June 1, 2015 Recent News





Things are just getting worse for the California chain Daughters of Charity.  First their deal with Prime got blown up by the political Kamela Harris.  Then they had to lay off employees and curtail services due to financial constraints.  Now, the state had not allowed new patients to come to their medical group and the physicians are departing to greener pastures.  Competitors Kaiser, Stanford and Palo Alto Medical Foundation are looking to pick some some of the best physicians.  They also lost a CEO from two of their hospitals who took another position in Illinois.

Three major health systems are banning low volume surgeries at their institutions.  Johns Hopkins, Dartmouth Hitchcock and the University of Michigan   The low volume procedures include bariatric surgery, esophagus surgery, lung cancer surgery and joint replacement.  

Many upstate New York hospitals are utilizing ED transfers to other hospitals due to a shortage of physicians.  Physicians do not want to practice in the area.

Lahey Health is laying off 130 workers and cutting the pay of top executives to close a budget gap.  This is due to a roll out of  their EHR and lost business due to patient cancellations.  It also blamed the usual low reimbursements from the feds.  They now expect to reach a break even point at the close of the fiscal year.        Top


Obamacare will cost $274 Billion in new administrative fees over the first 10 years.  This represents about 22% of the total costs of Obamacare in the same period.  Just over half of the administrative costs will be for private insurers and the rest for the expanded Medicaid programs.

The WSJ has an important story regarding cardiac screening for our youth.  As a caveat, I have been involved with this for many years by teaching CPR to teens and screening high schoolers for cardiac abnormalities that may lead to cardiac arrest.  The article states that one in 5200 college basketball players will have sudden cardiac death.  This is a real political football with many stating screening should be done and others say it is not necessary.  The NCAA is considering making it mandatory and about 65 of the power schools now require either an EKG or an echocardiogram.

Midsize firms are looking to get out from under the Obamacare costs.  Currently the 51-100 employee group is not required to purchase insurance under the law.  That will change starting the beginning of the year.  Some are looking at increasing their costs to purchase insurance by 18-20%.  

Blue Cross BlueShield of Tennessee is joining many other state Obamacare providers in looking for major rate increases next year.  They want an additional 36% in its premiums.  Humana is asking for a 16% increase and Cigna is flat.  This is not as bad as New Mexico's largest insurer wanted a 51% increase.  In Maryland insurers want a 30% increase across the products.  Even Oregon has an insurer requesting a 25% increase.  

Georgia's Humana Obamacare insurance is not doing well.  They erred in their planning and were overwhelmed with patients.  Because of the number thy allowed patients to see out of network physicians and they lost a ton of money.  They plan on significantly raising prices next year and go to an in network system.  I feel sorry for the patients.

California's Western Dental has stopped taking new Medicaid patients under the state Denti-Cal program.  The reason is simple, money.  The dumb state has reduced the money they pay to providers so low that the providers are saying enough.  The California officials re "very concerned".  

The New York mental health provider Promoting Specialized Care and Health wanted to reimbursed by the state for parties and other inappropriate expenses to the tune of $158,000.  Looks like they will eat their expenses.        Top


The Ponemon Institute has reported that healthcare breaches are the most expensive in the industry.  It costs approximately $398 per breach versus $154.  The lowest is public sector data breaches at $68.  Retail is at $165.  The study went across country lines and included not only America but also England, Germany Japan, Saudi and Australia.      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.