August 30th, 2010 by RyanDuBosar in Better Health Network, Health Policy, News
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More than one-fifth of hospitals are government-owned, but states and counties are out of cash to keep them open. So, charitable hospitals are being sold to for-profit groups or facing closures. Rising costs and more uninsured patients run smack into falling Medicare and Medicaid reimbursement. When bonds come due, there’s little chance of states and counties paying them back. And the facilities are often standalones, and they can’t fall back on corporate backing. This year, 53 hospitals have been sold in 25 arrangements. While the deals often stipulate that care for the poor continues, no one is certain exactly how or even whether such services will continue.
That said, other charitable hospitals are making big profits. What are they doing differently? First, they’re competing for patients, so they’re increasing room sizes, offering amenities and even investing in high-end procedures such as robotic surgery. They continue to offer community care, but they’re acting more like for-profit institutions to cover their charitable missions. But this conflicts with an old-fashioned view of what charitable care is supposed to be.
Stepping into the breach is the Centers for Medicare and Medicaid Services, which is offering one solution, by increasing reimbursement for inpatient services in rural areas. The agency is expanding a pilot program by increasing reimbursement for inpatient services. Facilities are eligible if they offer care to rural areas in the 20 states with the lowest population densities, have fewer than 51 beds, provide emergency-care services and are not a critical-access hospital. (Wall Street Journal, Washington Post, Modern Healthcare)
*This blog post was originally published at ACP Internist*
August 21st, 2010 by JenniferKearneyStrouse in Better Health Network, Health Tips, News, Research
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A new study in the American Journal of Obstetrics & Gynecology reports that low levels of vitamin D may be linked to early-onset preeclampsia in pregnant women.
The trial found that the average vitamin D level in 50 pregnant women with preeclampsia was 18 ng/mL, compared with 32 ng/mL in 100 women with healthy pregnancies. No casual relationship was proven, and the study’s lead author told Reuters Health that the recommended vitamin D intake in pregnant women hasn’t changed, but the study results raise yet more questions about this much-discussed nutrient.
ACP Internist covered the pros and cons of vitamin D in its November 2009 issue. (Reuters, ACP Internist)
*This blog post was originally published at ACP Internist*
August 11th, 2010 by admin in Better Health Network, Health Policy, Opinion
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By John Henning Schumann, M.D.
The Patient Protection and Affordable Care Act (aka “Health Care Reform”) signed by President Obama in March will revolutionize primary care in the United States. By 2014 tens of millions of uninsured people will “enter” the system by being granted insurance, either through expansion of the Medicaid program or through mandated purchasing of insurance via state pools or the private market.
This alone will have a profound impact, straining the capacity of our already frayed system. Therefore, embedded in the law are funds to encourage growth and improvement in primary care: Incentives to encourage graduates to enter primary care fields (family medicine, internal medicine, and pediatrics) and practice in underserved areas (through scholarships and loan forgiveness), and money to re-format the way that primary care is practiced and paid for. Read more »
*This blog post was originally published at ACP Internist*
August 2nd, 2010 by RyanDuBosar in Better Health Network, Health Policy, Health Tips, News, Research
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Monitoring vital signs remotely saves time and money for everyone: patients, physicians, facilities and insurers. Heart failure is a particular target because its increasingly common, its easily triggered (by as little as too much salt on food, for example), it costs so much to manage in the hospital, and it’s so easily avoided.
Remote monitoring equipment made even easier with wireless connections can take vital signs, and even ask standard questions every morning. The equipment puts patients in contact with nurses once they detect warning signs. That human touch is key. Case managers can screen out false alarms (avoiding alert fatigue) and can direct patients to the physician when needed. ACP Internist covered remote monitoring technology in its March issue. (Wall Street Journal, ACP Internist) Read more »
*This blog post was originally published at ACP Internist*
May 24th, 2010 by RyanDuBosar in Better Health Network, Health Policy, News
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Healthcare reform is forcing medical students to learn about the financial costs of the tests they order, as well as their clinical importance. Once a taboo topic, it’s being openly taught to students to prepare them for practice.
At Harvard, one physician in training duplicated television’s “The Price is Right” to keep his peers guessing at the costs of tests on a patient’s bill. Molly Cooke, FACP, a Regent of the College, encourages doctors to consider the value of the tests they order as they deliver care. (Kaiser Health News, New England Journal of Medicine)
The price isn’t right for electronic medical records. Even $44,000 in stimulus money isn’t enough to make doctors jump into using computers. Read more »
*This blog post was originally published at ACP Internist*
