Mylan Laboratories To Acquire Generics Business Of Merck KGaA For 4.9 Billion Euros

Mylan Laboratories Inc. (NYSE: MYL) and Merck KGaA today announced the signing of a definitive agreement under which Mylan will acquire Merck's generics business ("Merck Generics") for EUR 4.9 billion ($6.7 billion) in an all-cash transaction. The combination of Mylan and Merck Generics will create a vertically and horizontally integrated generics and specialty pharmaceuticals leader with a diversified revenue base and a global footprint. On a pro forma basis, for calendar 2006, the combined company would have had revenues of approximately 4.2 billion dollars, EBITDA of approximately 1.0 billion dollars and approximately 10,000 employees, immediately making it among the top tier of global generic companies, with a significant presence in all of the top five global generics markets.
In addition to retaining Hank Klakurka, currently President and CEO of Merck Generics, Mylan has executed long-term employment agreements with members of Merck Generics' senior management team, ensuring that senior leadership remains intact. Mylan views the existing management and employees of Merck Generics as key to the success of the combined company.

Source: Mylan Laboratories To Acquire Generics Business Of Merck KGaA For 4.9 Billion Euros

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Medicare Plans to Deny Coverage of Artificial Disks

 

Government regulators said yesterday that Medicare, the federal insurance program, planned to deny coverage for artificial disks implanted in the lower spines of older patients.

The preliminary decision, which is expected to become final in August, extends to the ProDisc-L made by Synthes a national coverage ban imposed a year ago on the Charité lumbar disk made by Johnson & Johnson; the Food and Drug Administration cleared the Pro Disc-L for sale last summer. It also signaled that Medicare will not cover Medtronic’s Maverick lumbar disk when that device reaches the market.

Yesterday’s decision applies to patients over 60, which is most of the 43 million people Medicare covers. Local administrators of Medicare benefits will continue to be able to pay for the devices in younger disabled patients on case by case.

Source: Medicare Plans to Deny Coverage of Artificial Disks - New York Times

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Blue Cross Earmarks $2 Million To Fight Health Reform Plans

 

Blue Cross of California on Thursday launched an advertising campaign to oppose health insurance market reforms that are being proposed by Gov. Arnold Schwarzenegger (R) and Democratic lawmakers as part of their plans to overhaul California's health care system, the AP/San Jose Mercury News reports.
Blue Cross, the state's largest health insurer, in Thursday's Sacramento Bee ran an ad that compared the health care reform proposals to the energy deregulation in 1996 that led to blackouts and other problems in the energy market. The insurer has committed $2 million to the campaign.
Blue Cross opposes provisions in proposals by the governor, Assembly Speaker Fabian Núñez (D-Los Angeles) and Senate President Pro Tempore Don Perata (D-Oakland) that would require insurers to sell policies to everyone, regardless of pre-existing medical conditions.
Ann-Louise Kuhns, vice president of Blue Cross of California, said, "We've got more than one million members who could face very significant [premium] increases under some of these proposals." Kuhns said the insurer supports expanding public subsidies to provide health coverage to more residents but opposes any changes to the insurance market.

Support for Health Care Reform

Blue Cross is the lone insurer in California that publicly opposes Schwarzenegger's and the Democrats' reform proposals. The insurer formed a political committee called The Coalition for Responsible Healthcare Reform, but so far it is the committee's only member.

Source: Blue Cross Earmarks $2 Million To Fight Health Reform Plans - California Healthline

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EHRs and Physician Training..Update

From Modern Health Care...this is a response to an earlier post with physician involvement with implementation of electronic medical records.  I can agree in one area myself, "begged" as I have done a bit of that myself and it has been a real challenge sometimes to get the physician to "buy in" with training.  If you read most of the articles on a successful implementation, most tend to agree that training is the key, it's all teamwork.  BD

I have spent countless hours in the middle of the night, on weekends and during extended "go live" support working with physicians who never showed up for scheduled training. They were presented with the same material that was presented in the classes scheduled for physicians prior to going live. But they couldn't be bothered with showing up for the class they themselves had signed up to take.
Poor EHR design doesn't wash either. The physician groups are asked and in many cases begged to get involved in system design from the beginning and no one ever shows up or one physician is designated as the representative for all services, physician levels and programs. How many conference sessions and articles have been written about techniques to involve physicians in implementing EHR systems? Then the system goes live and physicians who never thought about participating complain because no one met their needs.
Healthcare facilities have catered to physicians for decades and implementing information technology is no different. It's time to stop treating physicians differently than the rest of healthcare professionals. If physicians want to be properly trained and supported then they need to take responsibility, as a group, for their own learning and to make their wants and needs known just as every other discipline does. Until a plurality of physicians decide to get involved in the design and implementation of EHR systems and become partners in creating solutions, they will continue to need someone to pick up the tab for their mental health.

Source: Modern Healthcare Online

Related article:  EMR Stressed MDs

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Many Small Physician Offices No Longer Provide Injected Medications Because of Medicare Reimbursement Issues

If you are a Medicare participant, this is worth checking out as many of the injection compensations are being changed by Medicare.  Many small offices too may not be able to absorb the cost associated with maintaining a supply on hand if they cannot purchase in bulk quantity.  BD

Thousands of small physician offices are "getting out of the business of administering drugs for conditions ranging from anemia and cancer to arthritis and infections," the Wall Street Journal reports. The shift is "an unintended consequence of a change in the way Medicare reimburses doctors" to administer medications that are injected or infused, according to the Journal.
Companies that manufacture the medications, such as Amgen and Johnson & Johnson, offer large rebates or discounts for bulk purchases, but many smaller physician offices do not purchase such treatments in bulk. In addition, because Medicare determines the reimbursements for such medications based on the average price paid, the discounts reduce reimbursements for all physicians, regardless of whether they receive discounts.

