break up the fight.
The victim told police after the February incident that they should watch the video and that she wanted Hunt arrested, USA Today reported. Police said they did not see the video until it was made public. The NFL investigated but didn’t interview Hunt or the victim and also didn’t see the video, ESPN said.
No charges were filed against Hunt at the time, and the NFL didn’t discipline him. Hunt, 23, played in each of Kansas City’s first 11 games and entered Sunday’s contests with the fifth-most rushing yards in the league.
The league and the Chiefs moved quickly after the video surfaced. Almost immediately, TMZ reported, the Chiefs sent Hunt home early from a practice. The NFL placed him on the Reserve/Commissioner Exempt List, which would prevent him from playing. Then, hours after the video came out, the Chiefs announced they were releasing Hunt.
Statement from the Kansas City Chiefs on Kareem Hunt
?? https://t.co/MrjIX1Y7Ke pic.twitter.com/efSMqUDio1
— Kansas City Chiefs (@Chiefs) December 1, 2018
The incident drew comparisons to the case of Ray Rice, who in 2014 was initially suspended for two games after he was charged with felony assault. Rice was set to return to the field when TMZ published a previously unseen video of the incident. It showed Rice hitting his then-fiancée who then fell to the ground.
In that case, as with Hunt, the NFL said it had asked for the security video but hadn’t been given access to it. But according to several reports, the NFL had seen the video but didn’t act until it became public — and until it faced intense public blowback over what many fans perceived as a light punishment for Rice. An independent investigation — which was led by Robert Mueller, now the special counsel investigating Russian interference in the 2016 presidential election — determined that there was no evidence the NFL had seen the Ray Rice video but that the league should have investigated more thoroughly.
The specter of domestic violence and questions about the league’s willingness to address it have lingered since 2014. Other players have been arrested and accused of committing domestic violence. Teams continue to draft players who have a history of domestic violence — sometimes even players who have been seen on camera committing violence similar to Hunt and Rice.
In the wake of the Rice video and widespread criticism of the league, the NFL Players Association set up a commission to investigate domestic violence and how the league could address it. But this summer, two of its 11 members resigned. Deborah Epstein, a co-director of the Domestic Violence Clinic at the Georgetown Law Center, wrote in The Washington Post that the commission was “a fig leaf” and that the NFLPA “is no longer interested in even making a public show of concern about violence against women.”
Days before the video of Kareem Hunt became public, another NFL player lost his job. On Nov. 24, Reuben Foster of the San Francisco 49ers was arrested and charged with first-degree misdemeanor domestic violence — his second arrest this year on domestic violence charges. The 49ers released Foster the next day.
But Foster appears to have found a new home: Washington’s NFL team claimed him, with one its executives calling the allegations against him “small potatoes.”
First Student With Autism To Join Kent State Basketball Division 1 Team
Kent State university believes basketball player Kalin Bennett is the first student athlete with autism to sign a letter of intent for a Division 1 team. Bennett speaks with NPR’s Scott Simon.
SCOTT SIMON, HOST:
Eighteen-year-old Kalin Bennett, 6-foot-10 basketball player from Little Rock, Ark., has committed to play at Kent State University next year. Getting signed is a big moment for any student athlete. According to Kent State, Kalin Bennett may be the first student athlete with autism to sign a national letter of intent to play Division I men’s basketball.
Kalin Bennett joins us now from Branson, Mo., where he plays basketball at Link Year Prep. Thanks so much for being with us.
KALIN BENNETT: Yes, sir. I’m excited – glad to talk to you.
SIMON: Well, we’re excited to talk to you. How did it feel to sign that letter?
BENNETT: I mean, it’s all good. I already knew I can play with all these players, so it was good to sign.
SIMON: And why did you choose Kent State?
BENNETT: Out of all the offers I had, Kent State – I knew their tradition of winning, the coaching staff. And I just wanted to be part of that tradition. And also the autism program and this – the people in general. The campus was amazing. Everybody there treated me greatly. It just felt like home as soon as I touched down off the plane, so…
SIMON: Mr. Bennett, help us understand what it was like for you to grow up with autism.
