Tag: "hospital"

Should Charities, Hospitals, etc., Be Allowed to Pay Premiums to Insure High Cost Patients?

hospital magnify 300“It is a conflict of interest for hospitals and drug companies to pay patients’ premiums and cost-sharing for the sole purpose of increasing utilization of their services and products,” said Karen Ignagni, head of America’s Health Insurance Plans, the health-insurance industry’s trade group.

The group’s general counsel, Joseph Miller, said laws regulating tax-exempt organizations could limit activities aimed at enriching themselves or another organization. (WSJ)

Headlines I Wish I Hadn’t Seen

Thren-MULTIVITAMIN-large570e new studies: Multivitamins have no health benefits.

Supplements: Mislabeled, contaminated and probably useless.

NSA surveills man who sued them.

Study: Most hospitals are average; “good” hospitals cut the readmission rate on knee and hip replacement surgery in half.

In the jobless rate: For every person who found a job between September and November, three other people stopped looking.

Headlines I Wish I Hadn’t Seen

bigstock-Healthcare-Network-21692141-300x200Jonathan Cohn: narrow-network race to the bottom isn’t ObamaCare’s fault; sorry Jon, it’s very much due to ObamaCare.

Here is Aaron Carroll making the same mistake.

States push back against the narrow-network race to the bottom; some are considering “any willing provider” laws.

Only 30 percent of the people who applied for health coverage on the Affordable Care Act’s new exchange websites last month were eligible for government help, far lower than initial projections.

Markets at Work: MA Plans Compete in Florida

The scene at Leon Medical Centers’ Healthy Living Facility in Miami on a recent Thursday resembled a cross between a luxury hotel and a theme park.

White-gloved doormen wearing porter uniforms ushered elderly patients from white vans into a gleaming lobby with colored terrazzo floors and a bubbling fountain. Greeters in green vests and ear bud radios welcomed the Medicare members and made sure their doctors knew that they’d arrived. Refreshments were proffered: Would they like a cafecito and pastelito for the wait?

And that was just the entranceway. Three more floors of the sprawling center bustled with Leon members meeting with physicians or dentists, taking healthy cooking classes, exercising in the fitness center or learning to use Facebook in a lecture hall…

With so many providers in one place ― most of them salaried employees of the center ― [Benjamin Leon, Jr., founder of the center] says members can shorten the time between primary care physician referral to specialist to diagnosis.

“What takes six to eight weeks,” he said, “we can do in 3 1/2 to four hours.”

But Leon also holds down costs by managing patients within the center’s network of providers. Fewer referrals to outside specialists means bigger savings for Leon, particularly important as Medicare Advantage cuts are phased in. He said the plan has not eliminated any benefits for 2014.

Source:  KHN/Miami Herald.

Israel’s Two Tiered Health Care System

Foreigners are in the top tier:

People from Easmedical-travel1tern Europe, Cyprus and the United States have been flocking to Israel’s public and private hospitals over the past five years for inexpensive, high-quality medical treatment.

But this cash cow for the Israeli health care system may be in jeopardy.

…[M]any worry that the lure of foreign money is creating a two-tiered medical system, where hospitals shift the best doctors and facilities to the high-paying customers and lessen service to Israelis. (USA Today)

Is This an Opportunity for Entrepreneurs?

Tom Scully thinks so. This is from the NYT Magazine:

Medicare, which picks up a majority of their health bills, encourages hospitals to discharge patients quickly after surgery, but it doesn’t offer financial incentives to choose one form of post-acute care over another. And because discharging a patient to home care requires a lot of extra work — ensuring that the correct equipment will be in the home, training family members and so forth — many doctors choose the easier option. They can simply ask a nurse to send the patient to a rehab facility, and everything is handled in about a minute. Medicare automatically approves payment for 20 days of recuperation in a nursing home, and many facilities simply treat the patient for the full allotment. “Miraculously, everyone is cured on the 21st day,” Scully says…

On average, Medicare’s fee-for-service model pays for about 2,000 days in a post-acute care facility for every 1,000 beneficiaries. By comparison, Kaiser Permanente, a provider of low-cost quality care, averages 600 days per 1,000 clients while achieving better outcomes.

Study: Private Insurance is Better than Medicare

They measured within-hospital quality based on AHRQ’s innovative Inpatient Quality Indicators. Mortality due to heart attacks, pneumonia, and hip replacement were among the indicators examined.

Among the authors’ findings: Within hospitals, patients with private insurance had lower risk-adjusted mortality rates than Medicare patients for 12 out of the 15 indicators examined.

Source: Health Affairs.

The Sebelius Ruling: Not Good for Health Insurers

You wouldn’t know it from Robert Pear’s write up in The New York Times this morning, but a new HHS ruling appears to be great news for hospitals and bad news for private insurance companies. Here is what Pear said:

The Affordable Care Act is the biggest new health care program in decades, but the Obama administration has ruled that neither the federal insurance exchange nor the federal subsidies paid to insurance companies on behalf of low-income people are “federal health care programs.”

The surprise decision, disclosed last week, exempts subsidized health insurance from a law that bans rebates, kickbacks, bribes and certain other financial arrangements in federal health programs, stripping law enforcement of a powerful tool used to fight fraud in other health care programs, like Medicare.

Here is what I think this really means: hospitals are going to be able to sign up patients for insurance in the exchange (platinum plans, of course), pay the premiums for them and wave any deductible. Just one more reason to worry about death spirals.

Hits and Misses

Very funny Jon Stewart video on signing up for ObamaCare.

Why plants usually live longer than animals.

High cost hospitals appear to save more lives. HT: Jason Shafrin.

Headlines I Wish I Hadn’t Seen

Henry Aaron: suck it up on cancellations. Tyler Cowen takes him to task.

CBS News: 6 people enrolled on the first day.

The top hospitals are opting out of ObamaCare.