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Timing Discharges to Maximize Revenue - "Corruption" of Corporate Long-Term Hospitals?
A recent Wall Street Journal article that focused on a quirk in US Medicare payment rules that may be gamed by long-term hospitals also revealed the plight of physicians employed by such hospitals, and worse, the danger posed by such gaming to patients.Discharging Patients at Particular Times Maximizes Hospital RevenueHere is how the rule works: Under Medicare rules, long-term acute-care hospitals like Kindred’s typically receive smaller payments for what is considered a short stay, until a patient hits a threshold. After that threshold, payment jumps to a lump sum meant to cover the full course of long-term treatment.Th...
Source: Health Care Renewal - February 23, 2015 Category: Health Management Tags: corporate physician health care corruption Kindred Health mission-hostile management Select Medical Source Type: blogs

JAMA Internal Medicine Bias – Now You See Me
This study cherry-picks physician prescribing data for a subset of medicines to advance a false narrative. Manufacturers routinely engage with physicians to share drug safety and efficacy information, new indications for approved medicines and potential side effects of medicines. As the study says, the exchange of this critical information could impact physicians' prescribing decisions in an effort to improve patient care. Physicians' prescribing patterns are dynamic and based on individual patients' needs. According to a survey of physicians, 91 percent felt that a great deal of their prescribing was influenced by their...
Source: Policy and Medicine - June 21, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

Building Better Metrics: Invest in “Good” Primary Care and Get What You Pay For
By NIRAN Al-AGBA, MD In 1978, the Institute of Medicine published A Manpower Policy for Primary Health Care: Report of a Study (IOM, 1978) where they defined primary care as “integrated, accessible services by clinicians accountable for addressing a majority of heath care needs, developing a sustained partnership with patients, and practicing in the context of family and community.” The four main features of “good” primary care based on this definition are: 1. First-contact access for new medical issues, 2. Long-term and patient (not disease)-focused care, 3. Comprehensive in scope for most medical issues, and 4. C...
Source: The Health Care Blog - August 16, 2016 Category: Consumer Health News Authors: John Irvine Tags: 2016 Town Hall Physicians Building Better Quality Metrics Niran Al-Agba primary care Source Type: blogs

The Future Of The Affordable Care Act In A Trump Administration
This segment originally aired on The Diane Rehm Show on November 14, 2016. The HealthCare.gov website, where people can buy health insurance, is displayed on a laptop screen. AP PHOTO/ANDREW HARNIK Republicans in Congress have voted more than 50 times to repeal the Affordable Care Act without success. Now, they have an ally in President-elect Donald Trump, who promised on the campaign trail to “repeal and replace” the law. But over the weekend, Trump seemed to soften his stance. He told the Wall Street Journal he would consider leaving in place some provisions, including one that prohibits insurers from denying covera...
Source: Disruptive Women in Health Care - November 15, 2016 Category: Consumer Health News Authors: dw at disruptivewomen.net Tags: Affordable Healthcare Act Consumer Health Care Cost Coverage Policy Election 2016 Health Reform Source Type: blogs

Medicare Costs Associated With Mortality Rates in AMI Patients
Cardiac procedure costs tied to 180 - day mortality; postacute care spending moderately cost - effective
Source: Pulmonary Medicine News - Doctors Lounge - November 11, 2014 Category: Respiratory Medicine Tags: Cardiology, Family Medicine, Geriatrics, Internal Medicine, Critical Care, Emergency Medicine, Nursing, Pathology, Pulmonology, Journal, Source Type: news

Intense End - of - Life Care Found to Be Less Likely for VA Patients
Authors say results have important implications for the future of VA care, Medicare policy
Source: The Doctors Lounge - Oncology - January 9, 2018 Category: Cancer & Oncology Tags: Family Medicine, Internal Medicine, Critical Care, Emergency Medicine, Nursing, Oncology, Pharmacy, Radiology, Journal, Source Type: news

Health Care ’s Third Wave
By DAVID M. CORDANI Change and American health care have become synonymous. “Change” can be exciting and life-altering when it refers to the innovative new therapies and treatments that improve or extend life, many of those originating in the United States. Change, though, can be a tremendous source of anxiety for families concerned with the affordability of care and stability in their health care coverage choices. It is the tension between these two definitions of change that the United States has struggled to solve over the past three decades. As we have all witnessed, the health care marketplace has gone through two...
Source: The Health Care Blog - August 3, 2018 Category: Consumer Health News Authors: matthew holt Tags: Cigna Hospitals manage care medical cost sustainable health care system Source Type: blogs

Specialty Classifications of Physicians Who Provide Neurocritical Care in the United States
ConclusionsPhysicians with a dedicated clinical neuroscience background accounted for less than half of neurocritical care service in US Medicare beneficiaries.
Source: Neurocritical Care - August 28, 2018 Category: Neurology Source Type: research