BENNETT: I mean, it was hard. It was difficult because sometimes I wouldn’t know if people were being nice to me or not. And there are times where it just – there are some times it clicked, and some times it didn’t. Sometimes, I don’t process things as fast as everybody else, so I have to, like, slow down, like, think to myself, like, get in the details of it.
SIMON: Yeah.
BENNETT: And it’s just – it was just hard at times. But then as I started growing up, it just started unlocking for me. And by the grace of God, I’m able to do what I’m doing.
SIMON: Yeah. I understand – here you are playing Division I basketball. I understand you were a little late to walk.
BENNETT: Yes, sir. I wasn’t able to do as much when I was younger.
SIMON: Yeah. How old were you when you began to walk?
BENNETT: Around 4.
SIMON: Yeah. Well, you do pretty well now, don’t you (laughter)?
BENNETT: Yes, sir.
SIMON: And basketball’s not your only interest in life, is it? You’ve got a lot of talents.
BENNETT: Yes, sir.
SIMON: Like what?
BENNETT: I like playing instruments. I play drums, guitar. I’m still learning the keyboard. And I love math.
SIMON: What do you love about math?
BENNETT: I just like being around numbers. I know, like, a lot of people, like, think that’s weird, but I just like doing numbers.
SIMON: Yeah. What do you hope to do at Kent State?
BENNETT: Keep improving as a basketball player and then go and achieve my dreams of going to the NBA or whatever dreams God has ahead of me.
SIMON: Going to the NBA? Oh, that would be nice…
BENNETT: Yes, sir.
SIMON: …Wouldn’t it?
BENNETT: Yeah, and I can do it.
SIMON: Your mother’s really – well, your mother has her own story in this success, doesn’t she?
BENNETT: Yes, sir.
SIMON: She never gave up on you.
BENNETT: She never did, not one time. We just don’t like being told what we can’t do. So we just go ahead and work to get better and keep proving people wrong.
SIMON: You have anything you’d like to say to youngsters who might be living with autism, who might, you know…
BENNETT: Don’t let anybody tell you – don’t let anybody tell you what you can’t do ’cause you’re the only person who determines your future. And you can do it. And you are smart and intelligent and a beautiful creature. You can go out there and do anything you want. We’re all human. We all have a heart. Just go out there and keep competing, and go out there and keep doing what we’re doing.
SIMON: Mr. Bennett, you have made my week.
BENNETT: Thank you.
SIMON: (Laughter) Kalin Bennett, Kent State Golden Flash, thank you so much.
BENNETT: Yes, sir.
Copyright © 2018 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.
NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.
Saturday Sports: NFL Suspends Kareem Hunt
Howard Bryant of ESPN.com and ESPN the Magazine joins NPR’s Scott Simon to talk about sports.
SCOTT SIMON, HOST:
We’re going to go into sports now. Howard Bryant is standing by. The Kansas City Chiefs have released their running back, Kareem Hunt. And the Toronto Raptors are on a hot streak. How long has it been if we heard that, if ever? Howard Bryant of espn.com and ESPN The Magazine joins us. Howard, thanks so much for being with us.
HOWARD BRYANT, BYLINE: Good morning, Scott.
SIMON: Kansas City released Kareem Hunt after a video that shows him knocking down a woman and kicking her was made public. NFL…
BRYANT: In February.
SIMON: Yeah. Nothing was done over this time. But the NFL suspended him now that the video is made public. What do you know about this?
BRYANT: Well, I think that the first thing is you look at this – and I don’t know anyone who’s watched the video who’s not appalled by it. It’s incredibly disturbing. And there’s no sound to it. But you can watch it. And then, of course, TMZ also obtained the interview with the young woman talking with police and then also with Kareem Hunt and some of his friends who were part of the altercation. And you watch this, and it’s just very disturbing in so many different ways. I think one of the things that bothers me most about it is, having covered sports for all these years, you have to – it’s very unspoken in the business. And I think you have to reconcile this relationship between these young men with all of this fame and all of this wealth and entitlement and the women who are in these different places and the relationships between those two, the expectations. And when those expectations aren’t met, whatever they are, things become – they can become violent. And you’re looking at this. And when I watched that video, I was, like, you can just count – anyone who’s been in the business knows that, at some point, this celebrity culture has to change. And this – the relationship between these young men and the women and what happens out there is just – you could just see it happening so many times.
