Intel Co-Founder Donates $100M For Nursing School

Nice story and a wonderful contribution...Betty Moore getting an insulin shot that was not for her created the movement for the donation to fill the huge need for nursing education.  Medical errors of such do cost lives and education is part of the process to eliminate or reduce.  BD

The co-founder of Intel and his wife are giving $100 million to the University of California, Davis to establish a nursing school.
The gift from the Gordon and Betty Moore Foundation is the largest donation ever to the university and is believed to be the largest gift in the nation for nursing education.
The money will be donated over 11 years and will go to create the school at the UC Davis Medical Center in Sacramento.
Gordon Moore is co-founder and chairman emeritus of Intel, the Santa Clara-based chip maker.  He is best known for "Moore's Law," his 1965 prediction that the number of transistors on a chip should double about every two years.
 
Ken Moore, the couple's son, said the donation grew out of his mother's own poor care during a hospital stay.
A nurse gave her a shot of insulin that was supposed to go to the patient in the next bed.
"They nearly had two deaths out of one medical error. That was the start of her really being interested in nursing care," Ken Moore said.

Intel Co-Founder Donates $100M For Nursing School

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Hip resurfacing may delay hip replacement

 

The new technique has several advantages over standard total hip replacement (THR) and is an attractive alternative to many people, said Peter Brooks, M.D., a Cleveland Clinic orthopedic surgeon, according to Cleveland Clinic's Men's Health Advisor.

"I think it's probably preferable in the right patient," he said. "They absolutely love it. They love the concept."

However, the procedure isn't for people with weak bones or kidney problems, so it may not be ready to supplant THR as the gold standard in hip prostheses. What's the difference?

In hip resurfacing, a surgeon shaves the head of the femur (the large thigh bone) where it connects to the hip socket (acetabulum). A metallic cap covers the femoral head, guided by a small, short stem drilled into the bone. The capped bone fits into a metallic cup inserted into the acetabulum.

Hip resurfacing may delay hip replacement

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Many Patients Don't Pursue Referrals

All those time consuming administrative functions for a practice and better health care...the long term relationship with the patient from the primary care MD made the difference in the study...a level of trust and something you may not have with seeing different doctors at different locations when having to change physicians due to contract coverage.  BD

FRIDAY, Aug. 3 (HealthDay News) -- About 20 percent of patients don't follow up on their doctor's referrals to specialists, new research shows.

According to Forrest, patients are more likely to go to a specialist if their primary care doctor makes the appointment. "Patients who left the office with an appointment were more likely to attend," he said.

In addition, insurance coverage was also a factor in whether or not patients saw a specialist. Patients on Medicaid were less likely to follow through on the referral and more likely to be denied coverage by their health plan, the study found.

"And patients who did not have health insurance were less likely to be referred at all," Forrest said. "If they were referred, they had more difficulty finding a specialist who would give them an appointment," he said.

"Having a long-term relationship seemed to make a difference," Forrest said. "It makes a difference whether you have a strong relationship with your primary care doctor or a weaker relationship," he said. "That is an important factor in trusting the recommendation of the doctor."

Many Patients Don't Pursue Referrals - Forbes.com

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Man finds discarded medical records

Patient record story of the week....another paper mishap this time too, it seems like the paper folks are getting to be more careless than the electronic end of things lately...BD

News media are reporting that personal documents ended up in the wrong hands in Utah County and no one knows how it happened.

Yesterday KSL reported that a truck driver found medical documents containing personal information in his truck and on the ground while he picked up a load at a garbage transfer station in Pleasant Grove.   KSL reported that the driver, who wanted to remain anonymous, took some of the documents from his truck and brought them to KSL.

Daily Herald - Man finds discarded medical records

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Doctor accused of working while high

 

SAN ANDREAS -- The Medical Board of California filed a formal accusation against a doctor who allegedly treated patients while high on prescription drugs he prescribed for himself.   Dr. Gary Johnson, 60, of San Andreas, is accused of violating six state codes, including practicing medicine while under the influence of narcotics, self-prescribing a controlled substance and violating drug statutes, board spokeswoman Debbie Nelson said.

San Jose Mercury News - Doctor accused of working while high

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More arrests expected in doctor probe

Doctors flunked certification exams more than once and had results falsified...BD

SAN JUAN, Puerto Rico — Federal authorities hunted for nine suspects Friday amid an operation against dozens of "doctors" accused of obtaining their licenses through fraud — and the father of one of them allegedly threatened to kill anyone who cooperated with investigators.

Gilberto Rodriguez, who is himself a doctor, was jailed on a witness tampering charge. A notice taped to the door of his shuttered medical practice in a San Juan strip mall said he was away "on vacation" until Monday.  The Caribbean territory's licensing board said states including Florida, New York and Texas recognize Puerto Rican medical licenses, but the local Health Department said none of the suspects were known to have practiced medicine on the U.S. mainland.

A federal grand jury on Wednesday indicted 91 people, including a former director and a secretary of the licensing board and Rodriguez. A total of 88 people were accused of having obtained medical credentials by fraud.

More arrests expected in doctor probe | Chron.com - Houston Chronicle

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Ask your doctor, is Sicko right for you?

With managed care getting larger by the minute, it seems like it is almost starting to resemble a single pay system of some sort...except for what we pay...as the saga continues on our broken health system...BD

Michael Moore's documentary, "SICKO" now playing at our local theatres is proving to be an excellent sales pitch for a "single-Payer System, " in the ongoing campaign for universal health care for Americans. Like Michael Moore's other movies, SICKO has a point of view: To encourage Americans to revamp our failing health-care system.

Today much of the public remains confused by the on-going debate over government's role in medical care. The confusion is fostered by an insurance industry which, determined to hold onto its expensive share of the medical dollar, can only do so by misrepresenting itself. By massive lobbying, both in Washington and in all the state capitals, the industry has kept its hand in the till where it extracts at least a third of the medical dollar while providing, in addition to misinformation, reduced treatment options and added expense to an unwary public.

Coastal Post Online Article August, 2007

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Woo Suk Hwang, Who Faked Research, Made Spectacular Breakthrough

Do we believe him this time?  BD 

It has emerged that Woo Suk Hwang, the South Korean scientist who was named and shamed for faking his research, made an amazing breakthrough. According to Cell Stem Cell, he may have managed to create stem cells solely from human eggs, without fertilization with sperm. This breakthrough is possibly much more valuable than his original false claims about his work.
Hwang's work at Seoul National University was famous worldwide - he became a national hero and possibly the most esteemed stem cell scientist in the world. In 2005, his status came crumbling down when it was revealed he had faked much of his claims.

He had said that he and his team created cloned human embryos by putting a cell's nucleus into an empty human egg, and then used the stem cells for those embryos. It was later found that the embryos had originated from the eggs of female members of his laboratory team - in other words, not from cloned embryos. He was fired and then charged with fraud and misappropriation of funds (embezzlement).

Woo Suk Hwang, Who Faked Research, Made Spectacular Breakthrough

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Firefighters saving time with PDAs

Another good article about the use of PDAs in the field...paramedics doing their part with paperless transmission and saving valuable times and lives at the same time.  BD

SAN MARCOS – Until recently, San Marcos firefighter/paramedics were spending hours each day answering questions and filling in bubbles on medical, insurance and billing forms at the hospital.

The new method uses FieldSaver personal digital assistants, or PDAs, loaded with customized electronic menus that reduce the procedure to about 10 minutes, said firefighter/paramedic Jason Dobbins. Often, many questions can be answered before getting to the hospital, he said.

The one-time startup fee for the FieldSaver program is about $40,000, he said, and operating/maintenance fees are $6,000 a year. The charge is not based on the number of PDAs – San Marcos has 12 – but on the number of primary ambulances.

So far, the new technology has worked perfectly, said Dobbins, who spearheaded the change. “Everyone's really liked it,” he said. “Everyone was so excited. They actually did want to learn it.”

The company created its first PDA program in El Cajon and demand has been growing, said Hood, who also works as an emergency room doctor. The state doesn't require fire agencies to collect its EMS data in a standardized format, Hood said. As a result, many departments are still collecting the old-fashioned way, he said, but he sees that changing soon.

SignOnSanDiego.com > News > North County -- Firefighters saving time with PDAs

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More Than 40% Of New Orleans Adults Reported Worse Health Care Access After Hurricane Katrina

Still lack of medical care, even with incentives being offered for physicians to locate to the area...BD

Many adults in the Greater New Orleans area have experienced problems with access to health care since Hurricane Katrina, according to a report released on Tuesday by the Kaiser Family Foundation, the New Orleans Times-Picayune reports (Moran, New Orleans Times-Picayune, 8/1). For the report, titled "Health Challenges for the People of New Orleans," researchers last fall conducted a survey of about 1,500 randomly selected adults younger than age 65 in the Greater New Orleans area that included questions about their health insurance status and access to health care before and after the hurricane.

