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Updated: 1 day 13 hours ago

Behind Higher Physician Fees, a Big Problem Lurks

Thu, 07/02/2015 - 10:40

Joining forces with a like-minded, larger medical practice may afford economies of scale, but physicians should be aware that it could be at the expense of patients, who are becoming more cost conscious.

Categories: Healthcare News

Health IT Underused in Care Coordination

Thu, 07/02/2015 - 07:11

The capabilities of health information technology tools aren't always aligned with physician priorities, research finds. And the care coordination activities that matter most to clinicians aren't ones that are best supported by health IT.

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FTC and DOJ May Spoil Mega-Mergers Among Payers

Thu, 07/02/2015 - 07:05

Regulators at the Federal Trade Commission and the Department of Justice will scrutinize any potential mega mergers among health insurance companies for signs of market dominance and the attendant risk of higher costs.

Categories: Healthcare News

A pharma payment a day keeps docs' finances okay

Thu, 07/02/2015 - 06:53

Few days went by last year when New Hampshire nephrologist Ana Stankovic didn't receive a payment from a drug company. All told, 29 different pharmaceutical companies paid her $594,363 in 2014, mostly for promotional speaking and consulting, but also for travel expenses and meals, according to data released Tuesday detailing payments by drug and device companies to U.S. doctors and teaching hospitals. (You can search for your doctor on ProPublica's updated Dollars for Docs interactive database.) Stankovic's earnings were certainly high, ranking her about 250th among 606,000 doctors who received payments nationwide last year.

Categories: Healthcare News

New Obamacare enrollees are healthier, report finds

Thu, 07/02/2015 - 06:49

New ObamaCare enrollees are healthier and spent less on drugs than enrollees last year, according to a new analysis. The report from Express Scripts, the country's largest pharmacy benefits manager, is a positive sign for the law, given the need to maintain a mix of healthy and sick enrollees to keep costs down. Still, ObamaCare exchange enrollees tended to be sicker than those in other health plans. Costs were 16 percent higher per member per month compared to non-ObamaCare plans, the report finds, largely due to higher spending on costly drugs for complex conditions.

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Medicare proposes to ease 'two-midnight' coverage rule on hospital observation stays

Thu, 07/02/2015 - 06:48

Medicare proposed Wednesday to ease a coverage policy on short hospital stays that has been criticized because it can result in higher costs for seniors. Under Medicare, coverage for inpatient and outpatient care is determined under very different payment rules. In some cases, a hospital admission classified as inpatient can result in lower bills for beneficiaries. The problem has come when patients are admitted for short observation stays. Medicare policy generally required a hospitalization to span at least two midnights to qualify as an inpatient case. Wednesday's proposal from Medicare would allow for case-by-case exceptions.

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CA's tough new law overcomes decades-old distrust of vaccines

Thu, 07/02/2015 - 06:43

On Tuesday, Gov. Jerry Brown of California signed into law a requirement that nearly all children be vaccinated in order to attend school. With the stroke of a pen, California went from being a state with relatively lax vaccination rules to one of the most strict in the country — joining Mississippi and West Virginia as states where even exemptions for religious beliefs are not allowed. As the bill worked its way through the legislative process, it faced strong, consistent, vocal opposition from some parents, including a small group of protesters who stood vigil outside the Capitol in Sacramento for days before it was clear Brown would sign the bill.

Categories: Healthcare News

Doctors see big cybersecurity risks, compliance as key for hospitals

Thu, 07/02/2015 - 06:40

Cybersecurity and healthcare IT are both burgeoning areas of business. Put them together and you have a volatile mix of emerging technologies, security and privacy risks, and regulatory requirements—but also a lot of opportunity for growth and improvements. It's no surprise that doctors and hospital administrators are concerned with security. The healthcare industry is a top target of cyber attacks (see the Anthem data breach), and it has highly sensitive information about large swaths of the population. A new survey from MedData Group in Topsfield, MA, shows that physicians have very different opinions about cyber threats as compared to administrators and health IT professionals.

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Primary care workforce: The need to lower barriers for NPs and physicians

Thu, 07/02/2015 - 06:40

For the past three years, we have tracked primary care workforce numbers comparing the annual primary care residency match data with the primary care nurse practitioner (NP) graduation rates. The physician numbers continue to be relatively flat while the nurse practitioner data continues to surge. Under the Affordable Care Act (ACA), 16.4 million people are now enrolled for health care coverage. But we have yet to see the same sorts of increases in medical school graduates entering primary care. The National Center for Health Workforce Analysis (HRSA) predicts primary care shortages as high as 20,400 physicians by 2020.

