The Obamacare signups are reaching seven million if you count the people who signed up and have not paid. If you do not count them then the number is closer to 5.5 million. Obama is happy with the numbers and declared the law is here to stay. I think he is correct but with major fixes. The mandates must be removed in order to get premiums down. It is probable that the federal exchange will have the subsidies declared illegal. Those persons that like their plans and physicians should be allowed to keep them and not change because the plan does not meet a government imposed mandate.
Gee. A study was don by Express Scripts and found (wait for it) sicker people signed up early for Obamacare. They are also older than those covered under employer plans. They are using pharmacy claims to determine the ailments. The study did not look at those who signed up in March. This information is important for insurers who are now setting prices for 2015 premiums. The highest costs were for Atripla for HIV. The study also showed the patients paid a larger percentage than their cohorts in employer plans. This is leading to more generic being use. Top
Healthleaders had a story on the upcoming unionization of physicians and how HR at the hospitals or insurance companies should prepare or how they can head it off at their institution. They really can not stop it since that would require actually listening to the physician and making institutional changes. Hospitals are not willing to do that and unionization will ensue, hopefully soon.
Kaiser Health News tells the story of three physicians who are at the vanguard of the physician discontent with the present. One retired. One went to concierge medicine. One became a hospitalist. They used these three to tell about the physician burn out and rage at the EMR. The burn out is caused by the hospitals employing physicians and booking more and more patients per hour for their MD slaves to see. It talks about the discontent that EMR is causing for both the physician and the patient where physicians are now reduced to clerks. All three show the flight away from primary care in the country.
The western New York area is so inhospitable that there are not enough physicians therefore requiring hospitals to transfer patients to other institutions because the needed specialist is not available. They have lost almost 400 physicians in the last two years.
The Wall street Journal had an interesting op-ed regarding medical scribes. The writer, a cardiologist at the University of Minnesota, uses scribes regularly in his clinic practice. The cost is between $10 and $25 per hour. the scribes are usually college graduates who are planning to become health care professionals. Under the physician's supervision they do multiple tasks allowing the physician to see between 10%-30% more patients and get home on time after work.
Wow! Who could have thunk it? Patients with Medicaid are having a harder time finding physician appointments than those with private insurance. This fantastic study was done by the Univ. of Pennsylvania who called physician offices pretending to have either private or Medicaid insurance. They made about 13,000 calls to about 8000 offices in 10 states. Even the uninsured got in more than those with Medicaid.
The NYT has an article about some Texas physicians who have gone away from billing insurances and either to the concierge method or charging a flat fee per visit. In the former case one decreases the amount of patients seen and can spend more time per patient. In the latter one can see more patients since there is no paperwork to worry about. Currently in Texas about 10% of physicians have no insurance contracts. Also, it is interesting that there are over six million uninsured in the state and several hundred thousand signed up for Obamacare. This measures up to the seven million in the country that signed up for Obamacare. Top
New York's Mt Sinai Hospital has been accused of doing unnecessary cardiac procedures. They state they have nothing wrong and have asked for an external review of their cardiac lab. Of course, they are paying for the review so you know how that goes.
North Adams Regional Hospital in Massachusetts closed abruptly as reported in the last Medicalaw.net updates. The other local hospital Berkshire has hired 143 former Regional employees to staff services that Berkshire will offer in the community. Top
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article is updated periodically, it reflects the author's point of view at the
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