Florida lawmakers learned that former Gov. Jeb Bush's controversial Medicaid reform plan from 2005 includes a time bomb for hospitals: A $300 million penalty. That's the amount Florida could lose in federal charity healthcare money if legislators don't reorganize Medicaid statewide within two years. This is about an experimental program designed to shift more Medicaid patients to managed-care plans and make the public health system run more like private companies. It currently operates in Broward County and the Jacksonville area.
Franklin, TN-based Health Research Insights is riding a wave of interest among self-insured employers intent on examining bills from physicians and other providers for what could be overpayment errors. For employers, it is all part of a push to control rising healthcare costs while fulfilling obligations to ensure that their health plan dollars are spent wisely. But some doctors question HRI's techniques, suggesting that the approach seems to assume wrongdoing took place after studying payment data that doesn't necessarily take into account all the details of a particular patient's case.
In the emergency room at Long Beach Memorial Medical Center, the triage was simple: Those complaining of flu symptoms were masked and separated from the rest of the ER patients until they could be further evaluated. Those who were visibly ill were immediately isolated pending tests. Those determined to be the "worried well" were reassured and sent home. One thing officials there and elsewhere have learned is the need to educate potential patients to be as calm and collected as the hospital staff has been.
No comprehensive national data are available to know how often "wrong-site" surgeries occur. In Georgia they occur on average more than once a month, data indicate. Yet despite protocols required by the Joint Commission and years of initiatives by medical groups, the problem persists. Regulators at the Georgia Department of Human Resources have received 102 reports of wrong-site surgeries since 2003, when reporting the incidents became mandatory. Since July 1, the state has received 20 reports. It received 15 in fiscal year 2008.
St. Joseph Regional Medical Center of South Bend, IN, has announced a pay freeze for employees as it prepares to open a new $355 million facility later this year. St. Joseph representatives said that it also was making an 8% reduction in executive pay and cutting the hours of some departments. No layoffs were announced. Officials said it has faced a growing number of uninsured patients and that Medicare and Medicaid payments have not kept pace with expenses.
Despite Massachusetts' 2006 health insurance overhaul, healthcare costs are devouring more than 10% of thousands of residents' income, according to a new study from Families USA, a nonprofit organization that lobbies for affordable care. The study found that more than 1 million Massachusetts residents are in families that will spend more than 10% of their pretax income on healthcare this year, even though the vast majority of them have health insurance.