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Premium Subsidy Fight Creating Uncertainty for Hospitals, Health Plans

Healthcare News - Wed, 07/30/2014 - 07:02

A pair of conflicting rulings regarding tax credits for those who buy health insurance on the federal marketplace is a "credit negative" for health plans and not-for-profit hospitals, Moody's Investors Service says.

Categories: Healthcare News

IOM Identifies GME Problems, Calls for Finance Changes

Healthcare News - Wed, 07/30/2014 - 06:55

Downplaying the physician shortage, an IOM report's recommendations for improving the graduate medical education system include refocusing areas of clinical emphasis and changing how GME is financed.

Categories: Healthcare News

A health trade-off that's here to stay: Lower cost, limited choice

Healthcare News - Wed, 07/30/2014 - 06:32

Traditionally, there were a few ways that health insurers could keep premiums low for individual health plans. They could select people with no prior health problems, to limit the chances of getting stuck with big hospital bills. They could pare back the services and products they offered to avoid ones that could be expensive, like maternity care or prescription drugs. They could increase premiums or deductibles so their customers would pay a larger share of any eventual bills. By changing the rules, the Affordable Care Act pushed health insurers toward a new strategy: limiting the choice of doctors and hospitals they'll pay for.

Categories: Healthcare News

Oregon looks at regulating insurer doctor networks

Healthcare News - Wed, 07/30/2014 - 06:29

Oregon insurance regulators are seeking the authority to require private insurers to have enough doctors and other health care providers to adequately serve all their customers. The move comes as a growing number of insurance companies seek to save money by shrinking the number of providers in their network. Regulators also say consumers need more transparency when shopping for insurance, including information about which doctors are covered and whether they are accepting new patients. The Oregon Insurance Division has created a task force that is working on a bill for the 2015 Legislature to consider. The group, which includes representatives from many of Oregon's insurance companies and from various sectors of the health care industry, will meet Thursday.

Categories: Healthcare News

Kaiser, Hopkins collaborate on patient care

Healthcare News - Wed, 07/30/2014 - 06:17

Kaiser Permanente and John Hopkins Medicine said Tuesday that they plan to expand on an existing relationship between the health care organizations to improve quality of care for patients. The insurer, which operates its own medical centers, and the top academic medical center plan to collaborate on education and research endeavors, share best practices and develop new health care models. They will work to improve patient safety and treatment outcomes while reducing costs. And the pair will also strengthen their relationship at Suburban Hospital, a Hopkins hospital located in Bethesda.

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Jobs at risk as Mission Health eyes deep budget cuts

Healthcare News - Wed, 07/30/2014 - 06:16

Mission Health System will cut costs by $42 million next year under a reorganization plan that could mean layoffs. It plans to grow revenue by $10 million during the same fiscal year, which starts Oct. 1. The not-for-profit company — Western North Carolina's largest employer with 10,600 workers — has yet to determine how many jobs might be lost. Mission Health predicts a $500 million decrease in payments over the next decade as more people get medical care outside of hospitals and reimbursements from Medicare and Medicaid decline. Seventy-five percent of Mission's patients are covered by Medicare and Medicaid.

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Why are dope-addicted, disgraced doctors running our drug trials?

Healthcare News - Wed, 07/30/2014 - 06:12

I've reported before on doctors who fall foul of medical regulators. It's been a sobering experience, partly because mistakes like those made at Pioneers don't necessarily derail a career. Far from it—some sanctioned doctors find lucrative work with the drug industry. In 2010, for instance, I discovered that Pfizer, a pharmaceuticals giant, had made some questionable decisions when hiring physicians to talk to doctors about the company's drugs. One recruit had been fined $30,000 for dangerous prescription of addictive narcotics, yet was hired to lecture others on how to use Pfizer's leading antipsychotic drug. (Pfizer says it now screens potential speakers for disciplinary actions.)

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Deal allots $17 billion for overhaul of VA healthcare system

Healthcare News - Tue, 07/29/2014 - 07:44

House and Senate negotiators announced an agreement Monday on legislation that would allocate about $17 billion to overhaul the Department of Veterans Affairs' sprawling and beleaguered health care system. But the deal does not give the department everything that officials there have said is needed to fix its problems. The agreement set off a frantic rush on Capitol Hill to gather signatures from members of the conference committee working on the bill so that it could be put to a vote of the full House and Senate before lawmakers adjourn for an August recess on Friday.

Categories: Healthcare News

Medicare Advantage Carriers See 'No Choice' But to Accept Cuts

Healthcare News - Tue, 07/29/2014 - 06:51

With Medicare programs taking a $300 billion hit to help fund value-based healthcare reforms under the Patient Protection and Affordable Care Act, Medicare Advantage health plans are feeling the pinch.

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Physicians to Appeal 'Docs v. Glocks' Ruling in FL

Healthcare News - Tue, 07/29/2014 - 06:45

A Florida law prohibiting doctors from talking with patients about gun safety is upheld by a three-judge panel in the 11th Circuit Court of Appeals, but an injunction blocking the law remains in effect.

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Medicare's hospital trust fund appears flush until 2030

Healthcare News - Tue, 07/29/2014 - 06:29

Medicare's Hospital Insurance Trust Fund, which finances about half the health program for seniors and the disabled, won't run out of money until 2030, the program's trustees said Monday. That's four years later than projected last year and 13 years later than projected the year before the passage of the Affordable Care Act. Unlike Medicare, however, the part of Social Security that pays for people getting disability benefits is in far more immediate danger. The Disability Insurance Trust Fund is projected to run out of money in 2016, just two years from now, unless Congress intervenes, the trustees said.

