January 1, 2017 Recent News





The new premium hikes by the insurers will add about $10 Billion next year to the subsidies for Ocare.  This will go to $48.6 Billion next year for the subsidies.  About 80% of those on healthcare.gov and the states are on the subsidies.  This money is paid by the taxpayers.  This fuels more increases and more taxpayer money.

Per usual the administration and the Democratic states like California have found the enrollments in Ocare are not as high as they wanted so they extended the December 15 deadline by two days for California and four days for the healthcare.gov people.

The following week healthcare.gov reported that 400,000 more than last year had signed up for Ocare.  

The administration is paying the insurers only about 1.6% of what is owed under the risk corridor rule to reimburse insurers for caring for the very sick.  This is a shortfall of about $3 Billion.  

Some things boggle the mind.  The People's Republic of Massachusetts is looking to Minnesota for guidance in how to cut back Ocare spending.  Minnesota is in the throes of a huge insurance premium uptick and is calling a special session of the legislature to deal with it.  Minnesota is a leader in decreasing physician and hospital payments by "quality" over quantity.  Still, nobody can define "quality" but they know it when they see it, to paraphrase a Supreme Court justice.

California has obtained money from the feds to fund half of a $3 billion project to attempt to keep Medicaid patients out of the Eds.  The project will be different in different counties with different needs.  In one county money will be used to get homeless into housing and help keep them there.  In another county a respite center will open for homeless to go post hospitalization.  Prisoners will receive 30 days of meds when they are released or hooked up with a primary care person.        Top  


How to win friends and influence people.  Dale Carnegie's protégée Dr. Jack Sobel of Wayne State University Medical school blasted the partner Detroit Medical Center.  He says they have added nothing to the education or research of the university.  This is two months after the Wayne State physicians agreed to teach at Detroit Medical.  Sobel wants the University to find more partners. 

Several days later Detroit Medical Center stated that in spite of the Wayne State Dean they want a long term partnership.  This is a great example of turning the other cheek to get what you want.

Finally the University of Louisville hospital will be free of KentuckyOne as the managing partner.  Now if they fail it will be on their own with no one else to blame.

Florida's Broward County is not the only system in a mess.  Colorado's Park Hospital also has problems as a group of citizens have petitioned to recall the CEO and the head of the district board.  

Broward continues to be in the news.  The county commissioners have lifted the grant of $8.5 million for the beleaguered hospital to treat patients with uncompensated care.  They had withheld it due to the hospital board firing the CEO just for violating the anti-kickback laws.  They didn't like the way the hospital board fired her without notification on the agenda.  

Soon after the above the CEO filed suit against the Board and the Broward Counsel of failing the open meeting laws of the state.  The suit says that the Board had illegal pre meeting discussions regarding her tenure as CEO.  The worst system in the country.  

At the next board meeting of Broward Health, the community activists came out in support for the CEO as did many physicians.  Nothing happened except the vent.

Tri-City Hospital in San Diego has been trying to get a medical office building by eminent domain.  they have spent millions of dollars in legal fees but are now ready to give up the fight.  The building is been appraised at twice what the hospital was willing to pay.  They will attempt to get their $4.7 million deposit back and give the building back to the rightful owners.  The court has ordered Tri-City to immediately put up another $12 million into an account would be the full value of the building while the jury evaluation is under appeal.  The jury also ordered Tri-City to pay the attorney fees of the building ownership and also an additional $2.9 million in damages.  Anyone else want to try to strong arm an eminent domain?

UMass Memorial Health is planning to go live with Epic next October.  They expect this to cost about $50 million in training above the cost of the system.  The total cost will reach about $700 million over 10 years and has contributed to a $31 million loss this year.

Modern Healthcare reports that my old hospital Stroger in Chicago has settled 41 law suits with patients in the past 4 years.  That is a huge amount.  They are represented by the county state attorney offices and this may be the reason for the settlements.  The issue was investigated by the Better Government Association in Illinois.  They found that throughout the state a total of $180 million were spent on settlements by public hospitals over ten years and the U of Illinois and Stroger accounted for most of the losses.          Top


In 2017 about 170,000 physicians will get a nice 3% pay cut from Medicare for not doing meaningful use.  Part of the problem is CMS itself who did a 90 day only stretch in 2015 to meet requirements or be penalized in 2017.  Congress allowed all physicians to get out from the penalty but many did not get the memo.  Hopefully, Trump will reverse the whole thing and take away the penalty.

Congratulations to Dr. Tamika Cross, a resident at the University of Texas.  She was a passenger on a Delta plane when a medical emergency happened.  She attempted to help but was asked for her credentials by the flight attendants before she could help.  Dr. Cross is black.  She went on Facebook about the incident and Delta has changed its policies because of this.  No credentials required to help in an emergency.        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.