With entries dating back to 2004, here are 10 classic blog posts on Medicare:1. Hospitals lose money by preventing patient re-admissions2. Covering a virtual colonoscopy, or not, will test the cost-cutting will of Medicare3. Medicare now requires physician essays for hospice care, as if pre-authorizations weren’t bad enough4. Why hospitalized Medicare patients get re-admitted so frequently5. Once you hit Medicare age, good luck finding a ...
Posts tagged Medicare
How to get doctors to embrace health care reform
Doctors still wield tremendous influence in the health care debate, since they still have the confidence of most patients.If Congress and the Obama administration can convince doctors to support health care reform, it can be, as the ACP's Bob Doherty notes, "decisive in determining if the public will be behind the effort, because voters are much less likely to support health care reform if told that it will result ...
Is rationing health care impossible in the United States?
As long as as 911 and EMTALA remain, the answer appears to be yes.EMTALA is the flawed, unfunded, mandate forcing hospitals to provide a medical exam to anyone who presents to the emergency department. Emergency physician White Coat envisions a scenario where a family who is denied care can simply call emergency services, or show up in the ER, to get the care they want.For instance, what if ...
How much time do doctors spend on paperwork?
A common complaint is that doctors these days are spending more time doing clerical tasks.Examples include filling out pre-authorization forms, talking to health plans for pre-certifications on imaging studies, and spending time jumping through bureaucratic hoops. Generally, you do not need a medical degree to do these tasks.Bob Doherty points to a study that gives some numbers to back up the claims. Primary care doctors spend about 3.5 ...
Hospitals lose money by preventing patient re-admissions
Preventing re-admissions, or so-called "bounce backs," is one way for Medicare to cut costs.
Too bad there's zero economic incentive for most hospitals to do so.
It's obvious that keeping patients out of the hospital will save money in the long run. Many factors play a role in this, including, appropriate primary care follow-up. But, when hospitals diligently spend money to ensure good post-hospital care, they're ...
10 health reform posts you may have missed
With entries dating back to 2004, here are 10 classic blog posts on health care reform:
1. Convincing doctors to accept a public health care plan option
2. Why health reform is going to be difficult, and the trouble with saying no to American patients
3. Should a public plan option be part of any health reform initiative?
4. The Obama health ...
Convincing doctors to accept a public health care plan option
There's no question that the possible inclusion of a public plan is one of the most contentious issues that will be debated as health reform moves forward.
As I wrote previously, I'm somewhat indifferent about the option, but, feel strongly that doctors need to maintain the ability to opt out of the plan, and stress that reimbursements need to be competitive with those of private insurers.
Well, ...
Covering a virtual colonoscopy, or not, will test the cost-cutting will of Medicare
Medicare is in the midst of deciding whether to cover virtual colonoscopies.
I wrote two prior pieces on their pending decision::
Should Medicare cover a virtual colonoscopy?
Medicare will not cover virtual colonoscopies, gastroenterologists breathe a sigh of relief
In February, after reviewing the evidence, a federal agency simply said, "The evidence is inadequate."
Predictably, the move created instant dissent, mainly from CT-scan ...
6 top medical comments, May 3rd, 2009
Here are some of the more interesting comments readers have left recently.
1. Carla Kakutani on the lack of primary care access in Massachusetts:
So we have a chicken and egg problem. Do we wait health care reform until we have revived US primary care, or is that even possible without health care reform to create the disruption needed to change our entrenched fee-for-service, procedure-happy payment ...
Medicare now requires physician essays for hospice care, as if pre-authorizations weren’t bad enough
Medicare is considering throwing more bureaucracy our way.
As MedPage Today reports, because Medicare was "concerned about a rising number of hospice patients who survive longer than six months," they are now requiring physicians to write a narrative to "describe the clinical evidence supporting a life expectancy of six months or less."
Even worse, this comes on top of a 1.1 percent cut in reimbursements to hospice ...
