Some hospitals will gain income and some will lose millions under a provision in the recently approved state budget that taxes hospital income and redistributes the money. But how exactly each hospital is affected remains uncertain because the formula for the tax keeps changing. So far, there have been five different versions of the formula, with a new version expected any day. The most recent version of the formula is based on a flat tax of 4.6%. Under it, the state's hospitals would pay a total of about $330 million in taxes. Hospitals would then be reimbursed a certain amount, based mainly on the percentage of Medicaid patients they served. The amount paid to hospitals would be matched at 50 cents on the dollar by federal funds. The state's hospitals would get a net gain of about $32 million, but not all institutions would make back what they pay in taxes. Meanwhile, the state would gain about $150 million in federal funds that it can put toward budget deficit reduction.
The number of medical malpractice cases filed against Pennsylvania doctors and hospitals dropped in 2010, the sixth consecutive annual decline. "In reality, medical malpractice lawsuits are not as prolific as people think," Pittsburgh attorney George Kontos said. "Any good attorney is very cautious about taking a case. I probably reject about 90% of people that come to me." In 2002 -- the year malpractice lawsuits peaked at 2,904 -- new rules designed to weed out frivolous lawsuits took effect, and experts credit those rules with the decline in lawsuits in the years that followed. One requires plaintiffs to get another doctor in the same field to sign off on the claims, showing the suit had merit. Another requires malpractice claims to be filed in the county where the alleged malpractice occurred. That prevents lawyers from filing cases in counties where they believe juries will be more sympathetic, lawyers said. Last year, 1,491 malpractice suits were filed, according to a report by the Administrative Office of Pennsylvania Courts.
If you have a faulty heart valve and decide to get it replaced, a surgeon will implant an artificial one that has undergone rigorous examination by the Food and Drug Administration. But if you choose the option recommended for most patients -- repairing your valve with an annuloplasty ring -- there are no such guarantees, even though both devices are permanently stitched into the heart and considered life-sustaining. That's because, a decade ago, the FDA downgraded the regulatory class of the rings. Instead of being grouped with heart valves and implantable pacemakers, annuloplasty rings were put into a class with most catheters, sutures and hearing aids, which allows the medical device industry to gain approval for new rings without clinical studies. "It's absolutely ridiculous. How could something that is permanently implanted in the heart be regulated this way?" said Diana Zuckerman, president of the National Research Center for Women & Families.
Some guy in his pajamas, home sick with bronchitis and complaining online about it, could soon be contributing to a digital collection of medical information designed to help speed diagnoses and treatments. A doctor who is helping to prepare IBM's Watson computer system for work as a medical tool says such blog entries may be included in Watson's database. Watson is best known for handily defeating the world's best "Jeopardy!" players on TV earlier this year. IBM says Watson, with its ability to understand plain language, can digest questions about a person's symptoms and medical history and quickly suggest diagnoses and treatments. The company is still perhaps two years from marketing a medical Watson, and it says no prices have been established. But it envisions several uses, including a doctor simply speaking into a handheld device to get answers at a patient's bedside.
Wall Street's rebound hasn't just been a blessing to Connecticut's financial institutions. It's also providing a boost to Connecticut hospitals, which continued to show signs of recovery in 2010, as investment income -- a key source of their revenue -- bounced back strongly. That boost, along with widespread cost-cutting initiatives, caused fewer Connecticut hospitals to lose money last year and allowed the industry as a whole to grow its surplus by 59%, a Hartford Business Journal analysis of industry financial data has found. But, hospital officials warn, the improved results don't necessarily mean brighter days are ahead. Historically, Connecticut hospitals have barely broken even financially and their margins continue to be thin. While Connecticut hospitals saw their total margin increase, they actually experienced a slight drop in their operating performance. The difference is attributable, in part, to improved investment returns.
Many people move to Vermont in search of a slower pace; Deb Richter, MD, came in 1999 to work obsessively toward a far-fetched goal. She wanted Vermont to become the first state to adopt a single-payer healthcare system, run and paid for by the government, with every resident eligible for a uniform benefit package. So Richter, a buoyant primary care doctor from Buffalo who had given up on New York's embracing such a system, started lining up speaking engagements and meeting with lawmakers, whom she found more accessible than their New York counterparts. Twelve years later, Richter will watch Gov. Peter Shumlin, a Democrat, sign a bill on Thursday that sets Vermont on a path toward a single-payer system -- the nation's first such experiment -- thanks in no small part to her persistence.