Tag: "Medicare"

Hits and Misses

iStock_000004347437XSmallSome children now eligible for adult organ transplants.

Number of induced labors for early-term deliveries dropped 12 percent, 2006-2012.

Medical privacy: Let patients opt out of HIPAA and manage their own data.

36 percent increase in global use of antibiotics “alarming“.

Medicare expanding telehealth coverage to include wellness, psychotherapy, psychoanalysis.

Hospital Charges Surge for Common Ailments

Charges for some of the most common inpatient procedures surged at hospitals across the country in 2012 from a year earlier, some at more than four times the national rate of inflation, according to data released by Medicare officials on Monday.

Charges for chest pain, for instance, rose 10 percent to an average of $18,505 in 2012, from $16,815 in 2011. Average hospital charges for digestive disorders climbed 8.5 percent to nearly $22,000, from $20,278 in 2011.

In 2012, hospitals charged more for every one of 98 common ailments that could be compared to the previous year. For all but seven, the increase in charges exceeded the nation’s 2 percent inflation rate for that year, according to The Times’s analysis. (NYT)

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

Surgeon Operating on a PatientVA hospital administrators close operating rooms at 3 p.m.

ObamaCare causes hospitals to cut back on charity care.

Reference pricing for elective surgeries saved one large public employer $5.5 million in two years.

77 percent of doctors sanctioned by New York State Department of Health continue to practice.

Hospitals are lobbying to obliterate Medicare oversight that has recovered $8 billion in improper payments.

Headlines I Wish I Hadn’t Seen

air-pollutionEliminating all greenhouse gas emissions from the U.S. forever would impact warming by less than one fifth of one degree by 2100.

Federal health care lobbying has declined to “only” $130 million.

Septic (blood) infections involved in up to half U.S. hospital deaths.

Secret wait list cover-up spreads to more VA hospitals; records destroyed.

Big Brother? U.S. gave Medicare patients’ private medical information to local officials during New Orleans public-health scare.

Variations in Post-Acute Care Spending

A publication called “Becker’s Hospital CFO” recently ran a story based on data from a company called DataGen on “The Truth Behind Variation in Episode Payments.” The article claims it will explore “the regional variations in Medicare payments for 90-day episodes of care.” This is to prepare for the new era of bundled payments, which is supposedly right around the corner.

Toy Businessman on a Pile of MoneyIn fact, the article does two things:

  1. It completely fails to explain the regional variations it identifies, and
  2. It illustrates what a poorly thought-through idea bundling is, especially when designed by payers like Medicare.

The article defines four types of episodes that are likely candidates for bundled payment. These all start with an inpatient admission followed by post-acute care treatment –

  1. Acute Myocardial Infarction (AMI)
  2. Congestive Heart Failure (CHF)
  3. Pneumonia
  4. Major joint replacement

Will ObamaCare Prove More Costly Than Medicare and Medicaid?

One consistent argument in favor of expanding government-run health care in the U.S. goes like this: “We’re the richest country in the developed world, so we should be able to provide universal health care like all the other developed countries.”

Well, we are a heck of a lot richer than we were in the 1930s or 1960s, when Social Security, Medicare, and Medicaid rolled out. Despite our significant increase in income, those three programs are bankrupting the nation. And ObamaCare wreaks more fiscal havoc at a significantly faster rate than any of those programs.

With two simple charts, Charles Blahous of the Mercatus Center shows how much more expensive ObamaCare will be than Social Security, Medicare, or Medicaid — just five years after Congress enacted them.

In one chart, Blahous illustrates that the federal deficit will be about 5.5 percent of GDP five years after ObamaCare’s enactment — versus only 3 percent five years after Social Security’s enactment and less than one percent five years after Medicare’s and Medicaid’s enactment.

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Source: Mercatus Center.

Headlines I Wish I Hadn’t Seen

nutrition-labelAre serving sizes on food packages intentional attempts to mislead us? No, they are dictated by the government.

Medicare kept paying dozens of doctors after they were suspended or terminated from state Medicaid programs or were indicted or charged with fraud.

Terminal cancer patients in Russia are sent home to die; can’t get pain medication; some are committing suicide. (HT: Jason Shafrin)

Patients at risk: More than 100,000 doctors, nurses, medical technicians, and healthcare aides abuse prescription drugs.

Why We Spend So Much on Drugs

The editors at Bloomberg explain:

prescription-bottleHere’s how the system works: When a doctor administers a drug in his or her office, Medicare pays 106 percent of its average selling price. The doctor keeps the extra as compensation for administering the injection.

What has this got to do with eye doctors? The drug Lucentis, used to treat macular degeneration, cost Medicare almost $2,000 a shot in 2012. Another drug, Avastin, which works just as well, costs about $50. If you were the doctor, faced with a system that pays you 6 percent of the drug’s cost, which would you choose? That Medicare spent a total of about $1 billion on Lucentis in 2012 suggests most ophthalmologists went with the more expensive one.

It gets worse:

This problem goes beyond a single drug. Of the $20 billion Medicare spent on drugs administered by doctors in 2010, 85 percent went to the 55 most expensive ones. In what seems unlikely to be a coincidence, 42 of those drugs also showed an increase in use from 2008 to 2010.

Headlines I Wish I Hadn’t Seen

Canvbnadian study: Almost one-third of patients never fill the prescriptions for the medicines they are told to take.

Jails house 10 times more mentally ill than state hospitals.

Doctor billed Medicare for $21 million in 2012; investigated by the FBI; makes large donations to Democrats.

Washington Post fact checks TV ad Barrack Obama ran against John McCain and finds that all the scary predictions actually came true — it’s called ObamaCare.

Most of the 4,000 doctors who received at least $1 million from Medicare in 2012 billed mainly for giving patients injections, infusions and other drug treatments.