May 1, 2015 Recent News





Confucius said the truth, "May you live in interesting times."   Physicians are rejoicing that the terrible and stupid SGR is now gone.  They are relieved that their fed monies will not be reduced by 20-24%.  They are elated to be given a 0.5% increase in their stipend.  How did Congress do it?  They balanced the monies lost by reducing the monies paid to hospitals and nursing homes.  The wealthy Medicare folk, those single with incomes over $133,000 or couples with with incomes over $262,000, will pay more for their coverage.  Also, the bill gets rid of the fee for service payments and focuses on performance pay.  The law also changes Medigap for new enrollees.  The bill also extended funding for the CHIP that was set to expire for two years.  Community health centers will also get two more years of funding.  

Dr. Oz is under fire again.  This time by is own colleagues who state that he is giving bad advice.  They want him out at Columbia.  He is fighting back by releasing information on those physicians who have skeletons in the closet.  In the past he had to testify due his praising of supplements as weight loss manna from heaven.  

Only half of the nation's physicians have participated in the e-prescribing quality reporting system.  Only half reported on "quality measures"  Them that did not report gets no bonus.  Most that did not report see very few Medicare patients.  Them that participated in 2013 will get a huge 0.5% increase in Medicare payments this year.  They spend much more than that doing the reporting.

Physicians are not rushing into ACOs   To date, less than 1/4 of the nation's physicians are members of an ACO.  In the same idea 93% of physician are using fee for service as a basis for payment.  

The Washington Post reports the doctor patient relationship is going electric.  The electronic age is allowing patients to type a medical question to his physician or provider and get an answer later the same day.  It allows the use of a computer of smartphone to get medical information.  Patients may now learn of new medical advances prior to the physician but how do they know if they are a candidate for it?  This electronics does interfere with the office interaction as well.  Physicians including mine spend more time looking at the screen and almost none looking at me, the patient.       Top


How have the population fared with Obamacare?  Out of pocket expenses rose in 2014, the first Obamacare year, by 11%.  One said that healthcare insurance is expensive because healthcare is expensive.  He said that employers are cost shifting to higher deductible plans or just higher deductibles.  Patient deductibles rose 7% and is expected to go higher in the coming years.  

On the other hand, Obamacare has been a boon for the food stamp business.  The streamlined application process has allowed more to get more handouts with less work.  They can sign up for both at the same time.  There has been no change in the eligibility rules and the economy has been improving.  this means there should be less of the program, not more.  The average food stamp recipient was paid $125.35 per month per the US Department of Agriculture.  This is a total of $79 million more per month in the eleven states who made it easier.  In those states where Medicaid expansion was rejected, food stamp recipients have decreased along with the betterment of the economy.  Remember, those people vote and will not vote to get rid of an entitlement.

The NEJM has reported that the Pioneer ACO program has decreased costs minimally and not improved the perceived quality of care.  Of the original 32 programs participating 13 quit and 8 received either no payments or actually had to pay money to the feds.  That leaves 11 of the original 32 that made some money on the program.  There should be come some efficiencies as programs become better had withholding care but that will plateau in the future.

Gee, JAMA has released a surprising report.  Who would have thought that EHRs are not safe?  There have been about 1000 large data breaches affecting about 29 million individuals between 2010 and 2013.  Most were secondary to theft.  About 2/3 were electronic and 1/3 were secondary to health insurance companies contracting out their data management.  This could and should make patients resistant to future data sharing.

After coming under intense pressure EPIC will finally stop the record sharing fee until 2020 when the issue will be re-evaluated.  

Two thirds of Obamacare subsidy recipients had to return money to the feds.  I bet they were really happy. The average repaid was $729.  Those that did not do Obamacare got an average penalty of $178 or nearly double the baseline amount.  

Cassandra C, the teen from Connecticut, who was confined to the hospital under state law was finally allowed to go home.  She had been confined for 5 months.  She is in remission from her Hodgkin's Lymphoma.  I wonder who paid that bill.

The California Senate Committee finally did something good.  They did not listen to the idiots parents who are anti vaccine and passed out of committee a bill requiring all children to be vaccinated unless health reasons.  This removes the personal exemptions.  At the same time JAMA has released a large study again showing here is not any connection between autism and vaccination.        Top  


The California Attorney General must be real proud for her actions.  If one remembers she, just prior to announcing her candidacy for the US Senate, screwed the workers at the Daughters of Charity hospitals by putting onerous conditions on the sale of six hospitals to Prime.  Prime responded by reneging on the sale.  First Daughters cut services at two hospitals including Labor and Delivery at one and Peds at both.Now the Daughters are laying off 4% of its employees due to cost concerns with more on the way.  Now the state has also stepped in and told insurance companies not to send patients to the system's medical foundation, an affiliated medical group, due to solvency concerns according to the San Francisco Business Times.  California's Department of Managed Health Care issued a cease and desist order to the insurers to stop adding any new enrollees to the risk sharing foundation.

Doctor's Hospital in San Pablo, California, has closed after many years of fiscal disaster.  The hospital was a good one but its patient population was all Medicaid and Medicare.  They were losing $18 million per year.  This leave no emergency room in the area.  A new Urgent care center will take its place and be open until 8 pm.        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.