The IRS has closed the public comments on how they will go after hospitals that charge the uninsured alot of money. They will forbid hospitals from charging uninsured patients who qualify for help more than insured patients. It will be interesting to see if the IRS takes away the non profit status of those hospitals that do not toe the line.
OhioHealth did the unthinkable. They purchased an expensive piece of equipment to ablate fibroids with the use of ultrasound without knowing if it would be reimbursed by insurers. It is not. In the past three months they have done one procedure. It is considered experimental even though it was approved by the FDA eight years ago.
Hospitals have not cut their ICU infection rates despite prodding in the form of money from the feds. The feds only reply is we like to give money.
The hospitals in the People's Republic of Massachusetts are so afraid of criticism that they are putting people at risk. Their amount of angioplasties has fallen since they began reporting to a public data base. They are afraid of complications so they just don't do the procedure. This is especially true in patients who are having a heart attack. Top
HealthLeaders has an article regarding physicians stating "they are sick of it and will not take it anymore". It is talking about the article that stated 60% of physicians would quit if they were financially able. This includes almost half of the physicians under 40 years old. The survey found the two biggest concerns were malpractice reform and lack of cohesion among medical groups to fight for the physician. Other problems include reimbursement issues and dealing with federal regulations. The group stated that 70% of physicians believed the largest driver of healthcare costs is defensive medicine to help prevent med mal suits. This goes against the ivory tower physicians who believe the biggest driver is fee for service.
The AMA wants to know if the silent exodus of physicians from medicine will make the shortage worse. They are talking about physicians that go into the drug companies or other non patient activities. Many of those that are staying in medicine are cutting back. From 2008 to 2012 the average number of hours worked dropped by 6% and there were 16% less patients seen. Hospital based physicians are rising and they see less patients than those in private practice. It looks like the wonks will get the two tier medicine they did not want with some people seeing physicians and some seeing extenders.
The Commonwealth Fund believe ACOs need to discuss the way physicians will be paid with physician. The choices are salary, equal share, productivity, incentive or capitation.
Health Affairs came out with a report that showed even though ACOs made a 10% improvement change in diabetics that saved only 1% of money. This means ACOs should not expect to get alot of money from the feddies. It may even cost more if the costs of the tests needed are added to the formula.
In yet another blow to the policy wonks, physicians believe that EMR is useless without interoperability. They believe in the concept of EHR but not the practicality. The group also condemned the need to do charts after hours. This they believe will lead to early burnout and cutbacks of practice.
The two OB groups affiliated with Barton Health in Lake Tahoe have not renewed their contracts with the hospital. The physicians said they were losing money and the hospital said they were paying standard rates. The physicians may still have practices in the area but will not staff the hospital's clinics. These are independent physicians and not employees of the hospital. The hospital is looking for new physicians to staff the clinic in the soon to be empty hospital owned building. Barton is attempting to cut back on financial outlay with decreasing population in the area and less reimbursement. They will need to pay high rates for OBs to come to the area. 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