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Thursday, May 13, 2010

Daily news & Analysis

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How Quality Will Pay for Hospitals Under New Reform Measures

By: Janice Simmons, for HealthLeaders Media, May 12, 2010

Hospitals will feel the pressure to maintain continuous quality improvement or risk being penalized under reform incentives scheduled over the next several years, according to a PricewaterhouseCoopers' Health Research Institute report.

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Healthcare Costs Up 7.8% for PPO Plans; Miami, New York City Most Expensive

By: Cheryl Clark, for HealthLeaders Media, May 13, 2010

The cost of providing PPO plan healthcare to a family of four went up 7.8% to $18,704 for 2010, or $1,303 more than in 2009 and "the highest (dollar increase) we have seen in the last 10 years and since the inception of this index," reports the Milliman Medical Index issued yesterday. Interestingly, the average costs were not attributed to more patients getting care, but on higher costs of certain kinds of care such as outpatient and inpatient services, which represent 17% and 31% of all costs.

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New Frailty Test Could Improve Surgical Outcomes, Reduce Cost Discrepancies

By: Cheryl Clark, for HealthLeaders Media, May 13, 2010

For the most part today, doctors determine if a patient can withstand the stress of surgery based on the "eyeball test," a loose and variable judgment based on "a look-over or a glance," says Martin A. Makary, MD, associate professor of surgery at Johns Hopkins School of Medicine. That's why he and his colleagues derived the first test of its kind, a simple, 10-minute "frailty" evaluation tool, for doctors to use in their offices to much more accurately gauge whether elective surgery is more likely to help or harm a patient.

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CMS: Medical Necessity Reviews Are Coming, and Soon

By: James Carroll, for HealthLeaders Media, May 13, 2010

There has been much speculation as to when providers would see the first wave of medical necessity reviews by Medicare Recovery Audit Contractors (RAC); but the May 5 nationwide RAC 101 call helped to dispel a bit of that uncertainty. In the second nationwide RAC 101 conference call for DMEPOS (Durable Medical Equipment, Prosthetics, Orthotics, and Supplies), CMS addressed the imminent arrival of medical necessity reviews for the permanent RAC program, stating that providers might see medical necessity reviews "within the next month or so," according to Scott Wakefield, project officer, CMS.

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IOM: Improved Framework Needed For FDA Oversight of Drugs, Devices, Foods

By: Janice Simmons, for HealthLeaders Media, May 13, 2010

The Food and Drug Administration, in regulating drugs, medical devices, foods, and nutritional supplements, needs to coordinate with other federal agencies and improve its surveillance systems to gain better understanding of the use of biomarkers, according to a new Institute of Medicine report released Wednesday. The report calls on Congress to boost the agency's authority to require further studies of drugs and devices—after they are approved—if their approval is based on studies using biomarkers as surrogate clinical outcomes.

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How the Dakotas Keep Their Doctors: Sanford Merit Says: 'We Grow Our Own'

By: Cheryl Clark, for HealthLeaders Media, May 12, 2010

It is well-documented that rural areas throughout the U.S. are provider-poor. But apparently, Sanford Merit Care has overcome the physician recruitment challenge.

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Five Changes Health Plans Need to Make Now

By: Les Masterson, for HealthLeaders Media, May 12, 2010

Here are five changes health insurers need to make now in order to survive in 10 years.

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Emotional Advertising is Still Most Effective

By: Marianne Aiello, for HealthLeaders Media, May 12, 2010

Every so often someone will ask me if I have a favorite hospital ad. The same TV spot floats to the top of my mind every time.

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