August 3rd, 2011 by Happy Hospitalist in Opinion, True Stories
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Childbirth hospital costs these days aren’t cheap. Some studies suggest the cost of raising a child exceeds $200,000, not including education expenses. Most insurance companies charge women of childbearing age more for their insurance because the actuarial tables say so. Mrs Happy and I now have a 3 month old Zachary in our wings. He is a cute little peanut. His two brothers, Marty and Cooper adore him.
Forty-two days after his April 21st, 2011 delivery, we still had not received our explanation of benefits from Blue Cross Blue Shield for the midwife charge. I had previously received a statement from them saying the charge was under review. Perhaps they believed that delivering Zachary was not medically necessary. I can’t explain it.
When I called to ask them why this charge had not been approved, they said they could not give me a reason why my explanation of benefits statement had not been finalized after 42 days. I pressed for more information, but to no avail. I was given no reason other than to say that they had a lot of claims to review. That’s not an acceptable reason to delay a payment of a claim. Read more »
*This blog post was originally published at The Happy Hospitalist*
July 31st, 2011 by BarbaraFicarraRN in Health Policy, Interviews
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This is the first of a three part post addressing the legal concerns of social networking in the health care arena.
Legal expert, David Harlow, Esq., Health Care Attorney and Consultant at The Harlow Group, LLC in Boston, addresses the legal issues.
Q: Barbara: What are the legal implications for doctors, nurses and hospitals engaging in social media?
A: David: Health care providers are concerned about HIPAA privacy issues – HIPAA violations may occur as a result of staff posts, or as a result of patient, family or caregiver posts – as well as potential liability for medical advice provided on line. Physicians and nurses have been sanctioned and fired for privacy breaches via social media, so these are real concerns. Some communications that folks think are OK may in fact be violations of HIPAA or state privacy laws, so great care in training is needed. In addition, Read more »
*This blog post was originally published at Health in 30*
July 22nd, 2011 by BarbaraFicarraRN in Opinion
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Recently, I had the pleasure of being surrounded by brilliant health care thought leaders. First, I delivered a social media presentation at the Eyeforpharma conference. Secondly, I sat in the audience at the Social Communications and Health Care 2011 conference to listen to others present on social media, and participate in a round-table discussion on social media.
It’s clear from the personal discussion that followed with folks from the pharma industry, medical device companies, and hospitals, that they understand the need for social media (or social networking), but they are cautious to dive in.
A few concerns I’ve heard: “social media can be paralyzing,” “senior leadership in the pharma industry is looking for the FDA to make decisions because it’s such a highly regulated industry,” and “it’s still so new, what’s the ROI?” Concerns are real; however there will always be concerns and questions. Sometimes, the best approach is to just dive right in.
The brilliant reason to dive deep into the social media health space is Read more »
*This blog post was originally published at Health in 30*
June 26th, 2011 by Stanley Feld, M.D. in Health Policy, Opinion
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McKinsey Quarterly has reported its survey concluding there will be a radical restructuring of employer-sponsored health benefits (ESI) as a result of President Obama’s following the 2010 passage of the Affordable Care Act.
Healthcare insurance rates have already skyrocketed as a result of anticipating the conditions of Obama care. President Obama has been powerless to do anything about the increases.
Thirty percent (30%) of companies providing ESI to their employees will drop healthcare insurance coverage once Obama care takes effect in 2014.
The survey included 1300 employers providing ESI across industries, geographies, and employer sizes. Other surveys have found that as we get closer to 2014, President Obama’s Healthcare Reform Act will provoke a much greater number of employers to drop employer sponsored healthcare insurance.
The penalty for not providing healthcare insurance coverage is much cheaper than providing healthcare coverage.
McKinsey’s survey suggests that when more employers become aware of the new economic and social incentives embedded in Obamacare the percentage of employers dropping ESI will Read more »
*This blog post was originally published at Repairing the Healthcare System*
May 16th, 2011 by Dinah Miller, M.D. in Expert Interviews
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When Roy and I were on Talk of the Nation this past week, a called phoned in to ask about her sister. The question was about care in the Emergency Room/Department, so it was a perfect Roy question and he fielded it. I’ve been playing with it since, and wanted to talk more about this particular scenario, because the scenario was very common, and the question was more complicated than it seems.
From the transcript of the show:
ANN (Caller): Hi, thank you very much. I would like to ask Dr. Roy (oh, I gave him his blog name here) a question: My sister was admitted to emergency when she cut her wrists, and the doctor on call pulled me aside and said, do you think she was trying to kill herself?
And I said – because my sister is very intelligent – I said, if my sister really wanted to kill herself, she would have done it. I think she’s asking for help.
And so he said – and so he had her see the psychiatrist who was on call, or on duty. And she spoke with him for a while. And he sent her home, saying: Well, if you need me, I’m here.
What I would like to ask Dr. Roy is, what protocol was going on there? Why did they allow that to happen? And what would you change, if you could? Read more »
*This blog post was originally published at Shrink Rap*
