January 13, 2011 Recent News
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The AMA has an article about a survey that shows EMR may increase liability claims. The med mal insurers originally thought that those with EMR should get a reduction in their premiums. They soon changed their minds. They now believe that claims will rise during the time that providers are working out system problems. In the long term there may be some reduction in claims to those who utile the EMR system. However, until the coding errors and other malfunctions are worked out there may be an increase in claims.
Hospitals are becoming more wary of meaningful use of EMR as required by the feds. They fear the CPOE component the most. In a survey only 11% of hospitals surveyed thought they would be ready for the meaningful use requirements needed for extra payments. Hospitals need to have physicians use CPOE in the hospitals for their blood money. The physicians don't need to use hospital CPOE for theirs. The hospitals can force their employed physicians to use the system but will have a harder time with the independent practitioners.
About half of all physicians now have EMRs. The problem is that the vast majority are hospital based. Only 25% of office based physicians have systems and only 10% of those are fully functional. There are problems when hospital systems can not be manipulated to be physician friendly and therefore office based physicians use different systems that are user friendly for them but do not speak to hospital systems. Top
A recent analysis showed that the money paid into Medicare does not come close to how much is paid out for the person's benefit. A two income family making $89,000 a year will have paid into the system a total of $114,000 over their working life. They should expect to get $355,000 worth of benefits including prescriptions over their retired life. The means that we need three workers for each beneficiary and that just will not occur. In Social Security it is different. The average couple will have paid into the system $614,000 and receive only $555,000 in benefits, a more sustainable system. The reasons given for the Medicare discrepancy are the rapid rise in health care costs, payroll taxes do not cover the costs (only 1/4 of the costs) of Part A. Part B payments also cover only about 1/4 of the costs. There is trouble brewing in the future.
California Blue Shield must have a death wish. They are attempting to raise individual policy holders premiums up to 59%. The state will look at the requested raises and make sure that Blue Shield is doing at least 70% medical payouts. They have no power to make them decrease the premiums.
Lancet, the British Medical Journal, has called the research done by Andrew Wakefield in 1998 a fraud. In that infamous paper he linked autism to vaccines. The new researchers have found looking at the same information he had that he fudged the results. It is thought that he was paid $750,000 by the trial attorneys who wanted to sue the pharmaceutical companies. Mr. Wakefield had his medical license revoked, a very rare thing in Britain.
The hospitals in the Bay area of the People's Republic of Massachusetts have not contributed a single sou to the voluntary amount pledged to help the small employers. Partners Health alone pledged $40 million and made a profit of $196 million in annual profits. They pushed their help back a full year.
Boston's mayor wants the unions of the city to help form a group insurance plan for all city workers. This would save the city $12 million. It should be interesting to see the union response. Top
Obama administrators agree they are powerless to stop any insurance increases but they want a regulation to shine a light on insurers who raise rates over the mystical 10%. The HHS also will "work with" state authorities to review insurance increases if it is allowed under state law. If the states can not review the rate increases then the feds will. Of course, the feds have no expertise in this but that has never stopped them before.
Time reports on the increase of money the government is spending to decrease fraud in the Medicare and Medicaid arenas. They are trying to enlist the help of seniors and others in their cause. It would be nice if they could check the claims prior to paying.
Wisconsin is considering copying Oregon in rationing Medicaid care. This would mean ranking all diseases and treatments and draw a line where the state would run out of money. Anything above the line would be paid and those below would not. An interesting side note to this is that New York is considering copying its Medicaid after the present Wisconsin law.
Modern Healthcare states that the amount of HDAs have risen from 1.2 million to 5.7million in the past four years. More people are learning how to control their costs. Top
HealthLeaders has put out its top five physician challenges for 2011. They are (1) Permanently take care of the "doc fix", (2) Get on board with EHR and register for the incentive program, (3) the primary care shortage and its effect on healthcare reform, (4) ACOs- the physicians need to be the leaders here, not the hospitals and (5) The American Board of Internal Medicine and how they take care of the 139 physicians who passed along or received test questions.
The People's Republic of Massachusetts can not keep their physicians in the area. The owner of the New England Patriots has given a $20 million gift to Partners Healthcare to pay for physician's loans and other incentives to keep primary care physicians and nurses in the community care area.
A very biased and therefore useless article put out by employees of the American College of Radiologists showed that non radiologists with imaging capability have cost the healthcare system more and does not decrease episodes of care. This goes against other studies that show self referral gets patients seen faster and started on treatment sooner with shorter episodes of care. The radiology researchers used the EM codes as their source, a notorious unreliable method.
Medscape reports in the above article that more Medicare money is going to non radiologists than radiologists. That is not surprising when one considers the increase in in house imaging because of the lack of helpfulness of the radiologists. It is bad when there is monopoly and one sees it crumbling. This article states about total money and not money per study. Top
The feds are re-looking at the EMTALA law to determine whether or not inpatients should be included in the transfer policies. The federal law now states that they should but CMS says no, only those in ERs are covered. Comments are now being taken. 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.