Archive
The Cost Disease : Why Computers Get Cheaper and Health Care Doesn’t
The idea behind Mr Baumol’s theory revolves around the fact that “productivity is increasing in all sectors of the economy, so it takes less time, man power and money to create things.” However in industries like computing, manufacturing and biotech, productivity has increased at a much faster rate compared with service industries such as healthcare, catering & education. In these industries the product on offer or service being provided is customised, therefore has an irreducible labour component as a result.
Cars can be made by robots in a high tech factory because each model is almost completely standardised by the manufacturer. However, robots cannot perform neurosurgery, heart transplants or kidney replacements which are non standardised and require different processes and components every time.
See on www.zesty.co.uk
The Gulf Between Doctors and Nurse Practitioners
Nurse practitioners believe that they can lead primary care practices and admit patients to a hospital and that they deserve to earn the same amount as doctors for the same work. Physicians disagree.
For several years now, health care experts have been issuing warnings about an impending severe shortfall of primary care physicians. Policy makers have suggested that nurse practitioners, nurses who have completed graduate-level studies and up to 700 additional hours of supervised clinical work, could fill the gap.
Already, many of these advanced-practice nurses work as their patients’ principal provider. They make diagnoses, prescribe medications and order and perform diagnostic tests. And since they are reimbursed less than physicians, policy makers are quick to point out, increasing the number of nurse practitioners could lower health care costs.
See on well.blogs.nytimes.com
Online health communities improve chronic care quality
Online health communities can be powerful tools for addressing chronic care issues as the number of people afflicted with such ailments rises, according to a study published this week in the Journal of Medical Internet Research.
For the study, researchers define online health communities (OHCs) as Internet-based platforms that unite a group of patients, a group of professionals, or both, using blogs, chats, forums and wikis. In this case, the researchers–from Radboud University Medical Centre in the Netherlands–illustrated using OHCs for ParkinsonNet, a professional network made for participants with Parkinson’s disease in which providers deliver patient-centered care.
ParkinsonNet utilized community managers; in this case, it was a marketing and communications expert. The community manager distributed posters, information pamphlets, and “business cards” to patients and health professionals as part of educating people about the OHC.
See on www.fiercehealthit.com
New direction for Medicaid in Alabama
About 120,000 Medicaid patients in the Shoals and Tennessee Valley will receive most of their health care from a network of willing providers within a 10-county region beginning in late 2016
The new direction for the state agency is part of a plan legislators approved earlier this year to control Medicaid’s ballooning costs.
State leaders plan to turn Medicaid from its current fee-for-service model to a managed care approach, beginning in fiscal 2017.
To make the transition, Medicaid officials are splitting the state into five areas where Regional Care Organizations — largely run by healthcare providers — will operate.
“The (Regional Care Organizations) came about because we’ve been on a fee-for-service type system with Medicaid, which doesn’t encourage providers to maximize efficiencies,” said Rep. Ed Henry, R-Hartselle, one of several lawmakers on Gov. Robert Bentley’s Medicaid study commission.
“This reform measure is to try to put efficiencies in Medicaid,” he said. “We pay providers a set amount per patient and if they deliver that care for cheaper, they make money. If they don’t, they lose money.”
David Spillers, CEO of Huntsville Hospital, said the regional organizations, or RCOs, will be a complete change in how Medicaid providers are reimbursed. The Huntsville Hospital system includes 12 medical facilities in north Alabama, including Helen Keller Hospital in Sheffield.
See on www.timesdaily.com
New England Leads Nation In Primary Care – Newsroom: Bernie Sanders – U.S. Senator for Vermont
With Vermont leading the way, five of New England’s six states rank in the top six for primary care doctors per capita, according to datafrom the Association of American Medical Colleges. The sixth, Connecticut, ranks 12th. As the national shortage of primary care doctors expected to increase after the federal Affordable Care Act takes full effect next year, some are looking to New England’s states with an eye to what they’ve been doing right.
Several factors contribute to New England’s relatively strong position. Among them: strong public health programs ensuring that high percentages of residents have health coverage, meaning fewer doctors deliver uncompensated care. Massachusetts, which enacted a universal health care program in 2006, has about 97 percent of its residents carrying health coverage. In Vermont it’s about 94 percent.
See on www.sanders.senate.gov
Health Affairs: For States That Opt Out Of Medicaid Expansion: 3.6 Million Fewer Insured And $8.4 Billion Less In Federal Payments
According to a study published in the June 2013 issue of Health Affairs:
[F]ourteen governors have announced that their states will not expand their Medicaid programs. We used the RAND COMPARE microsimulation to analyze how opting out of Medicaid expansion would affect coverage and spending, and whether alternative policy options—such as partial expansion of Medicaid—could cover as many people at lower costs to states. With fourteen states opting out, we estimate that 3.6 million fewer people would be insured, federal transfer payments to those states could fall by $8.4 billion, and state spending on uncompensated care could increase by $1 billion in 2016, compared to what would be expected if all states participated in the expansion. These effects were only partially mitigated by alternative options we considered. We conclude that in terms of coverage, cost, and federal payments, states would do best to expand Medicaid.
