Telemedicine — doctors treating patients over the phone, online or by videoconferencing — is a growing subset of the health care system. But Idaho's medical licensing board doesn't approve and earlier this year punished a doctor for prescribing a common antibiotic over the phone. The sanctions against Dr. Ann DeJong are so severe that her board certification is threatened. State lawmakers are more welcoming, seeing telemedicine as an option to bring health care to sparsely populated rural areas and address a severe doctor shortage in the state. The Idaho Legislature passed a bill nearly unanimously this year calling for stakeholders to set state standards for the practice of telemedicine.
Older breast cancer patients who received radiation treatment after surgery were more likely to undergo a more expensive and somewhat controversial type of radiation called brachytherapy if they got their care at for-profit rather than nonprofit hospitals, a new study reports. Among the oldest group studied – women in their 80s and early 90s who are least likely to benefit from the regimen – the odds of receiving the more expensive brachytherapy were significantly higher at for-profit hospitals, the study found. The research, funded by the National Cancer Institute and the Robert Wood Johnson Foundation, was published Monday in the May issue of the journal Surgery.
As many observers have noted, the federal Affordable Care Act is more about reforming the health insurance system than reforming the health delivery system. To tackle that second part, Dr. Allen Dobson, of Mount Pleasant, recently encouraged federal lawmakers to give more support, including higher pay, to primary care physicians. These frontline doctors – who specialize in family medicine, internal medicine, pediatrics and obstetrics-gynecology – are the major providers of preventive care and management of chronic illness. Earlier this month, when Dobson testified before a U.S. Senate committee on primary care and aging, he urged congressional leaders to enact policies that would encourage more doctors to practice family medicine, especially in rural areas.
"Tiering and steering" is the catch phrase at the heart of the three-year dispute that threatens to end the UPMC-Highmark relationship. Health provider UPMC believes if it signs a contract with Highmark after this year, the Pittsburgh insurer will assign UPMC's doctors and hospitals to its most expensive tier in order to recoup the billions of dollars it is spending to develop its own provider network. By making it more expensive to get care through UPMC operations, patients would be "steered" to hospitals in Highmark's Allegheny Health Network. "There will not be a contract, there cannot be a contract, because we cannot put the fate of UPMC into the hands of Highmark," said Robert DeMichiei, UPMC's chief financial officer.
Inside the sleek hillside headquarters of Valley Health Systems, built with a grant from the health care law, two employees played an advertisement they had helped produce to promote the law's insurance coverage for young, working-class West Virginians. The ads ran just over 100 times during the recent six-month enrollment period. But three conservative groups ran 12 times as many, to oppose the law and the local Democratic congressman who voted for it. This is a disparity with consequences. Health professionals, state officials, social workers, insurance agents and others trying to make the law work for uninsured Americans say the partisan divisions and attack ads have depressed participation in some places.
Debate is already heating up over a bill that would regulate the amount of charity care nonprofit hospitals in California have to provide in exchange for tax-exempt status. Assembly Bill 1952 by Sacramento Assemblyman Richard Pan requires nonprofit hospitals to provide annual charity care amounting to 5 percent of the hospital's net revenue. The bill aims to ensure taxpayer subsidies result in some minimum amount of community benefits — including charity care — for their communities, proponents say. There is no uniform definition or measurement of these benefits currently.