Now, the impact of two major proposals in the House plan that are intended to level the playing field —a one-time luxury tax on high-priced providers and restrictions on contract negotiations—is in doubt after lobbying by hospitals. The Senate proposal, meanwhile, takes a more indirect approach to the problem, including establishing another commission to dig deeper for the reasons for price differences and requirements to publicly track price inequities. But Governor Deval Patrick and Senate President Therese Murray have made clear that they oppose the House plan to tax providers whose prices are at least 120 percent of the statewide median and redistribute the money to struggling hospitals, making approval in its current form unlikely.
Blue Cross and Blue Shield of North Carolina says the providers are charging an identical fee for each image taken during the radiology session, even though the setup is performed only once. Blue Cross says the providers are overcharging patients and their insurers by $16 million a year. The lobbyists for hospitals and doctors are fighting Blue Cross' effort to cut back on reimbursement, saying the insurance company is unilaterally trying to rewrite an active contract. The radiology dispute is a small but revealing example of how arcane billing practices can drive up healthcare costs, which have been rising faster than inflation, even during the recession.
The immediate reaction on Wall Street to last month's U.S. Supreme Court ruling upholding President Obama's healthcare law was to buy hospital stocks and dump health insurance stocks. But at least one analyst expects the long-term outcome to be exactly opposite of that. Sheryl Skolnick, co-head of research at CRT Capital Group LLC, thinks hospitals face as much or more financial risk as health insurers under Obama's Patient Protection and Affordable Care Act. "The hospitals may end up paying for the poorest and sickest of today's uninsured anyway AND see cuts in Medicare and Medicaid on top of that," Skolnick wrote in a June 29 note to investors.
A new study shows most women primary-care doctors would almost certainly have been better off financially had they become physician assistants instead. The research, conducted by two Yale economists and published this month in the Journal of Human Capital, factored in the economic and time costs of completing medical school and residency training versus a typical two-year physician assistant program, the existing gender gap in post-degree earnings, and the tendency for women doctors to reduce work hours when they have children.
Denis Fortier is Director of Pharmacy at Cheshire Medical Center in Keene. When he started in the field 30 years ago, that job involved loading carts with Dixie cups full of prescriptions. Today, it involves managing $250,000 worth of technology called automatic dispensing machines. They look more like Zerox machines than ATMs. Cheshire has 15 of them throughout the hospital, each loaded with hundreds of different medicines. These are common fixtures at hospitals across the state. Doctors enter in prescriptions through a computer. Then nurses and other medical staff use the machines, which are sometimes called cabinets, to access the drugs.
Many local hospitals said the outbreak at Exeter unfairly casts their profession in a negative light, said Cristina Galli, spokeswoman for Parkland Medical Center in Derry, N.H. But several officials interviewed last week admit what occurred at Exeter Hospital could happen anywhere, given that it appears the outbreak was caused by an individual employee. "I do think this is something that could happen in most hospitals," said Delia O'Connor, president and chief executive officer of Anna Jaques Hospital in Newburyport. With strict protocols in place for storing and administering medicine and sanitizing medical instruments and equipment, area hospital officials said their patients' safety is already a priority.