“Physician-owned hospitals seize their moment” – amednews.com
Physician owned and operated facilities are not necessarily bad places to go for healthcare.
American Medical News, amednews.com, reported in April 29, 2013:
When the federal government sorted through the first round of clinical information it was using to reward hospitals for providing higher-quality care in December 2012, the No. 1 hospital on the list was physician-owned Treasure Valley Hospital in Boise, Idaho. Nine of the top 10 performing hospitals were physician-owned, as were 48 of the top 100.
Yet, physicians can no longer own hospitals to which they refer their patients and are severely restricted from expanding those hospitals whose physician ownership was grandfathered.
The continued distrust of physicians and their vilification by Congress and most every state legislature hurts healthcare. It’s time to unburden physicians from lawyer mandated restrictions that never made any sense — repeal the Stark Law and every other restriction on physicians’ referring their patients to entities that they have an ownership in. The laws and the regulations that have been put into place are beyond comprehension and require physicians who are trying to be compliant to spend unnecessary dollars on lawyers. There are many appropriate tools for dealing with fraud and abuse by physicians who over utilize, or bill for services not performed, or who perform sub-par medicine — they can be professionally disciplined, lose their license, go to jail, fined. On the private side, they can be sued. Congress adopts these strict liability patient referral restrictions because they are easy to enforce. That should not be the basis for interfering with an entire industry.
Bill Would Let Texas Doctors Get Data From Driver’s Licenses
Health care providers in Texas could soon collect or verify patient information by swiping that patient’s driver’s license.
The measure allowing such data collection is one of a handful that the Texas Medical Association is pushing this legislative session to help modernize medical practices. The association is also backing bills that would standardize preauthorization forms used by health plans for prescription drugs and health care services.
Of course, this is why we have electronic medical records.
See on www.nytimes.com
Lawmaker urges extension of safe harbor for EHRs
Electronic Health Record Donation Safe Harbor
March 28, 2013
Gregory E. Demske, Esq. Chief Counsel to the Inspector General 330 Independence Avenue, S.W., Room 5527 Washington, DC 20201Dear Mr. Demske:
I write today to urge the Office of the Inspector General of the United States Department of Health and Human Services to renew its safe harbor provision that protects certain electronic health record donation arrangements under the federal Anti-Kickback Statute. As you know, this provision is set to expire on December 31, 2013. I write to respectfully ask that you consider extending this safe harbor provision. As you know, Congress is particularly interested in developing and continuing initiatives that are designed to reduce health care costs. As Ranking Member of the Ways and Means Health Subcommittee, eliminating wasteful spending in health care is an issue that is very important to me. Care coordination certainly represents good medical practice and can decrease health care costs by: (a) eliminating the need for duplicative and unnecessary testing, and (b) reducing the potential for medical errors that can occur when clinicians simply do not have all of the medical record history needed to appropriately care for a patient. The safe harbor that your agency has established, which protects the donation of electronic health records under certain limited circumstances, is a common-sense policy. It encourages collaboration among providers, yet also contains rigorous requirements that providers must meet in order to protect the Medicare and Medicaid programs from the few unscrupulous providers who would donate electronic health record software in exchange for referrals. Should you decide to extend this safe harbor provision, we are certain that you will make any necessary adjustments to protect taxpayers from fraud, waste, and abuse based upon your experience with the safe harbor thus far. Furthermore, I recommend that any extension that you publish should continue to have a corresponding sunset date so that you can address newly emerging fraud schemes that might negatively impact the federally-funded programs. I respectfully ask that you extend this important safe harbor provision as soon as is practicable so that providers have the certainty that they need to continue engaging in efforts designed to promote care coordination. I appreciate your dedication to this important issue and look forward to continuing to work with you in the future. Thank you in advance for your attention to this important matter.
Regards,
Hon. Jim McDermott, Member of Congress
See on www.modernhealthcare.com
Lack of e-health standards “unacceptable”
THE absence of compulsory basic standards for electronic health records in general practice is an “unacceptable” situation and its resolution is very much overdue, according to two experts involved in collecting GP data.
In an editorial in this week’s MJA, two senior members of the Bettering the Evaluation and Care of Health (BEACH) program, which collects information about clinical activities in general practice, have called for the urgent development of “nationally agreed standards for the electronic health record (EHR)”.
“We now have a variety of EHR systems with inconsistent structures, data elements and terminologies”, Associate Professor Helena Britt and Associate Professor Graeme Miller, director and medical director of the Family Medicine Research Centre, wrote.
They listed three negative effects caused by the absence of compulsory basic standards.
“First, it makes it extremely difficult to transfer patient data to other general practices and health providers”, they wrote.
“Second, it makes it hard for practices to change to a different EHR system because transfer of patient data to a new system, with different data structures and coding systems, is unreliable.
“Last, it makes it impossible to obtain reliable national information about the care provided to individuals and the population through passive data collection from GPs’ computers.”
See on www.mjainsight.com.au
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