HealthLeadersMedia.com - Physician Leadership News

Medicare Physician Payment Rule Factors in GPCI

Fri, 10 Feb 2012 12:53:00 GMT

The final 2012 Medicare physician payment rule from the Centers for Medicare & Medicaid Services includes an adjusted fee schedule for the Geographic Practice Cost Index. The adjustment prevents large cuts this year and will help California physicians in the future.

Feds Release Final Rules on Health Plan Language

Fri, 10 Feb 2012 12:26:00 GMT

Under the new rules, information provided to consumers about healthcare insurance eligibility and benefits must clearly specify a plan's deductibles, annual limits, and other details so that consumers can understand them.

UnitedHealth will tie doctors' payments to quality of care

Fri, 10 Feb 2012 12:07:00 GMT

UnitedHealth Group Inc., the largest U.S. health insurer by sales, will pay doctors based on the quality of their care in a cost-cutting effort that also benefits the company's consulting business. UnitedHealth expects to save twice as much as it would spend on incentive payments for doctors because patients will be healthier, according to company documents

What to do with an empty hospital?

Fri, 10 Feb 2012 12:00:00 GMT

Kaleida Health is offering $1 million to whoever can do some major medicine on the soon-to-be-vacant Millard Fillmore Hospital. The hospital system announced Thursday that it will award the prize to the developer or design team that submits a winning proposal for redevelopment of the hospital at Gates Circle, one of the most desirable neighborhoods in the city. The developer would not receive the prize until it has completed purchase of the property. By dangling the money, Kaleida hopes to generate interest in the project. But this won't exactly be like winning the lottery.

Opinion: Why we need more minority doctors

Fri, 10 Feb 2012 11:53:00 GMT

So how pressing is the need for more minority doctors? It turns out the physician workforce is a far way from reflecting the diversity of the general population. While 1 in 8 Americans is African American, only 1 in 15 doctors is. And though 1 in 6 Americans identifies as Hispanic/Latino, only 1 in 20 doctors does. (For more detailed diversity data, check out the 2010 U.S. Census and the American Medical Association's Diversity in the Physician Workforce: Facts and Figures 2010.)

The future of mHealth: Healthcare apps to lower insurance costs

Fri, 10 Feb 2012 11:41:00 GMT

Several large U.S. health insurance companies, including Aetna, WellPoint and UnitedHealth Group, currently offer mobile apps that help members find network providers and perform other simple functions. On the surface, these apps strengthen connections with members and providers. However, the mobile health revolution holds deeper implications for the insurance industry, which plans to enhance future mobile offerings to more directly impact patient health, according to the American Medical Association.

5010 Logjam Means No Pay for Physicians

Thu, 09 Feb 2012 18:26:00 GMT

Physicians are flooding their advocacy groups with complaints about cash flow problems as they seek deadline delays for a mandatory transition toward HIPAA 5010 electronic transactions.

UnitedHealth revamps fees

Thu, 09 Feb 2012 12:03:00 GMT

U.S. insurer UnitedHealth Group Inc will revise the way it pays doctors and hospitals, a move which it expects will bring down expenses, a Wall Street Journal report said, citing documents sent by the company to employer clients.

Some physicians not always honest with patients

Thu, 09 Feb 2012 12:00:00 GMT

Despite wide institutional acceptance of a medical professionalism charter that endorses openness and honesty in physicians' interactions with patients, not all doctors comply, according to a survey whose results are published in the February 2012 issue of Health Affairs, released Wednesday. Although about two-thirds of doctors responding to the survey did agree that they should disclose serious medical errors to patients, about one-third did not completely agree that they should.

Expect more insurance drama in Pittsburgh

Thu, 09 Feb 2012 11:44:00 GMT

If you think Pittsburgh's health insurance landscape has changed dramatically in the last year, you ain't seen nothing yet, according to six of the region's top insurance executives. Expect more friction between physicians and health plans as insurers try to wring what they call unnecessary procedures, scans and surgeries out of the system.

Getting to the Heart of Cardiology Alignment

Thu, 09 Feb 2012 11:00:00 GMT

Healthcare leaders are considering prospects for new payment systems and for value-based efficiencies. One physician alignment model is an integrated plan, such as a professional services agreement in which a hospital or health system operates a physician clinic and contracts with an independent group to provide professional services.

