Health cares future: An interview with a hospital CEO Not long ago I interviewed Dr. Todd Sorensen, the CEO of Regional West Medical Center, a 184-bed facility serving a large swath of rural western Nebraska. I've known Dr. Sorensen since junior high school, and we've kept in touch over the years to discuss the health care system from his perspective as a physician and administrator and mine as a health ...

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How to choose a good hospital? Hint: Dont listen to the ads. Nearly every day a press release from a health care provider or health care technology vendor shows up in my inbox urging me to look at what they offer and to write about it. Most of the time I don't find their news worth passing along, but occasionally a pitch sparks a column idea. That's the case with the press ...

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A while back I was sitting in a Toronto coffee bar and, as I often do in another country, I began chatting with people about their health care system. One employee taking people's orders was about to go off duty and sat down to visit. "I'm tired of hearing you Americans talk about rationing in Canada," he said. "Let me tell you how many MRIs I had when I was ...

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A friend of mine, a diabetic who has been pretty passive about his medical care, suddenly learned the importance of patient engagement a few weeks ago when a matter affecting his pocketbook grabbed his attention. A bill arrived from Express Scripts, the pharmacy benefit manager (PBM) for Emblem Health, a Medigap plan offered to former New York City employees. For years my friend had been taking the drug gemfibrozil that diabetics ...

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As we head into health insurance enrollment season, which opens in November, consumers/patients will face yet another challenge in selecting the best health plan. Sorting through policies was tough already, but now insurers are making it even harder by changing the way they will cover generic drugs. It used to be that opting for generics was a snap. Health plans usually offered three or four tiers of drugs -- one for ...

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American health care has become a gigantic game board with players of all sorts strategizing to win. Winning, of course, means getting more money from payers: government or private. It turns out this medical marketplace game is not all that new. It's just become wilier, as I have shared in a couple of posts over the summer. An obituary last week for Dr. Rashi Fein, an influential economist with a progressive stripe ...

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Just a few years ago it seemed that advocates for health care transparency had scored a big victory. The Centers for Medicare & Medicaid Services (CMS) announced that they would rate nursing homes by awarding five stars to the best and fewer stars to lower-quality facilities. Families searching for care for loved ones would have access to a familiar rating system to help them make choices. After all, star ratings for ...

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That the government overpays sellers of Medicare Advantage plans is well known in Beltway circles even if much of the public remains unaware. Recently, two Department of Health and Human Services (HHS) researchers posted new findings on the Medicare and Medicaid Research Review, a peer-reviewed online journal supported by the Centers for Medicare and Medicaid Services (CMS), documenting how some insurance companies are overbilling the government and have been doing so ...

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I recently wrote about a hospital system in Colorado that had discovered a way to cross market its more profitable emergency room services if a patient first came to its urgent care center. Pretty clever! Then recently I came across another health care marketing trick close to home and just as sly. As I sat on a New York subway one sizzler of a day, an ad for an ice cream ...

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Not long ago, Tracy Hume, a freelance writer who lives in Greeley, Colorado, sent me an email posing this question: "Do ER-affiliated urgent care providers ever try to escalate patients to the ER when it is not medically necessary?" It seems that over the July 4th weekend, Tracy’s teenage son was complaining of a headache, nausea and abdominal pain, and was vomiting. He doesn't complain much, she said, so thinking that ...

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