June 14th, 2010 by Shadowfax in Health Policy, Opinion
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This is something I haven’t seen reported on elsewhere, but according to the ACEP 911 Legislative Network Weekly Update, there was an interesting twist in the Democrats’ proposed SGR fix:
The latest plan increases physician payments by 1.3% for the remainder of this year and by an additional 1% in 2011. In 2012 and 2013, physician services would be separated into two categories, or “buckets.” One bucket would be for E&M services (including emergency department, primary and preventive care) and the other group would include all other services. The E&M bucket would increase at the same rate as the U.S. gross domestic product (GDP) plus 2%, while the other group would receive a payment increase of GDP plus 1%.After 2013, the payment formula would revert back to the current SGR formula, which means physicians would face cuts in the range of 30-35% unless Congress intervenes.
So it’s another temporary fix, kicking the can past the next presidential election. But it’s the first one I have seen that attempts to address the gross disparity in reimbursement for procedural services compared to the cognitive services. It bypasses the RUC and almost every other existing mechanism for determining reimbursement under the MPFS.
I’m not sure what happened with this proposal. I don’t think it was in the version of legislation the House passed, so I think it might be dead. But the situation is so in flux that who really knows? If nothing else, it’s an encouraging sign that policymakers know the problem exists and are willing to throw out possible solutions. This one may be dead, but it’s a good start.
*This blog post was originally published at Movin' Meat*
June 5th, 2010 by Shadowfax in Better Health Network, Humor, Medical Art, Opinion
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Here is another blogger’s take on the ubiquitous hospital pain scales. You’ve probably seen some version of this chart before. You may also have noticed how inadequate it is at helping you. Based on the faces, this is my interpretation of the chart:
0: Haha! I’m not wearing any pants!
2: Awesome! Someone just offered me a free hot dog!
4: Huh. I never knew that about giraffes.
6: I’m sorry about your cat, but can we talk about something else now? I’m bored.
8: The ice cream I bought barely has any cookie dough chunks in it. This is not what I expected and I am disappointed.
10: You hurt my feelings and now I’m crying!
None of that is medically useful and it doesn’t even have all the numbers, so I made a better one with all the numbers. Read more »
*This blog post was originally published at Movin' Meat*
June 2nd, 2010 by Shadowfax in Better Health Network, Health Policy, Opinion
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I saw this interesting article linked to from a blog about angry doctors dropping out of Medicare in Texas. As one who shares the universal annoyance at congress’ failure to fix the SGR for more than 30 days at a time, I was kind of cheered by this. That’s what it will take to get the system fixed — a grassroots, full-scale rejection of the system! Good for them. And the opening lines of the article were encouraging:
Texas doctors are opting out of Medicare at alarming rates, frustrated by reimbursement cuts they say make participation in government-funded care of seniors unaffordable.
An “alarming” rate. Wow. Cool. So how many is that, anyway?
More than 300 doctors have dropped the program in the last two years, including 50 in the first three months of 2010, according to data compiled by the Houston Chronicle. Texas Medical Association officials, who conducted the 2008 survey, said the numbers far exceeded their assumptions.
That’s 300, right? Hmm, not too shabby. Not exactly going to topple the state with that, but it’s a start.
Hey, I wonder how many doctors there are in Texas, anyway? I hear it’s a pretty big state, though I seem to recall it consists mostly of scrubland and swamp. Maybe there are only like 500 doctors in the state to start with. Something is tickling my head about Texas, though, I vaguely remember that they had some nice tort reform law a few years ago that I was pretty envious of. Read more »
*This blog post was originally published at Movin' Meat*
May 24th, 2010 by Shadowfax in Better Health Network, Health Policy, News, Opinion
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There’s just so much hidden and buried in the Affordable Care Act (ACA) that it’s like trying the find all the goodies in an Easter egg hunt. ACEP News pointed out one hidden goodie, nicely illustrated in this article from Kaiser Health News:
Under the new health law, insurance companies must extend several new protections to patients who receive emergency care. One of the biggest guarantees: Patients who need emergency treatment will have their costs covered at the same rate, regardless of whether they are treated at “in-network” or “out-of-network” hospitals.
The law also bars health plans from requiring prior authorization for emergency services. And it mandates that plans follow the “prudent layperson” rule. For example, if a person goes to the ER with chest pain, but ends up being diagnosed with indigestion, the claim has to be covered because going to the hospital under those circumstances made sense.
The provisions go into effect for every health plan issued after Sept. 23 – six months after the law was enacted — that offers emergency coverage.
This is potentially quite significant. As with so many things, the devil is in the details, and the implementation is not yet actualized. Read more »
*This blog post was originally published at Movin' Meat*
May 2nd, 2010 by Shadowfax in Better Health Network, Humor, True Stories
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An orthopedic doctor in Japan wanted to see what made the iPad tick, so he threw it under an X-ray machine and posted the images to his blog.
We guess the good doctor (whose name is Dr. Ambition, according to his blog) wasn’t happy with all of the teardown photos and videos of the iPad. Or maybe he just wanted to see what happens when you pump it full of radiation.
Appropriately enough, the iPad’s X-ray was processed with OsiriX DICOM medical imaging software for Mac.
The good news for the iPad is that nothing was broken and, as long as the stool samples come back negative, it seems it can look forward to a long life.
*This blog post was originally published at Movin' Meat*
