A growing number of hospitals are opting to move some people from the emergency room into observation units where they can undergo further monitoring or testing before doctors decide whether they should be released or admitted. More than a third of hospitals report having such units today, a number that has doubled since 2003. But many hospitals and insurers haven't set up their clinical and billing systems or their insurance contracts with these patients in mind. Not only does this sometimes result in a longer stay at the hospital, it also can cause confusion for patients and bigger bills.
Jaime Rosenthal, a senior at Washington University in St. Louis, called more than 100 hospitals in every state last summer, seeking prices for a hip replacement for a 62-year-old grandmother who was uninsured but had the means to pay herself. The quotes she received might surprise even hardened health care economists: only about half of the hospitals could provide any sort of price estimate, despite repeated calls. Ms. Rosenthal's grandmother was fictitious, created for a summer research project on health care costs. But the findings, which form the basis of a paper released on Monday by JAMA Internal Medicine, are likely to fan the debate on the unsustainable growth of American health care costs and an opaque medical system in which prices are often hidden from consumers.
It was an amazing feat when Watson, IBM's "cognitive"—listening, "thinking" and learning—computing platform handily beat two Jeopardy grand champions in February 2011, but it also left us wanting to know if, when and how the technology would be used in the real world. The world got its first glimpse of Watson at work in a commercial setting on Friday when IBM announced the release of three new health care decision-support applications. The three new applications include one for recommending cancer treatment options and two for reviewing and authorizing treatments and related health insurance claims.
The White House has begun a final review of two major rules drafted to implement President Obama?s healthcare law. Both of the rules, written by the Department of Health and Human Services (HHS), are considered significant, meaning they each carry an annual economic impact exceeding $100 million. The first would, among other provisions, create new standards for defining "essential health benefits" to be provided under the landmark law. The other rule moved to the White House for review involves parameters of programs designed to protect health insurers from financial losses.
Facing a doctor shortage in California, state lawmakers want to fill the gap by redefining who can provide healthcare in the Golden State. As detailed in Sunday's Los Angeles Times, they are working on proposals that would allow physician assistants to treat more patients and nurse practitioners to set up independent practices. Pharmacists and optometrists could act as primary care providers, diagnosing and managing some chronic illnesses, such as diabetes and high-blood pressure.
Online consultations are spreading fast now that payers have figured out how to use them to save money. Last week, Health Affairs published a paper by researchers at HealthPartners—a Minnesota-based health plan and physician group—showing that online consultations with nurse practitioners for minor ailments saved the insurer $88 per episode of care. In most cases, these "virtual visits" to Virtuwell, a HealthPartners subsidiary, replaced office visits and visits to ERs, urgent care centers and retail clinics. The online service produced a high level of patient satisfaction while delivering care that was said to be as effective as in-person encounters with providers.