You know, obviously, when you’re watching the video, you can’t go back and think – and not think about the Ray Rice video a few years ago.
SIMON: Yeah.
BRYANT: And it brings you to the NFL and makes you think about the – there’s the player responsibility side of it. But then there’s also the league side of it. The NFL didn’t want to know what was taking place here. They had this information. They trusted the player. And the player told them something that they believed not to be true. They have a security team. They have enormous resources. Yet they weren’t able to obtain this video but TMZ was? I don’t think that the NFL really does take any of this seriously. They are as untouchable – or they act as untouchable as the players believe they are. And then things like this happen.
SIMON: And, at the same time, the Washington football team, whose name I will not utter, has claimed the rights to Rueben Foster just days after he was released by the San Francisco 49ers following an arrest for domestic violence.
BRYANT: Three of them actually, Scott, and I think that’s the other point. So you have these two bookends, and it speaks to a pattern of behavior for the league. The – Washington – not only did they claim Rueben Foster but, on top of that, the people who made the decision – Bruce Allen hasn’t even really been public on it. They stuck Doug Williams out there, the VP of personnel, to pretty much take the fall for this ridiculous signing. And once again, you think about what message this sends. And when it sends this message, it goes back to the very same thing. They don’t care. They’re a $12 billion, $13 billion industry. They have no interest in any of this because there’s no sanction. When the business is affected, then maybe they’ll care. But you cannot look at the NFL to be a moral compass on this.
SIMON: I do want to note Toronto Raptors defeated Golden State Warriors this week by 51 – despite 51 points by Kevin Durant. We’ve got a few seconds left. Are the Raptors going to last?
BRYANT: Yeah. They’re going to last because the NBA is a best-player-wins league, and Kawhi Leonard is the best player in the Eastern Conference. And when you look at that team, everyone’s talking about the Boston Celtics and the others, but Kawhi Leonard is a legit player. And what you saw the other night may very well be an NBA finals preview.
SIMON: Howard Bryant of espn.com and ESPN The Magazine, thanks so much for being with us.
BRYANT: Thanks, Scott.
Copyright © 2018 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.
NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.
Medicare To Cut Payments To Nursing Homes Whose Patients End Up Back In The Hospital
Medicare’s new program will alter a year’s worth of payments to 14,959 skilled nursing facilities across the U.S., based on how often in the past fiscal year their residents ended up back in hospitals within 30 days of leaving.
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The federal government took a new step this week to reduce avoidable hospital readmissions of nursing home patients. The move targets the homes’ bottom lines by lowering a year’s worth of payments to nearly 11,000 nursing homes, and giving bonuses to nearly 4,000 others.
These financial incentives, determined by each home’s readmission rates, significantly expand Medicare’s effort to pay medical providers based on the quality of care instead of just the number or condition of their patients.
Until now, Medicare mostly limited these kinds of incentives to hospitals, which have gotten used to facing financial repercussions if too many of their patients are readmitted, suffer infections or other injuries, or die.
“To some nursing homes, it could mean a significant amount of money,” says Thomas Martin, director of post-acute care analytics at CarePort Health, which works for both hospitals and nursing homes. “A lot are operating on very small margins.”
The new Medicare program is altering a year’s worth of payments to 14,959 skilled nursing facilities, based on how often their residents ended up back in hospitals within 30 days of leaving.
Hospitalizations of nursing home residents, while decreasing in recent years, remain a problem: Nearly 11 percent of patients in 2016 were sent to hospitals for conditions that might have been averted with better medical oversight.
These bonuses and penalties are also intended to discourage nursing homes from discharging patients too quickly — something that is financially tempting as Medicare fully covers only the first 20 days of a stay and generally stops paying anything after 100 days.