Source: Coverage & Access | Many Small Physician Offices No Longer Provide Injected Medications Because of Medicare Reimbursement Issues - Kaisernetwork.org

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Demonstrators to target United Health Shareholders meeting

United Health Care issues in the news once more...BD

MINNEAPOLIS - To dramatize the need for health care reform, several organizations will demonstrate Tuesday outside the annual shareholders meeting of United Health Group.

The demonstration will start at 9 a.m. Tuesday, May 29, at the Minneapolis Convention Center, 1301 Second Ave. S., Minneapolis.
The event will "decry the gap between need and greed as United Health Group CEO William McGuire, his replacement Stephen Helmsley, and other Minnesota HMO executives bilk billions in stock options derived from denying health insurance to half a million Minnesotans," organizers said.

United Health Care is the largest HMO in the United States and McGuire was the highest-paid CEO in Minnesota history, with stock options totaling $2 billion. Helmsley, who replaced McGuire, has stock options in excess of $750 million. In contrast, the chief of Medicare, a single-payer system with the largest enrollment in the United States, makes $150,000 a year.

Source: Welcome to Workday Minnesota, your leading source for labor news!

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Google declares war on $2 trillion health care industry

Interesting perspective on medical record technology.  Will we someday "Google" our medical records?  BD

The Google health care die has been cast, it is a $2 trillion declaration of medical intent.

Adam Bosworth, Google Vice preisdent Engineering,  is no longer content with “touch-feely” consumer reach-out campaigns to “learn” what the “health care consumer” wants, he is now doing what Google does best: Telling the world how it will be.

It WILL be Google’s “vision for the future of health care.”

Those on the winning medical team will go the Googley way, or it’s the Google medical information highway.

Google scary now? Personal Health Records, sponsored by Google, next I warned one month ago. That day is nearing.

In Google’s medical push I present Bosworth’s health care (pay for the right to perform) IT road show underway over the past six months. Bosworth’s most recent stop was the American Medical Association of Informatics, and it was a big one, a $2 trillion one.

Source: » Google declares war on $2 trillion health care industry | Digital Markets | ZDNet.com

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Pharma Marketing Blog: Dumb Blonde Reps vs. Slovenly Genius Reps

John Mack creates some good questions here on the Pharma Marketing Blog...the Pharma companies do cater good lunches though, as many of the offices I visit invite me to partake if I happen to be there on business, but most of the time it tends to be much better than pizza.  BD

Ed Silverman over at Pharmalot posted a fun little item about a poll that Cafe Pharma is currently running.
Ed asked "Do Good-Looking Reps Do Better?" or rather that was the gist of the poll.
The devil is in the details. Here's what the poll asked:
Which type of rep gets the best results? An average looking rep that knows their products and can sell? or A super attractive rep that is an idiot and can't sell?
Only 16% of respondents chose the super attractive rep option.
Unfortunately, this survey can't possibly yield any meaningful insights.
To sell (ie, "do better" or "get best results"), you first have to get in the door. So, a better question would have been: Do attractive reps get better access to physicians than do slovenly, but knowledgeable, enthusiastic piglets?
I think a lot more than 16% would answer "Yes" to that!
Another, more meaningful question would have been: Do reps -- attractive, plain, or sloven -- who bear gifts -- pizza, sandwiches, cupcakes -- get better access than those who come empty-handed?
Again, I think the pizza-delivery rep would have no problem getting in the door to most doctor's offices.
Good looks and pizza are very visible attributes, in plain sight. You see the cleavage, you open the door. You see the pizza, you open the door. It's Pavlovian!

Source: Pharma Marketing Blog: Dumb Blonde Reps vs. Slovenly Genius Reps

Hat Tip:  Kevin MD

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FDA Approves Tigris System for testing donated blood

 

SAN DIEGO, May 24 /PRNewswire-FirstCall/ -- Gen-Probe Incorporated (Nasdaq: GPRO) announced today that the U.S. Food and Drug Administration (FDA) has approved the Company's PROCLEIX(R) TIGRIS(R) system, the first fully automated molecular diagnostics instrument, for use with the PROCLEIX ULTRIO(R) assay.

The PROCLEIX TIGRIS system was approved with the PROCLEIX ULTRIO assay to screen donated blood, plasma, organs and tissue for HIV-1 and hepatitis C virus (HCV) in individual blood donations or in pools of up to 16 blood samples. The system and assay also detect hepatitis B virus (HBV) in blood donations that are HBV-positive based on traditional serology tests for HBV surface antigen and core antibodies. As expected, the system and assay have not been approved at this time to screen donated blood for HBV, as the initial clinical studies were not designed to, and did not, demonstrate HBV "yield." Yield is defined as HBV-infected blood donations that were intercepted by the PROCLEIX ULTRIO assay, but that were initially negative based on the serology tests. Gen-Probe and Chiron have initiated a post-marketing study to demonstrate HBV yield and gain the associated donor screening claim.

The fully automated, high-throughput PROCLEIX TIGRIS system can process 1,000 blood samples in about 14 hours, a level of productivity that facilitates testing in smaller pool sizes, which in turn can increase assay sensitivity and blood safety.

