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Palliative Care Deserves Physicians’ Attention – HealthLeaders Media
Palliative care is the comprehensive treatment for the very sick, but not for those who are dying. Although not widely practiced, palliative care is becoming part of the discussion among healthcare leaders to improve care and trim costs.
Because the scope of care is evolving for the elderly populations, it’s important that physicians work closely with families to consider palliative or hospice care options. The Sutter Health system, a network of doctors and hospitals in northern California, has an advanced illness management program that partners with patients and families to better coordinate care for palliative patients and also consider end of life options, says Brad Stuart, MD, chief medical officer at the Sutter Care at Home in Fairfield, Calif.
Stuart says it’s important that both disciplines (palliative and hospice) “collaborate for the best outcomes we can have.” Much of the focus for improved patient care, especially those in palliative care, is moving toward ” focusing on goals of patients in their own lives.”
See on www.healthleadersmedia.com
For an aggregation of other articles on improving healthcare, go to my internet magazine Scoop.it! Changing Health for the Better.
To Cut Costs, Motivate Nurses, Take a Cue From Airlines – HealthLeaders Media
An online scheduling tool and a points-based rewards program helped St. Francis Hospital in Columbus, Georgia hospital resolve its ongoing staffing problems, cut nursing costs, and improve morale.
See on www.healthleadersmedia.com
For an aggregation of other articles on improving healthcare, go to my internet magazine Scoop.it! Changing Health for the Better.
Low HCAHPS Scores at Safety Net Hospitals Examined – HealthLeaders Media
On nearly every measure of the Hospital Consumer Assessment of Health Plans Survey patient experience questionnaire, 769 hospitals that treat the largest share of low-income patients scored 5.6 percentage points lower than their 2,327 non-safety net counterparts, according to a review of survey responses between 2007 and 2010.
See on www.healthleadersmedia.com
For an aggregation of other articles on improving healthcare, go to my internet magazine Scoop.it! Changing Health for the Better.
Physicians Weigh In on SGR Debate – HealthLeaders Media
Physicians added their voices on Wednesday to the intractable task of finding an informed solution to the sustainable growth rate. Sen. Max Baucus (D-MT), chair of the Senate Finance Committee, hosted five physician group representatives, part of a series of roundtables about Medicare payments. Previous roundtables featured former administrators of the Centers for Medicare & Medicaid Services and private payers.
“Every year, the flawed sustainable growth rate, or SGR, leads physicians to fear dramatic reductions in their Medicare payments,” Baucus stated in his opening remarks. “Next year physicians will face a 27% cut if we don’t act. While Congress has intervened to prevent these cuts each year, it is time we develop a permanent solution.
“We need to repeal SGR and end the annual ‘doc fix’ ritual. The year-in and year-out uncertainty is not fair to physicians or the Medicare beneficiaries who need access to their doctors.
“The discussion covered a wide range of topics, including models of care, specialty reimbursements, and quality and efficiency.
Sen. Baucus noted that physicians seem caught in what he described as “stove pipes of care. How do we get rid of some of these pipes?”
Speaking for the American Medical Association, Ardis D. Hoven, MD, said that a variety of new models of care coordination and payment such as medical homes and bundled payments hold promise of a more flexible system and will help. “We have to be accountable as physicians to make sure we are getting the job done and producing outcomes and quality in our work. These new models that are being tested now are going to give us that information, which we have never had before,” she said.
There was general acceptance among the five speakers that while the SGR should be repealed, no single payment replacement system would suffice. Glen Stream, MD, president of the American Academy of Family Physicians, described a blended payment system—common among patient-centered medical homes—that includes a combination of fee-for-service (FFS), care management fee, and quality improvement payments.
See on www.healthleadersmedia.com
For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.
For an aggregation of other articles on improving healthcare, go to my internet magazine Scoop.it! Changing Health for the Better.
PPACA Whips Up Uncertainty for Hospitals – HealthLeaders Media
Supporters of the PPACA cannot deny that implementation of the sweeping reforms will be a daunting task that may, ultimately, fail. Many critics of “Obamacare,” however, have provided no realistic alternatives to bending an unsustainable healthcare cost curve beyond vaguely worded demands for vouchers, block grants, and buying health insurance across state lines.
One reason why the American Hospital Association and other hospital groups supported the PPACA was because of its pledge to expand health insurance to tens of millions of people now uncovered, including dependent children age 26 or younger. But as Moody’s Healthcare Quarterly pointed out this month, that new revenue source for not-for-profit hospitals will be offset by Medicare reductions of $150 billion over the next 10 years, along with an additional $14 billion in Medicaid disproportionate share payments.
In addition, PPACA imposes new payment models that include lower reimbursements for hospitals with high readmissions and low patient satisfaction scores, and the effect of those is still unknown.
A study in the Archives of Internal Medicine estimates that safety net hospitals will take an additional hit on reimbursements because Medicaid patients tend to distrust the healthcare system and that distrust is reflected in their lower patient satisfaction scores.
Private payers will follow the government’s lead and suffer less tolerance for cost-shifting, preventable errors and other quality issues.
As a result, Moody’s deemed “credit neutral” the U.S. Supreme Court’s ruling in June that PPACA is constitutional. The rating agency said the high court’s decision would have no effect on a negative outlook for the not-for-profit hospital sector.
See on www.healthleadersmedia.com
For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.
Doctors booted from Medicaid for massive oxy doses in Florida
The state’s most prolific prescriber of Medicaid-financed oxycodone to the poor in 2010 and 2011 has been barred from participating in the taxpayer supported health care program, one of 76 such high-volume prescribers identified in a Palm Beach Post investigation.
Four others, including West Palm physician Dr. John Christensen, are either under regulatory scrutiny or have been disciplined for their prescribing patterns.
