Shorter shifts for medical residents don't appear to be making any big improvements in doctors' fatigue levels or in patient care, new research shows. The study found that although doctors weren't less tired during their shortest shifts, an adverse patient event was more likely to occur during a short shift. The results "question the rationale for shortening the exposure of the residents to the patients," said study leader Dr. Christopher Parshuram, an associate professor of pediatrics, critical care and health policy management and evaluation at the University of Toronto.
Insurers aren't required to encrypt consumers' data under a 1990s federal law that remains the foundation for health care privacy in the Internet age — an omission that seems striking in light of the major cyberattack against Anthem. Encryption uses mathematical formulas to scramble data, converting sensitive details coveted by intruders into gibberish. Anthem, the second-largest U.S. health insurer, has said the data stolen from a company database that stored information on 80 million people was not encrypted. The main federal health privacy law — the Health Insurance Portability and Accountability Act, or HIPAA — encourages encryption, but doesn't require it.
As House Republicans once again voted to repeal the Affordable Care Act this week, there was further evidence the controversial bill is contributing to the good health of some of the nation's major health insurers. Tuesday, the same day the House voted for repeal, Aetna reported adding more than 1 million new health insurance clients since last year, about half coming from the state health exchanges created by the health-care law. The Hartford-based insurer's 2014 earnings report said enrollment climbed 6 percent to 23.5 million people compared with 2013. That's about 1.1 million more people enrolled in Aetna plans. Some 560,000 came through the state exchanges Aetna participates in.
The Affordable Care Act has ushered in an era of complex new health insurance products featuring legions of out-of-pocket coinsurance fees, high deductibles and narrow provider networks. Though commercial insurers had already begun to shift toward such policies, the health care law gave them added legitimacy and has vastly accelerated the trend, experts say. The theory behind the policies is that patients should bear more financial risk so they will be more conscious and cautious about health care spending. But some experts say the new policies have also left many Americans scrambling to track expenses from a multitude of sources — such as separate deductibles for network and non-network care, or payments for drugs on an insurer's ever-changing list of drugs that require high co-pays or are not covered at all.
Partners HealthCare System is rethinking its expansion plans in Massachusetts as it seeks to repair relations with competing hospitals and government officials, its newly appointed chief executive said Thursday. "If we're perceived as a bully or we're perceived as arrogant through our actions, I don't want that," Dr. David Torchiana said in an interview. "We know we have to soften our external relations and get ourselves out of this place of being a miscreant in Massachusetts. It's not a place we aspire to be." Torchiana also said that Partners intends to focus on controlling medical costs by operating more efficiently and better coordinating care.
Thousands of more friendly and better-trained call-center employees will be working starting Monday to deal with the expected late onslaught of people signing up before the Obamacare open enrollment ends Feb. 15. A 40% increase, to a 14,000-person workforce, is expected to help with wait times, which averaged about 2 ½ minutes the last week of January, but are likely to get longer as the deadline nears. People who aren't covered by employer-provided insurance and don't sign up by the deadline won't be eligible for insurance this year and will face increasing penalties at tax time.