More Than 40% Of New Orleans Adults Reported Worse Health Care Access After Hurricane Katrina; Kaiser Family Foundation Survey Finds

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Rep. Weiner To Introduce Legislation To Increase Medicare Reimbursement For Mammograms

 

Rep. Anthony Weiner (D-N.Y.) said he plans to introduce a bill this week that would increase Medicare reimbursement rates for mammograms, with the aim of reversing a decline in the number of women receiving the exams, the Orlando Sentinel reports. Weiner said the measure, called the "Assure Access to Mammography Act," would help clinics offering mammograms stay open.
According to a report released last week by Weiner, the number of mammography clinics nationwide has decreased by more than 1,200, or 12%, since 1999 

The average cost for a mammogram has increased by 25% to $125 since 2005, while the Medicare reimbursement increased by 2% to $83.69 during the same time period, the report found. Sixty-seven mammography facilities have closed in New York City since 1999, a 26% decrease, according to the report (Weiner release, 7/22).

The number of certified mammography clinics in Florida also decreased from 505 to 456 since 2001, according to the American Cancer Society.

Rep. Weiner To Introduce Legislation To Increase Medicare Reimbursement For Mammograms

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AMA To Congress: Stop Unfair Business Practices Of Health Insurers

 

"The AMA urges Congress to pass legislation that will:
-- Establish a strong federal prompt pay standard;
-- Protect more robust prompt pay state laws by ensuring the federal standard is the "floor;"
-- Establish concurrent jurisdiction over enforcement between the state and federal government;
-- Clarify that state prompt payment laws apply to all ERISA covered health plans;
-- Strengthen penalties to prevent plans from considering fines and other associated financial sanctions as merely the cost of doing business;
-- Protect physicians from retaliation by insurers if they pursue their remedies under the prompt pay laws; and,
--Expand protections to address other tactics utilized by health insurers to delay or decrease payments.

AMA To Congress: Stop Unfair Business Practices Of Health Insurers

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CMS Announces Payment Reforms For Inpatient Hospital Services In 2008

 

Payments to all hospitals will increase by an estimated average of 3.5 percent for FY 2008 when all provisions of the rule are taken into account, primarily as a result of the 3.3 percent market basket increase. Payments to specific hospitals may increase more or less than this amount depending on the patients they serve.

In the previous two years, Medicare made important, incremental changes while it studied comprehensive reform of the inpatient hospital payment system.  CMS is making some initial changes this year and is further studying how to better recognize the cost of expensive devices as it considers other improvements to its payments for FY 2009.

CMS Announces Payment Reforms For Inpatient Hospital Services In 2008, USA

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DuPont Innovation Helps Allergy Sufferers Get A More Restful Night's Sleep

 

DuPont (NYSE: DD) today introduced a new innovation with Hybrid Membrane Technology (HMT) that will allow pillow and mattress covers to deliver unsurpassed protection from a range of harmful allergens without sacrificing personal comfort.

"For allergy sufferers, getting a full night of uninterrupted sleep can be a real challenge. Mattress and pillow protectors made with DuPont HMT will help allergy sufferers sleep better by providing an effective barrier that has been scientifically proven to seal off even the most microscopic allergens," Vice President & General Manager - DuPont Advanced Fiber Systems Thomas G. Powell, said. "Vinyl and films provide a high level of protection, but these materials are noisy and trap body heat and moisture near the skin. Alternatively, materials such as cotton are more comfortable but do not provide an effective barrier against microscopic allergens. With DuPont HMT, consumers benefit from the optimal combination of protection and comfort."

DuPont Innovation Helps Allergy Sufferers Get A More Restful Night's Sleep

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Wyeth Oral Contraceptive Lybrel Available In U.S.

 

Wyeth on Monday said its oral contraceptive Lybrel, which is designed to eliminate monthly menstrual periods, is now available in U.S. pharmacies. Lybrel, which contains a lower dose of synthetic hormones in a daily dose than traditional oral contraceptives, is taken 365 days a year with no placebo pills. The usual regimen for oral contraceptives is 21 active pills taken consecutively, followed by seven placebo pills. FDA approved the drug in May.

Wyeth Oral Contraceptive Lybrel Available In U.S., Company Says

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New high-resolution MRI machine comes to MIT

 

Last May, MIT acquired its first 3 Tesla Siemens MRI machine for noninvasive imaging of the human brain, located in the Martinos Imaging Center at the McGovern Institute. This spring, a new, more powerful scanner moved in next to it, thanks to a gift from an anonymous donor. This scanner, a 9.4 Tesla Bruker magnet with a small (20 cm) bore, will be used for rodents and small primates, as well as live cell cultures and chemical preparations. It will help researchers make direct links between molecular and genetic techniques and live animal studies, and between animal studies and human studies.

 

New high-resolution MRI machine comes to MIT - MIT News Office

Hat Tip:  Medgadget

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CryoCor Receives FDA Approval For Right Atrial Flutter

 

Based on this approval, CryoCor intends to begin selling its cryoablation system in the United States over the next several months. The Company will place an initial focus on console placement in high-volume ablation centers in the U.S. and is currently evaluating its sales and marketing requirements for this strategy. The Company has targeted an initial installed base of approximately 120 to 160 consoles by December 31, 2008, growing to approximately 300 consoles by 2010.

CONSOLE AND ARTICULATING CRYOARM™
The mobile Model 2020 Console is the control center of the CryoCor™ Cardiac Cryoablation System. The console houses the control electronics, software and refrigeration components. With the Cryoablation Console, the user can initiate and control the cryo-ablation procedure using a few simple commands. A LCD screen displays command prompts and provides the operator with continual updates on system performance. The system uses a precooler located at the end of the articulating arm mounted to the console as part of a two-stage cooling process to optimize system efficiency and performance.

CryoCor Receives FDA Approval For Right Atrial Flutter

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What drug rep visits cost you - By swearing off meetings with detailers, some doctors are seeing more patients—and watching their earning rise

Interesting comment about the drug rep software being more sophisticated than the EHR being used for charting...they do have the information and tools to use...and they do use the information...overall good article on how to mix patient flow and retailer visits for a happy medium for all.   BD

Hearing a drug spiel over a fajita wrap may not disrupt the schedule, but drop-ins and appointments eat up roughly 60 minutes a week, Health Strategies Group reports. If you used that extra time to see four established Medicare patients, using CPT code 99213 for an intermediate visit, you'd collect roughly $60 per visit, $240 per week, and $12,000 over 50 weeks. Subtract 50 percent for overhead, and you'd net an extra $6,000 a year—just a hair under what Brewer cleared after dropping rep visits.

Benjamin Brewer agrees. "I got turned off being a sales target," he says. He couldn't stand drug reps tracking his every prescription with their computer software, which was more sophisticated than his EHR.

What drug rep visits cost you - By swearing off meetings with detailers, some doctors are seeing more patients—and watching their earnings rise. - Medical Economics

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An effective way to use assistants - Training nurses and MAs to take histories and provide patient education boosts productivity, income, and quality of care

Good article on how to maximize the team concept and get the most from medical assistants to help you add more to your bottom line....train them well...and the return is a much happier and productive staff too, so everyone gains with teamwork and proper training.  BD 

With primary care reimbursement steadily dropping, having assistants do more of the clinical spadework is a cost-effective option to consider. You'll need to know how to get started, how team-based care works, and what some experts say about it.

Peter B. Anderson, a family physician in Newport News, VA, has three part-time nurses and a medical assistant—the equivalent of two full timers—who do nothing but take patient histories, document encounters, and teach patients to follow his treatment plans. These staffers cost a lot more than the single MA who supports the typical doctor. Yet in the four years since Anderson implemented "team-based care," he's seen his productivity—and his income—soar.

Within a year, he was seeing 30 patients a day. Meanwhile, he hired two MAs and trained one of them to interview patients. By the next year, his daily count was 35 to 40, and his gross revenues had gone from less than $400,000 to $580,000. Despite the extra cost of the two MAs, Anderson now earns $240,000 a year, $100,000 more than in 2002—and he goes home earlier.

When Anderson comes into the exam room, the nurse or MA hands him an EHR-generated list of current problems, meds, and lab results, and summarizes the patient's symptoms and history. The doctor follows up with the patient as needed, then conducts the physical exam while the assistant documents his findings and recommended treatment. The assistant spends another two to five minutes on patient education, while Anderson moves on to the next patient.

