March 1, 2011 Recent News

Medical Staff

Medical Devices

Insurance

Medical Staff

In a very unusual situation the medical staff of Ellensville regional Hospitals in New York has elected a nurse practitioner as the president of the medical staff.  Bob Donaldson was originally hired to be the first NP to work with an all physician ED group.  It was so successful for the hospital that all the physicians were replaced with NPs and PAs.  The medical staff voted to give equal rights to all admitting personnel.  No physician wanted the job of medical staff president so Mr. Donaldson put up his name and won against three other physicians who added their names after it was found out that a NP was the only candidate. 

HealthLeaders has reported that California hospitals due to the state's posture of not having physicians work for hospitals are having to pay physicians to take call.  This is true in both trauma and non-trauma hospitals.  It has become a line item on most hospital's budget.  It will also become more prevalent as only 88% of the non government hospitals pay for ED coverage at present.  Soon, all will as more patients will be covered by low paying insurance under Obamacare.  

Nurses working in hospitals with direct patient care are dissatisfied with their positions.  They do not believe that the care is of high quality and is safe.  This leads to early burn out.  The nurses were also not happy with their salaries or retirement benefits.  This article was in Health Affairs. 

Cleveland University Hospitals are in negotiations with 13 medical groups to buy their practices.  They believe that this can increase the hospital revenue by about $55 million.  This is money that the physicians should be getting.

In a smart move USC University Hospital has shut down it's renal transplant program after finding it transplanted a wrong kidney into a patient.  After going through everything it is set to reopen the program.  This is what Kaiser should have done several years ago instead of stonewalling and looking like idiots just out for money. 

The physicians who support the unions in Wisconsin are handing out sick notes to all who request them so they can protest.  They do not believe what they are doing is fraud but it is.  The physicians state the protesters are suffering from stress.  Many of the prescription writing doctors are from the University of Wisconsin Medical School which is a state run program and affected by the Governor's and Legislature's stance.   

The doctors of Czech have dropped their threat to resign en masse when the government agreed to their demands to pay them more money.  The money will come from the health insurance funds and not the country's budget.         Top

Medical Devices

In spite of a recent death following lap band surgery in LA, the FDA lowered the weight that lap band could be used.  It is now down to a body mass index of between 30 and 40 with one medical condition such as diabetes.  This will increase the potential population eligible by 37 million.        Top

Insurance

Insurance companies have learned how to make more money.  They have reduced the amount they pay out of network visits from UCR to Medicare rates.  This means they pay less and patients will pay more out of pocket.  The companies say that this is transparent after they got caught with their hand in the cookie jar with United Health's Ingenix and this is what is wanted.  The physicians are not happy with this as they now have to go after patients for the regular rate.

Did you know that California has a high incidence of Kwashiorkor, a disease of malnutrition?  This was true even in Huntington Beach where the average income is in the six figures.  It seems that Prime Healthcare had found how to bill for this disease in a great many patients allowing them more money for the care of the patients.  When questioned about their billing practices they state that other hospitals are not as good as they should be on diagnosing this entity.  Prime has a history of creative billing and usually pay penalties along the line.  Prime is blaming the unions for attacks on them. This may be true but overbilling is still overbilling.         

The Milwaukee Journal has a story that employers are willing to pay the $3000 fine per employee rather than the $10,000 insurance bill for the same employee.  The problem with that is the retaining and recruiting of new employees.  However, with the new law, if legal, allowing individuals to purchase insurance at low prices it may become a winning proposition. 

Obama is between a rock and a hard place with Medicaid.  He wants to add to the rolls but the states can not afford to do it.  The administration is now sending people to the states to see if they can help them spend less so that more can be covered.        Top

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  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.