December 2nd, 2009 by Richard Cooper, M.D. in Better Health Network, Health Policy, Opinion
Tags: Geographic Variations, Hospital Readmission Rates, Medicare, MedPAC, Poverty, Readmissions, Safety Net Hospitals
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According to MedPAC, 18% of hospitalizations among Medicare beneficiaries resulted in readmission within 30 days, accounting for $15 billion in spending. Since treatable chronic illnesses are responsible for many such hospitalizations, it is assumed that they represent failures of the health care system. MedPAC claims that 84% of readmissions are potentially preventable. However, as will become evident, most readmissions reflect differences in co-morbidities, poverty and other social determinants, all of which deserve attention, including better transition care, but few of which are under the control of hospitals. Nonetheless, health care reform assumes that regulators can accurately adjust for such risks and estimate the “excess.”
Both the House and Senate bills include reductions in payments to hospitals with “excess” readmissions. Payment would be reduced 20% for “excess” readmissions within seven days and 10% within fifteen days. Hospitals with 30-day risk-adjusted readmission rates above the 75th percentile would incur penalties of 10-20%, scaled to the time to readmission. Read more »
*This blog post was originally published at PHYSICIANS and HEALTH CARE REFORM Commentaries and Controversies*
December 2nd, 2009 by Dr. Val Jones in News, Opinion
Tags: 2009, Beldina Atieno, Economy, Eric Goosby, Event, Global, HIV/AIDS, Infectious Disease, Jack Lew, Joy Phumaphi, Michel Kazatchkine, PEPFAR, World AIDS Day, World Bank
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What does America’s economic recession have to do with a school teacher in Kenya? A lot more than you realize. If there’s one thing I learned at the World Bank’s World AIDS Day event yesterday, it’s that our lives, economies, and health are all inextricably intertwined on a global scale.
Beldina Atieno (second from the left in the photo) traveled all the way from Nairobi to offer her first hand account of life as an HIV+ school teacher in Africa. Ms. Atieno’s story was both heart-wrenching and eye-opening. She was first diagnosed after her youngest daughter became very ill from an opportunistic infection, which prompted HIV testing in both daughter and mother. After discovering that they were both positive, she was abandoned by her husband and was plunged into poverty and despair. Read more »
December 2nd, 2009 by Happy Hospitalist in Better Health Network, Health Policy, Opinion, True Stories
Tags: CMS, Incentives, Pay For Performance, PQRI, Quality
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It’s official. Happy has now earned his CMS physician pay for performance PQRI Bonus for 2008, a direct deposit into Happy’s bank account. PQRI stands for Physician Quality Reporting Initiative. How much was my PQRI Medicare pay for performance bonus for calendar year 2008? A $2,500 check written out directly to Happy by the Medicare National Bank. CMS gives a wonderful overview of the history of PQRI . PQRI is the Medicare pay for performance program for physicians that was initiated by Congressional mandate in the latter half of 2007. Doctors have an opportunity to earn back 2% of their gross Medicare collections (which the government calls a bonus but which I call legalized theft) by submitting a grotesque amount of quality performance paper work to the Medicare National Bank. It’s one giant PQRI guideline game.
PQRI reporting is currently voluntary, but legislation in future years will certainly mandate reductions in payment for not submitting data, all but making this program a punitive standard. Many physicians failed to meet the requirements to get paid under CMS pay for performance program guidelines in the latter half of 2007, the first year for PQRI measures. Read more »
*This blog post was originally published at The Happy Hospitalist Blog*
December 1st, 2009 by KevinMD in Better Health Network, Opinion
Tags: Flu Shots, H1N1, Influence, Influenza, media, Swine Flu, Vocal Minority
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My position on the H1N1 flu vaccine is clear: everyone should get it.
But not every physician shares that sentiment. The Washington Post reports that there are a minority who are unconvinced of the vaccine’s safety and believe the H1N1 pandemic is over-hyped.
Worse, they aren’t vaccinating their patients. And when you’re talking about pediatricians, that can mean trouble for their patients; children who are most susceptible to the damage caused by H1N1. Read more »
*This blog post was originally published at KevinMD.com*
November 30th, 2009 by EvanFalchukJD in Better Health Network, Health Policy, Opinion
Tags: Government-run Healthcare, Healthcare reform, Spain, Universal Sentiment
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I’ve spent the last few days with much of our European team, today in Madrid, Spain.
Here are a few quick observations, as the American reform process continues.
1. Every country’s health care system has developed in the unique circumstances of its history. That is, the health care system of each country is the result of a collection of changes, fixes, restrictions, reforms, market developments and whatever else has happened over the last several decades. The result in each country are systems that work better or worse, but which in most all cases are very confusing to the people that work in them or get care from them. Read more »
*This blog post was originally published at See First Blog*