An effective way to use assistants - Training nurses and MAs to take histories and provide patient education boosts productivity, income, and quality of care. - Medical Economics

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Healthcare, Computers and the Bottom Line

Good article here about efficiency with medical records...all charges at the front desk based on input from the back office, no more sloppy hand written receipts either...another good reason for no more paper...BD

A recent annual visit to my doctor's office showed me just how efficient electronic health records could be. I quickly noted that all of the healthcare professionals (doctors and physician assistants) were walking around with tablet PCs. These small laptops contain all of a patient's medical records that were formerly on paper.

In addition, my doctor's tablet PC contained patient screening protocols that assist the healthcare  professional in asking the right questions and not forgetting any important ones. My physician asked me a long list of questions such as do I wear seat belts, how much do I drink, etc. Additionally, he asked me some questions never asked before. It seemed obvious to me that all of these questions emanated from his computer, because he was looking at it as he was questioning me.

I had a pleasant surprise when I went to the reception desk to pay my bill. The receptionist already knew both the amount and the fact that the doctor didn't need to see me for one year. I asked, tongue in cheek, how the doctor could possibly beat me to the reception desk when I had just left him in the examining room.

She laughed and said that this was one of the wonderful features of the new computerized office -- appropriate information was immediately available to all of the staff. Therefore, there was no way that I could "beat" the flow of data from the examining room to the reception area.

Technology News: Data Storage: Healthcare, Computers and the Bottom Line

Hat Tip:  TabletPCTalk

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Storm e-mail worm evolves as it wreaks havoc

Watch for the emails telling you about a storm...according to the article the creator has reinvented the worm several times and can take control of your PC via a bot net.  BD

Storm first spread to e-mail in-boxes in Europe and the USA in January - enticing recipients to click on a link for a fake news story about a deadly storm or other dramatic event. Clicking on the link turned the PC over to Storm's controller.

Storm e-mail worm evolves as it wreaks havoc on Net - Yahoo! News

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U.S. says 18 charged in illegal online pharmacy case - California

 

WASHINGTON (Reuters) - Eighteen people have been indicted in California on racketeering and other charges for operating an Internet business that illegally sold prescription drugs, the U.S. Justice Department said on Thursday.

The defendants included three physicians, two pharmacists, a pharmacy operator, an administrator, two recruiters of physicians and pharmacies, a credit card processor and eight affiliate Web site operators.

U.S. says 18 charged in illegal online pharmacy case - Yahoo! News

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UC Irvine Raises $120.1 Million, Setting Campus and County Record

 

IRVINE, Calif., Aug. 1 /PRNewswire/ -- The University of California, Irvine raised $120.1 million in private gifts and grants for the 2006-07 fiscal year, nearly a 19 percent increase over last year. This amount breaks the single-year fundraising record not only for the campus, but also for any organization or institution in Orange County. UCI also received a record number of gifts -- 26,881. During the last five years, annual private gift/grant support to the university has increased nearly 243 percent (from $35 million to more than $120 million); the number of gifts has increased by more than 57 percent (from 17,088 to 26,881); and the endowment has increased nearly 97 percent (from $117.1 million to more than $230 million).

University of California Irvine :: UC Irvine Raises $120.1 Million, Setting Campus and County Record

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Washington Times Looks At Potential Effects Of Massachusetts Health Law On Small Businesses

One more article about Massachusetts and health insurance and the effects on small business...It' already getting difficult for many of the newly insured to find a primary MD, and added cost certainly won't help.  bD 

About two-thirds of uninsured state residents work at small businesses, "making those employers more susceptible to an increase in health care costs as more people fall in line with the mandate to buy health insurance," the Times reports. Felland said, "When these people want health insurance, they'll turn to their employer, and in turn, cost will go up," adding, "There is a concern about how prepared the small-employer market is for this change."

Washington Times Looks At Potential Effects Of Massachusetts Health Law On Small Businesses

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Health Care When You Want It

Something doesn't make sense here...with the new insurance law in Massachusetts, it is becoming increasingly difficult for those who did not have insurance prior to get set up with a primary care MD and there is a long wait...and now the state is one of a few wishing to block the use of retail clinics?   It seems like the clinics could be helpful in some areas.  BD

Some physician organizations, however, including ones in Illinois and Massachusetts, are pushing for new regulations that would impede the growth of convenient care clinics through expensive permitting requirements (which physician practices do not have to face), further limitations on the number of nurse practitioners that an individual physician can supervise, and prohibitions against advertising that compares the fees of convenient care clinics with those of physicians. This is exactly the kind of price transparency our health-care system needs. In addition, the American Medical Association passed resolutions at its recent annual meeting that push for government intervention, legislation and other measures that could curtail the expansion of convenient care clinics.

Health Care When You Want It - WSJ.com

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CIGNA HealthCare Acquires Sagamore Health Network

 

BLOOMFIELD, Conn., Aug. 1, 2007 /PRNewswire-FirstCall/ -- CIGNA HealthCare announced today that it has acquired Sagamore Health Network, Inc., the largest leased health care provider network in Indiana.

Sagamore provides access to an extensive preferred provider network consisting of 9,400 primary care physicians, 26,600 specialists, 1,100 ancillary providers and 210 hospitals. Sagamore also offers access to a broad range of utilization review and case management services. The company serves health claims payer organizations, self-insured employers and third-party administrators (TPAs) in Indiana and parts of Kentucky and Ohio.

The terms of the purchase were not disclosed.

CIGNA HealthCare Acquires Sagamore Health Network

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Investigation of found medical records continues

This time it was paper...BD 

The box contained information about lab tests and insurance approvals as well as other medical issues. The documents are not medical charts, but do contain patient names and contact information. Under HIPAA guidelines, documents such as the ones found are supposed to be kept confidential and then shredded before being disposed of.
At the time the Post first interviewed Dr. Padilla, he said the office followed HIPAA guidelines very carefully and that the rule in the office was to shred all documents being disposed of. He said he didn’t know how the box ended up in the trash bin and speculated it might have been accidentally thrown out by the building’s cleaning crew.
Dr. Padilla spoke to the Post on Monday and said he was trying to figure out what had happened.
“The action we take all depends on how the material got into the Dumpster in the first place,” Dr. Padilla said. “That’s what we want to find out. We have a process in place to prevent this from happening.

Investigation of found medical records continues

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House passes boost in kids' health plan

Good point made on how long this is taking for the kids...how long will the rest of us have to wait for the health care legislation outcome.  BD

"If they fail to reach a compromise on covering kids, it would be pathetic," said Drew Altman, president of the nonpartisan Kaiser Family Foundation, an information clearinghouse on healthcare issues. "If they can't agree on kids, what will they be able to reach a deal on when it comes to health reform? Failure to reauthorize [the children's program] would damage many of the most important state health reform efforts around the country."
Indeed, the outcome of the battle is crucial to Gov. Arnold Schwarzenegger's plan to expand coverage in California — and to competing proposals from Democrats. Both would rely on federal cash from the State Children's Health Insurance Program to cover all California children. The federal-state program, known in California as Healthy Families, expires Sept. 30. Its renewal is viewed as the most important health coverage decision in Washington this year.
The California delegation split along party lines, with all Democrats in favor and all Republicans opposed.

House passes boost in kids' health plan - Los Angeles Times

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GP Physicians Under Increased Workload Pressure, Says BMA, UK

UK physicians also facing bigger workloads....BD

Family doctors in the UK are working even harder than they did 14 years ago despite working similar hours, according to the results of a new general practice workload survey published last Tuesday. The BMA says this is because current consultations with patients are longer and more complex and GPs are increasingly treating patients previously cared for in hospitals, raising the intensity and quality of workload to an all-time high.

GPs Under Increased Workload Pressure, Says BMA, UK

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Deep Brain Stimulation Helps Near Vegetative Man

Almost a return from the dead...and maybe hope for others...BD

Following pioneering brain stimulation treatment, and after six years in a near vegetative state, a man is talking again, can feed himself, and has told his mother "I love you Mommy".
The 38 year old American man was in a minimally conscious state following a horrific assault in 1999 where his skull was crushed and he was left for dead. His dramatic recovery came after doctors stimulated deep parts of his brain with electrodes. However, the doctors wished to warn families of other brain trauma patients not to expect the treatment to work on everyone.
A report on the treatment and results is published in the early online edition of the journal Nature and is accompanied by a short news piece.
The man, who cannot be named, has been in a minimally conscious state since his attack, confined to a bed in a nursing home. He could not swallow or speak and rarely opened his eyes, although he was mouthing words and making some attempts to communicate and respond. Brain scans showed that parts of his brain were intact and active.