Source: Gen-Probe: News: Press Releases

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Insurers Promote Use Of Generic Anticholesterol Drugs

 

The Syracuse Post-Standard on Monday examined how many health insurers have begun to encourage members to use generic versions of the anticholesterol medication Zocor, which reached the U.S. market last June, rather than Lipitor, manufactured by Pfizer, to reduce costs.
For example, Excellus BlueCross BlueShield of New York has begun to provide members with a one-month supply of simvastatin, the generic version of Zocor, at no cost and has reduced the cost of simvastatin for members to about $7.50 monthly, compared with about $135 monthly for Lipitor. Joel Owerbach, chief pharmacy officer for Excellus, said, "Lipitor is a great drug, but the reality is, for the vast majority of people who are taking Lipitor, you can get to the same place by taking a drug that's going to cost a lot less."

Source: Insurers Promote Use Of Generic Anticholesterol Drugs

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Chapter 7, "Are you still just using your Cell Phone for phone calls?"

Windows Live Search for your cell phone can be a huge tool. In this example we did some live lookups on the phone. It has a very simple interface and will not only help you with a map, but can also help you locate a business, i.e. a restaurant, a medical office, hospital, you name it. The examples are fairly simple, but you can see we have driving instructions, traffic conditions, a map, and an option to search for other nearby businesses. I can also save the location to a contact file or forward to someone else. Now that has some huge potential with the medical business in the case of an emergency call, making a house call, finding a hospital, for a few examples.
If you are mobile and have left the "safe harbor" of your desktop PC, give this some real thought as it can be a huge time saver and just might be a life saver too. An ambulance company could easily send the emergency location to an MD, hospital, etc. or the MD could also forward the location in the case of an emergency too.
Shoot, if you just want to find a nice place to eat, it's not bad either. BD















Source: http://mobile.search.live.com/about/

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California Grants Provide Funds for Nurse Training

 

Gov. Arnold Schwarzenegger (R) on Wednesday announced more than $1.6 million in grants to help fund six nurse training programs statewide.
The grants are intended to help California residents find jobs that pay at least the average state hourly wage of $22.51 while also boosting California's supply of health care workers.
Funds to train registered nurses and licensed vocational nurses will go to these five Los Angeles area hospitals:

• Brotman Medical Center;
• Century City Doctors Hospital;
• East Los Angeles Doctors Hospital;
• Olympia Medical Center; and
• USC University Hospital.

Source: California Grants Provide Funds for Nurse Training - California Healthline

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Centers for Medicare and Medicaid Services - Hospital Compare

I gave this a try this morning using several different search criteria and the results for each hospital selected were given on a bar graph for easy comparison.  Some hospitals did not treat or supply enough data to show on every graph in a few categories.  Good tool to get a basic idea of the services and quality results by comparing side by side.  One nice small add on is the ability to use a larger font to view the pages too. BD

Hospital Compare - A quality tool for adults, including people with Medicare

This tool provides you with information on how well the hospitals in your area care for all their adult patients with certain medical conditions. This information will help you compare the quality of care hospitals provide. Hospital Compare was created through the efforts of the Centers for Medicare and Medicaid Services (CMS) and organizations that represent hospitals, doctors, employers, accrediting organizations, other Federal agencies and the public.

Talk to your doctor about this information to help you, your family and your friends make your best hospital care decisions.

By Name
I want to find a hospital by entering all/some of its name:

Hospital Name

By Proximity
I want to find all hospitals within a certain distance of:

City

ZIP Code

By Geography

Source: HHS - Hospital Compare

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Why hedge fund managers outearn doctors - BloggingStocks

 Interesting comparison on this blog, one person's opinion...BD

But there's really more to it than that -- society perceived that the pricing mechanism for doctors' services was broken. That is, if the free market set the price, many citizens would not be able to afford to pay. And society believes implicitly that health care should be widely available to citizens. (That doesn't mean everybody. 40 million Americans are not covered by health insurance but many of them can get care at hospital emergency rooms.)

But given the perception of a broken pricing system, government and managed care organizations intervened. Thus, if a doctor takes patients who do not directly pay their own bills -- but rely on Medicare, Medicaid, or an HMO -- then the price for that service is set by someone other than the doctor.

Most hedge fund managers let computers do much of the work -- something doctors can't do.

Meanwhile, a doctor's best chance to make big money is to go into investment banking -- where salaries and bonuses are in the millions and rising -- or to focus only on patients who have such deep pockets that they will write checks from their own bank accounts to hire the best talent.

Until these economic conditions change, Doctors will continue to earn the acclamation and hedge fund managers will get the money.

Source: Why hedge fund managers outearn doctors - BloggingStocks

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Health Benefits Direct to Enter California Market With Addition of PacifiCare as Health Insurance Carrier

If you have not used one of these services, this is an online service built to help companies and individuals select and purchase various types of health care coverage.  BD

RADNOR, PA -- (MARKET WIRE) -- May 24, 2007 -- Health Benefits Direct Corporation (OTCBB: HBDT), a leading innovator in the direct marketing and distribution of a wide range of health and life insurance products in the individual market, today announced that it has entered into an agreement with PacifiCare, a UnitedHealthcare company, to market a number of PacifiCare's health insurance plans for individuals and families in California.

"We are continuing to selectively and strategically expand our health insurance portal with leading providers like PacifiCare," said Alvin H. Clemens, Chairman and Chief Executive Officer. "As an advocate for individual insurance consumers, we want to line our customers up with the best, most reliable coverage offered by the most highly rated carriers. Adding PacifiCare enables us to enter the large California market with a premier offering of health insurance products."

In addition to PacifiCare, Health Benefits Direct's major medical insurance carriers include UnitedHealthcare's Golden Rule Insurance Company, Aetna, Humana, Time Insurance Company (marketed as Assurant Health), and UniCare (a Wellpoint company). The company offers life insurance through Fidelity Life and AIG American General (an AIG company). Indemnity, short-term major medical, and critical illness insurance is offered through various additional partners.

