Archive for January, 2013

Immigration reform could add millions of people under Obama health law – The Hill’s Healthwatch

January 27, 2013 Leave a comment

Comprehensive immigration reform could make millions of people suddenly eligible for assistance under President Obama’s healthcare law, assuming a final deal paves the way for undocumented immigrants to receive papers.

Illegal aliens are now prohibited from purchasing coverage through the Affordable Care Act’s insurance exchanges, which will launch next year.

They are also ineligible for Medicaid under most circumstances, making the law’s expansion of the program fruitless for people without documents.

The landscape  could change completely if Hispanic lawmakers get their wish — an overhaul of U. S. immigration policy that includes a path to legalization.

Helping people get and stay healthy, illegal immigrants or not, has to be cheaper in the long run. Sort of like Stephen Covey’s “sharpening the saw” — it takes time and resources to sharpen the saw, but once done, the work goes easier.

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Is Concierge Medicine Finally Ready for Takeoff? – HealthLeaders Media

January 20, 2013 Leave a comment

For years observers have been predicting the impending migration of physicians into direct pay or concierge medicine, where no longer will they have to accept low Medicare and Medicaid reimbursements or haggle with private payers.

Has that time finally arrived?

A recent survey of more than 13,500 physicians found that 6.8% of them would “embrace” direct pay or concierge medicine within the next three years. That includes 9.6% of practice owners, 7.7% of primary care physicians, and 6.4% of specialists, according to the survey conducted by physician recruiters Merritt Hawkins for The Physicians Foundation.

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Physicians have limited choices in front of them for how they will provide care in the future (and the future is now) — (1) maintain the status quo, (2) combine, merge, or consolidate with, or sell to, with other physicians, (3) sell to, or affiliate with, hospital systems or managed care companies, or (4) become independent of other physicians, of hospitals, and of managed care companies by doing concierge medicine.

Telehealth to Expand in Rural Communities with FCC $400 Million Fund

January 20, 2013 Leave a comment

The FCC has announced $400 million will be made available through a healthcare connect fund to create and expand telehealth networks and services.

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Mining Electronic Records for Revealing Health Data

January 20, 2013 Leave a comment

The New York Times reported last week ( another value of electronic health records — to supplement or even replace clinical research to improve patient care:

Over the past decade, nudged by new federal regulations, hospitals and medical offices around the country have been converting scribbled doctors’ notes to electronic records. Although the chief goal has been to improve efficiency and cut costs, a disappointing report published last week by the RAND Corp. found that electronic health records actually may be raising the nation’s medical bills.

But the report neglected one powerful incentive for the switch to electronic records: the resulting databases of clinical information are gold mines for medical research. The monitoring and analysis of electronic medical records, some scientists say, have the potential to make every patient a participant in a vast, ongoing clinical trial, pinpointing treatments and side effects that would be hard to discern from anecdotal case reports or expensive clinical trials.



Beth Kassab: Patients lose when hospitals take over doctors

January 20, 2013 Leave a comment

When a big hospital chain buys an independent doctor’s office, we often hear the move will “enhance care”, “integrate care” or “improve health-care efficiency.”

Spare us the euphemisms.

Patients are the losers in these deals.

We pay higher costs. We get fewer choices because doctors are pressured to refer patients only to providers who also work for the hospital. And, because these acquisitions are so common today, an independent doctor’s office is becoming as quaint as the house call.

Unfortunately, this is the entire article and is much too short to discuss a topic full of so many nuances.  Tough issues need far more analysis and thought than this.  The question to study is, if the goal of physician practice acquisitions is integration of healthcare to enhance and improve the patient experience while reducing costs, then where are the disconnects?  Why are hospitals and physicians failing (assuming this “reporter” is correct in her bottom line conclusion)?

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Physician groups eye mergers but blindsided by legal fights –

January 9, 2013 Leave a comment

Declining payments and increasing financial pressures have led more physicians to become employees of large medical groups and hospitals. At the same time, the Affordable Care Act is prompting smaller practices to consolidate as a way to more easily participate in new health system delivery models such as accountable care organizations.