Deep Brain Stimulation Helps Near Vegetative Man Say "I Love You Mommy"

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Workers are told to shape up or pay up

Employers may pass along higher premiums to workers who are over weight....BD

Looking for new ways to trim the fat and boost workers' health, some employers are starting to make overweight employees pay if they don't slim down.  Still, some lawyers say weight-based compensation plans may run afoul of other employment laws.  Still, some lawyers say weight-based compensation plans may run afoul of other employment laws.
Others, citing growing medical costs tied to obesity, are offering fit workers lucrative incentives that shave thousands of dollars a year off healthcare premiums.
In one of the boldest moves yet, an Indiana-based hospital chain last month said it decided on the stick rather than the carrot. Starting in 2009, Clarian Health Partners will charge employees as much as $30 every two weeks unless they meet weight, cholesterol and blood-pressure guidelines that the company deems healthy.

Workers are told to shape up or pay up - Los Angeles Times

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'Off-label' drugs denied to patients in Medicare D

 

Medicare patients who rely on "off-label" use of drugs for pain, rare diseases and other conditions are often barred from getting them through the new prescription drug program, says a patient advocacy group in a report out Thursday.

Under rules issued last year by the Bush administration for the Medicare Part D program, so-called off-label prescriptions written by doctors for their patients can be denied by insurers. "Off-label" means a drug is used to treat a condition for which it is not specifically approved by the FDA.

"For the first time in more than 40 years, we have a Medicare statute interpreted as not covering medically necessary care," says Robert Hayes, president of the Medicare Rights Center.

'Off-label' drugs denied to patients in Medicare D - USATODAY.com

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Social Security Administration Facing Record Backlog Of Disability Claims Appeals

 

The Social Security Administration has a record backlog of 745,000 pending disability appeals, with the wait for a hearing averaging 17 months -- also a record, USA Today reports (Wolf [1], USA Today, 7/30). Of the 2.5 million U.S. residents who file disability claims annually, close to two in three initially are denied benefits. More than 60% of people with denied claims who appeal the initial decision eventually are granted benefits.
Claimants and SSA officials maintain that the "lengthy waits lead to bankruptcies and foreclosures, drinking and drugs, depression and divorce, even suicide," according to USA Today. Social Security appeals will increase by about 90,000 annually over the next five years, likely resulting in a backlog of one million cases by 2010, according to SSA Commissioner Michael Astrue (Wolf [2], USA Today, 7/30).
Astrue said he is attempting to reduce the wait times but noted that Congress over the past six years has provided about $1 billion less in SSA funding than what President Bush has sought. Astrue is seeking to make "compassionate" early decisions and hold more hearings electronically to limit geographic disparities. However, Astrue said, "I can't look the Congress in the eye right now and say we're doing our job as well as we can do it" (Wolf [1], USA Today, 7/30).

Social Security Administration Facing Record Backlog Of Disability Claims Appeals

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Crisis for poor as Medi-Cal funds end in California

I guess it could be called "Black Thursday"....interesting comments by each political side below too as this will have a huge impact on health facilities more so than it has ever done in the past...as you read on, the republican leader of the State Senate is not overly concerned if the talks go on for months....and has more of a focus on dollars and tax revenue generated rather than healthcare for the poor and elderly...BD

In an emerging crisis for California's elderly and poor, all Medi-Cal funding will be halted this week to an estimated 500 hospitals throughout the state and 11,000 nursing homes, hospices and adult day care centers.

Medi-Cal funds have run out because of the state's monthlong budget impasse, forcing community programs and other facilities into a frantic scramble to cover their bills. Some care facilities for the aged are making plans to close.

California has nearly 6.8 million elderly, frail and chronically infirm Medi-Cal beneficiaries, and many would be forced to find help elsewhere, or make do on their own, without emergency funding from the state Legislature.

But help is unlikely because both the Senate and the Assembly would have to approve an emergency bailout, and the Assembly has gone on summer recess.

"We have not been cut off from Medi-Cal funding before so early in the fiscal year," said Lydia Missaelides, executive director of the California Association for Adult Day Services. "The magnitude of this crisis is overwhelming."

Medi-Cal coffers ran dry last week when the state was scheduled to issue $223 million to managed-care providers. Instead, checks for only $143 million were issued.  On Thursday, $227 million was scheduled to be paid to assorted hospitals, clinics and other providers of Medi-Cal services. No money will be paid.

Assemblywoman Noreen Evans, D-Santa Rosa, predicted that Medi-Cal recipients will begin flooding hospital emergency rooms, "making the health crisis even worse ... (as) emergency rooms are already stretched to the breaking point."   She called the Medi-Cal crisis "highly irresponsible."

Senate Republican Leader Dick Ackerman, R-Irvine (Orange County), said he is not overly concerned about the budget stalemate dragging out weeks or even months longer. He said the state continues to take in tax revenue and most agencies have plenty of money in reserve.

Crisis for poor as Medi-Cal funds end

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Bayonne Med Center back to court - NJ.com

But the good news is they have received a grant for electronic records...which could also help save the day with reduced cost and fewer errors....BD

Bayonne Medical Center is due back in U.S. Bankruptcy Court today to deal with several issues touching on the future of the troubled hospital.

At noon, the court will review applications by the hospital on various financial matters, including a short-term extension of its $30 million credit line, a proposed one-year renewal of the contract for its interim administrator, Daniel Kane, and the hiring of a nursing administrator.

In a related development, BMC has secured a $300,000 grant through the U.S. Labor-Health & Human Services-Education Appropriations bill to install an electronic medical records system. BMC credited Rep. Albio Sires, D-West New York, with helping secure the funds.

Bayonne Med Center back to court - NJ.com

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IPA, Inc. Chooses ITelagen for EMR Rollout and IT Support

More activity on the IPA/HMO business in northern California.  As you can see by the dates projected, this is a long process for roll out to all.  As we all know, IT change has been reluctant and slow with small practices and this is perhaps another way to reach out and bring small practices in to the 21st century with technology.  We still see all the "fax chasers" and paper charts being carted manually from room to room in many offices.  More consumers are now cognizant too of whether or not an office is still using paper, it's noticed within the first few minutes normally of a visit with the rush and disorganization that is just not there with a practice that is organized and using electronic records and technology to manage their patient care.  Organized offices are spending less time on the phone these days as well so they can devote more time to the patient at the time of the visit.  BD

Muir Medical Group IPA's plan is to roll out EMR -- with ITelagen's help -- to 200 providers by 2010. "We were looking down the road," Haegeland said, "and seeing that it was going to be extremely difficult for an individual practice to survive as an island." ITelagen provides a fully staffed IT department with the expertise to keep networks, PC's, software and people running smoothly. The service also includes unlimited onsite and remote technical support for employees, antivirus software and management; plus proactive computer health monitoring and online backup of data.

Muir Medical Group IPA, Inc. Chooses ITelagen for EMR Rollout and IT Support

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When Medical Studies Collide

Good points made here, things are not black and white today with health care..many differing opinions, studies, etc., sometimes too much for one to handle.  BD

No wonder people are confused. And not just about echinacea. On this roller coaster of health advice, caffeine, carbohydrates, and replacement hormones for women after menopause are bad one day, good the next. One meta-analysis was enough to send sales of diabetes blockbuster Avandia plunging when it suggested heart side effects. "The average reader can't sort it out," says Jeanne P. Goldberg, director of the Center on Nutrition Communication at Tufts University.
The problem is, the world of medical and health research is messier than most people realize. Black-and-white answers are rare, even when it comes to a single drug trial. In hormone replacement therapy, "people from the same study are disagreeing with each other," says Julie Buring, professor of medicine at Brigham & Women's Hospital in Boston.

When Medical Studies Collide

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Lawmakers In Health Care Brawl

 

WASHINGTON - The premier health care brawl of 2007 - now showing in Congress - is over health insurance for some of the nation's poorer children, including tens of thousands in Connecticut.
Democrats are considering a huge expansion of the State Children's Health Insurance Program, or SCHIP, saying they have a rare chance to expand a program that, most agree, is popular and generally works well.

Lawmakers In Health Care Brawl -- Courant.com

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Check Medicare Eligibility Online

New service via the web that charges a quarter for each individual check, need to sign up and establish an account before using.  Almost the same price as a phone call...BD

Check the eligibility and deductible status of Medicare patients in seconds!

This service can save you time and money! Here's how:

• Verify patient information and eligibility!
• Receive deductible amount remaining for the year!
• Receive Primary Insurance information if Medicare is the Secondary Payor
• Receive Managed Care Organization Information(MCO/HMO) if patient is enrolled.
• 25 cents per check! No minimum monthly fee!
• No Time Limit! Transactions never expire!
• Available Nationwide, 24 Hrs a day, 7 days a week!
• Uses Most Web Browsers, No Additional Software Required!*
• Optional Direct Interfaces Available for Sammy USA, Simple Sam Plus, & Simple Sam (Medisoft Coming Soon!)
• 100% HIPAA Compliant!

