Lovelace Health System has notified ABQ Health Partners that it will no longer let the physician practice's doctors and nurses treat Lovelace Health Plan members in Lovelace hospitals. Lovelace Health System, which owns Lovelace Health Plan, notified ABQ Health Partners on Oct. 12 that it was terminating contracts that allowed 74 ABQ Health Partners health care providers to treat Lovelace patients in the system's hospitals.
When hospitals close it's often a devastating blow to the municipalities where they're located, leading to the loss of significant tax revenue and jobs. A bill working its way through the Legislature, however, could go a long way toward softening the blow, providing state incentives to redevelop former hospitals as "medical arts complexes," where doctors and other healthcare providers could rent or buy space. The bill was approved by the Assembly Appropriations Committee on December 13.
North Carolina patients are likely to pay more for routine health care if their doctors are employed by a hospital, an investigation by the Observer and the News & Observer of Raleigh has found. It's true for services ranging from heart tests to routine office visits. And it's part of a national shift that experts say is raising costs but not quality. Hospitals are increasingly buying doctors' practices, then sending bills for routine services that are significantly higher than those charged by independent doctors.
UnitedHealth Group Inc., the biggest U.S. health insurer, will face a fragmented regulatory landscape in 2014 after the first approved state insurance marketplaces are launched as part of the health care overhaul. Rules for the six state insurance exchanges that won conditional approval from the Obama administration Dec. 10 are split evenly between those with strict criteria for companies that want to participate and others that intend to open their exchanges to all comers, a scenario supported by the insurance industry. A high bar for inclusion could limit the number of insurers offering health plans in some states.
A dearth of specialists available to low-income patients presents one of the bigger hurdles facing the country as it tries to bring spiraling healthcare costs under control. Doctors say meeting new government mandates to keep patients healthy and out of hospitals—a linchpin in reducing medical spending—will be virtually impossible without the ability to make timely patient appointments with specialists. By the end of the decade, the nation will be short more than 46,000 surgeons and specialists, a nearly tenfold increase from 2010, according to the Assn. of American Medical Colleges. Healthcare reform is expected to worsen the problem as more patients—many with complex and deferred health needs—become insured and seek specialized treatment.
"The pipeline is rich." That's what Gary Newsome, the CEO of Naples-based Health Management Associates Inc., had to say when an analyst asked for an update on its hospital buying opportunities during the company's last earnings conference call. Newsome's optimism came in October, several weeks before "60 Minutes" aired a segment on its investigation of the hospital operator, in which several former employees accused the company of fraud - and of pressuring doctors into admitting patients needlessly to boost revenues.