January 19th, 2011 by BobDoherty in Better Health Network, Health Policy
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Federal law generally prohibits physicians from referring their own patients to a diagnostic facility in which they have an ownership issue — a practice called “self-referral” — unless the facility is located in their own practice. This exemption exists to allow patients with access to a laboratory test, X-ray, or other imaging test at the same time and place as when patients are seeing their physician for an office visit. Less inconvenience and speeder diagnosis and treatment — what could be wrong with that?
Much, say the critics, if it leads to overutilization and higher costs and doesn’t really represent a convenience to patients. This is the gist of two studies by staff employed by the American College of Radiology, published in the December issue of Health Affairs.
One study analyzes Medicare claims data and concludes that patients aren’t really getting “one-stop-shopping” convenience when their physician refers them to an imaging facility that qualifies for the “in-office” exemption.
“Specifically, same-day imaging was the exception, other than for the most straightforward types of X-rays. Overall, less than one-fourth of imaging other than these types of X-rays was accompanied by a same-day office visit. The fraction for high-tech imaging was even lower — approximately 15 percent.” Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*
January 17th, 2011 by RyanDuBosar in Better Health Network, Research
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Medical expenditures for cancer are projected to reach at least $158 billion in today’s dollars by 2020. That’s a 27 percent increase, assuming that incidence and treatment costs remain at 2010 levels, according to a National Institutes of Health (NIH) analysis of growth and aging of the U.S. population.
But new diagnostic tools and treatments could raise medical expenditures as high as $207 billion, assuming that the costs of new treatments increases 5 percent, said the researchers from the National Cancer Institute (NCI), part of the NIH. The analysis appears in the Journal of the National Cancer Institute. Recent trends reflect a 2 percent annual increase in medical costs in the initial and final phases of care, which would boost projected 2020 costs to $173 billion.
Projections of expenses, assuming steady incidence and survival rates and no increase in treatment costs
Projections were based on the most recent data available on cancer incidence, survival and costs of care. In 2010, medical costs associated with cancer were projected to reach $127.6 billion, with the highest costs associated with breast cancer ($16.5 billion), followed by colorectal cancer ($14 billion), lymphoma ($12 billion), lung cancer ($12 billion) and prostate cancer ($12 billion). Read more »
*This blog post was originally published at ACP Internist*
January 14th, 2011 by RyanDuBosar in Health Policy, Research
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Far more primary care doctors report detailed referrals than do specialists report receiving them. The same applies in reverse. Specialists report returning quality consultations, while primary care physicians report receiving them far less often.
Researchers reported in Archives of Internal Medicine that perceptions of communication regarding referrals and consultations differed widely. While 69.3 percent of primary care physicians reported “always” or “most of the time” sending a patient’s history and the reason for the consultation to specialists, only 34.8 percent of specialists said they “always” or “most of the time” received the information. And, while 80.6 percent of specialists said they “always” or “most of the time” send consultation results to the referring physicians, only 62.2 percent of primary care physicians said they received it.
So where are the reports going? Read more »
*This blog post was originally published at ACP Internist*
January 11th, 2011 by BobDoherty in Better Health Network, Health Policy
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[Soon] the new GOP-controlled House of Representatives will be voting on and is expected to pass a bill to repeal the Affordable Care Act (ACA) — lock, stock, and barrel. There is virtually no chance the repeal bill will get through the Senate, though, which maintains a narrow Democratic majority, and President Obama would veto it if it did.
But let’s say that the seemingly impossible happened, and the ACA was repealed. What would the impact be on healthcare coverage, costs, and the federal deficit?
In a letter to Speaker John Boehner (R-OH), the Congressional Budget Office (CBO) released its preliminary estimates of the impact of repeal on the deficit, uninsured, and costs of care, and found that it would make the deficit worse, result in more uninsured persons, and higher premiums for many:
— Deficit: repeal of the ACA would increase the deficit by $145 billion from 2012-2019, by another $80 to $90 billion over the 2020-21 period, and by an amount “that is in the broad range of one-half percent of the GDP” in the decade after 2019* — or about a trillion dollars. Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*
January 10th, 2011 by RyanDuBosar in Better Health Network, Health Policy, News
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Repealing healthcare reform has become a way of stockpiling ammunition for the campaign trail. The Republican-led House has scheduled a repeal of healthcare reform for Wednesday, Jan. 12, and they’d garner as allies some but not all 13 Democrats that voted against healthcare reform to begin with. The House’s quixotic vote would then promptly die in the Democrat-held Senate.
But recording votes on repeal would put pressure on already vulnerable lawmakers, as well as give a quick boost to incoming ones. A Gallup poll shows 46 percent of Americans want healthcare reform to be repealed, 40 percent don’t want repeal.
Unfortunately, not only can’t the law be passed, it would add $230 billion to the federal debt by 2021, according to the Congressional Budget Office. House Speaker John Boehner said, “I don’t think anyone in this town believes that repealing Obamacare is going to increase the deficit,” although Republicans have already exempted a repeal of the healthcare law from new rules prohibiting legislation from adding to the federal debt. (Politico, Kansas City Star, [Aurora, Ill.] Beacon-News, USA Today, CNN)
*This blog post was originally published at ACP Internist*