Source: PRESS RELEASE Health Benefits Direct to Enter California Market With Addition of PacifiCare as Health Insurance Carrier

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Sometimes, Sightseeing Is a Look at Your X-Rays

Interesting article about both sides of medical tourism..and brings to light what type of medical attention the citizens of these countries receive...BD

But just as American travelers begin getting comfortable with the safety of foreign hospitals, they face a new question. With developing world hospitals focusing on medical tourists, some may take doctors away from understaffed public clinics in nations like India and Thailand, potentially leading to a public backlash against medical visitors. Already, the press in Thailand and India has warned that medical tourism, which can be more lucrative for physicians, is sucking doctors away from public clinics.

Only days after my luxury dengue treatment at Bumrungrad, I saw this other side. At a larger Thai hospital where I’d walked in after feeling my fever spiking, I sat on a hard bench in the middle of a waiting room littered with cigarette butts and empty plastic bottles. For over an hour, no one called me. When a nurse finally approached me, she warned there wouldn’t be any doctors around for hours, and then turned and walked away.

I got up and took a cab to Bumrungrad.

Source: Sometimes, Sightseeing Is a Look at Your X-Rays - New York Times

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Advertising pharmaceuticals with Legos?

Does marketing need to go this far?  BD

More new business opportunities for drugmakers - cross-promotional moments with toymakers. Here we have an item that's popular with children of many ages, particularly young boys.

Source: Pharmalot: Risperdal Legos: Building Blocks For Care

Hat Tip:  Kevin, MD

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Chapter 6, "Are you still just using your Cell Phone for Phone calls?"

In Japan a participant can simply snap a picture of the food and get expert advice back via the cell phone for nutrition information.   BD

TOKYO, Japan (AP) -- Wondering how much of a diet-buster that banana cream pie on your plate is? Some Japanese have a novel way to find out: Photograph it with your cell phone and send the image to an expert.

With cell phones ubiquitous in Japan and rising concern over expanding waistlines, health care providers have put two and two together to allow the calorie-conscious to send photos of their meals to nutritionists for analysis and recommendations.

Osaka is using a system developed by Asahi Kasei Corp., a Tokyo-based chemical and medical equipment manufacturer. The system is operating at about 150 health care providers and local governments around the country, company official Naoki Yoshimura said.

Nutritionists can work with photos from one day's meals to several weeks' worth, he said. Results come back in three days. Participants also can log onto a Web site to get further dietary information and upload photos from digital cameras.

"Cell phones are everywhere here," Onishi said. "We're hoping they can now make it easier for people to get help improving their diet."

Source: Cell phone cameras help Japanese lose weight - CNN.com

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Robotic Surgery May Improve Survival Rate For Prostate Cancer Patients

 

Performing less invasive laparoscopic surgery using robotic technology may improve survival rates for prostate cancer patients, according to a study by urologic oncologists at Thomas Jefferson University Hospital's multidisciplinary Genitourinary (GU) cancer center.
In a study presented May 21, 2007 at the annual American Urological Society meeting in Anaheim, Calif., the Jefferson urologists found that performing a laparoscopic radical prostatectomy (LRP) with robot technology can reduce positive surgical margins. Positive surgical margins refers to when cancer, seen under a microscope, goes to the edge of a specimen, meaning that cancerous cells likely remain in the patient. LRP is the surgical removal of the entire prostate gland and surrounding tissue including the seminal vessels through several tiny incisions.

The robotic system further refines laparoscopic prostatectomy by allowing a surgeon's hand movements to be scaled, filtered and translated into precise movements of micro-instruments within the operative field. The magnified, three-dimensional view the surgeon experiences enables him to perform precise surgery in complex procedures, such as radical prostatectomy, through small surgical incisions.

Source: Robotic Surgery May Improve Survival Rate For Prostate Cancer Patients

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Patient Pain Medication - Self Dispensing pill medication at bedside

This is not a new concept as IV dispensers have been around for quite a while, but new technology allows for the same type of dispensing with pills by using RFID (radio frequency ID).  BD

The MOD® is a Class I device approved for use by the FDA. Use of the device in the EQA Program is not considered experimental but rather, Institutions may collect data related to the use of the device for internal purposes as part of the device evaluation. Modules for data collection are included in the EQA Program Source Book to encourage a thorough evaluation.  No data or internal information collected will be requested by the program sponsor.

The device is delivered to the patient’s bedside and locked onto an IV pole within easy reach of the patient. The patient wears a Radio Frequency Identification (RFID) wristband that has been programmed into the device. When the lock-out interval has passed, the patient sees the bright green ready light on the MOD®. To request a dose of medication the patient follows these three easy steps:

• Touches the pain scale to record the pain level and activate the RFID reader within the device
• Swipes the RFID wristband over the front of the device to turn the tray to the open position
• Removes a single pill from the device and takes the medication

Source: AVANCEN, LLC - About the MOD®

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Medicare HMOs fend off oversight

 

WASHINGTON, May 16 (UPI) -- Facing down the threat of greater regulation, health insurers unveiled a plan to curb shady marketing practices to seniors at a congressional hearing Wednesday, but their efforts may come too late.

"Get on top of this and get on top of it fast," said Sen. Gordon Smith, R-Ore., at a Senate Special Committee on Aging investigation of unscrupulous sales tactics being used by insurers in the Medicare Advantage program.

At the hearing, senior advocates, state insurance commissioners and several members of Congress called for the elimination of limits on state oversight of the plans.

