Points of Interest 06/26/2014

Points of Interest

06/26/2014

 AHRQ Study Examines Impact of Regulation and Report Cards

An AHRQ-funded study published in this year’s Annual Review of Public Health examines and contrasts the effects of regulation and public reporting of the quality of care by various providers, including nursing homes, hospitals and physicians.

 

BREAKING – PRESS RELEASE]

 http://www.prweb.com/releases/2014/05/prweb11866315.htm

 HPP Management Group, Corp Announces an Expanded Product Line to Meet the Challenge of Change in Healthcare Practice Management

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How doctors can embrace direct-to-consumer advertising

Health care professionals should embrace direct to consumer advertising as it isn’t going away.  How?  Just imagine a world (or just the U.S. and New Zealand as I think they are the only Western nations that allow direct-to-consumer advertising) where after every time a drug company markets a drug to consumers, especially a potentially habit forming drug, these companies also have to pay for an intervention like this one that gets those very same people off of their drug when it is no longer indicated or inappropriately prescribed.  Now that would make me sleep more comfortably at night.

A country doctor’s proposal for health insurance reform

Health insurance needs to be simple to understand and administer. It needs to promote wellness, and it needs to remove barriers from seeking advice or care early in the course of disease. It needs to empower patients to use health care services wisely by aligning patients’ and providers’ incentives.

 Expand on these concepts below, but here are the main points:

1.      Have the insurance company provide a flat rate in the $500 per year range to patients’ freely chosen primary care provider, similar to membership fees in direct care medical practices.

2.      Provide a prepaid card for basic health care, free from billing expenses and administration.

3.      Unused balances can be rolled over to the following years, letting patients “save” money to cover co-pays for future elective procedures.

4.      Keep prior authorizations for big-ticket items, both testing and procedures, if necessary for the health of the system.

5.      Keep specialty care fee-for-service.

6.      Have a national debate about where health care ends and life enhancement begins and who should pay for what.

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Points of Interest - 06/19/2014



Points of Interest

June 19, 2014

 

Should physicians work for hospitals?

A physician I have known for many years recently told me about his decision to enter the world of concierge medicine. His reasoning was telling, saying that it came down to a very simple decision on staying independent or becoming a hospital employee. He liked being an independent solo practitioner, and that was his primary motivation: to maintain independence in a time of consolidation.

Richard Gunderman, writing for the Atlantic, tackled this question head on in a recent piece titled, “Should Doctors Work for Hospitals?” The article reflects on the dramatic shift in physicians either seeking or being forced by market pressures to join hospital systems as employees.

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Reasons why your wait time at the doctor’s office is so long

Here are some acceptable reasons why wait times are long:

      Ø  Scheduling

Ø  Emergencies

Ø  Too much time out of room for the doctors

Ø  Poor workflow in the office

Ø  Chronic overscheduling

What's an ACO?

Accountable Care Organizations (ACOs) are groups of doctors, hospitals, and other health care providers, who come together voluntarily to give coordinated high quality care to their Medicare patients.
The goal of coordinated care is to ensure that patients, especially the chronically ill, get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors.

 When an ACO succeeds both in both delivering high-quality care and spending health care dollars more wisely, it will share in the savings it achieves for the Medicare program.

Breaking News

Catholic Health Initiatives, one of the largest U.S. health systems, is rapidly expanding its Medicare managed-care business with plans to enter markets in four states next year.

The Medicaid expansion underway across half the country holds the promise of fewer unpaid medical bills, bringing financial relief to hospitals as well as poor households. Now, early reports from providers suggest that might be the case.

State officials are scrambling to control the burden of Gilead's $1,000-a-pill hepatitis drug Sovaldi, particularly in states that have agreed to cap Medicaid spending under CMS waivers.

 UnitedHealth Group is continuing to eliminate doctors from its provider networks for Medicare Advantage plans in states across the country.

A mix of 21 physician associations and healthcare organizations signed on to a letter to congressional leaders seeking an extension of the Patient Protection and Affordable Care Act's two-year provision equalizing Medicaid and Medicare payments for primary-care services.

 

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