September 15, 2015 Recent News
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The GAO has released a report that the VA is up to its old tricks. They are skirting the law of ethics again. The number of reported adverse actions between 2010 and 2014 has increased by 7%. At the same time the number of root cause investigations into these problems has decreased by 18%. This is a mark of an organization that does not care about quality or its consumers.
In another story about the VA, the Washington Times states that about 300,000 dead vets are attempting to register for care. These dead vets are taking the time of investigators to see if they are eligible or not instead of focusing on the real vets who need care. The VA continues to stonewall issues.
A study by Stanford University showed that consumers (used to be patients) will go to the hospital that controls their physician. This was a study of hospital-employed physicians. Patients of independent physicians would go to hospitals that are low cost high quality instead of the high cost low quality hospitals that employed physicians. Another ancillary study showed physician prices increased 14% when acquired by the high cost spread.
Remember all the way back to 2011 when the Medicare "Wellness Visit" came in. Physicians were finally to be paid for looking at people and attempting to do preventative care. Well, it has not worked. The visit must be separate not not include looking at symptoms but be devoted to reviewing immunizations, end of life planning , fall risk and other items in this vein. Patients are not allowed to talk about their ills as that ruins the visit and it them will not be paid for (with no co pay). How difficult is it to tell a person sorry we can not talk about that at this time but if you will make another appointment we can discuss your sore arm. Also, annual physical exams are considered preventative and as such are not paid for. Medicare does not explain well to the patient the difference between the "Wellness Visit" and an annual physical that the patient expects.
Obamacare has lost about 25% of its enrollees this year due to non payment of premiums or getting other coverage.
The ACO model has saved money for Medicare but not the organizations that actually do it. Only about 25% have seen any money do to the cost savings. Many lost money. Seems like a bad deal for the hospitals and physicians. Top
The San Francisco Business Times reports that there is a fight in the Chinese San Francisco community between the Chinese Hospital and the physicians who have been serving the local clientele for decades. The hospital has decided to not contract through the physician IPA group, Chinese Community Health Care Association, but to offer individual physician contracts. This threatens the alliance. The fight has now entered the courts as the physicians have filed suit against the health plan. The California Medical Association and the San Francisco Medical Society have both sided with the physicians against the hospital an plan. It should be noted that the plan has lost its accreditation from NCQA. It then got conditional accreditation so they could get Obamacare HMO patients. They are also under sanction for failing to provide required services under Medicare and Medicaid. They were also given limited marketing and enrollment period. The plan has kicked two members off their board for being part of the physicians who are suing the plan.
The AHA fought like crazy and won in Congress to prevent the spread of physician owned hospitals. One of the main talking points was that these physician entities would only take the good insured patients and leave the government poorly funded patients to the poor non profit hospitals. Well that load of crap is just that. An independent study has shown that these general hospitals have identical proportions of government funded patients as do the "real' hospitals. They also perform the same as to quality of care. The AHA called the study flawed and incomplete. They then went on to obscure the findings by asking a question which was not part of the study, Do physician self refer to these hospitals? I certainly hope that they do. Maybe it is time for Congress to re-look at the issue and let the AHA spend their millions of dollars to pay off the legislators again.
The Cleveland Clinic has put in cost containment and part is only having one or two orthopedic products. The one that got left out was DePuy and one of the busy orthopods uses that make. He has chosen to leave the Clinic and go to a nearby competitor instead of subjecting his patients to what he considers a lower service. Top
Blue Shield of California increased its pay to executives by 64% in 2012. They did this as they are appealing their removal of its non profit status. The scum at Blue Shield omitted their payments to execs who left the company in 2012. This is an error of omission. They skirted state law with this.
CalPERS has saved its insurers $7 million by mandating colonoscopies be done in low cost facilities not hospitals. They would cover the full cost if done there but only $1500 if done at a hospital. There was an exemption if the patient needed the procedure at the hospital or lived more than 30 miles from an ASC. Top
Over half of all the clinicians in the country would not recommend their own EMR to others. This is double from five years ago. However, the longer one uses an EMR the less unsatisfied they are. It is much worse if one is doing meaningful use as one continuously need to upgrade knowledge and systems. 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.