August 15, 2012 Recent News



Electronic Medical Records


The Wall Street Journal in the front page of it's Marketplace section has an article entitled "Medical Care Time Warp".  The article details how medical care has gone back to the era of calling 1-800 Mother May I Please.  The insurers are putting more barriers to care by lengthening the time between when the physician states the patient needs the care and when the patient actually receives the care.  Pre authorization review did not work in the past and only served to antagonize both the physician and the patient.  This is happening not only to certain surgeries but also to high cost scans and chemotherapy.  Welcome to the brave new (old) world.

In the same issue of the Journal, there is an article about Obamacare and small business.  It details the curtailment of the small business and the movement of employees to less than 30 hours per week so as not to have to cover them under the law. It also details how many businesses that now cover part of the health premium will drop health insurance rather than pay the entire amount.  All agree the penalty is cheaper than the insurance.

Mercer conducted a poll and found that 20% of the businesses queried thought their health insurance would rise by more than 5%. The poll also revealed 25% would make changes to their plans and 6% anticipate dropping insurance. 

What is Obamacare going to do for our health?  It may improve it since the Papa John's Pizza and other fast food restaurants will be raising their prices to cover the necessary insurance or reducing employment.

Politico has an article about attempting to change the tax code in order to get rid of the mandated taxes that start in 2014.  The insurers will need to come up with $8 billion in 2014, $11.3 billion in 2015 and 2016 on to 2022 $14,3 billion.  This will add about 2.3% on to premiums in 2014 up to 4% by 2023.  All neutrals agree that the tax will hit individuals and small businesses the hardest.  This may not get voted on since there are others in the line ahead to this.

An article by Health Affairs shows that only 30% of New Jersey physicians accept new Medicaid patients and the high state is Wyoming with 99% of physicians accepting new Medicaid patients.  Country wide the average is 70% for Medicaid and 85% for Medicare or private insurance.  Many will not take them with the new jump in payments since it is only good for two years and the physician would get stuck treating them after that for the low fee.

Business expects the largest jump in premiums in the last three years.  They expect a bump of 7% next year as insurers are changing and getting ready for Obamacare in 2014.

It is a new week and a new announcement by Sebilius as to how wonderful Obamacare is.  This announcement is actually something new.  As of August 1, insurers must cover at no additional cost to the patient contraception for women.  This does not cover vasectomy for men.  They obviously have nothing to do with making babies.  To date, there have been over 50 law suits filed to stop the contraception law as many believe it is against the freedom of religion.  This was not litigated in the Supreme Court case decided last month.

The following Wednesday Sebilius was in the key state of Ohio again pandering Obamacare preventative services.  She was asked by a reporter why she was in Ohio and did not answer the question for some strange reason.

In Oregon, Obamacare will increase health premiums 38% in the individual market and about 7% in the small employer market.  For the lower earning people they get to spend less for more benefits.

The California Nurses Association is again going into politics.  It gave $1 million to the Governor Brown ballot measure to raise income taxes.  The union believes that the politicians will use the money for healthcare instead of just tossing into the common pot for the usual squandering.  

Kaiser Permanente second quarter numbers showed an increase in membership and revenue but a decrease in income according to the San Francisco Business Times.  In the past six months the HMO's membership has grown by 94,000 in the first quarter but lost 7000 in the second quarter.  They have over 9 million members.  Revenue was up to 12.6 billion in the quarter from $11.9 billion one year prior.  The income is lower due to building new facilities and a huge amount on EHR.

Gee, I wonder how this could happen.  In the People's Republic of Massachusetts more money is paid to providers by the state Medicaid HMO program than by Medicaid itself.  The large hospital and physician groups of the Boston area have powerful friends and they get more money that the other hospitals and physicians by a large margin.        Top


It is rumored that the Omidi brothers, the physicians behind the ill fated 1-800-GET Thin billboard fiasco are attempting to buy Anaheim General Hospital.  The hospital denies it is for sale.  The potential sale happened in 2011 and the lawsuits regarding the sale continue. 

According to a poll by Cejka Search approximately 75% of new physicians want signing bonuses.  Group practice is preferred over hospital employment by almost 2:1.  Almost all new graduates want urban suburban settings.  Almost no one wants rural.        Top

Electronic Medical Records

Did anyone know that the servers at Cerner Corp., a major repository of EHR went down for five hours one day after having a 14 hour outage in December.  Hospitals and physician offices lost access to past data and patient information during this time but could still use a pen and paper to make notes and write orders.  This is a serious breach of protocol that greatly increases medical errors.  Many hospitals keep backup records because of this type of error.  Others, for financial reasons, outsource the information to the Cerners of the world.

A competetor of Cerner, EPIC, is also having a bad week.  These are the people that Kaiser is currently using after going through other vendors and spending billions of dollars that could have gone to patient care. EPIC is being used at the Contra Costa Hospital and the nurses are writing about three incident reports a day on the poor job it does.  They have gone to the Board of Supervisors of the county about the problem.  It is giving erroneous information to the nurses with potential patient harm.  The nurses want the system to go away until it is fixed.  Many of the problems are county induced since they did not give much training in the sophisticated system.

If all that were not enough a new scam has appeared.  Bloomberg writes that hackers get into either encrypted on non encrypted EHR and the re-encrypt so the information can not be used by the hospitals.  They then want money to allow the hospitals to use their own material.  This is probably illegal and extortion but there is a lot of controversy whether or not it is a HIPAA violation and needs to be reported.

Columbus Hospital in Columbus, Indiana, is blaming EHR for rising ED waits.  The waiting times doubled after the hospital started it's EHR.  As the staff has become more used to the program the waits have gone down but are still 50% higher than before the program was introduced.        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.