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Emergency Care’s Ambiguity In The Affordable Care Act

There’s just so much hidden and buried in the Affordable Care Act (ACA) that it’s like trying the find all the goodies in an Easter egg hunt. ACEP News pointed out one hidden goodie, nicely illustrated in this article from Kaiser Health News:

Under the new health law, insurance companies must extend several new protections to patients who receive emergency care. One of the biggest guarantees: Patients who need emergency treatment will have their costs covered at the same rate, regardless of whether they are treated at “in-network” or “out-of-network” hospitals.

The law also bars health plans from requiring prior authorization for emergency services. And it mandates that plans follow the “prudent layperson” rule. For example, if a person goes to the ER with chest pain, but ends up being diagnosed with indigestion, the claim has to be covered because going to the hospital under those circumstances made sense.

The provisions go into effect for every health plan issued after Sept. 23 – six months after the law was enacted — that offers emergency coverage.

This is potentially quite significant. As with so many things, the devil is in the details, and the implementation is not yet actualized. Read more »

*This blog post was originally published at Movin' Meat*

The Value Of Social Media For Patients, Doctors And Nurses

A patient apologized to me for asking so many questions. “There’s no need to apologize,” I said to the patient, “It’s wonderful that you have so many questions concerning your healthcare.” I mentioned to her that she is an “empowered and engaged patient,” and that’s a good thing.

It’s no secret that health consumers are turning to the Internet for health information.

In a recent article from MediaPost News, Gavin O’Malley writes that, according to new a study by Epsilon Strategic & Analytic Consulting Group, “40% of online consumers use social media for health information — reading or posting content — while the frequency of engagement varies widely. According to the study, individuals who use healthcare social media fall into two broad groups: the 80% who are highly engaged patients, and take active roles in health management; and the 20% who lack confidence to play an active role in their own health.” Read more »

*This blog post was originally published at Health in 30*

Why Creating Healthcare “Consumers” Won’t Work

I [recently] gave a speech at the Midwest Business Group on Health’s (MBGH) 30th Annual Conference. The MBGH is one of the country’s leading organizations on healthcare, and its members include the leading innovators and thought leaders on healthcare in America. It was a privilege to present to them.

I spoke about why healthcare just isn’t a consumer business in spite of all of the effort to turn people into healthcare “consumers.”

At Best Doctors, we have a closeup view of what happens to people when they try to find their way through the healthcare system. It’s not a pleasant picture. Healthcare consumers –- if you can call them that –- are often lost, confused, frustrated, alone. Read more »

*This blog post was originally published at See First Blog*

A “Decision Tree” For Personalized Medicine

ImagesWhat’s amazing is that despite the vocal movement to empower patients, no one has put together a well-referenced, readable book to help patients understand how they should use personalized medicine to influence their health — until now.

Enter The Decision Tree: Taking Control of Your Health in the New Era of Personalized Medicine (Rodale 2010), something of a blueprint of patient liberation written by Thomas Goetz, executive editor of Wired magazine. It offers constructive narrative not only about the importance of the decisions we make but how to apply the concept of an old-fashioned decision tree in making those decisions. Read more »

*This blog post was originally published at 33 Charts*

Unnecessary Medical Care: Consumers Are A “Powerful Force,” Too

One of the points of contention in healthcare reform is whether it will do enough to control costs. Forget about the Congressional Budget Office’s optimistic outlook, as it discounts the Medicare “doc fix,” which, when factored in, will erase any supposed deficit reduction.

Reform doesn’t do very much to change the underlying structure of our health system, which continues to pay more for quantity of medical services, rather than shift the focus to value and quality.

Sharon Begley, writing in Newsweek, offers some sensible suggestions on what we can do control costs. Better incorporating the best clinical evidence into their medical decisions would help. She cites the continued, and possibly unnecessary, use of back surgery, knee surgery, vertebroplasties, and angioplasties, despite mounting evidence that they’re being overused. Read more »

*This blog post was originally published at KevinMD.com*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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