A new problem has emerged with the federal government's Open Payments system, which is supposed to go live Sept. 30 and disclose payments to physicians by pharmaceutical and medical device companies. A couple weeks ago, the U.S. Centers for Medicare and Medicaid Services said it would be withholding information on one-third of the payments, citing data inconsistencies in company submissions. Now, a source familiar with the matter tells ProPublica that CMS won't disclose another batch of payments: research grants made by pharmaceutical companies to doctors through intermediaries, such as contract research organizations. In these cases, doctors apparently have not been given a chance to verify and dispute payments attributed to them, as required by law.
Signed into law by President Obama on March 23, 2010, the Affordable Care Act has proven to be its own kind of jobs act, especially when it comes to the Washington-area IT community. When, in several places, the bill called for the creation of an "Internet website" to allow Americans to find and sign up for new health insurance coverage, it opened the tap on hundreds of millions of dollars that would eventually go to creating HealthCare.gov's front end and back end, as well as a small universe of accompanying digital sites.
Pennsylvania will become the 27th state to expand Medicaid next year after Republican Gov. Tom Corbett (R) struck a deal with the Obama administration. The agreement was announced Thursday and made Corbett the ninth Republican governor to accept the policy, which has divided the GOP since it was made optional in 2012. The expansion will cover half a million low-income Pennsylvanians. Premiums will be levied for adults above the poverty line starting in 2016, but federal regulators said they must not exceed 2 percent of household income. These specifics were part of the agreement between federal health officials and Corbett, who had previously resisted the expansion on the grounds that states will have to eventually pay for 10 percent of the cost.
Freestanding emergency departments (ED) have been proposed in Georgia as a potential solution for struggling rural hospitals, or newly closed ones, that want to remain operational in downsized form to help patients in need. But the trend toward such standalone emergency rooms nationally is totally different from that picture, members of the Georgia Rural Hospital Stabilization Committee were told Monday. Freestanding EDs are actually proliferating in suburban areas, targeting high-income patients who have private insurance, said Charles Horne of accounting firm Draffin & Tucker. The prevailing emphasis is on patient convenience, not need, he told committee members at a meeting in Cordele.
Last week I discussed the prevalence of poor communication between doctors and patients and how it can compromise the quality of health care. Doctors can give the impression they are too busy, too preoccupied to really listen to what the patient has to say. And patients can mislead doctors, telling them what they think they want to hear instead of the truth, or they hide their feelings and say nothing. In other words, there is plenty of blame to go around, and both sides can contribute to poor communication. This is especially the case when it comes to preventive medicine and the need to make lifestyle changes.
There are about 6,000 federally designated areas with a shortage of primary care doctors in the U.S., and 4,000 with a shortage of dentists. Rural areas have about 68 primary care doctors per 100,000 people, compared with 84 in urban centers. Put another way, about a fifth of Americans live in rural areas, but barely a tenth of physicians practice there. A few stopgap measures have aimed to fix the problem, at least temporarily. The National Health Service Corps offers scholarships to students who train as primary care doctors, as long as they agree to serve for a year in a designated shortage area. medicine.