None wrote more oxycodone prescriptions than Dr. Jorge Leal. The Tampa-area anesthesiologist and pain clinic specialist prescribed over 715,000 doses of oxycodone billed to Medicaid over two years – on average, just under 1,000 doses a day. On busy days, Leal’s oxycodone scripts were filled by the bushel: Multiple times, more than 2,000 pills a day were filled by pharmacies and billed to Medicaid; during one 24-hour period, that number topped 4,000 pills.
See on www.palmbeachpost.com
For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.
SEC Charges Five Physicians With Insider Trading in Stock of Medical Professional Liability Insurer
The Securities and Exchange Commission last week charged five physicians with insider trading in the securities of an East Lansing, Mich.-based holding company for a medical professional liability insurer.
The SEC alleges that Apparao Mukkamala learned confidential information from board meetings and other communications about the anticipated acquisition of American Physicians Capital Inc. (ACAP) by another insurance company. Mukkamala in turn shared the nonpublic information with fellow physicians and friends Suresh Anne, Jitendra Prasad Katneni and Rao A.K. Yalamanchili as well as his brother-in-law Mallikarjunarao Anne. The five physicians each purchased ACAP stock based on confidential information about the impending sale in the months leading up to a public announcement. Collectively, they made more than $623,000 in illegal profits on their ACAP stock following the announcement.
Without admitting or denying the allegations in the SEC’s complaint, the physicians agreed to pay a combined total of more than $1.9 million to settle the SEC’s charges.
According to the SEC’s complaint filed in U.S. District Court for the Eastern District of Michigan’s Southern Division, Mukkamala is a resident of Grand Blanc, Mich., and served as a member of ACAP’s board since its formation in July 2000. He became its chairman in May 2007. At a meeting on March 12, 2010, ACAP’s board confidentially discussed whether it should consider a potential sale of ACAP and instructed company management to evaluate whether or not to continue as an independent, stand-alone company.
The SEC alleges that as ACAP’s board and management continued undertaking definite steps toward a sale, Mukkamala routinely disclosed material nonpublic information along the way to the other four physicians. Between April 30 and July 7, 2010, they illegally purchased nearly $2.2 million of ACAP stock based on the confidential information that Mukkamala shared. Mukkamala himself made a trade in the trading account of Chinmaya Mission West, a charitable organization for which he was then serving as president. On July 8, the acquisition of ACAP by Napa, Calif.-based insurer The Doctors Company was publicly announced, and ACAP shares closed approximately 28 percent higher than the previous day’s closing price.
See on www.sec.gov
For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.
Aetna and Hunterdon HealthCare Partners Forge Accountable Care Partnership
Aetna and Hunterdon HealthCare Partners announced on July 16, 2012 that they had entered into a new accountable care agreement that will improve the quality and cost of patient care, and help members and plan sponsors save money.
Under the new ACO agreement, 2,200 members in the Hunterdon Healthcare employee benefits plan, and approximately 5,700 fully insured Aetna members who live in five New Jersey counties will be served by the ACO. Aetna members served by this new model are ones who primarily received care from Hunterdon Healthcare’s providers in the last 24 months, as well as those who seek care from Hunterdon Healthcare physicians following the start of the agreement.
See on www.aetna.com
For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.
For an aggregation of other articles on improving healthcare, go to my internet magazine Scoop.it! Changing Health for the Better.
OIG’s Most Wanted Fugitives
U.S. Department of Health and Human Services Office of Inspector General Web page contains information about OIG’s most wanted health care fugitives. In all, the OIG is seeking more than 170 fugitives on charges related to health care fraud and abuse.
See more at oig.hhs.gov
For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.
Two Charged for Medicare Fraud Schemes in Detroit Involving $8.8 Million in False Billings
USDOJ: US Attorney’s Office – Eastern District of Michigan: A federal indictment was unsealed on July 11 in Detroit charging two individuals for their participation in a series of separate Medicare fraud schemes involving home health services, United States Attorney Barbara L. McQuade announced. McQuade was joined in the announcement by Acting Special Agent in Charge Edward Hanko of the FBI’s Detroit Field Office and Special Agent in Charge Lamont Pugh, III of the HHS-OIG Office of Investigation.
Charged in the indictment were Usha Shah, 63, and Deepak Shah, 63, both of West Bloomfield, Michigan. According to the indictment, the Shahs were allegedly involved in fraudulent claims submitted to Medicare totaling more than $8.8 million through their company, Miracle Home Health of Southfield, for home health care services that were medically unnecessary and/or never provided. In addition, the court documents allege that the Shahs engaged in a conspiracy to pay cash kickbacks in return for obtaining Medicare beneficiaries’ whose Medicare identifications were used to bill the Medicare program.
U.S. Attorney Barbara L. McQuade said, “Medicare fraud cheats taxpayers out of money intended to pay for health care. We want providers to know that we are scrutinizing billing records to root out fraud.” FBI Acting Special Agent in Charge Edward Hanko said, “Those who seek to steal from the medicare system and collect millions of dollars illegally must be brought to justice. These types of crimes motivated by greed will continue to be investigated vigorously by the FBI and our law enforcement partners.”
“The payment of kickbacks in exchange for the referral of Medicare beneficiaries is illegal,” said Lamont Pugh, III Special Agent in Charge of the Chicago Region of the U.S. Department of Health and Human Services, Office of Inspector General. “The OIG will continue to work with our law enforcement partners to hold those who participate in this type of illegal activity accountable.”
See more at www.fbi.gov
For an aggregation of other articles on Hot Topics in Healthcare Law, go to my magazine on Scoop.it – Hot Topics in Healthcare Law and Regulation and my newspaper on Paper.li – Hot Topics in Healthcare Law.
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Joseph Rugg's Health Law Blog 