Over this fiscal year, which began Oct. 1 and goes through the end of September 2019, the best-performing homes will receive 1.6 percent more for each Medicare patient than they would have otherwise. The worst-performing homes will lose nearly 2 percent of each payment. The others will fall in between. (You can check the scores for individual nursing facilities in your area here.)
For-profit nursing homes, which make up two-thirds of the nation’s facilities, face deeper cuts on average than do nonprofit and government-owned homes, a Kaiser Health News analysis of the data found.
In Arkansas, Louisiana and Mississippi, 85 percent of homes will lose money, the analysis found. More than half in Alaska, Hawaii and Washington state will get bonuses.
Overall, 10,976 nursing homes will be penalized, 3,983 will get bonuses and the remainder will not experience any change in payment, the KHN analysis found.
Medicare is reducing payments to 12 of the 15 nursing homes run by Otterbein SeniorLife, an Ohio faith-based nonprofit. Pamela Richmond, Otterbein’s chief strategy officer, says most of its readmissions occurred with patients after they went home, not while they were in the nursing facilities. Otterbein anticipates losing $99,000 over the year.
“We’re superdisappointed,” Richmond says about the penalties. She says Otterbein has started to follow up with former patients or with the home health agencies that send nurses and aides to patients’ houses to care for them. If there are signs of trouble, Otterbein will try to arrange care or bring patients back to the nursing home if necessary.
“This really puts the emphasis on us to go out and coordinate better care after they leave,” Richmond says.
Congress created the Skilled Nursing Facility Value-Based Purchasing Program incentives in the 2014 Protecting Access to Medicare Act. In assigning bonuses and penalties, Medicare judged each facility’s performances in two ways: how its hospitalization rates in calendar year 2017 compared with other facilities and how much those rates changed from calendar year 2015.
Facilities received scores of 0 to 100 for their performances and 0 to 90 for their improvements; the higher of the two scores was used to determine their overall score. Facilities were then ranked highest to lowest.
Medicare is not measuring readmission rates of patients who are insured through private Medicare Advantage plans, even though in some regions, the majority of Medicare beneficiaries rely on those to afford their care.
Through the incentives, Medicare will redistribute $316 million from poorer-performing to better-performing nursing homes. Medicare expects it will keep another $211 million that it would have otherwise paid to nursing homes if the program did not exist.
The new payments augment other pressures nursing homes face from Medicare and state Medicaid programs to lower readmissions to hospitals.
“Skilled facilities have been working toward this and knew it was coming,” says Nicole Fallon, vice president of health policy and integrated services at LeadingAge, an association of nonprofit providers of services for seniors.
The American Health Care Association, a trade group of nursing homes, reports in a written statement that it has supported the program and is gratified to see that more than a quarter of facilities received bonuses.
While most researchers believe that readmissions can be reduced, some consumer advocates fear that nursing homes will be reluctant to admit very infirm residents or to rehospitalize patients even when they need medical care.
“It may end up causing great pain to residents who actually need to be hospitalized,” says Patricia McGinnis, executive director of California Advocates For Nursing Home Reform, which is based in San Francisco.
Fallon says Medicare eventually may penalize homes that have done all they can to prevent return trips to the hospital. But because of the program’s design by Congress, Medicare still will need to punish large numbers of homes.
“There are always going to be winners and losers, even if you make good progress,” Fallon says. “At what point have we achieved all we can achieve?”
Meanwhile, Medicare is looking to expand financial incentives to other kinds of providers. Since 2016, it has been testing quality bonuses and penalties for home health agencies in nine states. Richmond, the nursing home executive, applauded that kind of expansion.
“There are a whole bunch of people in this chain” of institutions caring for patients at different stages, she says, “and we all need to be working in a common direction.”
Kaiser Health News, a nonprofit news service, is an editorially independent program of the Kaiser Family Foundation and is not affiliated with Kaiser Permanente. KHN data editor Elizabeth Lucas contributed to this report.
Linda Tourje – Bah Humbug Review
I enjoy the holidays. There’s the nippy weather, or the snow depending on your location, hot cocoa and fireplaces, excited kids running around, Santa, charity, family and good food. […]