People with Medicare are being locked into costly and ineffective health and drug plans with no oversight from the Bush Administration, while at the same time states are barred from protecting them," said Robert Hayes, president of the Medicare Rights Center, a New York City based beneficiary assistance group.

Brock Slabach, a board member of the National Rural Health Association, told lawmakers that seniors enrolling in a plan often don't know that physicians are not required by Medicare to accept the plans.

"When beneficiaries actually need the services is when they discover the gaps," he said.

Source: ScienceDaily: Analysis: Medicare HMOs fend off oversight

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Powerful MDs from the blog, "Running a Hospital"

This post is from the blog of Beth Israel Hospital CEO, Paul Levy giving recognition to the powerful MDs as ranked by Modern Healthcare magazine.  Earlier I had posted an article on Dr. Halamka, their CIO, being recognized too in an overall IT arena.  Good to see healthcare represented and as you can see from the listing below, when narrowed down to healthcare only, he's right up there, and the hospital has Mr. Levy who blogs too!  It certainly appears to be a good partnership all the way around for sharing knowledge and information in the pursuit of better healthcare for all.  BD

Powerful MDs

Modern Health Care presents its list of the 5o most powerful MDs in America. Four come from our little corner of the world.
#2, Jim Mongan, CEO of Partners Healthcare System
#3, Don Berwick, CEO of the Institute for Healthcare Improvement
#13, John Halamka, our CIO
#42, Gary Gottlieb, CEO of Brigham and Women's Hospital

Related post:  E-Week Award

Source: Running a hospital: Powerful MDs

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Hospital Mortality Rates To Go Online Beginning in June

 

CMS in June will post the first broad comparison of hospital mortality rates for heart attack and heart failure in Medicare beneficiaries on the Hospital Compare Web site, USA Today reports. Hospital mortality rates currently "are among the best-kept secrets in American medicine" and remain "closely guarded," according to USA Today.
The Web site will include information on whether the 30-day mortality rates for the conditions at more than 4,000 hospitals nationwide are higher than, lower than or equal to the national average.

Steven Nissen, a cardiologist at the Cleveland Clinic, said, "I feel strongly that the public has a right to see how hospitals and physicians perform," adding, "It's got to be done carefully. If not, it can backfire, and the whole system can fall down."

Source: Hospital Mortality Rates To Go Online Beginning in June - California Healthline (nay require subscription)

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Medicare changes coverage for Esophageal Doppler monitoring

 

CMS was asked to reconsider our current national coverage determination (NCD) on ultrasound diagnostic procedures. CMS has determined that there is sufficient evidence to conclude that esophageal Doppler monitoring of cardiac output for ventilated patients in the ICU and operative patients with a need for intra-operative fluid optimization is reasonable and necessary under Section 1862(a)(1)(A) of the Social Security Act, and therefore, we are removing the past national non-coverage of cardiac output Doppler monitoring.

CMS will amend the NCD Ultrasound Diagnostic Procedures at section 220.5 of the NCD manual by adding “Monitoring of cardiac output (Esophageal Doppler) for ventilated patients in the ICU and operative patients with a need for intra-operative fluid optimization” to Category I, and deleting “Monitoring of cardiac output (Doppler)” from Category II.

Private insurers often follow Medicare's lead when deciding which procedures and devices to cover.

Source: Centers for Medicare & Medicaid Services

Related Story:  http://www.reuters.com/article/health-SP/idUSN2245823820070522

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HMO News - Prospect Medical Holdings to Acquire ProMed Healthcare for $48.0 Million

 

Company to Assume Care of 81,000 HMO-Covered Lives, Including Almost 10,000 Seniors

CULVER CITY, Calif.--(BUSINESS WIRE)--Prospect Medical Holdings, Inc. (AMEX: PZZ) (“Prospect”), which manages the medical care of HMO enrollees in Southern California, today announced that it has signed a definitive agreement to acquire ProMed Health Care, which is comprised of two Independent Physician Associations (“IPAs”) -- Pomona Valley Medical Group and Upland Medical Group – and ProMed Health Care Administrators, the management services organization (“MSO”) that serves these IPAs. The acquisition, which is expected to be immediately accretive to earnings, is expected to close on June 1, 2007. The Boards of Directors of both companies have approved the transaction.

Source: Prospect Medical Holdings to Acquire ProMed Healthcare for $48.0 Million

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Judge Orders Medical Records in Legal Suit

 Medical records...coming to a court near you soon?  BD

BRENTWOOD, N.H. - A judge has ordered a former top official with the state medical examiner's office to submit to a physical exam and sign over medical records to settle a debate between prosecutors and her lawyer over whether she's too sick to face trial.
Judge Tina Nadeau handed down the order following a meeting last week when prosecutors called for a more detailed account of Kathrine Wieder's physical and mental well-being, according to a decision made public yesterday.

Wieder, who worked as the state's chief forensic investigator, faces 44 charges alleging she abused her position at the medical examiner's office to increase her wages by signing cremation certificates.

Adams has already interviewed Wieder once and has asked for a detailed list of her medications, as well as details of her medical and health records.

Source: NewburyportNews.com, Newburyport, MA - Judge orders defendant to share records, submit to exam

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A Woman’s Knee Replacement That Fits Their Shape and Size

While on the page I did a quick check by zip code to see how many surgeons offer this procedure and found 6 available from a zip code in Huntington Beach, CA providing listings within 25 miles.  BD

The Zimmer Gender Solutions Knee is contoured to fit the unique shape and size of women's knees. It does this by matching a woman's shape and size with its 3 distinct differences: The Zimmer Gender Knee has a thinner profile than traditional knee replacements, it allows for more natural movement of the kneecap, and it has a shape specially contoured for women.