Sign up Today!

Check Medicare Eligibility at www.CheckMedicare.com.

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TabletKiosk Now Shipping Sahara Slate i440D with Vista and Aero Glass support

 

First Slate Tablet PC with Dual Pen and Touch Screen Input Now Widely Available

TabletKiosk™, a leader in mobile computing solutions, today announced that the Sahara Slate PC® i440D featuring both pen and touch screen input, is now widely available with either Microsoft® Windows® XP Tablet PC Edition or Windows Vista® Business operating systems.

Standout features of the Sahara Slate PC i440D include:

• dual mode display that switches between touch screen and active digitizer (pen) input with Wacom® digitizer technology,
• I/O ports that include PCMCIA Type II, eSATA, USB 2.0 and IEEE1394a (6-pin),
• a biometric fingerprint reader,
• three user programmable buttons,
• user accessible memory slot,
• BTO configurations with up to 4 GB DDR2 RAM / 160GB SATA HDD,
• all powered by an Intel® Core™ Duo LV processor.

For touch entry, the screen on the Sahara Slate PC i440D relies on resistive touch technology that responds to contact from a finger, gloved hand or stylus. It does not require direct skin convergence to react. “The resistive touch screen is a key point of differentiation for us. It is advantageous for users in our targeted enterprise markets, including healthcare and field collection, who routinely wear gloves as they conduct their work,” stated Amber Chiu, GM of TabletKiosk R&D.

With its dual core processor, upgradeable system memory, DirectX 9.1 graphics support and wireless capabilities – the Sahara Slate PC i440D is designated Vista Premium Ready – making it the first dual mode slate Tablet PC shipping to run the Windows Aero Glass interface.

TabletKiosk.com - Tablet PCs, Ultra-Mobile PCs (UMPCs), Accessories and Custom Kiosk Solutions

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FDA Panel OKs Osteoporosis Drug To Cut Breast Cancer Risk

 

Despite concerns over cardiovascular side effects, a U.S. Food and Drug Administration panel last Tuesday recommended the osteoporosis drug Evista (raloxifene) for use in preventing breast cancer in certain high-risk groups of older women.
In a vote of 8 to 6, the FDA's Oncologic Drugs Advisory Committee recommended approval of the drug for postmenopausal women with osteoporosis, and, in a 10 to 4 vote, it also recommended the drug for postmenopausal women at high risk for breast cancer.
While the FDA usually follows the recommendations of its expert panels, it is not obligated to do so.
Evista's approval would give women a valuable option in fighting breast cancer, one expert said.

FDA Panel OKs Osteoporosis Drug To Cut Breast Cancer Risk

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Blood Donors Can Answer Their Health History Questions Online

Also operates well on a touch screen tablet pc ...see below...BD

Blood donation just got easier with advent of the Internet Quality Donor System(TM) (iQDS) by Talisman Ltd., of Vienna, Virginia. The US Food & Drug Administration recently issued 510(k) clearance to market the system. As Talisman President Paul D. Cumming, PhD points out: "Now blood centers that use the Quality Donor System(TM) (QDS) can have their donors respond to  health history questions in the privacy and convenience of their home or office instead of being asked questions at the blood drive." While donors must complete the questionnaire on the day of donation, they can now do it at a time and place that best fits their schedule. The prospective donor prints a bar-coded receipt from their computer that summarizes their health history interview and presents this to center staff when they arrive at the blood collection location. Center staff ask a few qualifying questions to ensure authorship of the of the form and, if acceptable, scan the bar-coded receipt entering the interview in the center's QDS system, review the interview and ask any necessary follow up questions. It is anticipated iQDS will save over 10 minutes of donor time at the donation center. Not only is this more convenient for donors and blood centers, but it is expected to increase the appeal for sponsorship of blood drives, since donors will be absent from their work or classrooms for less time.

The preferred client configuration is a touch-screen computer such as the Sahara (see below). This same client machine can also operate in a standalone mode, by running the QDS software directly on the tablet computer.

First Time Ever: Blood Donors Can Answer Their Health History Questions Online

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Sorry, folks, but it’s true: You are for sale

This is why they send out privacy notices in very small print that nobody has a tendency to read so they are within their legal boundaries when selling medical data base information.  BD

Other databases, such as Medical Marketing Service (MMS) sell specialized lists that include cross-referenced information on people with asthma, arthritis, cancer and just about any other healthcare affliction you can think of.

The Medical Information Bureau (MIB) gets its information from 600 member companies that send them information obtained “as part of their application underwriting process for life, health, disability, or long-term care insurance.”

That information can include “medical conditions represented by one or more of about 230 codes. ... (such as) height and weight, blood pressure, ECG readings, and laboratory test results,” (as well as) “information that could impact health or longevity including an adverse driving record, participation in hazardous sports, or aviation activity.”

Unfortunately, according to the Federal Deposit Insurance Corporation (FDIC), it is legal and yes, they can, and do sell their customers’ information — although some may choose not to. Because this is a consumer issue that is a growing concern when it comes to identity theft, the FDIC has special pages dedicated to consumer protection on its Web site at www.fdic.gov/consumers/consumer/news/index.html.
 
 “That’s why they have to send out those ‘privacy notices."

Sorry, folks, but it’s true: You are for sale

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What Does a chief medical information officer do?

 

Although use of electronic medical-record systems in ambulatory care remains low, in acute care, where most CMIOs work, their institutions have passed the tipping point for IT system adoption, particularly for patient record systems and imaging archival systems, Shaffer said.

In that light, Shaffer said, "The delightful news for job security is we're leaving the era of the hard stuff (selection of clinical IT systems and their implementation) and entering the era for the really hard stuff," (leveraging clinical data to reduce variance in care processes and quality, and achieving "process agility" to be able to react quickly to incorporate new medicines, techniques and research-driven ideas to improve care.)

"Being a chief medical information officer is different than being a physician," one CMIO had said.
Most of the 150 or so physician informaticists at last week's meeting of the Association of Medical Directors of Information Systems in Ojai, Calif., sympathized with the understatement.

Modern Healthcare Online

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As more patients turn to the Web every day, are doctors prepared for the influx?

A good web presence for MDs is a good thing....BD

It's surprising to me how many physicians do not yet have any presence on the Web, especially those who can set up such a presence at little or no cost. For example, many of our professional specialty organizations offer free Web space to their members. The cost is effectively part of their membership dues.

"Since many patients use the Web to look for doctors, not having a Web presence amounts to giving patients away to other physicians," he said.

Recordnet.com: As more patients turn to the Web every day, are doctors prepared for the influx?

Hat Tip:  Kevin, MD

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Healthcare for profit bad : Opinion, Nurses for Social Responsibility

One person's story about utilization management....BD

I am a registered nurse. Although I have spent most of my 25-year career caring for people, I made one enormous mistake. For a brief time, I chose to work for a medical insurance company. They gave me the title, "utilization review nurse," which really meant I had control over whether people were allowed procedures, stayed in the hospital or discharged early.

Because of my discomfort with a system that left me in charge of telling a doctor by phone, some 3,000 miles away with his patient, how to practice medicine, I was far more permissive with certifications than the company liked. My phone calls were soon tapped. I was denied bonuses and raises. Harangued and threatened, I was finally booted from the insurance industry.

I watched my own license abused by a medical corporation whose interest was not in saving lives, but in saving money, and whose profits soared as they denied claims under a "managed healthcare system." Meanwhile, its CEOs got salaries in the millions and stock values doubled.

Healthcare for profit bad : Opinion : Ventura County Star

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Glaxo Gets Grilled - Avandia

 

This morning, GlaxoSmithKline defended its controversial diabetes drug, Avandia, in front of a panel of federal advisers convened to decide whether the pill causes heart attacks.

The panel will help the U.S. Food and Drug Administration decide whether steps should be taken to limit sales of Avandia. Some of Glaxo's defenses were met with skepticism, and new information emerged tarring the diabetes pill. Glaxo itself said that new language on the drug's heart risks should be added to its packaging. In slides made public this morning, David Graham, an FDA drug safety expert, recommends that Avandia should be pulled from the market.

Glaxo Gets Grilled - Forbes.com

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Humana 2Q Profit More Than Doubles

 

Humana Inc. reported Monday that its second-quarter profit more than doubled from a year ago on the strength of improved cost controls and sharply higher income from its government business.

For the three months ended June 30, posted net income of $216.8 million, or $1.28 a share, up from $89.5 million, or 53 cents a share, in the same period last year.

