Insurers are betting that consumers who buy plans on the exchanges will be willing to trade some choice and flexibility in order to get cheaper premiums. Smaller networks of providers generally translate to lower premiums, because insurers can negotiate discounts with health-care providers who will then have less competition for patients within the network.WellPoint said it is using more-limited networks for most of the new marketplaces, and it aims to take at least 10% out of the premium costs. [Registration required.]
Medical costs are skyrocketing and a survey published last month in JAMA has us doctors pointing fingers in every direction but at ourselves. The more than 2500 physicians surveyed rested most of the blame on malpractice lawyers, insurance companies, healthcare conglomerates, and drug/device companies. Patients came next. Trailing the lot were the doctors themselves. Doctors' enthusiasm for cost-containment strategies that affected their compensation—eliminating fee-for-service reimbursement, "bundling" payments for the total care of patients, penalizing physicians when patients were re-admitted to the hospital—was notably lukewarm. However, nearly all were in support of eliminating waste and fraud, promoting continuity of care, minimizing corporate influence in medicine, and having better data about the relative quality of various medical interventions.
Clinicians are rapidly increasing their use of mobile devices at work, according to a new report from Epocrates, a vendor of mobile reference materials that is owned by EHR vendor Athenahealth. Of the 1,063 physicians and mid-level practitioners who responded to Epocrates' survey, 86% of the clinicians now use smartphones in their professional activities, up from 78% in 2012. In addition, 53% use tablets at work, compared to 34% last year. All of the respondents use desktop/laptop computers. And nearly half fall into a new category that Epocrates dubs "digital omnivores," who use all three platforms, or "screens."
Doctor and patient did all they had to do by video conference instead of a prolonged office visit that might have taken hours in travel time for some patients. The video view saved time and money, and makes sense. Still, most insurance companies in Florida won't cover it. Because telemedicine might be the wave of the future, it's gotten the attention of the state Legislature, which is being asked to pass legislation to certify and impose standards on a growing practice. Doctors want lawmakers to specifically take a look at the issue of forcing insurance companies to pay doctors for telehealth coverage. Though Medicaid and Medicare often permit virtual doctor visits, particularly for specialists, most insurance companies in Florida do not cover it.
Here is a basic fact of health care in the United States: Doctors and hospitals know what they charge, but patients don't know what they pay. As in any market, when one side has no information, that side loses: price secrecy is a major reason medical bills are so high. In my previous column, I wrote about the effect of this lack of transparency on the bills patients pay out of pocket. We know about these bills, which hit us directly. What most people don't know, because the costs are hidden, is that the same imbalance exists with insurance. The employers and employees who buy health coverage have delegated vigilance over health care costs to insurers — but insurers, for the most part, have gone AWOL.
Every morning, Sergio Castro crisscrosses this city to treat the intimate struggles behind its closed doors. Past a black metal gate, Diego Raúl López Sánchez lay on a bed in a concrete room. A motorcycle crash left him paralyzed from the neck down a few months ago, and bedsores have branded his emaciated body. Mr. Castro cleaned and dressed the broken skin as he murmured softly to his patient. He offered advice to Mr. López's wife, who seemed numb with despair at her husband's new reality. He would return the next day.