Most U.S. health insurers last year would have satisfied the much-disputed spending rules under President Barack Obama's healthcare reform, according to a new report by a congressional watchdog agency. The rules require insurers such as Aetna and UnitedHealth to spend most of customers' premium payments on medical care, not administrative costs or profit, or risk paying patients a rebate. Since the requirement went into effect in January, a number of states have sought waivers to get leeway in how fast the rules go into effect, which they say would keep insurers from abandoning the individual insurance market.
When U.S. hospitals cut expenses as the economy slid into recession, they looked first to basic supplies like light bulbs and bandages. Next on the list: artificial hips and knees. Implantable devices make up a sizable chunk of typical hospital budgets, and administrators are devising new ways to limit that cost as they brace for cuts to government reimbursement and treat more patients who can't pay for care. That means methodically working through each category of device, from heart valve replacements and stents to spinal products, to see where they can negotiate lower prices. It also means creating databases of shared information on pricing between hospitals.
The Wisconsin Hospital Association report last week that projected a shortage of almost 2,200 physicians by 2030 drew attention to an escalating problem: The United States is training too few primary care doctors. The hospital association estimates that primary care physicians - doctors who specialize in family and internal medicine and pediatrics - will account for about 80% of the projected shortage. It works out to an estimated 1,767 primary care physicians - or enough doctors to provide care for more than 3 million people. The state now has about 6,000 primary care physicians, some part time. Projections on the supply of physicians have often proved inaccurate. But no one questions that the country faces a growing shortage of primary care physicians.
On the Cal Hospital Compare website, conscientious consumers in California can look up scorecards for their local hospitals. How well does the hospital control infections? How often do patients die from complications that can be treated? How satisfied are most patients with their experience? Most major hospitals in California give the data voluntarily to independent researchers who analyze and publish consumer-friendly reports. The project was considered a pioneering effort when it started in 2004, but Jan Emerson-Shea, a spokesperson for the California Hospital Association, says the report cards have outlived their usefulness.
The shifting health insurance climate and escalating medical costs have created an opportunity for a new Waltham company that helps people deal with their medical debts. CoPatient, which launched in October, provides free audits of patients' medical bills to identify billing errors and overcharges and to determine if costs can be appealed. The company differentiates itself from similar services by crowd-sourcing medical bills, according to co-founder Katie Vahle. "We aggregate the experiences of all the people who we help, and we learn from those experiences and then apply them to the next individual who comes to us with their medical bills," Vahle said.
For a decade, Baptist Health South Florida has been a leader in urging its 13,000 employees to lead healthier lifestyles?offering such benefits as free 24/7 gyms at work and discounted low-fat meals in the cafeterias. When it came to choosing the carrot or the stick for promoting wellness and reducing skyrocketing healthcare costs, Baptist has offered the carrot. Many major employers are making similar moves elsewhere in South Florida and around the country. But now Baptist and others say those efforts may not be enough because healthcare costs have continued to rise. That has prompted some companies across the country to reach for the stick?for example, finding ways for employees with unhealthy habits to pay more for insurance.