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Partners Healthcare and it's rival Steward Healthcare have agreed that Steward would continue to have low level trauma centers but all severe cases would be sent to Partners for treatment. This is a win win for both organizations and a loss for the other major Boston hospitals and the community hospitals competing with Steward. Partners will help Steward get Level 3 trauma centers.
It appears that Obamacare has already started. Many hospitals throughout the country are already beginning to lay off workers due to reduced reimbursements and rising costs. This should fuel the unemployment numbers in the near future.
Hurricane Sandy has not only brought tragedy to the eastern states but also has shown that the NY hospitals were unprepared due to faulty backup generators. Two hospitals had to transfer all their patients due to loss of electricity. These hospitals, Bellevue and New York University had outdated backup generators that caused the failures. Top
Stanford University has done a study and shown that colonoscopy under the old criteria has significantly decreased colorectal cancer rates in the United States. This is yet another study that puts down the US Preventative Health studies that want less screening for cervical, prostate, breast and colorectal cancers.
A former CBO director who is a Republican states that Obamacare's IPAB is the way Obamacare will ration care. This includes less physicians to see patients which by itself will ration care.
California Blue Shield has made a promise to make only a 2% profit and return the rest of the money to the insureds. It is now keeping that promise and repaying almost $50 million to its customers. Top
There is the standard delay by the Administration as well as significant confusion as to which physicians will be paid Medicare rates for seeing Medicaid patients. It is assumed that the higher pay will cover primary care but the specialists may or may not be covered. As of now the Administration has not filed any final rules for the program so the answer is in flux. It is not known whether the increased pay will be for office visits or will include procedures as well. There is also no start date for the two year program and nothing to tell the physicians what will happen after the two years. Another interesting twist is that this is being done to have the patient stay out of the ED but the ED physicians also want the increase in pay to see the Medicaid patient.
Modern Healthcare reports that many physicians are ready to curtail services if the Medicare pay cuts as outlined by the SGR go into effect. They have already cut staff and not purchased needed items due to the projected cut and the kicking the can down the road mentality of Congress.
The MGMA reports that physicians are not spending on technology or anything else until the problem with their pay is resolved. Only 18% are participating in any government payment model.
For those physicians who want to hired by hospitals, be warned. Hospitals only want you if you are docile and do what you are told. They do not want independent thinking physicians. They want those who play well with others.
Bloomberg reports that Las Vegas is now the forerunner for American medicine. The waits for a patient to see a primary care physician for a physical is now six months. For serious matters the wait is even longer. It takes over one year to get an appointment with a neurologist that specializes in autism. This is not limited to the rural areas but is urban as well. The projected increase in NPs and PAs will not help with specialist care but may give some relief but less quality to people who want to see primary care physicians. The problem is baby boomers are aging and getting serious illnesses at the same time the baby boomer physicians are retiring or cutting back. One third of physicians now are over 55years of age. The waits are worse in areas that do not have major medical schools since physicians like to practice where they train. Uwe Reinhart, a professor of economics at Princeton states that physicians could see more patients if they had less paperwork but instead the government is pushing more red tape on physicians causing fewer patients to be seen. Nevada currently has no surgeons that do transplants other than kidney. I know first hand since today I called my physician for my physical and have an appointment for next July. This is in Walnut Creek, California, an affluent Bay Area suburb.
There's trouble a brewin in Pennsylvania. Seventy-eight physicians who belong to the West Penn Allegany Health System are not happy with the System. They have given them a vote of "no confidence" with the hired consultant and want permanent executives. They also want the System to merge with Highmark as soon as possible. The System board is largely ignoring the physicians. 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.