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Is Concierge Medicine Finally Ready for Takeoff? – HealthLeaders Media
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.
See on www.healthleadersmedia.com
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.
Beth Kassab: Patients lose when hospitals take over doctors
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)?
See on articles.orlandosentinel.com
CMS Issues Outpatient Policy and Payment Changes
CMS finalized the Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center rule on Thursday, November 1, 2012.
The final rule (which is over 1,200 pages and will be published in the Fed. Reg. on 11/15/12) updates the Medicare payment policies and rates for hospital outpatient and ASC services beginning January 1, 2013.
Rates and policies set in the calendar year (CY) 2013 final rule with comment period will increase payment rates for hospital outpatient departments by 1.8 percent. The increase is based on the projected hospital market basket—an inflation rate for goods and services used by hospitals—of 2.6 percent, minus 0.8 percent in statutory reductions, including a 0.7 percent adjustment for economy-wide productivity and a 0.1 percentage point adjustment required by statute.
The OPPS rule also contains a significant change from prior policy: as proposed, it bases relative payment weights on geometric mean costs rather than median costs. Basing the OPPS payments on mean costs better reflects average costs of services and aligns the metric used in rate-setting for the OPPS with the IPPS.
For CY 2013, ASC payment rates will increase by 0.6 percent—the projected rate of inflation of 1.4 percent minus a 0.8 percent productivity adjustment required by law. Medicare uses changes in the consumer price index for urban consumers (CPI-U) as the measure of inflation for ASCs.
The rule also makes changes to the quality-reporting program for hospital outpatient departments and for ASCs.
Modern Physician: Lovelace Health acquires physician practice
Albuquerque-based Lovelace Health System has acquired Southwest Medical Associates, a physician practice that will retain its name, leadership and all 150 employees in the deal. No financial terms were disclosed, said a spokeswoman for Lovelace.
Effective immediately, the transaction starts a new physician model for Lovelace that will rely on a mix of employed, strategically aligned and community physicians.
See on home.modernphysician.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.
Physician Associates to be bought by Orlando Health – Orlando Business Journal
According to the Orlando Business Journal: Physician Associates LLC has agreed to negotiate exclusively to be acquired by Orlando Health.
The details of the arrangement, including dollar value, have not been disclosed, but analysts spoken to for a story in August speculated the deal could be valued anywhere from $20 million to $60 million.
“Physician Associates LLC and Orlando Health today announced the physician practice has selected Orlando Health as the organization with which it will begin exclusive acquisition negotiations,” said Kena Lewis, Orlando Health spokeswoman.
Florida Hospital also was vying to buy the practice.
See on www.bizjournals.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.
Medical Holocaust Blogpost: Florida, HCA, Rick Scott and Medicare Fraud
Some strong opinions and YouTube videos from the Medical Holocaust Blogpost:
“Rick Scott is just one of many corporate gangsters operating in the lucrative and largely unregulated medical industry. Now street level thugs in Florida have taken a lesson form guys like Rick Scott and are bilking Medicare for billions. Rick Scott wins the gold medal when it comes to bilking Medicare and private insurance out of billions and his gold medal performance has inspired other criminals of a slightly different pedigree to follow in his footsteps.”
See on medicalholocaust.blogspot.fr
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.
USDOJ: Hospital Chain HCA Inc. Pays $16.5 Million to Settle False Claims Act Allegations Regarding Chattanooga, Tenn., Hospital
HCA Inc., one of the nation’s largest for-profit hospital chains, has agreed to pay the United States and the state of Tennessee $16.5 million to settle claims that it violated the False Claims Act and the Stark Statute, the Department of Justice announced today.
As alleged in the settlement agreement, during 2007, HCA, through its subsidiaries Parkridge Medical Center, located in Chattanooga, Tenn., and HCA Physician Services (HCAPS), headquartered in Nashville, Tenn., entered into a series of financial transactions with a physician group, Diagnostic Associates of Chattanooga, through which it provided financial benefits intended to induce the physician members of Diagnostic to refer patients to HCA facilities. These financial transactions included rental payments for office space leased from Diagnostic at a rate well in excess of fair market value in order to assist Diagnostic members to meet their mortgage obligations and a release of Diagnostic members from a separate lease obligation.
The Stark Statute restricts financial relationships that hospitals may enter into with physicians who potentially may refer patients to them. Federal law prohibits the payment of medical claims that result from such prohibited relationships.
“The Department of Justice continues to pursue cases involving improper financial relationships between health care providers and their referral sources, because such relationships can corrupt a physician’s judgment about the patient’s true healthcare needs,” said Stuart F. Delery, the Acting Assistant Attorney General for the Department of Justice’s Civil Division.
“Physicians should make decisions regarding referrals to health care facilities based on what is in the best interest of patients without being induced by payments from hospitals competing for their business,” said Bill Killian, U.S. Attorney for the Eastern District of Tennessee.
“Improper business deals between hospitals and physicians jeopardize both patient care and federal program dollars,” said Daniel R. Levinson, Inspector General of the Department of Health and Human Services. “Our investigators continue to work shoulder to shoulder with other law enforcement authorities to stop schemes that imperil scarce health care resources.”
See on www.justice.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.
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.
Forbes Insights: Getting From Volume to Value in Health Care
Download this Forbes Insight Report. This is the challenge of healthcare reform in this country.
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Value-based purchasing, where cost and quality are each integral parts of the equation, is now widely seen as a replacement for traditional fee-for-service reimbursement. For senior hospital and health system executives, the challenge is getting from the-way-things-have-always-been to the-way-things-will-be without tumbling into a fiscal chasm because of the-way-things-are-now.
Getting From Volume to Value in Health Care: Balancing Challenges & Opportunities examines the issues and concerns vital to chief executive officers, chief financial officers and chief medical officers who are charged with leading their institutions on that quest. While as a group they are cautiously optimistic and endorse the goals that value-based purchasing seeks to achieve, they know that the path is neither straightforward nor obstacle free.
See on www.forbes.com
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