September 5th, 2011 by DrWes in News
1 Comment »
I know what you’re thinking. “Did he fire six shots or only five?” Well, to tell you the truth, in all this excitement I kind of lost track myself. But being as this is a .44 Magnum, the most powerful handgun in the world, and would blow your head clean off, you’ve got to ask yourself one question: Do I feel lucky?
Well, do ya, punk?
Harry Callihan, from the movie Dirty Harry
It was a small article in the Wall Street Journal on 8 August 2011: “Zoll Medical Falls As LifeVest May Face Reimbursement Revisions.” No doubt most doctors missed this, but the implications of this article for our patients discovered to have weak heart muscles and considered at high risk for sudden cardiac death could be profound.
That’s because Medicare (CMS) is considering the requirement for the same waiting period after diagnosis of a cardiomyopathy or myocardial infarction as that for permanent implantable cardiac defibrillators (ICDs). To this end, they issued a draft document that contains the new proposal for their use. Read more »
*This blog post was originally published at Dr. Wes*
September 4th, 2011 by Toni Brayer, M.D. in Opinion, Research
No Comments »
Hospitals across the country are working on quality initiatives to reduce re-admissions to hospitals. There are consultants, conferences, forums, meetings, physicians, nurses and administrators who are spending hours upon hours (and lots of $$$) to find ways to keep patients who have been discharged from being readmitted within 30 days. Why all of this activity? It is one of the quality measures that is being tracked by Medicare and Medical (CMS) and decreased reimbursement will be next if a patient is readmitted to any hospital within 30 days of a discharge. The diagnosis doesn’t matter.
A new study shows all of this focus and cost may not be worth it. Readmission after a hospital discharge may not be an indication of poor care.
The study, published in the Canadian Medical Association Journal looked at 4,812 patients and had medical experts review the cases of the 649 who needed urgent readmission within 6 months. (Not one month as we are measuring). They found that Read more »
*This blog post was originally published at EverythingHealth*
September 1st, 2011 by DavidHarlow in Health Policy, News
No Comments »
Many health care provider organizations have not been overly eager to jump onto the Accountable Care Organization (ACO) bandwagon, citing high startup costs and uncertain returns on investment given the complexity of the program. Well, recently, the CMS Center for Innovation has announced the Bundled Payment for Care Improvement initiative. This initiative incorporates elements of earlier CMS demonstration projects — the gainsharing demos and ACE (acute care episode) bundled payments demonstrations which the HealthBlawger has helped a number of clients around the country qualify for in the past — and builds on the broad authority granted to the CMS Center for Innovation under health reform.
The advantages to proceeding with a Bundled Payment for Care Improvement project include the opportunity to participate in CMS shared savings programs while only providing limited commitment of organizational resources, i.e., limited to one or more discrete service lines or episodes of care. Of course, investments in a culture of collaboration must be made, but the system-wide investment in IT and other infrastructure at the level called for in order to qualify as an ACO would not necessarily be required in order to proceed with this initiative.
There are a number of different models open to participants, and nonbinding letters of commitment are due as early as late September.
From the CMS Center for Innovation announcement: Read more »
*This blog post was originally published at HealthBlawg :: David Harlow's Health Care Law Blog*
August 17th, 2011 by Stanley Feld, M.D. in Health Policy, Opinion
1 Comment »
Twenty seven million individuals were enrolled in Medicare Part D as of December 2009. The government spent $51 billion to subsidize Medicare Part D in 2009. The $51 billion spent is in addition to seniors’ premiums and co-pays. The government subsidy was $1,889 per individual subscriber.
Who is making the money?
“A provision in the Medicare Modernization Act (MMA), known as the “noninterference” provision, expressly prohibits the Medicare program (the government) from directly negotiating lower prescription drug prices with pharmaceutical manufacturers.”
This was a gift to the healthcare insurance industry by the government as a result of intense lobbying efforts.
Over 300 private plans (Medicare Plan D sponsors) enter into negotiations with pharmaceutical manufacturers separately to deliver Medicare Part D benefits.
Medicare Part D eligible seniors are forced to deal with Read more »
*This blog post was originally published at Repairing the Healthcare System*
July 20th, 2011 by BobDoherty in Health Policy, Opinion
No Comments »
Joe Scarborough reminds us that the divisions in American government are hardly new, paraphrasing Benjamin Franklin’s observation that “When you assemble a number of men, to have the advantage of their joint wisdom, you inevitably assemble . . . all their prejudices, their passions, their errors of opinion, their local interests, and their selfish views. From such an assembly can a perfect production be expected?” (This comes from a September 17, 1787 speech by Mr. Franklin to urge ratification of the U.S. Constitution, read on his behalf because he was too ill to deliver it in person. The Constitution was ratified the same day.)
I suppose we should be encouraged that Congress’s prejudices, passions, errors of opinion, local interests and selfish views are as American as apple pie, and the Republic has somehow survived nonetheless. Still, I find it deeply troubling that today’s politicians can’t find their way to agree on the debt ceiling.
No one should expect a “perfect production” to come out of this Congress and this administration, given how far apart they are on the need for tax increases and entitlement reforms. But they need to agree to something, and they need to do it soon.
I will leave it to others, who know a lot more about global economics than me, to explain what likely will happen to the economy if the debt ceiling isn’t increased by August 2. Let’s talk about the impact on health care, something I know quite a bit about—and why physicians especially should be concerned: Read more »
*This blog post was originally published at The ACP Advocate Blog by Bob Doherty*
