September 22nd, 2011 by Happy Hospitalist in Health Policy, Opinion
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Ask yourself this question: Would you pay 20-30% less in insurance premiums if it meant you were locked into one hospital system for your health care? I would. That’s what one hospital system in Massachusetts is offering to provide. It is, essentially, a concierge hospital plan. You or your employer will pay a set premium, which the hospital is offering at a 20-30% discount, and you get all your health care needs in their system, only going to a competing hospital system if they are unable to provide your necessary services.
What a great idea. In fact, it’s an idea I have thought about previously for Happy’s hospital. Why shouldn’t Happy’s hospital offer direct premiums to large and small business employers in our city in exchange for reduced pricing? I’d sign up. My health insurance premiums cost over $12,000 a year. In the eight years of my practice, I’ve probably sent over $100,000 to health insurance companies and realized less than $10,000 in expenses.
It’s a concept who’s time has come. In fact, direct concierge hospital plans also offer patients and their employers the opportunity for tiered pricing for special amenities (flat screen television service, pet therapy dog service, dialysis spa, designer ostomy covers, wine vending machines, free soda machines, gourmet cookies, closer parking, door-to-door service, and 24 hour special access to their physicians and nursing staff).
No more worries about Read more »
*This blog post was originally published at The Happy Hospitalist*
September 7th, 2011 by Linda Burke-Galloway, M.D. in News, Opinion
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Did you hear about the 17 year old teen that posed as a physician assistant at a Florida hospital for five days and got away with it? Are you surprised? I’m not.
It seems that Matthew Scheidt, had a summer job working part-time for a surgical supply company. He allegedly went to the Human Resources Department of the Osceola Regional Medical Center (ORMC) and convinced them that he was a Physician Assistant student at Nova Southeastern University and lost his identification badge. This is the hospital where many of my former patients were forced to go for medical care because they were either uninsured or received Medicaid. My former employer had a fiscal relationship with them. The use of the word “forced” is quite appropriate because my uninsured patients had no options. Read more »
*This blog post was originally published at Dr. Linda Burke-Galloway*
September 3rd, 2011 by Michael Kirsch, M.D. in Health Policy, Opinion
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There was an extremely popular game show where several times each episode the emcee would shout out, “Survey Said!”. Of course, this was just a game, not real life. Now, several times each week I am asked to respond to surveys. They pop up uninvited on the internet and are often veiled advertisements for products and services. They are on the back of receipts from coffee houses and doughnut shops. Is it worth 10 minutes of my time clicking through the doughnut survey for either a free chocolate frosted doughnut or the chance to be entered into the grand prize drawing months later? Hotels I stay at routinely follow-up with e-mail surveys for my feedback. I suspect most folks delete these instantly, which skews the customer base to those who do respond. (Remember, disatisfied folks are often more motivated to give feedback than the rest of us are.) How often do we call a restaurant, a retail store, a bank or even a doctor’s office to offer hosannas about great service?
Medicare recently released fascinating patient-survey data that raises interesting issues. In over 120 hospitals, patients rated the hospitals very highly, despite high death rates for heart disease and pneumonia. So, who do we believe here, the patients or the death rates? I wonder if the patients’ survey results were more optimistic since only the live ones were available to complete them.
Surveys are now serious bu$ine$$. Read more »
*This blog post was originally published at MD Whistleblower*
September 1st, 2011 by DavidHarlow in Health Policy, News
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Many health care provider organizations have not been overly eager to jump onto the Accountable Care Organization (ACO) bandwagon, citing high startup costs and uncertain returns on investment given the complexity of the program. Well, recently, the CMS Center for Innovation has announced the Bundled Payment for Care Improvement initiative. This initiative incorporates elements of earlier CMS demonstration projects — the gainsharing demos and ACE (acute care episode) bundled payments demonstrations which the HealthBlawger has helped a number of clients around the country qualify for in the past — and builds on the broad authority granted to the CMS Center for Innovation under health reform.
The advantages to proceeding with a Bundled Payment for Care Improvement project include the opportunity to participate in CMS shared savings programs while only providing limited commitment of organizational resources, i.e., limited to one or more discrete service lines or episodes of care. Of course, investments in a culture of collaboration must be made, but the system-wide investment in IT and other infrastructure at the level called for in order to qualify as an ACO would not necessarily be required in order to proceed with this initiative.
There are a number of different models open to participants, and nonbinding letters of commitment are due as early as late September.
From the CMS Center for Innovation announcement: Read more »
*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*
August 23rd, 2011 by DavidHarlow in Health Policy, News
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Partners Health Care (the dominant provider network in Greater Boston) and Neighborhood Health Plan (a local mostly-Medicaid HMO) just announced that the former intends to acquire the latter, and maintain it as a separate operating entity. No money will change hands between the parties, but an unspecified amount of money will be given by Partners as grants to community health centers where NHP members receive much of their health care services. Gary Gottlieb, CEO of Partners, graciously allowed that it would not seek to interfere with the current referral patterns of NHP members to the two local safety-net hospitals (which get disproportionate share hospital payments; Partners hospitals do not).
The deal is contingent on several layers of regulatory review, including Read more »
*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*