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Health Policy Commission says discharge trends driving MA healthcare spending

Healthcare News - Tue, 07/29/2014 - 06:26

Massachusetts hospitals discharge a larger portion of their patients to other health care settings than the national average, a difference that has contributed to the state's higher post-acute care costs and has driven health care spending, a state analysis concludes. The findings come courtesy of a supplemental cost trend analysis report undertaken by the state's Health Policy Commission, which is tasked with keeping state health care costs and quality in check. The state first performed the analysis in 2013, and will conduct a hearing on the first cumulative comparative results come October 2014. In the interim, analysts looked to further delve into the 2013 findings, issuing a supplemental report in July.

Categories: Healthcare News

Medical identity theft can threaten health

Healthcare News - Tue, 07/29/2014 - 06:22

Anndorie Sachs had her life turned upside down when authorities showed up at her door in Salt Lake City and threatened to take her four children away - all because another woman had stolen her identity and given birth to a baby who tested positive for drugs. When CBS News first reported her story back in 2006, it was estimated that 200,000 Americans each year were the victims of what is called medical identity theft, but in the years since, the problem has gotten dramatically worse. According to a recent report by the Ponemon Institute, an independent research organization specializing in privacy and security issues, the number of victims grew to 1.85 million in 2013 - a 19 percent jump from the year before.

Categories: Healthcare News

Improving the 'handoff' in children's hospitals cuts down on errors

Healthcare News - Tue, 07/29/2014 - 06:18

Most parents intuitively know what a handoff is — the last time you had a babysitter come take care of your kids, or you dropped a child off at daycare, you probably performed a pretty sophisticated one yourself. You checked backpacks, lunchboxes, passed along instructions about sleep habits and illnesses, and left emergency numbers. Handoffs happen thousands of times a day at children's hospitals, when sick kids are admitted to the hospital, when they are transferred between nurses or doctors changing shifts, and when they are sent to receive diagnostic tests. Fumbling these handoffs — through miscommunication or misunderstanding — can cause serious harm.

Categories: Healthcare News

Can doctors teach the body to cure cancer?

Healthcare News - Tue, 07/29/2014 - 06:10

What if the path to curing cancer has been part of the body all along? For generations the three pillars of cancer treatment have been surgery, radiation, and chemotherapy. But both chemotherapy and radiation are crude weapons with significant collateral damage to healthy tissue, and surgery can leave cancerous cells behind. Scientists have long tried to understand how to get the immune system—the body's natural defense mechanism—to recognize cancer cells as the enemy and destroy them. And now we may finally be turning the corner: Doctors are finding that clinical regimens known as immunotherapies can empower a patient's immune system to fight the disease like it might an infection, while sparing a person's normal cells.

Categories: Healthcare News

Some FL doctors are refusing to accept Obamacare

Healthcare News - Tue, 07/29/2014 - 05:24

After being without health insurance for two years, Miranda Childe of Hallandale Beach, Fla., found a plan she could afford with financial aid from the government using the Affordable Care Act's exchange. Childe, 60, bought an HMO plan from Humana, one of the nation's largest health insurance companies, and received a membership card in time for her coverage to kick in on May 1. But instead of being able to pick a primary care physician to coordinate her health care, Childe says she repeatedly ran into closed doors from South Florida doctors who are listed in her plan's provider network but refused to see patients who bought their coverage on the ACA exchange.

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ICTC, TMA's BWI Team Up to Vaccinate Kids for School

Texas Medical Association - Hot Topics - Mon, 07/28/2014 - 11:47

TheImmunization Collaboration of Tarrant County (ICTC) and Texas Medical Association’s (TMA’s) Be Wise — ImmunizeSM program join to provide vaccinations to prepare Tarrant County children for school and prevent harmful and potentially deadly diseases.ICTC also provides meningococcal vaccination for college students and limited adult vaccinations.

Categories: Healthcare News

CA Fines 8 Hospitals for Medical Errors

Healthcare News - Mon, 07/28/2014 - 07:03

In the latest round of medical errors leading to fines in California hospitals, the state has levied financial penalties totaling $775,000 for placing 10 patients in immediate jeopardy of serious injury or death.

Categories: Healthcare News

As Medicare Advantage Cuts Loom, Disagreement Over Program's Stability

Healthcare News - Mon, 07/28/2014 - 06:56

The ability of cost savings achieved through healthcare reform efforts to offset the coming cuts to Medicare Advantage is hotly debated at a House Ways and Means health subcommittee meeting.

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Maryland hospitals aren't reporting all errors and complications, experts say

Healthcare News - Mon, 07/28/2014 - 06:42

Nadege Neim won a $1.4 million verdict last year after suing her Ellicott City obstetrician for removing a healthy ovary and fallopian tube from her right side when she went into the hospital for surgery to have a cyst excised from her left. A few years earlier, an unnamed man in his 50s sought treatment for pneumonia at a Maryland hospital and ended up losing both legs. No one properly assessed him, and scans that might have found the blood vessel blockage were delayed for nearly two days in a "cascade of poor decisions," state regulators said in an investigative report obtained by The Baltimore Sun.

Categories: Healthcare News