Tag: "emergency room"

Headlines I Wish I Hadn’t Seen

thttyAfter 5 months of legal recreational marijuana use, Colorado sees increase in ER visits, violence, and stoned driving.

The U.S. economy shrank during the first quarter of 2014.

Adult obesity rate in U.S. is at 27.7%, the highest since 2008.

Medicare overpaid $6.7 billion in 2010 for evaluation and management services.

Wikipedia entries for 9 of 10 most expensive heath conditions have significant errors.

Hits and Misses

Physician and Nurse Pushing GurneyEmergency room visits increase in wake of ObamaCare.

Nanotech chip detects signs of cancer in blood protein markers.

318,000 federal workers owe $3.3 billion in back taxes.

1 in 4 Americans now consults Google before going to doctor.

California counties sue drug-makers for marketing painkillers in accordance with FDA regulation.

Hits and Misses

wine-glassA mouthwash you can swallow: Red wine fights cavities!

Social traits of thrift, docility and nonviolence have been bred within agrarian societies.

Most emergency room “frequent fliers” have a substance abuse addiction.

Alcohol triggers junk food cravings.

New pill designed to treat symptoms of hunger (I thought that was called celery).

Two large meals (breakfast and lunch) are better than 6 small ones with same calories for controlling weight and blood sugar in diabetics.

ObamaCare Will More than Double Profit Margins for Hospitals’ Emergency Departments

Think ObamaCare is all bad news for hospitals? Not according to a new study:

Physician and Nurse Pushing GurneyWe estimated that hospital revenue from ED care exceeded costs for that care by $6.1 billion in 2009, representing a profit margin of 7.8 percent (net revenue expressed as a percentage of total revenue). However, this is primarily because hospitals make enough profit on the privately insured ($17 billion) to cover underpayment from all other payer groups, such as Medicare, Medicaid, and unreimbursed care. Assuming current payer reimbursement rates, ACA reforms could result in an additional 4.4-percentage-point increase in profit margins for hospital-based EDs compared to what could be the case without the reforms.

(Michael Wilson & David Cutler, Health Affairs)

Headlines I Wish I Hadn’t Seen

wine-glassRed wine is healthier when it’s non-alcoholic (sorry).

ObamaCare premiums are about to skyrocket; they will double in some parts of the country.

The Obama Administration is will spending $17 million a month advertising for ObamaCare.

Emergency room visits increased after Massachusetts health reform was enacted.

Half of callers to Covered California give up as deadline looms.

Hits and Misses

heartStunning finding: Saturated fat doesn’t cause heart disease.

Laszewski trashes the new Republican health plan.

Johnathan Chait: Is the new Republican plan really a plan or is it just promises, promises?

Are we headed toward a zero marginal cost society?

Should there be special emergency rooms for the elderly?

In five states, an average full-career retiree receives a retirement income higher than his final salary.

Least Surprising Health Research Result Ever: Medicaid Increases ER Use

Medicaid is a welfare program jointly funded by federal and state governments, which claims to provide health insurance to low income people. A few years ago, Oregon expanded Medicaid enrollment by lottery. This created an excellent environment to study the effects of being uninsured versus being enrolled in Medicaid, because it approximated a randomized-controlled trial — the gold standard of medical research, but seldom conducted in the social sciences.

20131231104928-0The latest result of the study, published in Science, reported that Medicaid increased use of emergency rooms by 40 percent (gated abstract here, and reported here).

This result is important for anticipating the consequences of ObamaCare. About half of the 30-plus million people expected to get health insurance under ObamaCare will be enrolled in Medicaid, not private health insurance. Already, the Administration asserts that four million new Medicaid enrollees have signed up via ObamaCare (but this estimate has been questioned).

Medicaid Expansion Means More ER Visits

A number of years ago, Governor Romney told me that under Massachusetts health reform people would go to physicians’ offices for care instead of going to the emergency room. He wasn’t saying that Massachusetts would deliver more care. He was saying that the care would be more appropriate and less expensive.

As it turns out he was wrong. Traffic to the ER in Massachusetts today is higher than it was before the state’s health reform was enacted.

er23The same argument has been used by President Obama and by supporters of the Affordable Care Act. And now it turns out they are wrong too. As The New York Times reports:

The study, published in the journal Science, compared thousands of low-income people in the Portland area who were randomly selected in a 2008 lottery to get Medicaid coverage with people who entered the lottery but remained uninsured. Those who gained coverage made 40 percent more visits to the emergency room than their uninsured counterparts during their first 18 months with insurance.

This is consistent with our own predictions in an NCPA study done soon after the ACA was passed. Ah, if only they had listened.

This is Why We Need More Jeffrey Brenners

file-206642429A 58-year-old Maryland woman breaks her ankle, develops a blood clot and, unable to find a doctor to monitor her blood-thinning drug, winds up in an emergency room 30 times in six months. A 55-year-old Mississippi man with severe hypertension and kidney disease is repeatedly hospitalized for worsening heart and kidney failure; doctors don’t know that his utilities have been disconnected, leaving him without air conditioning or a refrigerator in the sweltering summer heat. A 42-year-old morbidly obese woman with severe cardiovascular problems and bipolar disorder spends more than 300 days in a Michigan hospital and nursing home because she can’t afford a special bed or arrange services that would enable her to live at home. (KHN)

See previous post here.

A Market is Emerging for ER Care

Convenience

Medical entrepreneurs are remaking the emergency room experience. They’re pulling the emergency room out of the hospital and planting it in the strip mall.

It’s called a “free-standing ER,” and some 400 of them opened across the country in the past four years.

Amenities

The waiting room, furnished with brown leather armchairs and a coffee station worthy of a spa, is empty because patients are usually seen right away.

Expense

Free-standing ERs can make a lot of money because they charge ER prices. A visit that might have cost $200 at an urgent-care center can cost four or five times as much at an ER.

Source:Kaiser Health News.