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Team Models Could Provide Care for Increased Patient Loads | Science Codex
While patient studies show that cancer survivors don’t even want to use a primary care physician for anything more elaborate than shining a light in their ear, service surveys show that doctors are already trying to see too many patients – a problem that will only get worse when the Afforadable Care Act mandates go into force.
Primary care is facing the dilemma of excessive patient pool sizes, authors claim — the average primary care physician’s panel size of 2,300 is too large for delivering good care under the traditional practice model — and we are about to witness an environment of primary care workforce shortage, which means patient panel size will only increase.
Solution: let someone besides doctors handle a lot of stuff that some patients don’t even want their general practitioner handling.
See on www.sciencecodex.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.
Partnership for Patients — a public-private partnership to improve the quality, safety, and affordability of health care
The Partnership for Patients is a public-private partnership that helps improve the quality, safety, and affordability of health care for all Americans.
The Obama Administration has launched the Partnership for Patients: Better Care, Lower Costs, a new public-private partnership that will help improve the quality, safety, and affordability of health care for all Americans. The Partnership for Patients brings together leaders of major hospitals, employers, physicians, nurses, and patient advocates along with state and federal governments in a shared effort to make hospital care safer, more reliable, and less costly.
The two goals of this new partnership are to:
* Keep patients from getting injured or sicker. By the end of 2013, preventable hospital-acquired conditions would decrease by 40% compared to 2010. Achieving this goal would mean approximately 1.8 million fewer injuries to patients with more than 60,000 lives saved over three years.
* Help patients heal without complication. By the end of 2013, preventable complications during a transition from one care setting to another would be decreased so that all hospital readmissions would be reduced by 20% compared to 2010. Achieving this goal would mean more than 1.6 million patients would recover from illness without suffering a preventable complication requiring re-hospitalization within 30 days of discharge.
See on www.healthcare.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.
For an aggregation of other articles on improving healthcare, go to my internet magazine Scoop.it! Changing Health for the Better.
Manoj Jain: Doctors need to eliminate waste from healthcare — Memphis Commercial Appeal
Dr. Manoj Jain is an infectious disease physician and also writes for The Washington Post. His articles can be seen on MJainMD.com.
Thirty percent of health care spending — amounting to $750 billion a year — is wasted, according to a recent report by the Institute of Medicine.
I know. As a doctor, I am party to this waste, and I think doctors can play a major role in recovering it.
In a private conversation, a cardiologist tells me about his partners — “loose guns” he calls them. “At the hint of chest pain they will do a cardiac cath and this makes everyone happy,” he says. The patient feels good that something was done, the doctor gains certainty of his presumptive diagnosis and the hospital makes money. While it may seem like a win-win-win, in fact, we all lose as the health care expenditure tops $2 trillion, siphoning funds from education, housing and business innovation.
The IOM report notes that unnecessary services are responsible for nearly a third, or $210 billion, of wasted expenditure.
I, too, order excessive services like CT and MRI scans, without regard to cost. Often these services are in the gray zone of medicine where it is unclear if some procedures are really necessary.
When we doctors talk about waste, we often beat around the bush. We know the system is full of waste, but when confronted we blame the patients or malpractice attorneys.
There is another less-talked-about reason for unnecessary services. One person’s waste is another person’s income. Another cardiac catherization, another back surgery means more income for doctors, hospitals and the health care system and its archaic administrative services.
To reduce waste, doctors need to become integral partners in the cost-cutting process.
See on www.commercialappeal.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.
CMS Press Release: Medicare Advantage Program is projected to remain strong with an increase of 11% for 2013
Enrollment in the Medicare Advantage (MA) program is projected to increase by 11 percent in the next year and premiums will remain steady, Health and Human Services Secretary Kathleen Sebelius announced today. Since the Affordable Care Act was passed in 2010, Medicare Advantage premiums have fallen by 10 percent and enrollment has risen by 28 percent.
“Thanks to the Affordable Care Act, the Medicare Advantage and Prescription Drug programs have been strengthened and continue to improve for beneficiaries,” said Secretary Sebelius. “Since the law was enacted in 2010, average premiums have gone down, enrollment has gone up, and new benefits and lower drug costs continue to help millions of seniors and people with disabilities.”
For the third year in a row, the Centers for Medicare & Medicaid Services (CMS) used authority provided by the Affordable Care Act to protect beneficiaries from significant increases in costs or cuts in benefits. Access to supplemental benefits remains steady and beneficiaries’ average out-of-pocket spending remains constant.
The average MA premium in 2013 is projected to increase by only $1.47 from last year, coming to $32.59. However, if beneficiaries choose lower cost plans at the same rate in 2013, as they did in 2012, the average premium is expected to increase by only 57 cents. Access to the Medicare Advantage program will remain strong, with 99.6 percent of beneficiaries having access to a plan. Additionally, the number of plan choices will increase by 7 percent in 2013.
