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The Kaiser Family Foundation ran a poll and found that 40% of Americans were unaware Obamacare is the law of the land. Twelve percent believe that Congress repealed the law. Remember, these people are our voters. Of those who realized there was a law 35% did not view it favorably and 40% viewed it unfavorably. The new simpler Obamacare forms are akin to IRS forms asking about employment history, income and SSNs. They also ask race and ethnicity. The form will ask nothing about medical history. The short five page form is for single people but families will need to fill out the 12 page form. After that ordeal then one will need to pick out a health plan that is offered in their state and depending on the cost may get financial assistance.
Cigna has decided that they will not join the exchanges in DC, Maryland or Virginia. The reason is that they do not insure small business or individuals in those states.
Reuters has an article that states the big insurers will not go into many markets leaving them with no competition. The four largest insurers will only be in about 1/3 of the exchanges. In heavily populated states there will be competition as the insurers are already there. Not so in the other states. There is no clarity as to the exchanges with only 17 being run by the states. Sebelius is still the shill for the program and continues to state erroneously that there will be major competition in all states. Top
Hospitals
The Denver Post has a story about the potentially illegal and definitely immoral hospital facility fees. These are the fees that hospitals add when they buy physician practices and are now paying for the office help and rent. The problem is that the physicians should receive less since their costs decrease and they don't. The only way to get around the higher charges and co-pays is to switch to non-employed physicians. I recommend this action. Medicare has attempted to get rid of the fees but intense lobbying (paying major money to legislators) by the AHA has kept the status quo.
St. Vincent Healthcare in Billings, Montana, is not doing well. They have agreed this week to pay money damages to the feds for paying physicians to refer to the hospital. Now they have an imposter nurse. She has posed as an intensive care neonatal nurse, the director of nursing, nurse practitioner and student nurse practitioner. She has a medical background and has rounded with physicians. This is similar to the nurse in Seattle who stole narcotics from patient's IVs in mid April.
Hoag Hospital in San Diego has decided to give up doing elective abortions. They were doing very few a year as most are done in outpatient facilities. They acknowledge that there is a direct correlation between the numbers of procedures done and the quality of care. As an aside they just partnered with St. Joseph Health, a Catholic institution. They deny that St. Joseph had anything to do with their decision as they still do tubal ligations.
Hospitals are not holding up their end of the hiring. The employment statistics show that for the past few months hospital hiring has been significantly less than the hiring by physician offices. The AHA is blaming the sequestration of a whole 2% budget cut to a possible loss of 766,000 fewer healthcare jobs by 2021. Maybe it is just that hospitals are becoming less relevant.
Merritt Hawkins released its latest poll showing how much each specialist provides to the bottom line of a hospital per year. Number one was Ortho at $2.68 million followed by invasive Cardiology at $2.17 million. The lowest were Neurology at $691,000 and Ophthalmology at $725,000.
CMS is cracking down on EHR users that cut and paste without giving attribution and bringing the h&P up to date. This may lead to denial of payments. The same with macros and templates even though more physicians are going to them for physicals. The standard EHR is unusable as is and more physicians are railing against it due to it's time consuming tasks without adding any value.
Imprivata did a study on hospitals and the money they are losing due to HIPAA and outmoded technology. The figure was $8.3 Billion per year. HIPAA, according to the respondents, was a barrier to providing effective patient care by reducing time available for patient care, making access to electronic medical records harder and restricts the use of electronic communication. Clinicians are only spending 45% of each day with patients and the rest looking at screens or collaborating with other physicians. The lack of ability to use modern communication has lengthened the discharge process to 102 minutes. This could be cut in half with modern communications.
The San Francisco business Times reports Sutter Hospital in California will pay Alameda County $22 million to take the ailing San Leandro Hospital off its hands. Last year alone Sutter lost $24 million on the one hospital. An attempt to give the hospital to the county was nixed so the money was added. Top
Merritt, Hawkins reports that over the next three years more than half of the physicians will cut back seeing patients either by cutting hours or other means to reduce the amount of patients. This will translate to a shortage of about 135,000 physicians in the next ten years. The report states that morale is at a decline mainly due to the change from medicine as an art to one of a trade. To go along with this is an anticipated shortage of nurse practitioners by 2005.
It is hard to believe but McClatchy actually had an article that said physicians are not taking Medicaid patients. Duh! Why would they? The paperwork is terrible and the pay is worse. The feds think docs will take Medicaid under Obamacare since it will raise primary (not specialty) care up to Medicare rates for two years. Docs hopefully can see through this and reject the offer since then they may get stuck with the lower fees again in two years and they still will have no one to refer patients to. To date the promised money from the government has not appeared, as one would expect from this government. Also if physicians take too many Medicaid patients they lose the ability (time) to care for the higher paying patients. 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.