Tag: "doctors"

Headlines I Wish I Hadn’t Seen

doctor-mom-and-son70 percent of physicians spend more than one day per week on paperwork; up from 58 percent in 2013.

Colorado: 1 in 4 Obamacare enrollees plan to drop out.

Hospital elevator buttons carry more bacteria than toilet seats.

Teen suicide attempts rise as warning cuts medicine use.

The same people who fumbled Obamacare have custody of the flood of illegal immigrant children.

 

Who’s Your Doctor?

Over at Forbes, Bruce Japsen reports that the Affordable Care Act is boosting demand for primary care providers. As we’ve said before, Obamacare does nothing to boost physician supply. The millions of newly insured will increase their demand for medical care — and someone has to provide it. This has caused a Gold Rush of sorts among medical practices and hospitals scrambling for primary care providers.

Physician staffing firm, MerrittHawkins reports primary care providers — family physicians and internists tops the list. The number of requests for nurse practitioners and physicians’ assistants it’s been ask to recruits is up more than three times (i.e. 320 %). Advance practice nurses and physicians’ assistants didn’t even make the top 20 of most recruited medical practitioners three years ago. Here’s the current list.

In many cases, increased use of nurse practitioners and physician assistants can provide high quality care at reduced costs. I have long advocated increasing these professionals’ scope of practice as an important part of innovation in delivering medical care. On the other hand, this should happen as a consequence of increased consumer-direction of healthcare spending, not as a response to increased government control, as imposed by Obamacare.

Hits and Misses

electronic-medical-recordCall your doctor: CMS says telehealth services should cover annual wellness visits, psychotherapy and psychoanalysis.

A remote control for your birth control.

A simple blood test for Alzheimer’s.

Weight loss: The best medicine for osteoarthritis.

And you thought you were a hoarder: CDC finds smallpox vials from 1950s in FDA storage room.

Poop in a pill: Fecal transplant drug nearing Phase 3 clinical trials.

A problem that self-identifies: Microwave oven that counts calories as it nukes.

Headlines I Wish I Hadn’t Seen

Confident DoctorsObamaCare made me fire my doctor.

As health care law’s employer mandate nears, firms cut worker hours, struggle with logistics.

Insurers on New York’s exchange seeking significant rate increases.

Only 25 percent of patients are offered cost estimates before treatment

Injury, violence are leading causes of death for young Americans.

More on Medicare’s Latest Data Dump

Yesterday, we noted the New York Times‘ analysis of hospital charges from the Centers for Medicare & Medicaid Services (CMS) latest data dump. The same data dump showed how the amounts Medicare paid to hospitals and other providers for different services. The Hill‘s Ferdous Al-Faruque has pointed out some extreme differences:

health-care-costsThe agency found wide discrepancies in how much services cost in different regions of the nation and within the same geographic area. In 2012 a major joint replacement surgery cost Medicare $15,901 in Baltimore while the same procedure cost $239,138 in Los Angeles, the report says.

This variation appears too extreme. If it is a quality difference, surely the lower-quality provider is so bad that it should not be accepting patients! The seeming arbitrariness of Medicare payments might be one good explanation for the variance in costs observed by the Dartmouth Health Atlas team.

Like the physician data dump, for which we praised CMS, this is a treasure trove of data. CMS has also presented the data in a reasonably user-friendly way. It took me less than ten minutes to figure out the dashboard, which allows users to make charts and tables of almost any shape and size.

Well done, CMS. Keep ‘em coming.

Hits and Misses

woman-with-childA commonly used drug can protect fertility in women undergoing chemotherapy.

Shocker! Bernie Sanders, the only socialist in the U.S. Senate, wants to fix the VA by privatizing the provider network.

Are health insurers lobbying to extend the risk-corridor “bailout” beyond three years?

Thousands of Georgia doctors lack medical-malpractice liability insurance.

Californians complaining to state regulators about ObamaCare plans: Can’t get ID cards, few providers in networks.

More Reasons Why Doctors Do Not Participate in Medicaid

doctor-xray-2This blog has many entries discussing how few doctors participate in Medicaid, the joint state-federal healthcare program for low-income people that ObamaCare expands. One reason is that fees are too low to induce doctors to participate. But even if doctors are willing to accept low fees, they find that Medicaid is the worst payer in their practices:

  • Medicaid programs have the highest number of days to collect payment (days accounts receivable): All payer average = 26 days; Medicaid average = 44 days.
  • Medicaid programs have the highest denial rate: All Payer average = 6.8%; Medicaid average = 18.5%.
  • Medicaid programs have the lowest transparency in electronic explanation of payment and adjudication of claims (electronic remittance advice): All Payer average = 95%, Medicaid average = 89.4%.

Primary-Care Physicians Earn Only 20 Percent of What They Charge

If $180,000.00 is 20% of the total reimbursement, then a PCP brings in $900,000.00 a year. Therein lays the misconception that doctors are overpaid, but remember: the doctor does not pocket that total. At a patient load of 7,200 patients that is $125.00 for a 15 minute appointment. This is great pay. But remember also that 80% of that total goes to pay the staff salaries and benefits, rent, utilities, as well as such government mandated programs like Electronic Medical Records and all other costs needed to keep a business running. (The InsureBlog)

Government Handouts for Electronic Health Records: Standards Lowered to Ensure Money Keeps Flowing

We recently noted that, halfway through the year, only four hospitals and 50 physicians have achieved the federal government’s goals for “meaningful use” of electronic health records (EHRS). The federal government has a goal of spending $30 billion to induce hospitals and physicians to adopt EHRs, and it still has about $8 billion to spend. In order to ensure the money keeps flowing, standards have been lowered:

The new rule, released May 20 and slated to be published in the Federal Register May 23, would enable providers to use the 2011 edition of certified electronic health record technology for Stage 1 or Stage 2 in 2014. They would have the option to attest to the 2013 definition of Meaningful Use core and menu items and use the 2013 definition of clinical quality measures. (FierceHealth EMR)

So, hospitals and physician practices which received handouts in previous years are pretty much guaranteed to receive a handout this year, just by resubmitting the old paperwork.

Headlines I Wish I Hadn’t Seen

risingObamaCare is driving up Medicaid costs — even in states that rejected Medicaid expansion.

Buyer’s remorse: ObamaCare patients learn their doctors are not in network — even though insurers told them they were.

ObamaCare contractors paid to do nothing: “Their goals are set to process two applications per month and some people are not even able to do that.”

Study: Being ignored on Facebook leads to low self-esteem.

Goldman Sachs: ObamaCare is good for economy.