The Zimmer Gender Knee has a contoured shape proportioned to fit women's anatomies. This helps the implant from overhanging the bone and potentially pressing on or damaging surrounding ligaments and tendons.

 

 

    

 

 

 

Source: Zimmer Gender Knee, A Woman’s Knee Replacement That Fits Their Shape and Size

Hat Tip:  Medlaunches.com

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Google doubles Gmail attachment limit

Thanks for the folks at JKOnTheRun for bringing this new fact to our attention!  One other small item worth mentioning too about GMail, it uses SSH, an encrypted connection to send and receive email.  If you are a physician using a service that does not encrypt, perhaps Yahoo or any other web based email system, think about Google for sending any sensitive patient information.  GMail can also be configured to work with Outlook once you allow POP3 in the overall settings.  They also offer a couple other web based suggestions for sending large attachments below.  BD 

Please try not to send me any 20 MB attachments, but if you do, you can now use Gmail. The (unofficial) Google Operating System blog says that Google's Gmail service just increased the attachment limit from 10 MB to 20 MB, which ought to make most e-mail clients choke twice as fast now.

While it's nice for Google to raise limits at the e-mail poker table, here's an alternative to sending those large attachments: try either the senduit or MailBigFile services. These freebies allow you to upload and store a large file for a pre-determined length of time up to a week. You get a URL for the file which you can then e-mail to a bud in lieu of the large attachment. This gives your mobile pal time to get to a faster or wired connection for the quicker transfer. ;)

Source: jkOnTheRun: Google doubles Gmail attachment limit; try these alternatives

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The Catch 22 of Health Insurance

Many families make too much money to qualify for assistance, but on the other hand paying for individual policies breaks the bank as well.  BD

LOS ANGELES (Reuters) - Volunteer firefighter Cindy Holland has no medical insurance, and her husband's health benefits as a full-time paramedic do not extend to family members, so she and their three children go without.

The hard-working Northern California family makes too much money to qualify for public health insurance but too little to afford a private policy, caught in a Catch 22 that puts many U.S. workers at risk of financial ruin.

"It would kill us financially to do the insurance -- if we want to keep a roof over our head and food in my kids. You end up rolling the dice," said Cindy, a California native who works a pair of part-time jobs on top of firefighting.

That number is widely believed to be higher today as healthcare costs skyrocket, employers slash worker benefits and insurers gut coverage and cherry-pick the healthiest customers.

Source: Health care crisis squeezes working families | Health | Reuters

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Electronic Records put some MDs on Edge

I haven't run across any MDs yet that needed professional help yet over using Electronic Medical Records, but I have seen the frustration, mostly from offices that do not get enough training or don't take training seriously.  I think the one line below says it all, "change".  This could be something new, Disruptive Physician Syndrome...and from the full article, the cure doesn't appear to be inexpensive.  I also comment on a forum called EMR Update where we discuss EMR topics all the time and most of the physicians on the forum pretty much agree hands down too that training makes all the difference in the world on a successful implementation and they advise all to be sure and take all offers from the vendors when it comes to training...BD

But there's another downside that not many people are talking about: disruptive physicians. That's according to physician Alexis Polles, medical director of the professional enhancement program at Pine Grove Behavioral Health & Addiction Services in Hattiesburg, Miss. Polles and the program's clinical director, Phillip Hemphill, gave a presentation on disruptive physicians at the American College of Physician Executives' Spring Institute May 5-10 in Orlando, Fla. I covered the conference for the first time and sat in on the disruptive-physician session looking for some news.

According to Polles and to several physician-executives I spoke with after the session, some practicing physicians are getting so frustrated trying to figure out how to use EHRs that they're lashing out at their peers, co-workers and staff—so much so that they need to seek professional help at places like Pine Grove. Said one physician-executive sitting at my table, "They just don't see why they have to change, and they take it out on everyone else." And off they go for some expensive behavioral modification.

Source: Modern Healthcare Online

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How Many Patients Can One Doctor Manage?

This article from Medscape gives some food for thought with the idea of creating a "panel".  Might be helpful with P4P considerations.  BD  (may require a subscription)

Practices and individual providers should not take on more work than they can manage. If a panel is too large, the excess demand results in a never-ending and ever-expanding delay in services in addition to constant deflections to other providers, resulting in discontinuity. On the other hand, if a panel is too small, demand may not be adequate to support the practice. The demand for appointments must equal the supply of appointments if timely service is desired. A simple equation can be used to express this:

Panel size × visits per patient per year (demand) = provider visits per day × provider days per year (supply).

1. It makes patients happy. Patient surveys clearly demonstrate that patients want the opportunity to choose a primary care provider; they want access to that provider when they choose; and they want a quality health care experience. Establishing a panel links each patient with a provider with whom they have a health care relationship.
2. It defines the workload. Establishing a panel helps divide and define workload within a practice and helps ensure that each provider is carrying his or her fair share.
3. It predicts patient demand. Panels are the source of demand not only for visits but also for non-visit work (paperwork, e-mail, etc.), tests, procedures and hospitalizations. Understanding the panel helps a practice anticipate that demand both.
4. It reveals provider performance issues. Understanding the panel allows groups to see the effects of provider variability. For example, if two providers have the same panel size but one provider has more demand than the other, then the practice can explore why this difference exists (e.g., one physician uses shorter return-visit intervals) and whether it is justified.
5. It helps improve outcomes. Identifying individual panels enables providers to make a commitment to continuity (that is, to taking care of their own patients for all their visits), which results in improved clinical outcomes,^{[17,18,28-30]} reduced costs and enhanced revenue per visit.^{[13,16,19,31]}

Source: Panel Size: How Many Patients Can One Doctor Manage?