How the primary care doctor shortage threatens Obama’s health reform plan
Top story in The New York Times.
Excellent.
There's hope that maybe, just maybe, we're getting through to the decision makers in Washington.
The article itself is old news to regular readers of this blog, and regurgitates many of the arguments impeding health reform, as well as the problems in solving them.
"Obama administration officials, alarmed at doctor shortages, are looking for ways to increase ...
Health insurance doesn’t automatically lead to health care
Well said.
NYU's Marc Siegel writes a poignant op-ed in the Wall Street Journal, echoing much of the sentiment on this blog.
"With more and more doctors dropping out of one insurance plan or another, especially government plans," writes Dr. Siegel, "there is no guarantee that you will be able to see a physician no matter what coverage you have."
He goes on to cite the ...
Can the stimulus money save or worsen health care IT?
Billions of dollars are going to be spent modernizing our antiquated medical record system.
However, if these new digital systems fail to talk to one another, it's simply going to balloon costs.
Consider this example, which occurs pretty commonly. A man is urgently rushed to a hospital 25 to 30 miles away from the one he normally goes to. Both hospitals have EMRs, but because they ...
5 top medical comments, April 12th 2009
Here are some of the more interesting comments readers have left recently.
1. Dr. Gwenn on limited health literacy:
For us to do a better job with patients and teach them to be better advocates for themselves, we need more time - plain and simple. At the same time, patients need more community supports to understand the complex health world and build the skills they need ...
Are we wasting money on Alzheimer’s care?
According to the Alzheimer's Association, now is the time to address the burgeoning Alzheimer's crisis, especially with baby boomers in the midst of Medicare age.
Alzheimer's dementia boosts the cost of caring for the elderly almost three-fold, from about $10,000 to $33,000 per year, and as Amy Tuteur blogs, "the report of the Alzheimer's Association assumes that the enormous cost of Alzheimer's care is a morally necessary burden, but ...
Rationing health care by waiting times, or by cost
How do Americans ration health care?
It's by cost, as well as the number of uninsured.
Ezra Klein actually has a pretty balanced take on health care rationing issue. He says that what's happening Stateside is equally as dismal as the waiting times both in Canada and the UK, calling each system opposite ends of "awful extremes."
The ACP's Bob Doherty picks up on that, ...
Why hospitalized Medicare patients get re-admitted so frequently
Hospital re-admissions are hitting Medicare patients particularly hard.
Otherwise known as "bouncebacks," MedPage Today reports on a recent NEJM study showing that, during a 15-month period, 20 percent of hospitalized Medicare patients were re-admitted with 30 days of discharge.
When you consider how few outpatient doctors accept Medicare, compounded by the appointment shortage that many primary care physicians face, it's no wonder that these elderly patients who ...
Once you hit Medicare age, good luck finding a primary care doctor
Almost 30 percent of Medicare beneficiaries have trouble finding a new primary care doctor.
Expect that number to rise dramatically in the near future, as the number of Medicare beneficiaries balloons, and the amount of primary care physicians plummets.
The whole scenario is a perfect example of how poor physician access makes medical coverage practically worthless.
Contrary to popular belief, Medicare's paperwork requirements and ...
Multimorbidity, and why it’s difficult to care for complex medical patients
The majority of patients on Medicare have several medical issues to contend with.
For instance, according to this piece in the NY Times, "Two-thirds of people over age 65, and almost three-quarters of people over 80, have multiple chronic health conditions, and 68 percent of Medicare spending goes to people who have five or more chronic diseases."
And, often times, these patients are seeing anywhere from five ...
Did the University of Chicago sacrifice patient care for profit?
The University of Chicago Medical Center is under the national microscope, with a recent death in their emergency department's waiting room, and an alleged, inappropriate transfer of a patient needing surgical care.
Blogging over at MedPage Today, Shadowfax gives a more detailed look at their indiscretions.
With margins are already well above the national average, the hospital has decided to double down on profits, by limiting hospital ...
