Hospitals took extraordinary measures — and faced tough choices — as New England was frozen into place Tuesday by howling winds and relentless snowfall. From ferrying patients home in four-wheel-drive vans to fashioning temporary rooms out of waiting areas, hospital administrators got creative. At South Shore Hospital, two Chevrolet Tahoes were rented to drive roughly two dozen discharged patients to their homes, with emergency medical technicians doubling as the van drivers and even shoveling out some of the patients' walkways to gain access to their homes, hospital spokeswoman Sarah Darcy said. In Boston, Brigham and Women's Hospital teamed up with Fallon Ambulance Service for door-to-door service for some patients who lived as far as 45 miles away, said that hospital's spokeswoman, Lori Schroth.
Shocked and saddened by last week's shooting at Brigham and Women's Hospital, Dr. Miranda Fielding wrote a blog post that appeared on KevinMD, a popular site that gets 5 million clicks a month: "The Legacy of Dr. Michael Davidson." KevinMD, as founder Dr. Kevin Pho puts it, aims "to share the stories of the many who intersect with our health care system, but are rarely heard from," including practicing physicians. He adds: "The public often doesn't know what it's like to work in our health system. KevinMD.com gives them an unfiltered view of our world."
Patients should be able to trust that their doctors are making unbiased medical decisions, but administrators at a West Side hospital "turned that trust upside down" by doling out hundreds of thousands of dollars in kickbacks, a federal prosecutor told a jury Wednesday as a fraud trial got underway. "There was a secret behind the doors at Sacred Heart Hospital," Assistant U.S. Attorney Diane MacArthur said in her opening statement. "The secret was that the most sacred thing at Sacred Heart was money." But attorneys for the three former administrators on trial told jurors that underlings were to blame for the misconduct, pointing the finger at two other former executives who are expected to be key witnesses for prosecutors.
One of the most important things the Affordable Care Act was supposed to do was put an end to a practice called pre-existing condition exclusion. Before the law passed, health insurers could refuse to cover any medical services for a health condition a person already had when they joined that insurance plan, or they could prevent the person from joining the plan entirely. So, for example, if you had psoriasis, the company might say that you could be on their plan, but you'd have to pay for all your psoriasis medications out-of-pocket.
The Barack Obama administration has announced plans to tie 90 percent of all Medicare fee-for-service payments to some sort of quality or value measure by 2018. Sounds exciting! Who wouldn't like to ensure that their doctors are paid for delivering value, rather than just randomly sticking needles into us? Unfortunately, as both the Official Blog Spouse and Aaron Carroll of the Incidental Economist have noted, there is less to this announcement than meets the eye. Saying you want to pay for quality instead of procedures is quite easy to say; indeed, many an administration has said so, because "paying for outcomes instead of treatment" is the holy grail of health-care economists everywhere.
During last week's State of the Union address, President Obama briefly highlighted a new "Precision Medicine Initiative," a project focused on developing more personalized therapies to treat illness. A White House press release described the approach as one that "takes into account individual differences in people's genes, environments, and lifestyles, making it possible to design highly effective, targeted treatments for cancer and other diseases."