Analysts had been expecting net profit of $1.17 per share for the quarter, but the company said earlier it would exceed that by 11 cents.

Revenue rose 19 percent to $6.43 billion, compared with $5.41 billion a year ago, while premium and administrative service fees were up 18 percent, mainly driven by higher average Medicare membership.

Humana 2Q Profit More Than Doubles - Forbes.com

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Votes may be harmful to parties' health

 

Republicans are calling the Democrats' action a step toward socialized medicine, and the Bush administration has vowed to veto both bills. The outcome will influence the course of the presidential election debate over how to cover about 45 million uninsured people in the U.S.; about 9 million of those are children.
The children's program, known in California as Healthy Families, must be reauthorized by Sept. 30 or it will expire.

"This is a package that helps kids, helps seniors and helps doctors, and is opposed by the tobacco and insurance industries," said John Rother, group executive officer of policy and strategy for AARP. "Which side do you think the public is going to line up with?"
Greenstein, of the antipoverty group, said Congress would probably have to roll back the 10% cut in Medicare doctors' fees later this year. Lawmakers may find it advantageous to try to work out both issues at the same time, he suggested.

"There's probably better than a 50-50 chance that the Senate will insist on taking out" the Medicare provisions, Greenstein said. "But if they can work out some Medicare changes, acceptable to the Senate, to finance a fix for the doctors, the overall bill may become stronger."

Votes may be harmful to parties' health - Los Angeles Times

Related Story:  Conflicts with California Schwarzenegger's plan

Bush also opposes a House bill that would add even more money to the program. Instead, he favors an alternative that would add $5 billion and reduce eligibility.

Bush's position set up a clash with Schwarzenegger, who has made expanding the program a top priority. It is a critical component of Schwarzenegger's plan to provide health insurance to the state's 6.5 million uninsured residents.

Schwarzenegger, who campaigned for Bush in 2004, repeatedly has disagreed with the Republican president on a variety of issues, including California's attempts to limit air pollution and greenhouse gases.

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CPU-controlled artificial leg offers new freedom of natural movement for amputees

 

July 27, 2007 Prosthetics is a fascinating field – science’s ability to mimic the complicated natural function of lost limbs can make a truly life-altering difference for amputees. Nowhere is this difference more strongly felt than in the field of artificial legs that get amputees out of wheelchairs, off crutches and back to a level of mobility that lets them blend back in into ordinary life. The latest drive towards the development of advanced prosthetics includes this new microchip-controlled artificial knee joint that’s opening up an  unprecedented level of freedom of movement for above-knee amputees and allowing amputee servicemen to remain active in their jobs if they so choose. The US$30K hydraulic C-LEG’s CPU “brain” automatically adapts to changes of speed and direction, and can be pre-programmed into up to 10 switchable “modes” to enable natural driving, cycling and other programmable activities that require different leg actions to normal walking and stair climbing.

CPU-controlled artificial leg offers new freedom of natural movement for amputees - gizmag Article

Hat Tip:  Medlaunches

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Does my doctor want to kill me? - California

Will be interesting to see if the bill makes it through the legislature.  BD

Hospital patients undergoing treatment in California might eventually need to speculate about whether their doctor harbors homicidal intentions. A proposed law, Assembly Bill 374, the California Compassionate Choices Act, if passed, will legalize physician-assisted suicide, a practice outlawed for more than 700 years and forbidden by every state except Oregon.

Regrettably, the poor and mentally ill are the most susceptible victims of state-sponsored doctor homicides. Those without money might resort to physician-assisted suicide as a means to spare their family the severe financial costs attendant to end-of-life health care. Likewise, AB 374 does not require hospitals to report vital statistics about patients who choose the procedure, which, if made public, could facilitate efforts to challenge the disproportionate impact of physician-assisted suicide on minorities and the poor.

Having a physician assess a patient's mental stability is ineffective because a mentally ill patient could just shop around for a physician willing to finish them off.

Does my doctor want to kill me? - North County Times / The Californian - Community Forums

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N.J. fines Aetna over 9 million, saying it didn't cover services

By comparison, Kaiser got off lightly as this was over 3 times the amount of the fine...and ordered 12% interest on the unpaid claims...BD

NEWARK — New Jersey insurance regulators have fined Aetna Health Inc. nearly $9.5 million, charging that it failed to properly cover some services by out-of-network providers. 

The fine, announced Wednesday after being filed Monday, came after the state Department of Banking and Insurance received complaints following a letter issued in June by Aetna to health care providers.

In the letter, Aetna said providers outside its network would be reimbursed for services at 125 percent of the allowable Medicare amount, and 75 percent for lab fees and durable medical equipment.

Insurance Department Commissioner Steven M. Goldman ordered Aetna to halt its limited reimbursement practice and reprocess all claims for services rendered by nonparticipating providers hurt by Aetna's practices.  He ordered the company to pay providers based on the billed amount plus 12 percent interest from the date the claim was initially paid.

 

APP.COM - N.J. fines Aetna, saying it didn't cover services | Asbury Park Press Online

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Suit accuses United Healthcare of fraud

Additional story details on the post made last week with the announcement of the class action lawsuit.  BD

ST. PETERSBURG - Like many older people, Charleen Edge finds today's smorgasbord of Medicare plans confusing.

Last year, she says, she found herself in a private health maintenance organization she neither requested nor desired. Her repeated requests to switch back to regular Medicare went for naught. After she broke her pelvis in April, neither Medicare nor the HMO would pay the bills, she says, so she's stuck with the $30,000 tab.

"I have no insurer," says Edge, a 78-year-old retired social worker. "I don't know whether Medicare is going to take me back."  But Edge does have one advantage: a board-certified trial lawyer for a son.

Southpinellas: Suit accuses United Healthcare of fraud

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System failure - 3 contributing sectors

One person's thoughts and a bit of history on healthcare change through insurers, employers and hospitals...all who can be considered bad guys at times...due to current practices, etc.  and his thoughts on reform...BD

Why the shift? There are a lot of reasons. But a big one, surely, is the growing outrage at corporations -- starting with America's insurance companies -- that seem to make more money while the people they serve get less health care.

The commercial insurers had hit upon a bonanza, passing the Blue Cross plans in overall enrollment by the 1950s. One by one, they moved away from community rating and guaranteed issue, adopting the same underwriting practices as the private sector -- and, in many cases, converting outright to for-profit status.

Employers, too, used to act differently. One reason employer-sponsored insurance worked for as many Americans as it did, for as long as it did, was that until the 1970s the large manufacturers dominating the American economy basically agreed on the desirability of providing their employees with coverage.  

The behavior of hospitals hasn't changed as much as that of insurers and employers. Truth be told, hospitals were never that excited about treating the uninsured. But it was during the 1980s and 1990s, when the insurance companies began putting unprecedented pressure on them to reduce costs, that many changed their pricing structure -- in ways that transferred higher bills onto the uninsured -- and outsourced their collection work to specialized legal firms.

The real solution, then, is wholesale reform -- so that insurers can't game the system by picking out the healthiest people, so that employers can't gain an edge on their competitors by stiffing them on coverage, and so that hospitals can't offer lower prices simply by shirking the uninsured.  So as the debate over health care heats up, go ahead and bash the bad guys. They probably deserve it. Just remember that the bashing alone won't change the rules of the game.

System failure - The Boston Globe

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Cutting Hospitals Out Of Surgery

Outpatient surgery helps some MDs with additional income and avoids the administrative hospital costs...BD

When someone has minor outpatient surgery in a hospital, payment includes the cost to cover the procedure, plus an extra few thousand dollars in so-called facility fees. If Rock Rockett has his way, more doctors will ditch the hospital and stitch out of their own offices--in theory capturing a fraction of those facility fees that insurers no longer have to pay.

Happy result: Docs make more dough, insurers save money and, just maybe, the overall cost of health care drops.

A 30-year health-insurance industry vet, Rockett is now the head of San Ramon, Calif.-based Validare, a small firm formed in 2001 to help physicians apply for formal accreditation to perform. Today the company also negotiates pricing with insurance companies and even handles doctors' back-office payment services.

Accreditation isn't cheap. Upfront costs for the certification: $11,000, including $6,000 for Validare's consulting services and $5,000 in fees to the Joint Commission. In addition, Delmonte pays Validare a kingly 15% on the fees he generates in excess of what he would have earned performing surgery in a hospital. All well worth it, says Delmonte, who claims he now pulls in an extra $1,000 or so per procedure and is able to perform more surgeries by avoiding costly hospital delays.

Cutting Hospitals Out Of Surgery - Forbes.com

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New York warns of lawsuit over physician rankings by United ...