Last month, CMS announced that the average estimated basic Medicare prescription drug plan premium was projected to be $30 in 2013, holding steady from last year. Today’s projections show that access to a Medicare prescription drug plan will remain strong in 2013. Everyone with Medicare will have access to a wide range of plan choices.
The Annual Open Enrollment Period for health and drug plans begins on October 15 and ends December 7.
See on www.cms.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.
For an aggregation of other articles on improving healthcare, go to my internet magazine Scoop.it! Changing Health for the Better.
Report faults Medicaid patient cost in New York’s residential centers for the developmentally disabled
ALBANY — New York’s residential centers for the developmentally disabled cost Medicaid about $1.9 million a year for each patient, and federal overpayments that total $15 billion since 1990 should end immediately, according to a congressional oversight committee.
In a report this week, the House Committee on Oversight and Government Reform said the overpayments represent “massive waste,” are likely illegal and should stop immediately. The report also faulted lax oversight.
“Overwhelming evidence suggests that the federal government has failed to question New York state’s excessive developmental center payment rates adequately,” the report said. “Given the extraordinarily dire federal budget situation, the Center for Medicare and Medicaid Services’ failure to prevent the massive Medicaid overpayments flowing to New York state’s developmental centers needs to be corrected immediately.”
See on www.timesunion.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.
Prices soar in North Carolina as hospitals purchase oncology practices and dominate cancer market
Large nonprofit hospitals in North Carolina are dramatically inflating prices on chemotherapy drugs at a time when they are cornering more of the market on cancer care, an investigation by the Observer and The News & Observer of Raleigh has found.
The newspapers found hospitals are routinely marking up prices on cancer drugs by two to 10 times over cost. Some markups are far higher.
It’s happening as hospitals increasingly buy the practices of independent oncologists, then charge more – sometimes much more – for the same chemotherapy in the same office.
Asked about the findings, hospital officials said they are relying on a longtime practice of charging more for some services to make up for losses on others. Hospitals have a name for this: cost-shifting. …
Unlike many independent clinics, they say, hospitals suffer losses from treating patients without insurance and patients covered by Medicaid, the government program for the poor and disabled. Some independent oncologists acknowledge that they often refer such patients to hospitals.
Hospital officials say they provide counseling and many other cancer services that insurers don’t cover.
Officials for Carolinas HealthCare and Novant, which runs four Mecklenburg County hospitals, emphasize that they provide free care to many financially needy cancer patients.
See on www.charlotteobserver.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.
Curbing hospital readmission vital, Connecticut making progress
Recent headlines about high readmission rates forcing 2,200 hospitals nationwide to forfeit Medicare funds for patients who are readmitted to hospitals raises the questions: Can hospital readmission rates be reduced? …
The individual and combined successes of Connecticut health care communities show that improved medical processes, transfer of critical information and standardized education leads to better health care outcomes, and that translates to healthier patients and families, and a health care system that is much more cost-effective.
Reducing preventable hospital readmissions should continue to be a national priority. However, the community care transitions work in Connecticut is a harbinger of hope. We can be proud and optimistic that Connecticut is taking a proactive stance to reduce avoidable hospital readmissions in all communities statewide. This is not a challenge that can be fixed overnight, but real progress has been made.
See on articles.courant.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.
AAFP recommends greater role for primary care docs in Medicare | Healthcare Finance News
Congress must repeal the sustainable growth rate formula to stabilize Medicare physician payments, and CMS needs to adopt a series of strategies that would strengthen the Medicare program by enhancing the role of primary care physicians, said the American Academy of Family Physicians in a recent letter to CMS.
See on www.healthcarefinancenews.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.
Healthcare Business Models Clash with Reforms – HealthLeaders Media
Healthcare executives responding to a survey say the nation will see major changes in the way healthcare is delivered and paid for in the next five years as providers and payers struggle to do more with less.
Most of those executives, however, also believe that the fee-for-service-based business models they’re using now will be at least “somewhat sustainable” or fare even better in the face of new challenges brought on by healthcare reform.
KPMG LLP consultants surveyed more than 200 senior leaders in healthcare and found that 73% of health systems executives, 81% of health plan executives, and 79% of drug makers said their business models were somewhat sustainable or better over the next five years.
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.
HCA Probe Spotlights Cardiologists’ ’Irresistible Temptation’ – HealthLeaders Media
Physicians specializing in cardiology coined the term “oculostenotic reflex” over a decade ago. But the phrase has been popping up this month in conversations about accusations that thousands of patients underwent inappropriate heart procedures at HCA hospitals in Florida and in three other states, the subject of a federal probe.
Writing in the journal Circulation in 1995, Eric Topol, MD, and Steven Nissen, MD, described this phenomenon as “an irresistible temptation among some invasive cardiologists to perform angioplasty on any significant residual stenosis after thrombolysis”—that is, after clot-busting medications have been used.
Nissen and Topol wrote that while professional organizations don’t support this practice, “the ritual of reflex angioplasty is exercised thousands of times each year.”
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.
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