Due to a bureaucratic tangle, 1,000 cancer patients at Memorial Sloan Kettering's new center in Basking Ridge, NJ, may be forced to find new doctors. The cancer center recently sent letters to patients covered by Horizon Blue Cross Blue Shield of New Jersey telling them they will be charged out-of-network prices after Sept. 1. The patients can avoid the higher charges by switching their care to Sloan Kettering's Manhattan hospital, the letter said.
While most people have heard about the nationwide nursing shortage, the country is also experiencing a shortage of trained workers in the allied health professions such as respiratory care practitioners, medical transcriptionists, radiographers, and about 200 other occupations that make up about 60% of healthcare workers. According to a recent study, California and its burgeoning population lags behind the rest of the nation in the number of allied health professionals per capita.
The Georgia Department of Community Health has denied allegations by Blue Cross and Blue Shield of Georgia that state officials failed to follow established rules in deciding to reduce the number of insurers that cover nearly 700,000 teachers and other state employees and their dependents. The state eliminated Blue Cross and Blue Shield of Georgia as an insurance provider, along with Kaiser. Blue Cross and Blue Shield of Georgia said that the department's decision to reduce insurer options to Cigna and United Healthcare illegally cut out Blue Cross and Blue Shield of Georgia and Kaiser. DCH spokeswoman Matia Edwards denied the claim, saying the decision to reduce the number of insurance provider options would save the state plan more than $700 million over five years.
To help children come to terms with their treatment, hospitals across the country are having young patients act out medical procedures on dolls. Their are more than 400 such programs in the United States and Canada, according to the American Academy of Pediatrics. The idea is to lessen the terror that kids may feel before a scary procedure, and research shows that structured play can reduce stress. In the short term, specialists say that working with a petrified child before a minor procedure can also help avoid sedation.
UnitedHealth Group Inc. has stopped marketing an insurance plan to Massachusetts senior citizens with disabilities after state officials received dozens of complaints that the company was using abusive and misleading sales tactics. Senior citizen advocates said some UnitedHealth sales representatives refused to leave people's homes without getting a signature on a policy, and added others misrepresented the plan by claiming it would pay for care that is actually not covered. In addition, the advocates said, some agents repeatedly called seniors, despite requests from family members that they stop.
In this piece from the Wall Street Journal health blog, the author asks whether long emergency room waits are good for a hospital's bottom line. The author notes that patients who show up at the emergency room are less likely than patients admitted to the hospital by a staff physician to need lucrative, procedure-driven care. Because a hospital only has so many inpatient beds, it may make economic sense to fill the beds up with the lucrative, well-insured patients admitted by staff physicians, he notes.