 

United Healthcare is going ahead with plans to release its physician rankings for the New York area, despite a threat of legal action from the state's attorney general, a United spokesman said.

However, the company is delaying implementation of the rankings system for a few months so physicians can get more familiar with it -- a move United says has nothing to do with the attorney general's threat.

A July 13 letter from the attorney general's office said the ranking system would influence patients to use physicians who are cheaper but not necessarily better. The letter told United it would face legal action if it released the rankings as planned at the end of July.

Mason said United will release the rankings at the end of the year, and added that the delay is not because of the letter, but because the plan had already decided to give physicians more time for input and review.

 

AMNews: Aug. 6, 2007. New York warns of lawsuit over physician rankings by United ... American Medical News

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Physicians offered incentives to practice in New Orleans ...

 

The corps offers each physician:

• Up to $110,000 in loan repayment or income guarantees.
• As much as $40,000 for a sign-on bonus or medical liability insurance premium payments.
• A maximum of $20,000 for relocation expenses.
• Up to $10,000 for continuing medical education on health information technology.

AMNews: Aug. 6, 2007. Physicians offered incentives to practice in New Orleans ... American Medical News

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Medicaid measures performance: The push to improve care and save money ..

 

Private health plans' push for pay-for-performance and Medicare's first steps in that direction have garnered much attention. But the trend isn't confined to these two sectors. State Medicaid agencies have quietly entered the game in an effort to try to improve enrollees' care.

As of mid-2006, at least 28 states had 35 Medicaid pay-for-performance programs. Two were specifically designed for primary care physicians, although others involve doctors.

AMNews: Aug. 6, 2007. Medicaid measures performance: The push to improve care and save money ... American Medical News

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Health coaches nag employees to better care - UPS offers service to employees

Can this accomplish 2 things at once, cost and better health care?  What about privacy issues...more data mining to be used elsewhere?  Thus far only 30% have agreed to enroll. BD

NEW YORK - For Myrtha Suralie, keeping things rolling at UPS' New York sales office is no sweat, but keeping her diabetes in check during her pregnancy was another story.

She was confined to a hospital bed her entire third trimester, with a blood sugar level of 400, almost four times as high as that of a healthy person, potentially life-threatening to her and her baby.

That was when she received a life-changing call from a health coach hired by her company.  UPS has been offering health coaching to its employees for more than a year. The company hires outside firms who mine medical records for potential red flags and reach out to employees with chronic illness like diabetes and heart disease. By coaxing these at-risk employees into better sticking with prescription-drug and behavior-change regimens, the company hopes to save money by avoiding increasing health insurance premiums.

Like UPS, more companies are combating the spiraling health care costs by taking an ever more proactive approach.

But critics say programs like these can work like a Big Brother. Already some companies are asking employees to pay higher co-payments based on obesity and smoking. Giving companies free pass in digging up employees' medical records, they fear, might give away too much information.

"We are very concerned about the civil liberties implications if this data were to somehow to get out into other situations," said Michael Dixon of the Libertarian National Committee.

Health coaches nag employees to better care - CNBC Special Report: Healing Health Care - MSNBC.com

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U.S. patients choosing Mexican hospitals - Medical tourism - Texas

2 Hospital organizations working with "medical tourism" in Texas...both have searches for locating hospitals in both the US and Mexico.  BD

Two North Texas-based hospital chains, Christus Health of Irving and International Hospital Corp. of Dallas, are tapping into a need and an opportunity by providing in their hospitals in Mexico what their executives say are the best of both worlds – U.S.-quality health care and relatively low Mexican prices.

"Our goal is to have the safest hospitals in the international market," said Cliff Orme, CEO of International Hospital Corp. "We're implementing U.S. standards into these hospitals so you won't notice the difference going to a hospital in Dallas than one in a Latin American country."

Some experts, including Peter Maddox of Christus Health, see Mexico as an answer to the complex question of how to treat aging and underinsured Americans at a time when the retirement of baby boomers will further tax the U.S. health care system. An estimated 43 million Americans, about 15 percent of the population, are uninsured, according to a Census Bureau study.

U.S. patients choosing Mexican hospitals for price, quality | Dallas Morning News | News for Dallas, Texas | Nation/World

More information below: 

International Hospital Corporation (IHC) is a Texas based company that develops hospitals and clinics in Latin America.

Ranked among the top 10 Catholic health systems in the United States by size, the CHRISTUS Health system includes more than 40 hospitals and facilities in six American states and Mexico, with assets of more than $4.1 billion.

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Kaiser Best Provider in Colorado Springs

Last week in California, not as well...BD

Kaiser Permanente is a nonprofit insurance agency that celebrates its 10th anniversary in Colorado Springs this year.

The agency has 45,000 members in the Springs and 460,000 throughout the state. It only offers commercial products, focusing on a network model and working with community physicians that represent all specialties.

Colorado Springs Business Journal

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PepsiCo to launch water-based health beverages

 

PepsiCo has announced that it’s getting ready to launch two water-based health beverages and to re-launch of its SoBe LifeWater.

The move comes in response to slowing sales of its Gatorade brand, which is the the No. 2 moneymaker for the company behind Pepsi-Cola.
The company is said to be focusing on more health-oriented products in an effort to improve its bottom line.

PepsiCo to launch water-based health beverages - Hospitality News on Barkeeper.ie

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Caterpillar Sues Union Over Health Care

Contract negotiated, employees and union don't appear to be satisfied as a law suit is filed.  BD

Caterpillar Inc. filed lawsuits Wednesday to make the United Auto Workers pay if courts rule that the heavy equipment maker reneged on a promise to provide free health care for life to retirees and surviving spouses.

Peoria-based Caterpillar argues that the union negotiated and approved contracts that scaled back health care coverage, but is now backing two class-action lawsuits seeking lifetime coverage for thousands of retirees and surviving spouses.

"How can the union sponsor lawsuits that fight the very terms that the union proposed, negotiated and ratified during collective bargaining? That's the question," Caterpillar spokesman Rusty Dunn said.

Caterpillar Sues Union Over Health Care - Forbes.com

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First job: Pay in to health care

Good tips in this article on various types of benefits offered by employers...it is getting a bit more complicated these days with so many choices available.  BD

If you think starting your first job is challenging, just wait until you have to sign up for the benefits your employer offers.
In olden days, new employees would typically get a thick binder filled with information, booklets and forms about health insurance, retirement plans and other benefits.

Nowadays, workers have to pore over countless Web pages to learn about their options.

First job: Pay in to health care, retirement now - Newsday.com

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Safety net for Medi-Cal has run out of cash - California

 

SACRAMENTO – A $2 billion fund created to keep money flowing to Medi-Cal providers when a legislative deadlock delays a new state budget has hit empty, reducing payments yesterday to HMOs and threatening payments to hospitals and nursing homes due Thursday.

“The check-write today was supposed to be $223 million,” Palmer said. “Medi-Cal will only be able to pay $143 million.”  If there is no budget, Medi-Cal will not be able to make an estimated $227 million payment Thursday to hospitals and nursing homes.

The president of the California Hospital Association, C. Duane Dauner, warned that not getting the payment could be “disastrous” for some hospitals.

SignOnSanDiego.com > News > State -- Safety net for Medi-Cal has run out of cash

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Media Members Who Covered 9/11 Now Experiencing Health Woes, asking members to come forward

 

NEW YORK The New York Press Photographers Association is asking members of the media to come forward if they are suffering from long-term health effects of covering the World Trade Center attacks on Sept. 11, 2001.
David Handschuh, the NYPPA intergovernmental affairs chair and a photographer for the New York Daily News, says he has heard from about a dozen 9/11 media workers who are experiencing health problems. Handschuh, who was hit by debris and suffered a broken leg while covering the attack, said he is among those now experiencing breathing problems.

"As journalists every day we go out and fight for the underdog. In this case we're the underdog and need to go out and fight for ourselves," Handschuh says.

Some Who Covered 9/11 Now Experiencing Health Woes, Group Says

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Cardinal Health To Pay $35 Million In SEC Settlement

 

WASHINGTON -(Dow Jones)- Cardinal Health Inc. (CAH), a drug distribution company, will pay $35 million to settle Securities and Exchange Commission civil charges that it engaged in a three-and-a-half year scheme to overstate its operating revenue and growth in order to meet analyst expectations, regulators said on Thursday.

Cardinal Health To Pay $35 Million In SEC Settlement

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Diabetics: We want privacy

One word in this story bothers me...."somewhat"...being somewhat concerned with privacy issues to me is just not good enough.  BD

STATEN ISLAND, N.Y. -- Diabetes isn't infectious like tuberculosis, hepatitis or gonorrhea, so why is the city Health Department tracking people with the disease?

