July 15, 2010 Recent News
Leapfrog has put out a study stating that CPOE misses 1 of 3 potentially fatal medication errors. It also missed almost half of routine medication errors. This is a study in 214 hospitals. This was a web based study using fictitious patients and the hospitals improved after being told of their problems. Top
Michigan is waking up to having private ambulatory centers owned by physicians. Hospitals have been notorious non caring about physician time and money. They now have to compete with the more efficient surgical centers and are losing. The old saw about physicians performing more procedures than before may be true. It is easier to do the surgeries and therefore more can be performed. It is not true that unnecessary surgeries are being performed.
The Texas physicians are planning to drop Medicaid patients due to payment cuts. It is a one percent drop that starts in September and is seen as the first of many. Obamacare will add 1.5 million to the Medicaid rolls and that means many more people in EDs. The HHS has only about 15,000 of the state's 48,700 practicing physicians seeing Medicaid patients. That estimate is not accurate since it does not state how many have dropped out or limit Medicaid patients.
A study in JAMA shows that physicians are not comfortable being the watchdog for impaired or incompetent physicians. The study was done by MGH on 3000 physicians. Younger physicians were more likely to turn in other physicians whereas those in practice for 20 or more years were less likely to do so.
The AMA is losing any clout it had in Congress. It is not getting its bang for the buck in the Congress especially as compared to the AHA. This comes from Politico. Top
Anthem Blue Cross in California has again raised its premiums. After being caught with its hand in the cookie jar and "finding mathematical errors" that caused the 39% increase in premiums, they are now raising rates for individual policy holders by 20%. They feel that they can justify the raise and that they still won't be whole with the raise. This means another significant raise next year.
The Pennsylvania insurers are on the warpath. They are now second guessing the hospitals as to how long a patient is to stay and downcoding. There is no dispute that some hospital stays are too long and should not be paid for. These are probably the very few and should be agreed to by the hospital. However, when an insurer states that a patient only needed 12 hours observation after having an emergency coronary stent, the insurer should be the one punished. The reason for the difference between a hospital stay and a downcoded observation is that the insurance company may and will collect co-pays for all outpatient treatments versus one for a hospital stay.
The Colorado Springs Gazette has a story of a woman with leukemia who lost her COBRA benefits while undergoing chemotherapy due to a one cent shortfall in her first payment. The third party sent her a letter that her benefits were not reinstated due to a shortfall in her payments. They had not sent her a bill and did not state how much short she was. She called from the hospital and was told it was a penny and until it is paid no benefits could be paid. The third party is Discovery Benefits in North Dakota. When told the patient was going to the media Discovery Benefits said the payment was correct after all. Top
The NHS in England has finally found that they are not efficient in handling healthcare. They are turning money over to groups of primary care physicians to take care of patients. They will then fire many of the managers that are now mucking up the system.
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