April 7th, 2011 by Toni Brayer, M.D. in Health Policy, Opinion
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I am all for any proposal that will improve heath care in America. Improvement means controlling costs, covering all Americans so no one has to worry about going bankrupt to pay for health care. Improvement means access to quality care without having to worry about losing your job, which means losing your coverage. Improvement means a system where all incentives are aligned to prevent disease, rather than using expensive technologies and hospitals to treat disease after the fact. Any proposal that gets us there has my vote.
In the GOP “Path to Prosperity” budget for 2012, they propose a few things that are good and a few big things that are bad…really really bad. First the good. Capping the medical malpractice lawsuits for “pain and suffering” would be a huge step forward. Patients should be compensated for medical errors but the “hit the lottery” windfalls for pain and suffering are costly drivers that make no sense. There is no place in the world, besides the USA, that has such onerous medical malpractice lawsuits. And they drive up cost for everyone. Read more »
*This blog post was originally published at EverythingHealth*
March 30th, 2011 by Emergiblog in Health Policy, Opinion
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We hear so much about health care fraud and how much it costs us all in terms of higher Medicaid, Medicare and private insurance costs, and if we could just rein in this fraud we could make our health care system pay for itself.
My trusty Mac widget dictionary defines fraud as:
- a person or thing intended to deceive others, typically by unjustifiably claiming or being credited with accomplishments or qualities and
- wrongful or criminal deception intended to result in financial or personal gain.
Well, I’m wondering, what is actually considered fraud?
Let me give some examples, and help me understand whether or not this is fraudulent behavior. The examples are purely hypothetical and do not represent any known individuals, living or dead, or specific situations in any known emergency department, living or dead. Read more »
*This blog post was originally published at Emergiblog*
March 28th, 2011 by DrWes in Health Policy
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In case people are wondering if our governmental overlords really care about the latest and greatest treatment guidelines published by our professional health care organizations, take note.
CMS (Center for Medicare and Medicaid Services) is still using guidelines for defibrillator implantation from 2005 to justify payment for services in their national coverage decision, whereas the latest guidelines published by the Heart Rhythm Society published in 2008 carry signficiant differences in their recommendations for appropriate patients for this technology.
So which set of guidelines should doctors use?
The answer is obvious: if you use the latest data to decide who should receive a defibrillator, you might be subject to a Department of Justice investigation.
So much for using updated guidelines.
-WesMusings of a cardiologist and cardiac electrophysiologist.
*This blog post was originally published at Dr. Wes*
March 27th, 2011 by DrRich in Health Policy, Opinion
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In 2008, the Centers for Medicare and Medicaid Services (CMS) announced it would no longer pay for the treatment of “never events,” i.e., certain medical conditions in hospitalized patients which the Feds deem to be universally avoidable under all circumstances. These conditions included:
* Decubitus ulcers
* Two kinds of catheter-associated infections
* Air embolism
* Mediastinitis after coronary bypass surgery
* Transfusing patients with the wrong blood type
* Leaving objects inside surgery patients
* In-hospital falls
Then, having been delighted with the results of its original list (or dismayed that healthcare costs continued to skyrocket despite its original list) CMS subsequently proposed declaring several new conditions as “never events,” including: Read more »
*This blog post was originally published at The Covert Rationing Blog*
March 7th, 2011 by Debra Gordon in Health Policy
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The latest from moi: “Implementing Electronic Medical Records: Advice from the Trenches” in the March/April 2011 issue of HIT Exchange magazine. An excerpt:
The news released in late December from the Centers for Disease Control and Prevention that more than half of the nation’s physicians are now using electronic medical records (EMR)—double the adoption rate of just five years ago—is surely worth celebrating. Until, that is, you take a look and realize that just a fourth of office-based physicians have access to a “basic” EMR system including patient history, demographics, problem lists, clinical notes, and computerized physician order entry (CPOE), while just one in 10 has a “fully functional” system, which also includes the communication system required for meaningful use, such as the ability to send tests and prescriptions electronically.
But the floodgates are about to open. In January, the Centers for Medicare & Medicaid Services (CMS) began registering physicians and hospitals in 11 states for the EMR incentive program announced in 2009 as part of the federal stimulus package. Registration for California began in February, and the rest of the country should be up and running by the end of the year. Physicians could be eligible for up to $44,000 in bonuses over five years through Medicare and up to $63,750 over six years through Medicaid.
*This blog post was originally published at A Medical Writer's Musings on Medicine, Health Care, and the Writing Life*
