May 1, 2014 Recent News

Healthcare

Physicians

Malpractice

Hospitals

Healthcare

The CBO has lowered the cost of Obamacare by$100 Billion over the next decade.  The cost will now be only $1.383 TRILLION.  The reason for the decrease is the narrowing of networks with less physicians and hospitals. including the major cancer hospitals.  They also predict a 4% increase in the insured this year.

Ah yes.  The administration has no timetable for the release of information about Obamacare's 7.5 million signups.  

Now Obama says it is 8 million enrolled.  This means that that many went on line but not that they paid for their first month's premium to actually get coverage.  Most of the last minute flurry of signups came from California where about 200,000 signed up in the last two weeks.  In good news for the program about 28% of the "enrollees" are the 18-35 year olds.

The good-bye girl Sebelius has been investigated by the GAO and found that she did indeed telephone companies including those in the healthcare business for donations to ENROLL AMERICA, the for profit organization that was to advertise for citizens to join Obamacare.  The solicitations themselves were legal but since HHS regulates some of the companies solicited the cloak of impropriety is present.

The US Census Bureau is messing with the Obamacare statistics.  They have changed the question regarding the law.  They did ask if the person has insurance and now ask whether they had insurance last year.  The GOP is accusing the administration of doing this purposely to avoid meaningful data.

In another blast at EHR, a study by Bingham and Women's Hospital showed the meaningful use component had no correlation with quality.

A report on medical practices show that 40% are replacing their current EHR.  This was in the first quarter of this year.  Of those that are replacing 85% have current EHR and 15% have both electronic and paper records.  The major reason for the changes are their current system is cumbersome or not able to communicate with other systems.  Other reasons include the need for regulatory compliance or the system is outdated.  The expense to healthcare for this is huge.

TJ Samson Hospital in Glasgow, Kentucky, is laying off 49 employees in order to reduce costs prior after installing a new Siemens billing system.  It was so bad that the hospital is out many millions of dollars.  

UNC Healthcare in Chapel Hill, North Carolina, will reduce its number of patients seen in all its facilities due to an EPIC rollout.  This is the first notice I have seen that makes sense.  Almost all others did the rollout without cutting back on the amount of patients seen in their various clinics.  After the program is up UNC will slowly increase the numbers until back at full scheduling.

Obamacare authorized PCORI, an organization to research "comparative effectiveness".  They are doing this by collecting data at 10 sites around the country.  The data is all the medical information on about 26 million people.  Obama has given this a low budget priority and the ethical questions are legion.

Obamacare also required physicians to do face to face meetings with patients prior to prescribing home health visits.  That ain't happening.  The Inspector General believes but can not prove that about $2 Billion have been misspent by Medicare for either unneeded or never done home health visits.

JAMA has an article about the leakage in ACO populations.  They show that about 20% of patients assigned to an ACO were in the same ACO the following year.  Also about 6% of the primary care visits went outside the ACO but a whopping 67% of specialty visits went outside the organization. 

In a report blasting the VA system, CNN reports on about 40 vets that died while awaiting care at the Phoenix VA facility.  This was due to the VA administration wanting to look good and decrease the numbers on their wait for appointment list.  They instituted a "secret wait list" for people to seen initially a PCP.  

Washington is in the throes of attempting to get more choice for patients under the dreaded exchanges.  The narrow networks have left out the state's Children's hospitals and some of the cancer hospitals.  The insurers are objecting to the plan since the insurance commissioner wants to put it in by May 1 and the time is too short.  The hospitals are objecting since they do not believe the new rules allows the insurers to negotiate in good faith with the hospitals.

How much are you worth?  How much are your medical records worth?  The records are worth more.  The street value is about $50 per record on the black market, according to the FBI.  Think about this in relation to the 30,000,000 EHR already compromised means this is major crimes.  The FBI states that the medical profession is doing a poor job of protecting the personal information and they state what makes it worse is that the medical IT people think they are doing well when the data states otherwise.        Top

Physicians

The USA Today had a long article on what they say are 100,000 physicians and other medical personal that are addicted and practicing their profession.  The article talks about the people that divert drugs and give patients hepatitis and/or HIV.  All agree that addiction is a problem but the division is in how to prevent it and how to treat it.  Some want to increase education to prevent and others say this is not enough, you need to do random drug tests for all physicians in the hospital.  Some believe that the state medical boards should sponsor medical rehab while California has done away with it.  

USA Today had an article on the fast in and out in a physician office.  The physician is now being asked by their employer to see patients in 11 minutes.  This includes the seeing and charting.  This is not good for the idiotic idea that quality equates to good patient satisfaction scores.  This also is great for the pharmaceutical industry since most of these patients will get a prescription instead of some behavior change such as losing weight.  

Shame on the physicians of Grand Coulee Hospital in Georgia.  They did not want their base salaries changed to production.  This caused a rift between them and the CEO that proposed the change.  The CEO just could not take all that criticism and up and resigned citing the physician issue and the Board retaliating against him. Boo Hoo!  He is going to up and sue.          Top

Malpractice

On April 17 the WSJ had a lead editorial about the chicanery of California's AG Harris.  It tells of the greatness of the 1975 med mal law in the state and how the proposition is being manipulated by Ms. Harris.  She writes the proposition summary and forgets to mention medical malpractice until the last line of the summary.  If the proposition passes it will mean a major boost in physician's premiums and hasten the exit of those on the cusp of retiring.  However, Ms. Harris has made her Trial Attorney backers happy.  More money for her campaigns.        Top

Hospitals

PeaceHealth St. Joseph Hospital of Bellingham, Washington is being hit with taxes.  They either will be taxed on their off site clinics or on all their operations.  They originally been tax exempt due to a religious exemption.  The city attorney has questioned the propriety of an exemption based on religion.

Sebastopol California has lost their hospital.  Palm Drive Hospital has closed due to finances.  They have had decrease overnight stays along with decreased reimbursements and increased competition.  This is a district tax supported hospital.  They want to reopen the hospital in some other iteration and without the medsurg ward.

Boston Medical Center has fired MDF Transcription Services, their transcription vendor, for posting on line the records of 15,000 patients with out password protection.          Top

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 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.