January 15, 2012 Recent News
The L.A. Times has an article regarding the California enrollment of the patients with pre-existing conditions. The last article told that the state was cutting the program out due to the cost of the claims. This article doesn't mention that aspect and only states that California has now enrolled 6,000 people and will continue to enroll as long as more money from the fed is available.
A report from California Healthcare Foundation states that fewer California's companies offered health insurance last year and those that did reduced benefits or charged more for the same coverage. This is directly attributable to the economy and will continue in the same direction until the economy improves.
How do you measure mortality. CMS uses fatality within 30 days of hospital discharge, a reasonable variable. Some states and insurance companies use death in the hospital. In the age of quick hospital release this is not an acceptable variable. This is the conclusion just published in the Annuls of Internal Medicine. The authors state that mortality should be measured in a standard increment and not just in days in the hospital that vary so much from hospital to hospital.
It apparently is already starting. The inability for Medicare patients to find physicians. The AMA news says that Medicare patients hare having slightly more difficulty in finding primary care physician that will accept them. MedPAC finds this worrisome and wants the SGR repealed for good. They want to freeze primary care pay and reduce others by 6%. That may make it difficult to get either primary or specialist care.
The slippery slope has started. Several insurers in New Hampshire have begun to pay patients to go to cheaper physicians or hospitals. They are also paying physicians refer patients to cheaper lab and x-ray facilities. Quality plays no part in the decision making process just money. Shame on you Anthem and Harvard Pilgrim. Top
The American College of Physicians has a new manual that states the physicians first duty is to the patient but use less resources in caring for the patient. It actually used the word "parsimonious" in the article. Does this mean care should be withheld? Would physicians who look for "zebras" such as Dr. House be tossed from the profession. The ACP goes on to state that physicians who receive information about a patient from a third party may tell the patient about the information and who it came from.
Are you starting to lose money? You are not alone. A CNN Money article states that physicians are slowly going bankrupt. This is really true in independent practices. Physicians are seeing stagnant income and increasing costs, a bad combination. Recently, Medicare cardiology cuts have hurt the practices, some as much as 10%. More physicians are having thoughts about leaving medicine as they have known it and joining the pharmaceutical businesses, etc. Oncologists have already stopped taking new patients because of the costs of the meds are not being reimbursed by insurers fully. One can not lose money on a patient and make it up in volume. Primary care physicians are seeing patients piecemeal, making them come back for each complaint since insurers will not pay them for their time. Socialization will increase the problems.
The AHA reports that physician employment has risen 32% over the past ten years. This is mostly in the New England states where 56% of physicians are employed versus only 29% in the West South Central region. About 50% of hospitals have hospitalists and about 20% have intensivists.
Hospitals and physician centers are hiring former pharmaceutical representatives to call on physicians in order to have them refer more to their institutions or practices. They are paid a straight salary with bonuses depending on the referrals from their geographic location. Physicians who are targeted should be sure that any claims made be the liaisons have back up data.
The Endocrine Society has a weak guideline that states all inpatients should get a blood glucose.
In a major screw up by Jackson Health in Miami they via the CEO (who states she had the OK from the board and the county attorneys) co-signed a 10 year lease for medical offices for 12 physicians who Jackson was attempting to buy. The deal fell through but the hospital is still on the hook for the space. The new CEO wants to settle by paying the landlord $700,000 instead of being on the hook for a potential $7 million for the lease. Apparently the bylaws require board approval for all contracts over $1 million and this never happened or did it. The county attorney says it's an invalid contract but there is a board committee resolution that gave the prior CEO authority to negotiate and purchase the physicians with all it entails. I don't believe it. It was signed by one who gave the indication that they had the power to bind the hospital. The Board has a bunch of attorneys and they are afraid that if they settle the landlord will go after the physicians for the remainder and the physicians will then sue the hospital for their loss. Apparently Jackson has been buying physician practices and hiring physicians for several years. They now consider this a losing proposition. 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