April 15, 2008 Recent News




An agreement between the AMA, ACS and insurers will allow the go ahead for a national standard to rank physicians.  The deal was brokered by a group of businesses.  The physicians will now be ranked by both cost and quality of care provided.  The individuals will also be allowed to review their rankings.   

WellPoint has decided that it will not pay hospitals or physicians for eleven preventable errors.  This includes hospital acquired infections which the insurer states can be prevented with hand washing between patients.  The executive vice president for clinical health policy stated however that only "many" of them could be prevented.  Who is going to decide which were preventable and which weren't?  Some of the eleven are straight forward such as operating on the wrong body part, the wrong surgery or the wrong patient.  Others are also clear such as leaving a sponge in a patient.  Others are not so clear such as UTI secondary to a catheter or bed sores.  People may develop these even with the best care possible 24/7.  There must be some give in the system or it will collapse.  

California now collects data on which physicians speak which languages and who is of what race.  The state has now stated that although there are 7% of states population are Black, only 3% of the physician population are Black.  There is a discrepancy the other way in Asians where there are more percentage of Asian physicians than there are Asians in the population.  Could this be cultural as is professed by the CMA.  There is no mention of the percentage of different races in the med schools.  

About a year ago the California regulators found that Blue Cross had illegally rescinded insurance coverage of about 90 patients.  The organization was fined but the insurer was not ordered to reinstate the insurance.  The Department states the regs do not allow them to order reinstatements.  This is the reason that the LA City Attorney is suing to get each policy reinstated.  

In Los Angeles, the deal to purchase the King Hospital has fallen apart and with it the County health service director.  He had been director for two years and the relationship with his bosses, the LA Board of Stupes had deteriorated.  Dr. Chernof also was not liked by the community around King Hospital as they wanted more say in the running of the non existent hospital.  Another prime example of politicians attempting and failing to understand healthcare.

UnitedHeath is continued to get blasted for its poor policies and communication.  The political and public pressure is becoming great enough an embarrassment for the organization that it is actually considering changing its ways.  The other aspect is that employers are leaving the organization and enrollment has decreased.  The insurer admits they were faulty and are working to correct their many faults.  This is also affecting their bottom line with over $1 Billion in fines in California and a sharp drop in the price of its shares.  

United has also started to drop on a pick and choose basis physicians that have opted for retainer practices.  United states they don't mind that type practice but believe their members are being charged more than the contracted rates.  They forget that it was the members choice to join the retainer practice to get the things that United wouldn't pay for.      

The Wall Street Journal had a story regarding the lack of charitable care given in return for non taxable status by the non profit hospitals.  The for profits beat them hands down in the amount of community service.  Some non profit hospitals put the salaries of the employees down as community service. The actual amount of true charitable work is miniscule to that received in tax savings.  The last sentence of the article stated it all, 
"Non Profit is a misnomer-it's nontaxable.  When you're making hundreds of millions of dollars a year, how can you call yourself a not for profit."  These hospitals need to be taxed unless they are truly doing community service and not some of the junk they are trying to pass off as community service.  

Summa Health Systems of Akron, Ohio, has purchased 26 cardiologists in the area.  The physicians have a five year contract with the cardiology arm of Summa but the patients can go where they wish, including rival Akron General Hospital. It seems like the purchase is being done to stabilize the cardiology in the area in order to retain and recruit new cardiologists. 

In the imaging department, hospitals have outside competition.  Over 50% of hospitals have over 3 outside competitors.  I wonder how many of those are the same radiologists as do the hospital radiology.  The statistic is also telling in that it states hospitals are not providing the service needed in the community.  They make people wait for appointments, wait when they get to the hospital for their appointment, wait in the room for the technologist and wait for the report.   

When the People's Republic of Massachusetts enacted its poorly thought out Universal health plan, it forgot to count the number of primary care physicians in the state.  The newly insured can not find physicians to care for them and when they do the waiting times are long or longer.  The Republic is considering forgiving medical school debt for those primary care physicians who work in the boonies.  There are fewer American born physicians going into the primary care fields but many more foreign born physicians.  There is also an increase in the mid level practitioners who see a way to get paid.  Many of the new physicians are female and so do more work life balance.  They work less.          

Some left coast schools are about as dumb as they come.  They will not partake in the blood donation programs because of the rule that gays can not donate.  This is truly allowing people to bleed to death for a political statement.  

Cuba is smarter than the left coast schools.  President Raul Castro has realized that the family physician program in the country could be improved.  He will close about half of the offices and increase staffing in the rest.  This will increase productivity.      Top


After Brit Spears' medical records were breached, it was told that Farrah Fawcett's medical record at UCLA was also hacked and the information was on a website that she had cancer before she had a chance to twll her family and friends.  The employee was terminated.  This was the second time her record was breached at the hospital.  Fawcett has now given up on UCLA and receives her care elsewhere as should others of renown.  

Soon after the above story, another appeared stating that UCLA has a habit of breaking privacy of the "stars".  They didn't stop there.  They not only broke into the records of an additional 12 other "stars" including the state's first lady, Maria Shriver, but also over 60 others.  The hospital broke the law in not notifying those whose records were compromised nor did they inform the state.  This shows that the more records are electronic the easier it is to compromise the privacy of the records.  Of course, it is also easier to find out who the culprit is.  Expect UCLA to have a major fine but since it is a state institution the taxpayers will pay the fine. 

About half of all the privacy breaches are not reported.  In a study of 263 institutions 13% stated they had a breach and 45% stated they did not notify the patients.  The reason was a loophole in the laws that are now being closed but on a state by state basis.  The study showed a three time more likely breach in hospitals over 100 beds than under.  Almost all breaches were by employees. 

Isn't it terrible that surgery centers don't have EMRs.  A full 82% have eschewed the costly devils.  The reasons are lack of interfaces with current scheduling software, lack of capitol investment, lack of software that capture patient mix and lack of personnel to implement.  They also don't believe they are cost effective in their environment.  The feds new lack of payment schedule fuels their desire not to spend.  

New York Presby, Cornell had medical records stolen on 50,000 patients by a clerk in the admissions office.  These were sold for illegal activity.  The hospital is in the process of notifying the patients and offering free credit checks. Top  


DISCLAIMER: Although this article is updated periodically, it reflects the author's point of view at the time of publication. Nothing in this article constitutes legal advice. Readers should consult with their own legal counsel before acting on any of the information presented.