Archive
Match Day: More medical graduates entering primary care
The number of medical students committing to primary care rather than specialties increased for the fourth straight year in the largest ‘match program” in history.
[The success of healthcare reform depends on primary care physicians, and there is a shortage. Hopefully, this trend continues.]
See on www.usatoday.com
Overcoming Obstacles to Better Health Care
Transforming the American health care system could include offering safe harbor from malpractice suits for doctors who demonstrate high-quality care. See on www.nytimes.com
Meaningful healthcare reform needs tort reform so that healthcare providers can spend less time (and less insurer’s money) on defensive medicine and more time (and arguably less insurer’s money) on preventive medicine and thereby achieve more accountable medicine.
Actually, Mr. Brill, Fixing Healthcare Is Kinda Simple | Wired Science | Wired.com
When you need health care, you enter not a market but a con game in which you’re first a guarantor and source of profit, and second a patient. Wired Science blogger David Dobbs explains why the government needs to step up. See on www.wired.com
Patients have no clout in so-called market driven healthcare because of its fragmented delivery and billing systems. Having insurance further mystifies the process and hides the information necessary to make market decisions. Something like a patients union is needed to equalize the playing field. For now, Obamacare is all that patients have to give them some protection against the two Titans in healthcare who have all the market power.
Christensen, Flier and Vijayaraghavan: The Coming Failure of ‘Accountable Care’
In The Wall Street Journal, Clayton Christensen, Jeffrey Flier and Vineeta Vijayaraghavan say that the Affordable Care Act’s updated versions of HMOs are based on flawed assumptions about doctor and patient behavior. See on online.wsj.com
Beware the nay sayers. ACOs and other accountable care measures can only succeed if there IS a change in physician behavior. Changing the way healthcare is done in this country is the basis (and only workable basis) for meaningful improvement in healthcare while controlling costs at the same time. No one ever thought it would be easy or quick.
Primary care doctors becoming more involved in mental health care
Don’t be surprised if your family doctor seems as interested in your brain as in your body. (RT @BeneficentGuild: Primary care doctors becoming more involved in mental health care – The Observer-Dispatch, Utica, N.Y. See on www.uticaod.com
This is not a new situation. The AMA reported on this trend in 2010, as resulting largely from increased focus on depressions and other mental health issues and the lack of psychiatrists for treatment.
Can we learn something from America – Accountable Care Organisations
It has become de rigueur on the left to regard the US healthcare system as the very incarnation of evil and therefore a country from which nothing of value can be learned for improving our NHS. This might be about to change. There is now growing interest in the notion of the ‘Accountable Care Organisation’ (ACO) – or as it is tending to be termed over here, the Accountable Integrated Care System.
The Accountable Care Organisation concept is gathering pace in the US following the 2010 Patient Protection and Affordable Care Act, which included a pilot programme to explore ACO structures and processes. Under the new law, an ACO would agree to manage all of the healthcare needs of a minimum of 5,000 Medicare beneficiaries for at least three years. The ACO can gain extra money through sharing savings (with Medicare) resulting from collaborative efforts to provide care cost-effectively. Stringent governance conditions must be met, along with transparency and quality performance – Medicare ACOs will report on 33 different quality metrics.
In his recent ‘Green Paper’ speech on future Labour Party health policy, Andy Burnham spoke of the need for “one service co-ordinating all of one person’s needs“, with the district general hospital “evolving over time into an integrated care provider from home to hospital“. Indeed, he went on to say:
“If we look to the US the best providers are working on that highly integrated basis, co-ordinating physical, mental and social care from home to hospital. We have got to take the best of that approach and universalise it here.” See on www.sochealth.co.uk
From the Socialist Health Association of Scotland. I don’t want to think about the ramifications of having an important part of Obamacare endorsed by a socialist health organization. However, labels aside the ability to provide coordination of care in a private setting is a good thing, which is why ACOs are so critical to meaningful healthcare reform.
Your EHR needs a population health management system
Office-based medical practice is changing fast. The government is providing incentives to those practices that use electronic prescribing and electronic records systems and will soon penalize those that don’t. Health reform will shortly deliver many newly insured patients to your office. A host of new patient care models aimed at making healthcare more team-based are emerging. Reimbursement tied to outcomes will demand a greater level of patient management and engagement in the care process.
Often, though, an EHR alone cannot provide the functionality necessary to manage a specific population of patients.
There are many reasons a practice may need to identify and proactively work with a defined group of patients. Primarily, it’s to insure they are receiving care according to the evidenced-based standards agreed upon by the practice. See on www.kevinmd.com
Many physicians are re-evaluating their first choice of EHR and are changing to others as they learn how they work and what is needed for their medical practices. This is just one more instanceof making saure your EHR is robust enough to add new important components as the need develops.
