U.S. budget experts raised their forecast yesterday of how many Americans will probably have to pay a penalty in 2016 for not buying health insurance to 6 million from 4 m illion. The 50 percent increase likely will draw fire from Republicans on the campaign trail who want to repeal President Barack Obama’s signature healthcare law and who reject the penalty as a government intrusion into the lives of individuals. But the nonpartisan Congressional Budget Office said some of the increase reflects state opposition to an expansion under the healthcare law of the Medicaid program for the poor, which is most unpopular in states with Republican governors or Republican-majority legislatures.
Enrollment in private Medicare plans offered by insurers led by UnitedHealth Group Inc. (UNH) is expected to surge 11 percent in 2013, the U.S. government said, while premiums may increase an average of 4.7 percent. About a quarter of Medicare’s 49 million elderly and disabled beneficiaries are enrolled in Advantage plans, in which insurers are paid a fixed monthly fee to provide services. Some of the plans offer benefits not available in the traditional Medicare program, such as discounts for gym memberships and eyeglasses.
A University of Florida physician and colleagues have "mythbusted" a notion long held in medical circles: patients at teaching hospitals fare worse in July when new medical graduates start their residency training and older residents take on more responsibilities. A large national study revealed no such "July phenomenon" or "July effect"—at least not in the field of neurosurgery. The findings are published today in the journal Neurosurgery. Previous studies of the July phenomenon in fields such as general surgery, obstetrics, gynecology and internal medicine have yielded inconsistent results, some finding an effect and others finding none. One earlier study of pediatric neurosurgery found no effect, whereas another study found a small effect.
Rochester, Minn.-based Mayo Clinic plans to announce an affiliation Wednesday with NorthShore University HealthSystem, which operates four hospitals in the northern suburbs. The multiyear agreement, scheduled to begin Oct. 1, will give NorthShore physicians fast access to Mayo specialists and research targeting three areas of care: cardiovascular, cancer and neurological cases. NorthShore, a nonprofit that owns hospitals in Evanston, Glenview, Skokie and Highland Park, said the partnership will allow it to better treat existing patients, expand its patient base and enhance its expertise in complex cases.
Many hospital affiliations do lead to expanded services and even capital improvements. But relinquishing local control comes at a cost, and the dustup in Sandstone shows the difficulties that can arise when working out the details of these agreements. It's a pressing issue right now because increasingly, independent hospitals in rural Minnesota are joining bigger systems—Sanford Health, Essentia Health, Mayo Clinic Health System and others. According to the Minnesota Hospital Association, 16 hospitals have joined systems since 2005. Of 148 hospitals in the state, only 42 remain independent.
One of every 10 emergency room patients at the county's public hospitals in September left without ever being seen by a doctor or nurse because of long waits—a number rising since implementation of Contra Costa's $45 million computer system July 1. One patient waited 40 hours to get a bed. Dr. Brenda Reilly delivered the troubling news Tuesday afternoon to county supervisors. She was one of three dozen doctors in the supervisors' chamber complaining about EPIC, new computer software aimed at integrating all of the county's health departments to create a federally mandated electronic medical record for patients.