The Critical Element in Billing Medicare for Telemedicine The Critical Element in Billing Medicare for Telemedicine
New telemedicine codes are great for physicians, but know the rules when it comes to Medicare patients. Coding expert Betsy Nicoletti answers this question and others for coding and billing correctly.Medscape Business of Medicine
Source: Medscape Business of Medicine Headlines - May 28, 2019 Category: Pharmaceuticals Tags: Family Medicine/Primary Care Article Source Type: news

Outcomes Poor With Medical Care From Fraud, Abuse Perpetrators
Mortality and emergency hospitalization rates higher in Medicare beneficiaries with FAP exposures
Source: Pulmonary Medicine News - Doctors Lounge - November 11, 2014 Category: Respiratory Medicine Tags: Cardiology, Dermatology, Endocrinology, Family Medicine, Geriatrics, Gastroenterology, Gynecology, Infections, AIDS, Internal Medicine, Allergy, Critical Care, Emergency Medicine, Nephrology, Neurology, Nursing, Oncology, Ophthalmology, Orthopedics, ENT, Source Type: news

ACP: Medicare for All Needed to Fix ‘ Ill ’ U.S. Health Care System
American College of Physicians has endorsed two proposals being discussed by Democratic presidential candidates
Source: Pulmonary Medicine News - Doctors Lounge - January 22, 2020 Category: Respiratory Medicine Tags: Cardiology, Dermatology, Endocrinology, Family Medicine, Geriatrics, Gastroenterology, Gynecology, Infections, AIDS, Internal Medicine, Allergy, Critical Care, Emergency Medicine, Nephrology, Neurology, Nursing, Oncology, Ophthalmology, Orthopedics, ENT, Source Type: news

End-of-Life Care: New Strategies for Working with Families Who Aren’t Ready to Let a Terminal Patient Go
Check out this 90-minute webinar from the American Health Lawyers Association, on December 17:  "End-of-Life Care: New Strategies for Working with Families Who Aren’t Ready to Let a Terminal Patient Go." Five major critical care organizations have issued a Joint Policy Statement recommending the use of conflict resolution and mediation processes when health care providers and families have conflicts over end-of-life care. Further, the Centers for Medicare & Medicaid Services recently proposed changes to the 2016 Medicare Physician Fee Schedule to allow for end-of-life care planning payments, highlighting the...
Source: blog.bioethics.net - December 10, 2015 Category: Medical Ethics Authors: Thaddeus Mason Pope Tags: Health Care medical futility blog syndicated Source Type: blogs

GAO Report Harshly Critical of Medicare Advantage Plans
This report follows an October 2014 audit by the GAO that was prompted by the Center for Public Integrity's "Medicare Advantage Money Grab" series. The series documented nearly $70 billion in improper payments to health plans, most of which were inflated fees from overstating patients' health risks, from 2008 through 2013 alone. The investigation performed by the Center for Public Integrity traced the overpayments to abuse of a billing formula known as a risk score, which pays higher rates for sicker patients and less for people in good health. Since 2004, that risk score has been used on the "honor system," despite crit...
Source: Policy and Medicine - June 19, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs

Hospital-Level Changes in Adult ICU Bed Supply in the United States
We described the number of beds, teaching status, ownership, intensive care occupancy, and urbanicity for each hospital in each year of the study. We then examined the relationship between increasing intensive care beds and these characteristics, controlling for other factors. The study included 4,457 hospitals and 55,865 hospital-years. Overall, the majority of intensive care bed growth occurred in teaching hospitals (net, +13,471 beds; 72.1% of total growth), hospitals with 250 or more beds (net, +18,327 beds; 91.8% of total growth), and hospitals in the highest quartile of occupancy (net, +10,157 beds; 54.0% of total gr...
Source: Critical Care Medicine - December 17, 2016 Category: Emergency Medicine Tags: Online Clinical Investigations Source Type: research

Patient-centered care: turning the rhetoric into reality.
Abstract Although patient-centered care (PCC) was proclaimed a core health system aim in a 2001 Institute of Medicine report, it remains one of the most-used and least-understood terms in healthcare. We interviewed leaders at 15 Medicare accountable care organizations (ACOs) across the country that have been the most successful in putting patient-centeredness into actual practice to develop an operational definition. The ACOs we spoke with had a 3-pronged practical approach of: 1) patients as partners, 2) proactive customer-service orientation, and 3) care coordination with a whole-person approach. We believe this...
Source: The American Journal of Managed Care - December 31, 2016 Category: Health Management Authors: Weissman JS, Millenson ML, Haring RS Tags: Am J Manag Care Source Type: research