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Thursday, November 5, 2009

Daily news & Analysis

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Surgeons Give Six Reasons Why Senate Reform Plan Will Worsen Care

By: Cheryl Clark, for HealthLeaders Media, November 5, 2009

The American College of Surgeons, a group representing 200,000 doctors in 20 surgical specialties, says it will fight health reform as proposed by the Senate Finance Committee, because "it will make an already-flawed system worse" in six ways. A. Brent Eastman, MD, chairman of the ACS Board of Regents, emphasizes that the doctors are not opposed to health reform per se, and supports changes to provide cost-effective, high-quality care.

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Dying In a Hospital Costs More than Surviving an Inpatient Stay

By: Cheryl Clark, for HealthLeaders Media, November 5, 2009

If anyone needs more evidence that healthcare spending is concentrated at the end of life, here's another raft of confirming statistics from the federal government for 2007. The statistics were released by the federal Agency or Healthcare Research and Quality, which analyzed 765,651 hospital patient deaths in 2007. The statistical brief issued yesterday is the first analysis of the cost of death for payers other than Medicare.

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Commonwealth Fund: U.S. Healthcare is Lagging Behind Other Countries

By: Janice Simmons, for HealthLeaders Media, November 5, 2009

When it comes to paying for healthcare, the United States—when compared with 10 other industrialized countries—tops the list as having the highest spending per capita ($7,290), while lagging behind those nations in access, quality, and use of health information technology, according to the Commonwealth Fund's 12th annual international health policy survey.

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Could RAC Mass Adjustment Changes Mean More Automatic Audits?

By: Andrea Kraynak, for HealthLeaders Media, November 4, 2009

Providers who believe their RAC denials will be limited to 200 every 45 days (corresponding with the medical record request limits) may be in for a surprise. Those limits apply only to complex audits, but no such limits exist for the number of automatic reviews RACs can perform.

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Maryland Electronic System Provides Early H1N1 Detection

By: Evan Sweeney, for HealthLeaders Media, November 4, 2009

When H1N1 outbreaks were first encountered in April, the Maryland Department of Health was one of the first to notice a trend in flu-like illnesses. The state had been on a mission to achieve 100% hospital compliance by June 30, 2009, within the state-run Electronic Surveillance System for the Early Notification of Community-based Epidemics.

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ZPIC Audits in Zone 4 Have Begun

By: Ben Amirault, for HealthLeaders Media, November 5, 2009

Health Integrity LLC, the zone four (Colorado, New Mexico, Oklahoma, and Texas) Zone Program Integrity Contractor, has begun requesting medical records for review. The ZPICs are Medicare audit contractors that specifically identify cases of fraud and abuse. According to the CMS Program Integrity Manual, ZPICs may "take immediate action to ensure that Medicare Trust Fund monies are not inappropriately paid out and that any mistaken payments are recouped."


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What Should Rural Healthcare Look Like After Reform?

By: Cheryl Clark, for HealthLeaders Media, November 4, 2009

Numerous proposals in the various reform bills under discussion are designed to improve healthcare for rural communities. But one issue that seems critical in the eyes of some advocates is that of insurance coverage.

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Insurers Must Pay Promptly or They'll Pay in Other Ways

By: Les Masterson, for HealthLeaders Media, November 4, 2009

If your health insurance company is not paying claims promptly, the state may soon come calling.

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To Prepare for the New Normal, Marketers Must Show Strategic Value

By: Gienna Shaw, for HealthLeaders Media, November 4, 2009

If your hospital or health system leaders understand the value of a strategic marketer—or if you'd like to convince them they should—SPM Marketing and Communications has some advice for you.

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