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Doctors, Legislators Resist Drugmakers' Prying Eyes

There are 2 sides to every story, but the one comment included below puzzles me to a degree...was the pressure to increase sales high enough for job security perhaps to create this type of a comment to reflect upon the judgement of the physician?  What happened to "Doctor knows best."  BD

Seattle pediatrician Rupin Thakkar's first inkling that the pharmaceutical industry was peering over his shoulder and into his prescription pad came in a letter from a drug representative about the generic drops Thakkar prescribes to treat infectious pinkeye.

In the letter, the salesperson wrote that Thakkar was causing his patients to miss more days of school than they would if he put them on Vigamox, a more expensive brand-name medicine made by Alcon Laboratories.

"My initial thought was 'How does she know what I'm prescribing?' " Thakkar said. "It feels intrusive. . . . I just feel strongly that medical encounters need to be private."

Source: Doctors, Legislators Resist Drugmakers' Prying Eyes - washingtonpost.com

Hat Tip:  Kevin, MD

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Chapter 4, "Are you still just using your cell phone for phone calls?"

Nice way of connecting those with asthma to the professionals who can help.  Interesting as well how the prompts could be set up for either a parent or child to enter information.  BD

A remarkable story of success fighting asthma exists at the San Mateo Medical Center, San Mateo County's hospital.

The cell phone prompts the child/parent at various times during the day through eight questions. The child/parent responds to the prompts. For example, did the child take his/her medicine? Is breathing more difficult? After the child measures her/her lung capacity, the cell phone prompts the child to put the measurements into the cell phone. Adverse indicators are relayed, via the phone, to a case manager and then, if needed, to physicians assigned to monitoring the children. If problems are indicated, the phone rings. A case manager seeks more information. The cell phone also offers encouraging messages if the indicators are themselves encouraging, for example, "Doing great! You go girl!"

Over this past year, none of these children has experienced symptoms so severe as to require a visit to the hospital emergency room. Not one. Through intensive patient support and communication, medications are taken on time. Exposure to allergens is reduced. Bottom line: These children are gradually learning how to take better care of themselves. Their health has improved.

Source: Inside Bay Area - Cell phones, support make strong asthma medicine

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Aetna Awards $275,000 To Chicagoland Nonprofits

 

Organizations invited to apply for 2007 grants addressing obesity, depression, the nursing shortage, and diversity and cultural competency in the health professions

Source: WebWire | Aetna Awards $275,000 To Chicagoland Nonprofits

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People Feed Up With Long Doctor’s Office Visits Find a New Alternative Online

 

Relief awaits those who hate waiting at the doctor’s office or simply don’t have medical insurance. The new wave has become free online doctor’s consultations.

Los Angeles, CA May 21 2007 – Free online doctor’s consultations are becoming increasingly popular with people all over the world, making visiting doctors in person a thing of the past.

Many people ask, “Is this legal”, the answer is yes. Legal ruling by the US Supreme Court has upheld that personal medication can be obtained by mail. Many seniors and individuals who cannot get to the doctor or to the pharmacy rely on these services for their medication.

Source: WebWire | People Feed Up With Long Doctor’s Office Visits Find a New Alternative Online

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CalPERS workers lose health option with Blue Shield

 

LAKE COUNTY -- With the gargantuan CalPERS Blue Shield health care benefit provider planning to quit Lake County to cut costs, county employees will be digging deeper into their pockets.

A cost-cutting plan voted on last week by the pension fund's board of directors will allow Blue Shield to pull out of four rural counties, citing rising costs of providing service. Lake County, along with Napa, Plumas and El Dorado counties, will take the hit within the next year.

"It's going to cost employees more out of pocket for the same health coverage they're getting now because of the deductible," Ferguson said. "The Blue Shield EPO option will no longer be available as of January 2008.

"This is disappointing but not unexpected because we had a benefit without the network to support it," added Ferguson. "We hope that CalPERS is going to be working to develop an HMO in Lake County so they can bring HMO products back." Ferguson noted that the agency created an HMO in Humboldt County last year that became effective in March of this year.

Source: www.record-bee.com - CalPERS workers lose health option

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Personal Health Records - physicians speak out on both the benefits and issues created from Modern Health care

I asked an employee this week at Verizon if they had begun using their electronic records from Verizon, but this employee was not aware of the new offering yet, so it appears to be in the works at this point. BD   

Like a recurring dream about having to take a test they didn't study for, some physicians view the idea of patients with electronic personal-health records as their own personal nightmare.
Visions of patients handing over a computer disk containing years' worth of blood-pressure readings taken every four hours along with random recollections of rashes and muscle strains that physicians are required to somehow make sense of and memorize are followed by thoughts of being sued because there was a kernel of important information missed in the deluge.

Peter Basch, medical director for e-health at MedStar Health in Washington, says "physicians love a (hospital) discharge summary" that gives one to two pages of key points. What they may get from a PHR, however, could be something that has no resemblance to a discharge summary at all.

Nevertheless, he says that PHRs could be an important tool in developing a partnership with patients, so he "gently forces" them to use the spreadsheets—either paper or electronic—that he has developed.