Categories: Healthcare News

Opinion: The fatal cost of hospitals' IT ignorance

Thu, 07/02/2015 - 06:38

The most significant issue with health-care technology in the U.S. is a humble problem: how to manage all the new stuff. The health-care industry lags behind most other industries in technology, so health administrators lack experience operationalizing new systems. Too often, they make rookie mistakes. They assume everything is plug-and-play, then panic when things go wrong. They set unrealistic timelines that demoralize staff. They rely too much on vendors. And they expect technology to somehow electronically solve complex human and managerial issues. This management problem is very serious, at the roots of widespread dissatisfaction—sometimes outright revolt—from physicians, nurses and other clinicians who are not happy when their hospitals convert to digital solutions.

Categories: Healthcare News

CMS proposes outpatient payment update

Wed, 07/01/2015 - 09:29

The Centers for Medicare and Medicaid Services released a plan for reimbursing hospitals and ambulatory surgical centers starting in 2016 on Wednesday. Proposed changes include a reduction in outpatient payment rates as well as updating Medicare's conversion rate in the physician payment schedule.

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Evidence counters myths about Medicare, Medicaid

Wed, 07/01/2015 - 09:25

A pair of recent studies use evidence to challenge two widely held beliefs, namely that undocumented immigrants are draining the Medicare trust fund and Medicaid provides poor quality medical care.

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Aging Doctors: Time for Mandatory Competency Testing?

Wed, 07/01/2015 - 06:42

The American Medical Association's House of Delegates voted in its June meeting that the time has come to address the issue of aging physicians more systematically, perhaps with formal guidelines and methods for competency testing. From Medpage Today.

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AMA Delegate Blasts ICD-10 Implementation Requirements

Wed, 07/01/2015 - 06:14

"To think we can implement this huge undertaking all on one day is simply ridiculous," says the former president of the Medical Association of the State of Alabama.

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VA law clarifies status of hospital patients

Wed, 07/01/2015 - 05:52

How do you know if you've been admitted to the hospital? It sounds like a trick question, but the murkiness surrounding the distinction between inpatient and outpatient status — in both instances you might spend the night, or nights, in the hospital — will be clarified with a law that takes effect July 1. Under legislation sponsored by state Sens. Dick Black, R-Loudoun County, and George Barker, D-Fairfax County, and passed this year in the General Assembly, patients in Virginia hospitals will be required to sign an acknowledgment that they understand that they are an outpatient, not an inpatient, when that status applies. The distinction has ramifications for billing and reimbursements, whether through Medicare, Medicaid or private insurance.

Categories: Healthcare News

CA is now the perfect test lab for vaccine laws

Wed, 07/01/2015 - 05:47

On June 30, Governor Jerry Brown signed a bill into law that will ban the use of religious and personal belief exemptions—ways that parents can opt out of certain vaccines for their kids before attending public or private school. California now joins only two other states, Mississippi and West Virginia, that have no exemptions in place (though students can still opt out if a doctor says they shouldn't get vaccinated for medical reasons). The hotly-contested law was passed in the hopes that increased vaccination rates will help stave off the spread of vaccine-preventable diseases like the measles, which broke out earlier this year in a cluster that started in Anaheim's Disneyland.

Categories: Healthcare News

Telemedicine deal means some patients skip doc's office for tests

Wed, 07/01/2015 - 05:16

Thanks to progress in telemedicine, some patients no longer have to go to the doctor to see a doctor. It's an approach that could mean that both health care providers and patients save money and time by cutting down on the number of visits to the doctor's office. HealthTap, a Palo Alto telemedicine and medical information startup, said Tuesday it will team up with New Jersey's Quest Diagnostics to integrate diagnostic testing into its digital health platform, so patients can consult with a doctor remotely and get lab tests ordered online. It is the first time a telemedicine company has established a partnership with a diagnostic provider, according to HealthTap.

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The Perils of Cut-and-Paste Documentation

Tue, 06/30/2015 - 07:02

Not only is the practice of copying a block of prewritten text and pasting it into a patient record a questionable billing practice, it also creates the potential for adverse patient outcomes.

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Readmission Location Linked to Post-Surgical Mortality Rates

Tue, 06/30/2015 - 06:57

Patients with complications after major surgery are 26% more likely to survive if they return to the hospital where they had their operation, researchers find.

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Patient safety in children's hospitals: The journey to zero harm

Tue, 06/30/2015 - 06:38

In contemporary society, we like to talk about thinking outside the box. Sometimes, though, you have to build an entirely new box. Such is the case for children's hospitals working to improve patient safety in their facilities. Since the Institutes of Medicine first published "To Err is Human: Building a Safer Health System," their report on patient safety in 1999, health care has struggled with how best to protect those cared for in our system. Now, 16 years later, the search for how to do just that might be close to finding that elusive treasure.

Categories: Healthcare News