Yet another story describing wrong-side surgery. Although not surprising in their incidence, one would think that the rate of wrong-side surgical procedures is on the decline in this country, or at the very least, leveling off. Can the quality assurance admonitions of healthcare organizations occur soon enough?
Think all of the concerns of primary care physicians regarding time management and patient visits aren’t valid? With all of the demands upon a generalist’s time, the last thing that a busy physician wants to be reminded of is the number of patients he or she could be seeing, as opposed to actually seeing daily.
This observation is highlighted by the fact that the rate of insured patients choosing emergency room care is rising. Number one reason? Lack of access to the primary care physician with no other option. With the incentive for medical school grads to enter subspecialties outside of the less lucrative primary care “market”, this situation is sure to get much worse. | LINK
Just how healthy is the healthcare marketplace? If you ask the insurance companies, business couldn’t be brisker, even if it involves fraudulent activity cloaked within the invisibility of the homeless. Just ask the CEO of a Los Angeles County hospital.
FBI agents arrested Rudra Sabaratnam, 64, the owner and top executive of a hospital, and Estill Mitts, 64, the operator of a homeless “assessment center” in the city’s Skid Row area. They enticed homeless people with the promise of payments to act as hospital patients, an indictment alleges. The homeless people are said to have received medical treatment, and the government was billed for the services. The unnecessary hospital treatments were then billed to Medicare and Medi-Cal in a scheme that began in August 2004 and lasted until about October 2007, the indictment states.
In an effort to assuage the increasing antipathy of medical lobbyists and physicians against the recent GOP-led campaign to enforce Medicare reimbursement cuts to healthcare providers, Republican leaders recently held a private meeting with top healthcare thought leaders to mend a relationship which has increasingly favored Democrats as of late. The last time Republicans seemed as though they were in the good graces of the medical leadership community was in 2003, when George W. Bush held his own against those in the medical provider cohort who were being bruised by unfair tort practices nationwide. That was also the year in which bold GOP initiatives were easily passed and yielded, among other things, a complete overhaul in how the government, Pharma, and patients later obtained prescription medications — under Medicare Part D.
However, recent spikes in the number of uninsured and a general sense of healthcare management malaise on the part of legislators on both sides of the ideological divide have made a tenuous relationship even more fragile. Can the Republicans make it up to physicians this time?
In the run-up to the 2006 midterm elections, doctors and the groups that represent them gave 62 percent of their combined $52.4 million war chest to Republicans, compared with 37 percent to Democrats, according to the Center for Responsive Politics. That breakdown mirrors previous cycles since Bush entered the White House. But since 2006, doctors and related groups have given Democrats 53 percent of their combined $53 million in campaign contributions, according to the watchdog group. The switch is even more stark for the AMA. In the run-up to the 2006 election, the AMA’s political action committee gave Republicans 70 percent of its campaign cash, according to the Center for Responsive Politics. In 2004, the AMA’s PAC contributed 80 percent of its total donations to Republican lawmakers and candidates. Since 2006, that PAC has directed 53 percent of its contributions to Democrats.
If the current state of re-election possibilities continues to wane for the GOP, don’t bet on it. | LINK
There’s no easy money. That’s the mantra echoed in an interesting piece today in the NYT. Critics of Barack Obama’s healthcare financing plan are beginning to question the senator’s rationale for major policy points behind his pledge to “bring down premiums by $2,500 for the typical family”. They also contend that the presidential candidate has no essential timeline with which to carry out his audacious initiatives. Potential roadblocks:
The heatlhcare debate just got a little more interesting. | LINK
It’s inevitable. Electronic prescribing may be a early-adopter niche-driven tech blip on the EHR tableau, but it is here to stay; and the government is getting in on the act. Medicare will now provide incentives for physicians who wish to incorporate this method of prescribing into their practices. Makes sense. The days of physicians getting a free pass on illegible prescriptions and healthcare’s expectations of working within this potentially dangerous construct are numbered — from a patient safety standpoint. | LINK
Minnesota-based insurer UnitedHealth is lowering its earnings forecast for the year, citing — among other reasons — increased payouts to Medicare Part D beneficiaries, as well as court settlement costs stemming from lawsuits over its stock options practices.
[T]he company also said it agreed to pay $895 million to settle a class action lawsuit with the California Public Employees Retirement System (CalPERS) and Alaska Plumbing and Pipefitting Industry Pension Trust. The 2006 suit filed in the U.S. District Court in Minnesota related to historical stock options practices.
What is a patient (um, healthcare consumer) to believe today? If it wasn’t enough for them to wade through their insurance plans to determine what is and what isn’t covered, now they have to contend with headlines like this:
A new “health report card” has found that diabetics are much more likely to get their disease under control at some Minnesota clinics than others. […] “The data show that where you go for health care matters just as much as what you eat and whether you exercise,” said Jim Chase, executive director of MN Community Measurement, a nonprofit group.
Really? The problem with trying to glean meaningful information from stories such as this is that the reader is left to wonder what the article isn’t saying. A blanket statement such as this is rarely reflective of the sensationalism it is designed to provoke. But that doesn’t matter to healthcare organizations’ CEOs, their payers, and their advertisers. Because, after all, this is a healthcare market and choice is king — assuming one is insured enough to choose. | LINK
“We should use real patients as sources of real information we need about quality of care,” said Dr. George Anstadt, an AMA delegate from Pittsford, N.Y., who is representing the American College of Occupational and Environmental Medicine. “This goes against the grain of the doctor-patient relationship.”
The advice was published online yesterday in the journal Hypertension, will be printed in the June issue of the Journal of Cardiovascular Nursing and comprises a joint statement from three medical organizations: the American Heart Association, American Society of Hypertension and the Preventive Cardiovascular Nurses’ Association.
The panel wrote that an increasing number of patients are measuring their blood pressure regularly at home, and although this practice has been endorsed by national and international guidelines, there are no detailed guidelines.
A California healthcare advocacy group is praising the decision to reinstate lost healthcare coverage to patients belonging to two of the states largest health plans. The move comes less than two years after Kaiser Permanente and HealthNet were cited by state regulators for the practice of retroactively canceling policies of patients — oftentimes for reasons deemed fraudulently obtained. Moreover, the underwriting practices of many of the state’s other prominent insurers is also being investigated. | LINK
“I didn’t feel no pain. I was just trying to survive,” Wilder said in his high-pitched, gravelly voice. “I got relief right away. There was a big gush of blood, and I was able to start sucking in air.”
Wilder said he fell asleep watching television in his basement but awakened when he felt himself suffocating. His wife, Cora, called an ambulance.
“I thought they might get here fast enough that I wouldn’t have to do that,” he said. “But I couldn’t breathe no more.”
He bolted for the kitchen and picked up a steak knife and made a quarter-inch incision.
CMS is not known for speedy reactions to policy promises, but when the nation’s largest healthcare insurer jumps on a target, it usually sees the project through — this, in spite of the usual critical grumbling by detractors of organizational underfunding and understaffing in getting the job done.
CMS is proposing new rules targeting private plans which misrepresent associations with Medicare or engage in fraud and abuse with respect to marketing practices. These plans were made possible with revisions described in the landmark Medicare Modernization Act of 2003. Although the bill which led to sweeping changes in Medicare was passed in 2003, the proposed rules would cover infractions for marketing practices 2006 and onward – around the time many programs offering seniors choices began to flourish (via Part D prescription drug plans and Medicare Advantage plans).
“At first glance, the proposed rule offers an improvement over the status quo,” said Rep. Pete Stark, D-Calif. “However, in order for it to be effective, the rule must be accompanied by a commitment to aggressive enforcement.”
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