Jackson Health System, SEIU agree on $52M in concessions

Wed, 08 Feb 2012 12:08:00 GMT

Negotiators for Jackson Health System and SEIU Local 1991 agreed Tuesday to a contract that calls for $52 million in concessions for each of the next three years, but workers could get some of that money back if they find ways of saving the hospitals money or gaining new revenue. The tentative agreement will be voted on next week by the bargaining units covering nurses and other healthcare professionals. A third unit, covering physicians, was still in discussions with management late Tuesday afternoon.

Doctor discipline: MN fails to offer full disclosure

Wed, 08 Feb 2012 12:04:00 GMT

Malpractice findings are increasingly easy to find on websites maintained by medical boards in 19 states, but not in Minnesota, where regulators have resisted efforts to make more information available to people who want to check into the backgrounds of their doctors. The Minnesota Board of Medical Practice also doesn't disclose whether doctors have been disciplined by regulators in other states or lost their privileges to work in hospitals and other facilities for surgical mistakes and other problems—information provided in 13 other states.

Rethinking hospital readmissions

Wed, 08 Feb 2012 12:02:00 GMT

Hospitals have always said there's nothing they can do to change how people behave once they leave the hopsital. But starting this October that excuse won't wash any more. As part of the new health care law, hospitals will face hefty fines for allowing too many readmissions. At University of Pennsylvania Hospital, Dr. Shreya Kangovi launched a program that focuses on the five poorest zip codes in Philadelphia—responsible for 85 percent of readmissions in the city.

Fake PA blames hospital for issuing badge

Wed, 08 Feb 2012 11:49:00 GMT

A teenager accused of bluffing his way into an Osceola County hospital emergency room last year says it's not his fault. The state attorney's office released interviews with Matthew Scheidt, 18, who is being held on no bond after he was accused of impersonating a physicians assistant and a police officer. Scheidt faced two counts of impersonating a physician's assistant and four counts of practicing medicine without a license in October.

HCA profit tops expectations; shares rise

Tue, 07 Feb 2012 12:16:00 GMT

HCA Holdings Inc, the largest U.S. hospital operator, on Monday reported better-than-expected fourth-quarter earnings as it admitted more patients to its facilities and recorded a one-time gain from an investment, sending its shares up 6 percent. A focus on controlling operating expenses and a reduction in bad debts helped offset lower surgical volumes, the company said. Cardiovascular surgery volumes were down for the third consecutive quarter, though the rate of decline slowed, company officials said on a conference call. Managed-care admissions, which slumped during the economic downturn as workers lost jobs and insurance, rose slightly for the second quarter in a row.

Medicaid changes challenge TX hospitals to do things differently

Tue, 07 Feb 2012 12:09:00 GMT

The goal is lofty: improve and expand health care for millions of Texans. But with billions of dollars at stake and the new project under way before the rules are even written, decisions made over the next few months are causing anxiety in many Harris County hospitals. The new rules—part of a complicated, first-of-its-kind project approved by the federal government—will determine who gets paid for providing charity care, and how much. Hospitals that historically received the most government reimbursement for charity care are not guaranteed to prosper under the new rules.

Why do cardiologists often pass up safe, low-tech treatments for chest pain?

Tue, 07 Feb 2012 12:00:00 GMT

Can American doctors say "No" to an aggressive and high-tech treatment they're used to providing even when it turns out a less heroic and cheaper one works just as well? It's an important question. The affordability of American medical care in the future will depend, in part, on the ability of physicians to simplify and economize, which are two things they've never been good at. With national health expenditures amounting to $2.6 trillion a year—45 percent of it paid by government—prosperity and political stability may also be at stake.

NY eyes tough reporting system for dispensing of prescription drugs

Mon, 06 Feb 2012 12:18:00 GMT

Maybe it's the mounting death toll or the sobering addiction statistics. Or that it's an election year for all state lawmakers. No matter the reason, efforts are taking hold for New York to join other states that require doctors and pharmacists to participate in a real-time reporting system before dispensing prescriptions for painkillers, sleeping pills and other controlled drugs. Stalled for several years, the push is on at the state Capitol to end a system that now permits growing numbers of people addicted to powerful narcotics to physician- and pharmacy-shop for their drug supplies.

TX prisons consider switch to local hospitals for convict care

Mon, 06 Feb 2012 12:05:00 GMT

State prison officials are poised for the first time in 18 years to contract directly with someone other than a state university to provide medical care for Texas convicts. Officials confirmed to the American-Statesman on Friday that an agreement has been reached for Huntsville Memorial Hospital to provide nine emergency-care beds on the second floor of its hospital, and that negotiations are under way for the hospital to operate an emergency room and specialty care clinic inside the Estelle Unit east of town.