Headlines I Wish I Hadn’t Seen
ObamaCare reforms may hurt vulnerable patients.
You need a license before you can enter more than 1,000 professions in the United States.
Tag: "ER"
Jun 26, 2012 | 9 comments | by John Goodman
How Good Is Medicaid Managed Care?
This is Aaron Carroll quoting from a Christopher Flavelle study:
The largest Medicaid managed-care plans in Florida and Illinois, and some for-profit plans in California and New York, provide health-care access that is significantly and consistently worse than the national median for such plans. Studies suggest that failing to provide some types of care, such as childhood immunizations, may lead to higher medical costs in the future.
It gets worse:
The evidence is limited that managed care sustainably reduces emergency-room visits in the five largest states. California had shown some reductions in ER visits among managed-care plan patients, but the gap between them and fee-for-service beneficiaries is shrinking. In New York that gap has almost disappeared, and in Illinois, ER visits are now slightly more common among managed-care beneficiaries. Only in Texas does managed care consistently produce significantly lower ER visits than in fee-for-service, though the cost of those visits is much higher.
And, “even in Texas, where managed care is succeeding in reducing the number of emergency room visits, the cost for those visits are, on average, more than twice as expensive as emergency visits under fee-for-service plans.”
Jun 12, 2012 | 4 comments | by John Goodman
Medicaid Stops Paying for Non-ER, ER Care
The new cuts, set for April 1, focus on about 500 diagnoses including common infections, mild burns, strains and bruises. If an enrollee comes to an emergency room and is diagnosed with one of these conditions, the Washington Medicaid program won’t pay the hospital and doctors…Some 43 states have Medicaid initiatives designed to deter unnecessary use of emergency rooms, according to the Kaiser Family Foundation, a nonpartisan, nonprofit organization that studies health issues. Several states now charge patients copays for nonemergency services in an ER…
“If you fall down the stairs, and your ankle is twice its normal size, and I X-ray it and it’s broken, they’ll pay me, and if I X-ray it and it’s not broken, they won’t,” said one doctor.
Full article by Anna Wilde Mathews on this plan by Medicaid to stop paying for certain emergency-room visits in The Wall Street Journal.
Feb 28, 2012 | 4 comments | by John Goodman
Once People Have Health Insurance, They Will Seek Care…
At the emergency room!
New research in the Archives of Ophthalmology warns hospitals to prepare for an overload of emergency department (ED) visits after health reform kicks in. Florida hospital EDs already saw patients eligible for Medicaid jump 6 percent between 2005 and 2009, well before millions of Americans are expected to gain health insurance in 2014, reported The Tampa Tribune.
Meanwhile, approximately 68 percent of emergency physicians in Massachusetts saw an uptick in visits due to the state’s universal health plan, the model for national health reform, according to a 2009 survey, noted The News-Press.
Source: FierceHealthcare
Jan 16, 2012 | 6 comments | by John Goodman
Caplan on Gruber
Jon Gruber has written a graphic novel. This is from Bryan Caplan’s devastating review:
3. More generally, Gruber ignores almost everything government does to increase the cost of health care. There’s no discussion of medical licensing versus certification. There’s no discussion of the regulatory barriers to low-cost, high-deductible policies. There’s no discussion of medical liability. He mentions the high cost of “free” emergency room care, but fails to mention that this is a side effect of long-standing populist policy: government forces emergency rooms to treat people even if they certainly won’t pay.
4. There’s zero discussion of moral hazard – the unhealthy lifestyles that many people choose despite the risks. For Gruber, or at least Gruber the graphic novelist, bad health is something that “just happens to you.” Sigh. Insurance companies aren’t omniscient, but they could do a lot more to tailor rates to risks – if it were legal to do so. And maybe people would respond to those incentives by living healthier lives.
Entire review is worth reading.
Jan 04, 2012 | 8 comments | by John Goodman
Nursing Pays
The U.S. Bureau of Labor Statistics (BLS) predicts that the registered nurse (RN) will be the fastest growing profession between 2008 and 2018. And the profession is financially rewarding. The BLS estimates that the average salary for a registered nurse in 2010 was $67,720, or $32.56 an hour. In 2009 the average salary was $63,750, or $30.65 per hour. That’s about a 6 percent increase in a bad economy when millions of Americans were just thankful to have a job.
However, as in all professions, some segments do better than others. A recent survey of 3,000 nurse practitioners conducted by “Advance for NPs and PAs” found full-timers earned $90,770 in 2010. But nurse practitioners in emergency departments earned on average $104,549. Good salaries considering that Medscape reports that nearly half of family physicians, with all their additional training and educational expenses, made between $100,000 and $175,000 in 2010.
See full Merrill Matthews post at The Health Care Blog.
Dec 29, 2011 | 5 comments | by John Goodman
What Does an HMO Emergency Room Look Like?
In the editorial, the ER docs — who are from several large institutions — also warn that increased pressures on emergency physicians to save money could raise the probability of missed diagnoses, and boost medical-liability risks. ER physicians, who often make the decisions to admit patients to the hospital, will also face challenges given that hospitals are under pressure to limit admissions and readmissions, the editorialists contend.
Dec 09, 2011 | 4 comments | by John Goodman
The New Model of Urgent and Not-So-Urgent Care
Charlotte, N.C.-based Carolinas HealthCare System, for example, operates 32 hospital emergency departments, four freestanding ERs with five more planned, and 19 urgent-care centers. It is considering starting retail clinics in grocery or drugstores. “We can integrate care across a broad spectrum of settings and we have an electronic medical record that links all our patients no matter where they go,” says president and chief operating officer Joseph Piemont.
Full article on urgent care clinics.
Dec 07, 2011 | 7 comments | by John Goodman