But as physicians attempt to escape administrative burdens and financial stress, they are encountering another hurdle­ — legal disputes brought about by mergers.

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Preventive Services, Including Contraceptive Coverage, Under the Health Care Law

January 3, 2013 Leave a comment

All Women Should Have Access to Preventive Health Services, including Contraception, Without a Co-Pay, and Have It No Matter Where They Work

The health care law makes preventive care more accessible and affordable to millions of Americans by making certain preventive services, including all FDA-approved contraceptive methods, available without co-payments or other cost sharing requirements. This is especially important to women, who are more likely than men to avoid needed health care, including preventive care, because of cost. This requirement is a huge step forward for women’s health. Over the next few years, as an increasing number of health plans come under the law’s reach, more and more women will have access to a wide range of preventive services without co-payments or deductibles.

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Primary care doctors growing scarce

January 3, 2013 Leave a comment

Roughly 4 million additional Californians are expected to obtain health insurance by 2014 through the federal health law, an expansion that will likely exacerbate the state’s doctor shortage and could even squeeze primary care access in the Bay area, experts say.

Even without the Affordable Care Act, a worsening doctor shortage had been forecast as the state’s and nation’s population ages and grows, and as a generation of older doctors retires. But by mandating that individuals have insurance and expanding Medicaid, the law will extend coverage to an additional 30 million Americans and place a greater strain on the physician workforce, especially for primary care.

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7 Big Data Solutions Try To Reshape Healthcare

January 3, 2013 Leave a comment

Skepticism is a two-edged sword. Not enough of it, and an IT manager might find himself duped into investing in software “solutions” that go nowhere. Too much of it, and skepticism can leave an IT department behind as it waits for enough proof to show a particular platform will improve outcomes beyond a reasonable doubt.

Big data analytics is at that tipping point right now in the healthcare industry. Several vendors promise better quality of care and reduced expenditures, but evidence to support those claims is somewhat tentative. Similarly, some critics of the big data movement say healthcare providers need to squeeze all the intelligence they can from small data sets before moving on to larger projects.

In a recent post in The Health Care Blog, for instance, consultants David C. Kibbe, M.D., and Vince Kuraitis argue that instead of succumbing to the allure of big data analytics, providers should focus on using small data better. In other words, concentrate on the clinical data already available in digitized form and use only those health IT tools that are directly applicable to care management.

Big data analytics, on the other hand, attempts to parse mounds of data from many disparate sources to discover patterns that could be useful in problem solving. For example, researchers are employing the big data approach to study genetic and environmental factors in multiple sclerosis to search for personalized treatments.

Some of this research might lead to exciting payoffs down the road, but IT companies are not waiting. As Kibbe and Kuraitis point out, technology firms are touting big data analytics as a must-have for healthcare systems and physician groups that aim to become accountable care organizations or make ACO-like arrangements with payers. As these ACOs and healthcare organizations try to profit under shared-savings or financial risk contracts, these proponents claim, big data can help them crunch the data for quality improvement and cost reductions.

Some providers are already using big data in patient care. According to BusinessWeek, “many [providers] are turning to companies such as Microsoft, SAS, Dell, IBM, and Oracle for their data-mining expertise.” And healthcare analytics is a growth business. Frost & Sullivan projects that half of hospitals will be using advanced analytics software by 2016, compared to 10% today.

Are healthcare providers ready for big data analytics, or should they be content with the more limited data analytics capabilities built into their EHR systems and relational databases to point the way to new policies and procedures?

When asked to weigh in on the big data/small data debate during a recent interview withInformationWeek Healthcare, David Blumenthal, former head of the Office of the National Coordinate of health IT, said, “It’s not an either/or choice. Big data starts with small data. As we have more information on health and disease and the patterns of care … that information will provide useful insights into what works, what doesn’t. What the natural history of disease is. It will enable us to do studies faster and more efficiently … But it’s going to take a while to figure out how to use the data.”

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