May 15, 2011 Recent News
So far the quality bonuses for physicians have not gone to about half. Of the 200,000 that attempted to qualify, only have received any bonus. The bonus was about $2000 per physician. The physicians that failed to earn any money usually got frustrated by the lack of feedback from the program or some small thing making it so they would receive no money. The program is too complicated for physicians to do it on their own. They need to hire someone to do the coding, which reduces the amount of money they get to keep.
An article in the Archives of Internal Medicine again iterates the failure of med students doing into primary care. The authors conclude that better residency experiences won't cut it, only better payments and practice reform will help.
The AMA belittles the government for their inability to get biographical things correct on their web sites. This leads to the conclusion that since they can not get the simple things correct they certainly have and will get it wrong when they put up Physician Compare.
Disruptive physicians and other health professionals may cause problems in hospitals by interfering with good medical care. A Harvard student's article in the Boston Globe states a way to get rid or at least reduce the problem. She suggests that medical schools teach how to talk to other members of the health care team. She states that Harvard now teaches how to talk to patients via role play with volunteer patients. Not a bad idea.
California physicians are going to EMRs. That is, all but the small practices. Only 20% of solo practices and 40% of small groups are using EMRs. The physicians are using computers to bill and to visualize radiographs and lab results. Less than a third of the physicians in the state use computers to communicate with patients.
Physicians at the California Association of Physician Groups which represent large groups are worried that their cap payments will be reduced under ACOs. These groups believe they will have to add more hospitalists to make sure about competency. If the HHS does not change their rules there may not be any ACOs to worry about. Top
People new to Medicare are eligible for a "Welcome to Medicare" wellness exam. The problem is physicians aren't doing them since they are fairly useless. They entail a history, BP, Ht., Wt., Waist measurement, cognitive screening, depression screening, level of safety screening and outgoing schedules for preventative tests. One may notice that there is no laying of hands on the patient and all can be done without a physician.
The feds are warning states regarding marijuana. The warnings left those governors with no spine like Washington's Gregoire to veto a law creating licensed dispensaries. Gregoire now wants to work to change the culture of the feds who are flip flopping on the issue.
CNN Money has a long article on how special interest medical groups are pushing CMS to get their medical flavor of the month covered as a healthcare mandate. The more of these mandates that are included, the higher the costs of the insurance will be. Remember, Obamacare does nothing to control costs only allows all to be insured. If these get through, small business will have no choice but not cover their employees and allow them to be covered by state exchanges driving up those premiums. Plans can not be both generous and affordable. Sebelius is solely responsible for what goes into the mandates. It will be interesting to see where the rationing goes, if at all.
The GOP is pulling back on its attempt to get rid of Obamacare. They are now interested in continuing to rein in the growing costs and not let it get more out of hand. They have already passed the budget and gotten people to commit to votes that are open and can be made part of the 2012 election.
In a story or perhaps a fairy tale, the USA Today reports the HHS believes Obamacare will keep those without insurance from becoming bankrupt or keep hospitals from losing money on the uninsured. As all know Obamacare does nothing about the cost of healthcare, it just allows all to purchase insurance for whatever the price will be. The story states that hospitals are not being paid $49 Billion per year due to the uninsured. Again, this is an exaggeration. They use costs which are never the true costs. They never use what they actually get from Medicare, Medicaid or insurers. The article goes on to say that some without insurance have the means to purchase it but choose not to.
The Hill reports that consumer advocates are awaiting HHS regs on how they will review insurance rates. They have the power to review but no power to block any increases.
Obamacare was debased by the American Medical Group Association. They represent the large group practices such as Mayo Clinic. The organization states that their groups can not deal with the proposed ACOs as the regs are so complex as to be unworkable. The CMS said it will take the rebuke into consideration when they come out with the final rules.
The Hill reports that the administration claims Obamacare will save Medicare $120 billion over five years. They want to strengthen the Board so more money will be taken from physicians and less physicians will see Medicare patients.
Who's closer to the truth? The CMS states that setting up an ACO will cost about $1.8 million. In a study commissioned by the AHA, McManis Consulting says it will cost $11-$26 million to set one up. If it is anything over several million dollars there will be no ACOs.
CMS has announced that it will run out of money years prior than previously thought. This also is true for Social Security and especially Disability Social Security. The new projections for the exhaustion of the trust funds are Medicare in 2024, Social Security 2038 and Disability 2018. There are now three choices: (1) borrow to pay, (2) reduce benefits and (3) raise the taxes. The law state if something is not done and the funds are exhausted benefits would still be paid but at a 75% decrease of current benefits. Someone in Washington must wake up and do the unpopular thing to address the soon to occur disaster. The Ryan plan is a proposal that can be modified but should not be just put on the trash can by the Senate.
This is coming to your state. The Boston Globe states that waits to see primary care or specialists for non emergent items has ballooned to an average of 48 days for an internist and 24 days for a pediatrician. The specialist waits have increased significantly as well. Top
Again, Dallas' Parkland Hospital is in trouble with CMS. They have found rape, amputations and death at the hospital. Parkland had no formal supervision for residents.
The San Francisco Business Times reported UCSF is starting up its new EMR system. It is $100 million over budget and costing $160 million. UCSF decided on Epic, the same one the University of Iowa is having problems with. Epic is also used by Kaiser, Sutter Health, UCSD and UCD.
The San Francisco Business Times also reported that Catholic Healthcare West and its CIO have parted company over the problems with getting Meditech EMR into its hospitals. CHW is spending over $1 Billion on the EMR projects in its hospitals. It seems like a large waste of money.
New York City public hospitals have a long wait for mammograms according to the City comptroller. As is usual for government, their records are not up to date. The hospitals do not have the 148 day wait that was supposed by the comptroller. Their waits are hours for emergency or very urgent exams and about a month for routine mammograms. Top
THE INNOCENCE PROJECT OF THE CENTER FOR PEER REVIEW JUSTICE
Another article by Dr. Wilner is as follows:
PHYSICIAN BROWNOUTS AND HOSPITAL LIABILITY SHIFTING ON THE
RISE UNDER OBAMACARE
DISCLAIMER: Although this
article is updated periodically, it reflects the author's point of view at the
time of publication. Nothing in this article constitutes legal advice. Readers
should consult with their own legal counsel before acting on any of the