Florida Medicaid Managed Care Receives Green Light From HHS
From Akerman’s Health Law Rx Blog:
POSTED BY SHERYL D. ROSEN AND BRUCE D. PLATT ON FEBRUARY 6, 2013
Florida has been working on a plan to shift the state’s Medicaid population into managed care for nearly two years – ever since the Florida Legislature directed the change in 2011. On Monday the state received the approval it needed from the federal government.
By letter dated February 1, 2013, the U.S. Department of Health and Human Services granted Florida’s request to waive certain provisions of the Social Security Act, allowing the state to transfer some Medicaid recipients from the traditional fee-for-service program into a Medicaid managed care plan for individuals needing long-term care.
The federal waiver is limited to the state’s Medicaid Long-Term Care Managed Care recipients. It will allow up to 36,795 Medicaid recipients to receive long-term care services from health maintenance organizations (“HMOs”) or provider services networks (“PSNs”) in the recipient’s local area. Such a transition would include access to services including adult day health care and case management, instead of more costly nursing home care. The waiver goes into effect on July 1, 2013, ahead of the state implementation deadline of October 1, 2013. On January 15, the Florida Agency for Health Care Administration (“AHCA”) posted notices of intent to award Medicaid Long-Term Care Managed Care contracts to PSN American Eldercare and HMOs including UnitedHealthcare of Florida and Sunshine State Health Plan.
A second waiver request is pending with HHS. If granted, it will allow Florida to shift the majority of remaining fee-for-service Medicaid recipients into the Managed Medical Assistance program via an HMO or PSN in the recipient’s area. On December 28, 2012, AHCA issued the invitations to negotiate seeking managed care organizations to provide Mandatory Managed Medical Assistance to Medicaid recipients in Florida. It is anticipated that AHCA will post the notice of intent to award these contracts on September 16, 2013. If the second waiver request has been granted by this time, the anticipated contract execution date is December 31, 2013.
Health Care Reform – Should Employers Reduce Expected Health Costs in 2014 by Transitioning Some Full Time Employees to Part Time Status Now?
From Akerman’s Health Law Rx Blog:
POSTED BY BETH ALCALDE ON FEBRUARY 1, 2013
2013 is shaping up to be a very busy year for employers in all industries, with the continued implementation of the Patient Protection and Affordable Care Act (“ACA”). Recognizing that in 2014, applicable large employers will avoid ACA-related penalty taxes by offering required affordable group health plan coverage just to full-time employees (i.e., those working an average of 30 hours or more per week, as calculated in a number of permitted ways), some applicable large employers have already begun examining whether to cut their employees’ hours.
Considerations in the reduction of hours decision will vary by industry and by employer, and there is no one-size-fits-all approach. Some of the factors to weigh should include the following:
- How much will the costs of health coverage continue to rise for this employer? What portion of those costs are expected to be specifically attributable to these employees?
- What tax savings are currently available for the employer-sponsored coverage for these employees?
- Are there employee morale, recruitment, productivity, and/or retention issues to consider?
- Are there public relations or government relations issues to consider?
- How many part-time employees does the company currently have? Does the company’s business model permit a shift away from full time employment?
- Will salary increases be needed if no insurance is offered to these employees?
- How many of these employees are expected to be eligible for subsidized health insurance coverage in a state or federal exchange? (Note that employers are not advised to solicit pledges from employees to not seek a subsidy in exchange for continued full time employment.)
Akerman’s Health Law Rx Blog
I am pleased to announce my firm’s new health law blog, Health Law Rx Blog.
Akerman’s Health Law Rx Blog provides timely updates on the latest health law issues, keeping the firm’s clients, friends, and readers up to date on pertinent legal developments. Akerman attorneys regularly update the blog with changes in the law and other relevant news. As this is meant to be an interactive site, your comments and contributions are appreciated. I am one of the contributors, so I hope you will visit the blog often and participate in any discussions that interest you. I plan to shadow post articles from the blog that I think you will find interesting.
Content on Akerman’s Health Law Rx Blog is intended to inform you about legal developments, including recent decisions of various courts and administrative bodies. It should not be construed as legal advice or a legal opinion, and you should not act upon the information without seeking the advice of legal counsel.
With more than 550 lawyers and government affairs professionals and a network of 19 offices, Akerman is ranked among the top 100 law firms in the U.S. by The National Law Journal NLJ 250 (2012). The firm’s Healthcare Practice Group includes over twenty attorneys and professionals representing health systems, physicians, health insurers, and other clients in all aspects of healthcare law across Florida and throughout the United States.
Joseph Rugg's Health Law Blog 