Posts Tagged - ‘hospitals’

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Health Insurance Reform: Healthcare Mergers Coming Up?

Monday, November 22nd, 2010

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The healthcare reform law may end up having an unfortunate side effect: although one of its stated goals is to help make affordable health insurance more widely available by spurring competition, several health care providers are considering merging.

According to many groups of doctors, hospitals, and clinics, the alliances and joint ventures are necessary in order to maintain their profit margins and take advantage of the potential savings of the law while avoiding the additional costs. However, consumers may suffer as a result.

The industry’s lobbying groups also want the Federal Trade Commission and the inspector general of the Department of Health and Human Services to give them exceptions from antitrust and Medicare fraud laws. This could potentially be dangerous. On the positive side, it can force medical service providers to coordinate care, leading to better health outcomes for patients.

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Will AT&T’s New Business Make Health Insurance Plans Cheaper?

Tuesday, November 9th, 2010

Last week, AT&T announced that it will be launching a new unit called ForHealth. The target market is doctors, health insurance companies, hospitals, and pharmaceutical firms.

It aims to provide cloud-based networking solutions, which are set to lower medical costs while improving communication–and therefore patients’ health. Many believe that moving to digital record keeping will lower the cost of health insurance plans, with the savings hopefully being passed onto consumers.

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Hospitals Criticize Unrealistic Electronic Medical Record Goals

Tuesday, June 8th, 2010

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Electronic medical records have been largely looked upon as a panacea: they have the potential to reduce costly and harmful errors, as well as lowering administrative expenses–savings that can then be passed on through lower health insurance rates.

To this end, funding for incentives was included in Obama’s stimulus package last year. Unfortunately, doctors, health insurance plan providers, and hospitals are complaining that the goals are far too unrealistic for the short term. Even facilities that have been praised for their implementation would not qualify on enough of the nearly 30 guidelines to receive funding.

President Obama has called for all medical records to be computerized within five years. Insurers like Kaiser Permanente doubt that will happen on schedule.

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Obese Mothers-To-Be Cost Hospitals More

Monday, June 7th, 2010

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The obesity epidemic has resorted in an increasing number of pregnant women who are already overweight prior to becoming pregnant. Although losing weight prior to conceiving is ideal, that is not always possible. Unfortunately, both the baby and mother can experience serious complications, which her health insurance plan must pay for.

As a result, hospitals must spend far more money on delivery for obese mothers. Caring for a premature birth–which is more likely in seriously obese women–helps drive the cost up to $200,000 for that high-risk birth. By contrast, a normal delivery costs about $13,000. The increased expense of labor and specialized supplies is passed on through higher health insurance rates for all women.

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Top 8 Children’s Hospitals

Monday, June 7th, 2010

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Recently, U.S. News and World Report released its ranking of the best children’s hospitals in America. They judged them on criteria related to cancer, neonatal care, and other specialties.

Here are the overall winners! Hopefully, your health insurance company includes some of these hospitals in its network.

  1. Children’s Hospital Boston
  2. Children’s Hospital Los Angeles
  3. Children’s Hospital of Philadelphia
  4. Children’s Hospital of Pittsburgh of UPMC
  5. Cincinnati Children’s Hospital Medical Center
  6. New York-Presbyterian Morgan Stanley-Komansky Children’s Hospital
  7. St. Louis Children’s Hospital-Washington University
  8. Texas Children’s Hospital, Houston

(Step your game up, Miami Children’s Hospital!)

Call your insurer to see if they are covered under your family health insurance policy.

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FL Gov. Charlie Crist Vetoes Money For Uninsured

Wednesday, June 2nd, 2010

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Florida Republican-turned-Independent Governor and Senate Candidate Charlie Crist just vetoed a bill that budgeted almost $10 billion for hospitals to care for the uninsured and under-insured. Recent figures show 27% of non-senior citizen residents lacking Florida health insurance.

He may believe that healthcare reform will reduce the need for uncompensated charity care, since more people will have insurance. In addition, his state has been hard hit by the real estate slump. Still, people are confused, because Crist appeared to have given up on the conservative Tea Party vote once he dropped out of the Republican primary.

This particular line item has been in the state’s budget for over 30 years, far before affordable health insurance reform was a gleam in Barack Obama’s eye, and has been relatively noncontroversial during that time. However, the political climate is very heated, especially in an area where the Attorney General (Bill McCollum) has famously launched a lawsuit against the Obama administration on constitutional grounds.

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Healthcare Reform Penalizes Hospitals With High Readmission Rates

Wednesday, June 2nd, 2010

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When a person goes into the hospital, they hope to get out as soon as possible. Unfortunately, early discharge isn’t best if they later end up being readmitted.

Currently, the fee-for-service compensation system has health insurance plans paying a lump sum to hospitals for each treatment–making it more profitable to move patients out quicker. Sometimes, those patients aren’t provided with appropriate support to prevent their return to the hospital. Readmission is more costly for patients, in both health and financial terms.

Healthcare reform looks to change that, starting in 2012. In that year, hospitals with high rates of readmission will be financially penalized. It is a tactic to encourage appropriate-length hospital stays (as opposed to the highest possible turnover), as well as quality care after discharge. The exact details of that provision are as of yet unknown.

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Make Sure Your Health Insurance Covers Surgery

Wednesday, June 2nd, 2010

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As strange as it sounds, health insurance companies won’t automatically cover every surgery you undergo, even if it’s involuntary. That’s why you should do your research prior to entering the operating room.

For example, experimental treatments such as spinal fusion may not be covered. Purely cosmetic plastic surgery is usually not covered, even if a medical problem or accident caused the disfigurement.

In most cases, doctors and hospitals should know whether or not a procedure is covered, and if it needs pre-authorization under your health insurance plan. Just in case, it’s important to confirm that by checking with your insurer.

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Is Ego Responsible For U.S. Healthcare Woes?

Tuesday, June 1st, 2010

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In the Boston Globe, an opinion editorial by Douglas S. Brown has an interesting viewpoint regarding the problems that have faced the American health insurance system for decades. His view is that ego and hubris from all sources (hospitals, doctors, insurers, medical school professors, and even patients) has stood in the way of improvements.

He acknowledges that our nation is deservedly proud of technological innovations that increase the length and quality of life. However, we are behind several other developed nations in efficiency, quality, and access–although many refuse to acknowledge it. For example, there are too many preventable medical errors each year. Many hospital boards, meanwhile, are more concerned about flashy cosmetic improvements and additional facilities.

Physicians are trained as independent craftspersons, and have historically had little interest in teamwork. However, current compensation from health insurance plans–as well as the best outcomes–depend on cooperation. Brown feels that we can learn from our errors in order to truly become the best health care system in the world.

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Most ER Patients Have Health Insurance

Thursday, May 20th, 2010

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Contrary to common belief–which states that the uninsured pack hospital emergency rooms with largely nonemergency ailments, a new survey has found that the majority of ER patients actually do have health insurance.

In 2007, only 10% of visits were for nonurgent cases. That was before the recession kicked in, so the percentage may be higher now. Moreover, the insured and uninsured went to the ER at similar rates. On the other hand, high-income individuals (whom are the most likely to have insurance) were least likely to go.

The findings from the National Center of Health Statistics undercut one of the arguments for health insurance plan reform. They believe that the primary cause of ER overcrowding is instead the consolidation and closing of emergency departments over the past several decades, leaving fewer facilities for a similar volume of patients.

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