Source: Modern Healthcare Online

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Who Killed HealthCare

New book written about the healthcare system in the US.  BD

Who Killed Health Care?: America's $2 Trillion Medical Problem -- and the Consumer-Driven Cure
(McGraw-Hill, 240 pages, $24.95)
Try to imagine health care as a police lineup, with the patient behind the one-way mirror, trying to pick out the suspect. The lineup includes big hospitals, employers, big insurance companies, health care academics and government. When asked which of the suspects killed health care, the patient points to all of them.

Indeed, the only ones to not make out on managed care were patients and doctors. Patients loathed the restrictive nature of HMOs, to the point that eventually HMOs were replaced by managed care organizations like Preferred Provider Organizations that put fewer restrictions on patient access and choice. Under managed care, doctors are pressured to conform to managed care organizations' disease management advice. Academics frequently complain of doctors' low compliance with such advice. However, it may be that the doctors, and not the academics, know what they are doing. As Herzlinger notes, "There is no accepted evidence of the cost effectiveness of disease management."

Who Killed Health Care? points out that they actually came to prominence due to the HMO Act of 1973. With an economy facing rising health care costs in the early 1970s, President Richard Nixon turned to HMOs to hold costs down. His HMO Act required employers who offered insurance to offer at least one managed care product. It also offered subsidies to companies that opened HMOs.

Source: The American Spectator

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Is the new family doctor a nurse?

 

Cathy Giorgio wears a traditional white lab coat when she takes patient histories, performs physical exams, diagnoses health problems, reads lab reports and X-rays, writes prescriptions, and authorizes advanced medical tests.

She performs almost every task a family doctor does, though she isn’t one.

A growing number of healthcare experts believe nurse practitioners like Giorgio are the cure for an ailing U.S. health system faced with a growing number of patients and a looming shortage of general doctors, especially ones willing to treat poor patients.

They cite statistics such as lower malpractice rates, lower care-related costs, and higher rates of patient compliance with treatment recommendations associated with these advanced-care nurses compared with their doctor cousins.

Source: Is the new family doctor a nurse? (phillyBurbs.com) | Health, medical

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Mobile Medical Services - Dream Center

This is just a thought of my own, but many cities, Los Angeles included have mobile medical services for the homeless and hospital services through the Queen of Angels hospital. Just as an afterthought on the story on dumping the homeless who are still in need of further medical attention, is it an option? A couple years ago I was able to see the mobile medical office that helps take care of the homeless and it is a first class medical office on wheels and they do a great service in traveling to the homeless.

The Dream Center is sponsored by gifts and donations. Is this something perhaps some other hospitals could perhaps entertain by donations and perhaps working with the homeless to get additional medical attention when needed. Here are a couple links that provide additional information. BD

http://www.dreamcenter.org/donating_corporate.shtml

http://www.kathieleegifford.com/lamb04/charity/dc.php

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Democrats prescribe bigger health levy - employer health insurance contributions could rise

Some employers are already beyond the 7.% proposed increase with their present offerings..BD

SACRAMENTO — Escalating the already tense fight about what financial burden businesses should bear, the Democrats who control the Legislature proposed Tuesday that most California employers be required to spend the equivalent of at least 7.5% of their payrolls on healthcare — nearly twice the amount Gov. Arnold Schwarzenegger has proposed.
The mandate on employers would raise more than $5 billion and — along with federal taxpayer money and worker contributions — allow California to extend insurance to about 69% of the 4.9 million people who lack it at any given moment. Among states, only Hawaii has a significant employer mandate. But the Democratic proposals in California would go further by including dependent coverage and more part-time workers.

There are 233,000 firms that spend less than 7.5%; they employ 4.5 million workers. An additional 327,000 firms make no contribution; they employ 1.5 million workers.

Source: Democrats prescribe bigger health levy - Los Angeles Times

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Chapter 3, Are you still just using your cell phone for phone calls?

This concept not only involves Cell Phones, but also RFID (radio frequent ID technology) too. This could really be a life saver for post surgery and a new way to monitor cardiac and glucose readings as well.  A phone is a phone is a phone...????  Perhaps not by today's standards...BD

Low cost disposable RFID sensors are now possible with Gentag’s proprietary reference technology. Since RFID-enabled cell phones are currently either already available or under development with major cell phone manufacturers worldwide for both the 13.56 and UHF (Gen-2) frequencies and that market forecasts predict that up to 1 out of 2 phones in the future will be RFID-enabled, the global emergence of RFID sensor networks can be anticipated.

By combining RFID cell phones and RFID sensors with cellular networks or the Internet, the consumer will be empowered to read any RFID sensor tag anywhere for almost any application.

 

Via:  Gentag

Hat Tip:  Medgadget

Source: RFID Diagnostic Sensors Read By RFID-Enabled Cell Phones: Science Fiction in the News

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Tale of last 90 minutes- woman dies while nobody helps in the ER room

This is indeed a sad story and it was all captured on tape.  The hospital already has huge issues on it's doorsteps and this is not going to help matters.  Complacency?  Humanity?    BD

County officials express dismay at the events surrounding the recent controversial death at King-Harbor hospital. One nurse has resigned. 

In the emergency room at Martin Luther King Jr.-Harbor Hospital, Edith Isabel Rodriguez was seen as a complainer.
Aside from one patient who briefly checked on her condition, no one helped her. A janitor cleaned the floor around her as if she were a piece of furniture. A closed-circuit camera captured everyone's apparent indifference.

According to preliminary coroner's findings, the cause was a perforated large bowel, which caused an infection. Experts say the condition can bring about death fairly suddenly.

"Where was their heart? Where was their humanity? … When Jose came in, everybody was just sitting, looking. Where were they?"

Source: Tale of last 90 minutes of woman's life - Los Angeles Times

Hat Tip:  Kevin, MD

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