The infamous MLK Hospital in LA is reopening with new priorities. The new institution is focused on outpatient treatments with minimal hospital care. There will be no trauma service. The downsize is that it is still controlled by the LA Board of Stupes, albeit different Stupes.
Steven Thames, the CEO of Citizens Medical Center in Texas has been fired after the physicians and nurses asked for his resignation. They say he has been responsible for the departure of many personnel and a decrease in the level of care. Top
The US Center of Disease Control has stated that about 69% of the nation's physicians will see Medicaid patients. The two worse states for participation are New Jersey at 38% and California at 54%. Neither state pays well and they get what they pay for.
The experiment failed. Opening Obamacare to enrollees who were too stupid not to recognize they would be fined if they didn't enroll got a grand total of 36,000.
The treatment of false negative breast cancer and over treatment for tumors that do not grow or cause problems costs the healthcare system $4 Billion per year. Therefore, according to the thinking of the professionals, maybe we should not do screening at age 40. This is the same thinking as to not do PSA exams for prostate cancer. Both are equally short sighted.
Speaking of short sighted, CMS was supposed to decrease payments to the Medicare Advantage plans by 0.9%. Instead the increased payments by 1.25%. CMS says this does not reflect a change in their policy but their actions speak differently. CMS continues to spend more on this form of insurance than on traditional Medicare with more perks but no benefits. This is to cover only 30% of the Medicare enrollees.
The AP states the VA has done almost nothing to improve the wait times the vets have for care. In the year since the VA fiasco came to light the waits of 30-90 days have stayed flat and the waits for longer than 90 days has doubled. Most of the delay is in the Southern states with strong military presence. One of the main problems is the large increase in vets using the system and the lag time to plan for care of these vets.
The Obama administration lashed out at the EHR vendors for their lack of interoperability and the cost of sharing information. Most of the vendors have joined together to form the Commonwealth Health Alliance that shares information without fees. Of course the king of the hill Epic has not joined. They say all their clients can already share with each other. They do not care about the rest of the world.
Consumers seem to be opting for the limited networks in order to save money. They do not understand that this will affect their health in a negative manner. Some are even choosing the ridiculous "ultra narrow networks" with even less choices. These are equivalent to the restrictive HMOs on the 1990s. If the consumer does not understand they will pay a high price for going out of network. It seems that employers are using the narrow networks in order to save a bunch of money. Top
The physicians at 10 University of California student health centers will go on a five-day strike for unfair labor practices. The Union of American Physicians and Dentists want financial information from the university and they will not provide it. The union is attempting to sign their first contract with the university. This is the second work stoppage in six months for the same thing.
A study at the Fairview Health Services, an ACO, showed that the greatest driver for improvement of care was to show primary care physicians their tertile. Those in the lowest had the most improvement, those in the middle had next and the least improvement came in those physicians who were already in the highest.
CMS has begun the process of alienating physicians even more than they already do. They have set "quality" parameters for large groups and those who meet the criteria will get bonuses. Sounds good but in the first year of the program, the say that only 14 of about 1000 large groups performed well enough to get the bonus. The group's response is "so why bother."
A wonk who knows nothing about the practice of medicine published an opinion piece in CIO that said that objections to EHR are "bogus". He takes the Rand Corporation's three main objections to EHR and attempts poorly to pooh pooh them. The cost of the systems he says is true but he goes on to say that hospitals are footing the bill for the physicians. He has not come to my area. They do foot the bill for their employed physicians but the rest can pound sand. The EHR takes time away from patients. He does not dispute this but takes a new tack by saying physicians overbook their schedule to make more money. The third one is that EHR is hard to use and not secure. He says the EHR can reduce expenses but he talks at the total system level and not the physicians level. He states the quality of treatment can be improved significantly. This is due to the full medical record being available to the provider. I would agree with this except the record is so disjointed that the provider takes a long time to go between various screens instead of on a one page summary. The writer goes on to say the only truism. EHR is very good for preventative health and for the wonks to do population health. He needs to spend more time with the end user.
There is a fascinating opinion piece in Newsweek by Kurt Eichenwald on the fraud in the American Board of Internal Medicine. He implies the real reason behind the MOC is that the ABIM needs the money as they have pissed it away on bloated salaries and trips. He also goes after the ABMS equally for making physicians take time away from their practice for nonsense.
The New York Times also has a piece about how physicians are rallying against the stupid time consuming an expensive non quality maintenance of certification. They mention the ABIM and the notion that they threaten physicians who buck the system. The Board says they are voluntary but they really are not. They are very expensive and geared for a certain percentage to fail and re-take the exam with more fees and more time away form patient care. 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