SEATTLE -- There's been a massive amount of consumer spending over the holidays this year, but it's likely that online shopping is the source of the uptick.

Online sales on Black Friday were up 22 percent in 2016 over 2015 sales, topping a record $3.3 billion. What will all the trend toward more online sales - and consumers' expectations of faster delivery times - do to America's cities?

That's where the newly created Urban Freight Lab at the University of Washington comes in. The lab's director, Barbara Ivanov, said cities still manage loading zones with an old technology: a stripe of yellow paint.

"And a lot of times when you look around, all the inventory at the curb is sitting empty,” Ivanov said; "and it could be used more efficiently, more effectively, if we actually had applied more technology to the way that piece of space, that piece of real estate, operates."

Over the next three years, the Urban Freight Lab is collaborating with Seattle's Department of Transportation - which contributed $285,000 to the lab for its research. The lab also is partnering with companies such as FedEx, Costco and Nordstrom, as well as the U.S. Postal Service.

The lab will begin its research with what it calls the "Final 50 Feet" challenge of deliveries. This includes everything from ensuring packages are secure from "porch pirates" to the many facets of commercial deliveries.

Ivanov said if she could start over with the design of a city, she would make sure the city had good alleyways.

"You don't want all this going on, this sort of commercial activity, through the front door of a retail center,” she said. "You want it out of sight, you want more of an environment at the street level that's really friendly to pedestrians and other folks out doing their shopping and going to the office."

E-commerce is likely to continue to rise across the country in the coming years. An online UPS study this summer found that, for the first time, respondents bought more than half of their goods online.

Seattle is home to Amazon, which accounts for the largest slice of online shopping sales.




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Colorado hospitals got failing grades for compliance with the Colorado Hospital Discounted Care law, according to a new report.

The law passed in 2021, and requires hospitals to tell patients about their rights and access to discounts.

Sophia Hennessy is policy and research coordinator with the Colorado Consumer Health Initiative.

She said people across the state still report the cost of health care is too high, and without access to discounted care, many are skipping doctor's appointments.

"Fear of that hospital bill, and if care is so expensive that it will put you in medical debt," said Hennessy. "Or make it harder to have housing, or food. And that's never a decision that we want anyone in Colorado to have to make."

Researchers audited all of the state's 89 hospitals.

While 58% of hospitals technically met the law's basic requirements, the report shows many just went through the motions - hiding information about discounts in remote parts of their website, or not posting it at all.

Just 20% of patients were able to solve their problem by phone, but that number dropped to under 5% for Spanish-speaking callers.

You can find a fact sheet about your rights at cohealth.co/hospitaldiscounts.

Hospitals must post a conspicuous link to discounted care information on their main website, along with a uniform application for assistance. They also need to list patient rights in both English and Spanish.

Hennessy said the new law also limits how hospitals take action against patients.

"Hospitals can't send your account into collections until 180 days after your date of service," said Hennessy. "So there's way more time for you to figure out how you want to pay those bills, or if you can't pay those bills. And they also have to notify you that they are sending you to collection."

The report finds access to discounted care is twice as hard to get at large health system-owned hospitals than at independent facilities.

Proponents of hospital consolidation have argued mergers will improve the quality of care and access, but Hennessy said she isn't buying it.

"This report showed that that's not true," said Hennessy, "that it was actually harder to get a financial assistance representative on the phone at health system-owned hospitals, and harder to get the information that you needed from them."

A recent study from Florida Atlantic University highlights a concerning rise in alcohol-related deaths across the United States, with mortality rates nearly doubling between 1999 and 2020.

The findings point to significant public health challenges, particularly among younger age groups and in the South.

Dr. Charles H. Hennekens, professor of medicine and preventive medicine at Florida Atlantic University and the study's co-author, analyzed data from the U.S. Centers for Disease Control and Prevention's "WONDER" database.

"There was a doubling of the mortality from alcohol-related deaths that we saw at all ages," Hennekens reported. "The most alarming spike, nearly fourfold, was in those 25 to 34 years of age."

The number of alcohol-related deaths skyrocketed from just over 19,000 to nearly 49,000. Experts said the findings should be a wake-up call for Florida, where nightlife and tourism are key drivers of the economy. Hennekens urged health care providers to step up screening for alcohol use and educate patients about the dangers.

Hennekens stresses rising rates of obesity and diabetes exacerbate the problem, highlighting one immediate effect of excessive alcohol consumption is liver damage, which can lead to cirrhosis and liver cancer.

"This also contributes to early liver damage," Hennekens pointed out. "These two deleterious effects may be additive or perhaps even synergistic and may contribute to greater and earlier onset of alcohol-related mortality."

While moderate alcohol consumption, defined as up to one drink per day for women and two for men, may have some benefits, Hennekens cautioned against misconceptions. He explained it doesn't matter whether it is a glass of wine, a shot of liquor or one bee, it is about the quantity, not the type. People who drink moderate to large amounts have the highest risk of premature mortality and morbidity.


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The number of Medicare enrollees is projected to rise over the next few years as the baby boomer population ages. More than 2 million Illinoisans are currently enrolled in the federal health care program, according to Healthinsurance.org,

The Office-Based Facility Association, a coalition of practitioners, is calling for a change in what they view as an ineffective and unfair pricing structure of the Medicare Physician Fee schedule.

Jason McKitrick, executive director of the association, said other payers linking themselves to Medicare is one of the issues.

"When you've got ongoing cuts to Medicare, that means you've likely got ancillary cuts going on with the private side, with the Medicaid side, etc.," McKitrick explained. "It's the Centers for Medicare and Medicaid Services, CMS, ultimately, that's the agency and the federal government that sets the rates for the Medicare Physician Fee Schedule."

The association pointed out the current fee schedule addresses doctor's fees only, not the costly and necessary supplies and equipment needed for their practices. According to the Centers for Medicare and Medicaid Services data, there are 300 office-based services under the fee schedule for which Medicare reimbursement is less than the direct costs, before even considering other costs like overhead and physician work.

Dr. Sreenivas Reddy, a vascular interventional radiologist in Hinsdale, said in addition to seeing patients, he has to monitor overhead expenses such as office space and employee salaries, both affected by inflation. Not having the proper medical equipment and supplies, he added, limits his ability to perform specialized procedures and forces patients to seek care elsewhere.

"That makes these patients go to the hospital-based facilities," Reddy noted. "We have to close our offices and try to join these hospital-based models. They would love to come to the office, get the procedure done in one or two hours, versus it takes like a whole day in the hospital setting."

Reddy emphasized physicians' reimbursement, based on the current physician pay schedule, has been on the downtrend for the last five years. The group has further concerns about a decrease in the number of private practices causing more medical deserts for interventional radiology, cardiology, vascular surgery, radiation and oncology care.