The newest Health Wonk Review has been posted. This time around, Colorado Health Insurance Insider’s Louise Norris is the host, and it’s an excellent read.
A few highlights:
Doctors Sue Hospitals, Protect Patients
Over at Healthcare Renewal, Roy Poses digs into how doctors are pushing back against hopsitals who put profits above everything else. His article describes two recent lawsuits filed by physician groups alleging that the hospital systems they worked for were sacrificing patient welfare in the name of profit.
As Louise observes, “the details are sickening to read: One hospital group encouraged its docs to exaggerate the severity of patient conditions and needlessly admit patients from the ER to hospital beds in order to bill more for their treatment. Another hospital group that owns three hospitals and also partially owns an ambulance company was making patient transfers (using their own ambulance company despite slower response times) a top priority – to the extent that a doctor’s transfer rate was a factor in bonuses and performance reviews. An admin email stated that “the performance we are looking for are transfers.” Wow. Transfers just for the sake of racking up revenue – patient welfare had nothing to do with it, and was likely compromised when the slower ambulance company was used in cases where the transfer was actually warranted.”
Often doctors are afraid to stand up to greedy hospital administrators. But by banding together, physician groups can stand up for patients.
I would add that, in the past two doctors— working at separate non-profit hospitals—have told me about hospital administrators pressuring physicians to admit ER patients, even when they did not need to be hospitalized. This is how some hospitals “put heads on beds.”
When Universities Buy Inadequate Insurance for Their Students
On his blog, Duncan Cross tells the story of the Arizona State graduate student who died because his Aetna plan (a student plan purchased through the university) capped how much the insurer would pay out over the course of a lifetime at $300,000. It also didn’t cover prescription drugs. One might be tempted to blame the insurance company,
but as Cross points out, university was the organization responsible for choosing a health insurance plan for its students – Aetna just provided the coverage that the school requested.
Under the Affordable Care Act, this won’t happen. Insurers will not be able to cap life-time or annual pay-outs, and policies will have to cover prescription drugs.
Nurse Practitioners and Satisfied Customers
Norris also comments on HealthBeat’s post on Nurse Practitioners and confides: “For years, my primary care provider was a PA at a women’s clinic in Denver – I don’t think I ever saw any of the doctors at the practice at all. The PA handled all of my well-woman care needs perfectly. And now that we’re in Northern Colorado, I go to a practice run by nurse-midwives who provide excellent well-woman care. I would say it’s been at least a decade since I’ve seen an MD, and I’m 100% satisfied with the healthcare that I receive.”
Expensive Snake Oil
At Managed Care Matters Joe Paduda zeroes in on $700 pain relief gels that at Gensco Labs has been compounding and marketing to docs who take care of workers’ comp patients. Guess what’s in the gels?
Read Louise’s entire HWR and learn more about
– what Medicare has been doing as it gathers data from patients being treated to determine whether the treatment is effective and evidence-based;
– what new Gay marriage laws mean for same-sex partners who are not married/
– online reviews of doctors;
— price transparency in healthcare
and More !