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Milwaukee has an interesting problem. There is a mega physician group in town with revenue of over $200 million per year and control of about 162,000 patients. The hospital systems now want to buy the practice for over $100 million. The physicians now mostly practice at two hospitals which are very worried. They should be and should be offering the physicians the sky. It is possible that one of the suitor hospital chains, Aurora, might build a hospital along with the physicians to continue and enhance the revenue stream of the physicians.
As all know, Congress is considering a bill to stop the decrease in payments for Medicare in 2007. If the lame duck Congress does not act the reductions will occur and physicians will begin to reduce their staff and their Medicare patients accordingly. They would also offer less benefits such as health coverage to their employees. As physicians are business people and they cannot absorb losses in revenue with rising expenses, they have no choice but to cut back on the expense side.
After writing the above, Congress has decided to agree with me and has cancelled yet again the proposed 5% decrease in fees and again instead gave a small increase in the same fees. It is time to stop the last minute charade and instead get rid of the law in its entirety.
What is right, to have patients pay for their care and have to think about whether or not they really need the visit or give the patient complete carte blanche to see a physician or more probably a physician extender with every sniffle. The HSA with its high deductible would make patients consider whether the visit is truly necessary. There are about 10 million people now covered under this type plan. The Commonwealth Fund and the Employee Benefit Research Institute feel that the high deductible do not grow the ranks of the insured but they do agree that the plans do work having people think about whether or not the visit is necessary. The insurance industry states that their research shows that the people who purchase the high deductible plans were in about 40% of the cases uninsured prior. All agree that managed care is a waste of time and energy. Top
In Des Moines, Iowa, an insurer, Wellmark, is objecting to a hospital closing its inner city hospital and moving to the suburbs. The hospital states that it doesn't need state approval since it is not wasting money and it is economical to do the move within the same county. The state may not agree since one week prior it stopped a hospital from building within the same county since it might raise healthcare costs. Another hospital is planned close to where this one is supposed to go.
The Archives of Internal Medicine has an article stating that non profit hospitals provide better care in three areas than for profit hospitals. The for profits did not challenge the figures but stated that the new figures show the differences are no more. The AHA who has o look out for all hospitals wonder why the difference. It seems that non profits have more gadgets and nurses per patient than the for profits.
Gee, I thought everyone knew this. The University of Pennsylvania actually did a study to show that the government's quality measures are nonsense. They found that even if the hospital did well of the Medicare quality measures, the risk of dying remained the same. This is what happens when bureaucrats make up faulty political guidelines. The study states that real quality measures are needed that show outcomes, not like the Medicare or JCAHO political measures.
Dr. Sloan of Diagnosis Murder would be happy with this article. Dr. Sloan would be always busy solving hospital murders. The article in the Journal of Forensic Sciences linked about 2100 deaths worldwide to 54 physicians and nurses who have been convicted or murder or lesser charges since 1970. The writer of the article Dr. Ken Kizer, the head of the VA, states it is wrong that hospitals do not share their suspicions regarding an employee when the employee moves to a different institution. The problem is the word "suspicion". More importantly would be the original hospital doing the work necessary to confirm or deny their suspicions early on. That doesn't happen since the hospital and their protective attorneys are more worried about their image and potential loss of patients. Top
There hasn't been a story on the malpractice crisis of last year for a while. The physicians of Wyoming are not happy. A recent survey showed that about 1/3 of the state's physicians are planning to move to another state. High malpractice premiums is the main cause for about half of the physicians. The legislature looks at the reverse, 2/3 have no plans to move. What's the problem? Already about 16% of physicians have quit doing some procedures due to med mal concerns. At present over half of the counties in the state have no OB. The study was commissioned by the legislature. The data will be updated twice a year so no change will be necessary.
In this issue's Recent Legal Updates there is a case of Blue Cross in Washington being sued by the physicians and the AMA for the defamatory letters they sent out to patients as to why some physicians were not in a new network. After being sued, Blue Cross decided they probably should put the issue of the new network to rest. Maybe Texas is following suit. Blue Cross of Texas has agreed to suspend the new physician rating system that it devised without checking the accuracy of the information. The Blues used billing information to rate physicians, never a good idea. This puts all on money and nothing on true quality. The Texas Blues want the site to be a meaningful one to its customers. This means the physicians who charge the least. The Texas Medical Association is prepared to go to court or to the legislature over the faulty information. 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.