That's what Melissa of Eltingville, a diabetic, wants to know -- for her sake, and the sake of her mother, who also has the disease.  "We had no choice, and we've been sending the results since January or February of this year," said Linda Kraynock, chemistry laboratory manager for Richmond University Medical Center in West Brighton. "Initially I had the same complaint that (Melissa and her mother) have."

"Every time I go to have my blood-sugar checked, my test results are being wired to the (city) Health Department," said Melissa, who didn't want to have her last name included for this article due to fears that her status as a diabetic could affect her ability to get affordable insurance.

"We applaud this kind of work," Dr. Sheehan said. But he added, "We're somewhat concerned about the privacy of individual."

Diabetics: We want privacy - SILive.com

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Doing Battle With the Insurance Company in a Fight to Stay Alive

Having a long battle to pay the bills...one more story, but the surgery did save his life.  BD

His doctors thought he was among the lucky few with pancreatic cancer found early enough to be cured by surgery. But they warned him not to have the surgery in his home city, Albuquerque. They said the operation he needed, a Whipple procedure, was so risky and complicated that it should be done only by a surgeon who performed it often and at a hospital with many similar cases. But neither was available locally.

But his insurer, the Presbyterian Health Plan, refused to pay for treatment in Houston. The company insisted that the operation be done in Albuquerque and sent him a list of five local surgeons.

Figuring that a small chance was better than none, Mr. Hendrickson had the surgery. It went well. But he was left with more than $80,000 in medical bills, which Presbyterian Health Plan refused to pay.  Dr. Bordenave said she was appalled: “No patient fighting for their life should have to fight for their insurance too.”   Mr. Hendrickson waged a long battle with Presbyterian. “I fought with the insurance company for over a year,” he said.

After Presbyterian rejected two appeals, he took his case to a state review board, where he represented himself because he could not afford a lawyer. Presbyterian showed up with two lawyers, a doctor and a nurse. Dr. Bordenave and a gastroenterologist from Albuquerque testified on Mr. Hendrickson’s behalf.

Ultimately, Mr. Hendrickson won the case, and Presbyterian Health Plan paid the entire bill.

Doing Battle With the Insurance Company in a Fight to Stay Alive - New York Times

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Residents can weigh in on health care debate - 12 cities to be part of the national conversation

 

(July 28, 2007) — Rochester has been selected as one of 12 cities to be part of By the People, a national conversation about health care cost, access and quality, and local residents may be getting a phone call about this soon.
Beginning August 4 MacNeil/Lehrer Productions will be telephoning people in the Rochester area to invite them to be part of a program called Dialogues in Democracy: Life, Liberty and the Pursuit of Happiness.
The program, which is being co-sponsored by the Voice of the Voter, a media collaboration between the Democrat and Chronicle, WXXI-TV, WDKX radio and WHAM TV-13, will beheld Oct. 20, 2007 Rochester Institute of Technology.

Democrat & Chronicle: Local News

Perhaps a blog like this one dealing with broadband would be helpful with health issues as well.  Nice to see congress value blogging as a reference for legislation.  BD

OpenLeft.com, a blog focused on liberal issues, has been hosting a wide-ranging discussion on broadband policy since Tuesday. Senator Dick Durbin, an Illinois Democrat and assistant majority leader in the Senate, has joined the discussion, saying he'll use the ideas from OpenLeft to craft broadband legislation.

http://news.yahoo.com/s/pcworld/20070729/tc_pcworld/135194

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U.S. health info technology lags

Interesting story and it amazes me as well when I still see a 2 inch thick file with either staff or the the physician taking an enormous amount of time to dig through for past history and sometimes I see paper articles fall out of the charts accidentally.  Even in a small office, there are enough affordable solutions to keeping better records, even if one cannot afford the large ticket electronic medical records.   The records can be kept within the office until standards are someday created whereby a united system comes into play, but in the mean time important patient health items are simply missed with thumbing through huge paper charts.  I have also seen some physicians who take the time to document a chart in a computer, but then still have the staff drag out the old paper chart instead of viewing the chart on the screen or at minimum print a report for the file, but they still rely on the sometimes illegible and incomplete notes.  In other words they take the time to document but don't reap the rewards of their time spent documenting, thus some of the patient health concerns can be missed when the patient comes in for the next visit. 

Some MDs seem to just not "comprehend" as far as having the information available in a nice formatted screen that give a pretty good snapshot of the patient chart overall, complete with history and graphs.  Time after time I see huge drives of "Word" documents that are barely one step above paper charts, in other words, you still have to find and view the information with a search process, when medical records make this available with a couple clicks of the mouse and in a nice formatted view, and it can usually be transferred to another program with a data transfer, something you can't do with a Word document without manually manipulating each chart.  Programs are created that allow for an export to a Word document if needed too, but again, hanging on to the old "big chunks of documented text"  whether on paper or on a document created by a word processing program still seem to befuddle many.  There are 2 steps to the process, one being documentation, and two is re-using and quick referencing patient chart data, the 2nd one is the issue many MDs still seem to struggle with as it relates to viewing a chart on a computer screen and not a paper chart.  BD

Meanwhile, patient privacy issues, complaints about costs, competition among technology providers and doctors' apparent reluctance to embrace the system have left many medical records in the informational Stone Age.

According to statistics from the Centers for Disease Control and Prevention, only 1 in 10 U.S. physicians in 2005 were using systems that included prescription and diagnostic test orders, test results and physician notes, which are vital to a complete health information network.

Insurance companies, which have come under fire for cherry picking the healthiest patients or limiting payments to members, make up another sector that stands to benefit from digital information to find the most effective treatments.

"The good and the bad is that it <keeping digital records> makes things more transparent," Agus said.

U.S. health info technology lags - washingtonpost.com

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Las Vegas Now - Public Hearing Held on Major Health Insurance Merger

Looking at what has occurred as a result in other states fuels the fire and concern.  BD

potential merger between two major health insurance companies that would affect hundreds of thousands of Nevadans has critics worried about potential abuse. That merger would be between UnitedHealth Group and Sierra Health Services.

At a Friday public hearing, a packed room of politicians, practitioners and patients had a serious debate about health care and the impact of a possible monopoly.

"A monopoly is a monopoly no matter what face you put on it," said Carol Austin-Fink, cancer survivor.

Austin-Fink is a cancer survivor. She's against the merger because she says UnitedHealth denied her claims for jaw and mouth treatments after chemotherapy. But she's not the only one casting a critical eye.

Las Vegas Now - Breaking News, Local News, Weather, Traffic, Streaming Video, Classifieds, Blogs - Public Hearing Held on Major Health Insurance Merger

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Poster child for rotten health care system

We have seen this done in the movie "Sicko" but others are doing the same or similar with newspaper press coverage in areas where medical care is not taking care of the problems.  Once press coverage is attained, it appears more and more of these issues get resolved immediately.  There are the appeals processes in place and we have included some of those in prior posts here as well, but again depending on the individual patient and health care situation, it appears going for the immediate "press" coverage seems to be a solution that more folks are opting for as we see more of these types of stories emerging almost daily and perhaps rightly so.  BD

Two years ago, Anthony and Maria Falzone moved here from Staten Island, from a cramped townhouse in a noisy neighborhood to a spacious home at the end of a quiet street. They invested everything they had in their new place, and then some. Now they live from paycheck to paycheck.

He is agitated. He tries to keep his voice down as best he can. His daughter is sitting on the sofa in the next room. She can hear the conversation. She doesn't understand everything her parents are talking about, but she knows it's about her, and she knows they're upset.

Now there is a sadness in the little girl's eyes that doesn't belong there. But it is there for a reason.Over the past six months, Nicolette has been shuttled back and forth between hospitals from Philadelphia to New York. Ever since they found a hard mass on her bottom in late January, she has been subjected to a series of long ambulance rides and MRI tests, PET scans and CAT scans. She has had biopsies. She has had complications, profuse bleeding. She has been diagnosed and re-diagnosed. 

Meanwhile, her parents have been put through hell, first by a doctor who blew the diagnosis and was evidently too arrogant to admit his mistake, then by a health insurance company that was always more than happy to cash the hefty check the family sent in every month, without fail.

"If I'd found him that day, I would've been arrested," Anthony said, referring to the doctor who made the initial diagnosis and stuck to it.  The doctor at Sloan, a world-renowned pediatric surgeon, immediately identified the problem as a rare malignant tumor that can be removed surgically.

Sorry, out of network, request denied. Go back to the hospital where the treatment originated, the hospital that's in the network.  Desperate, the Falzones took their case to the media. A columnist on Staten Island, a good friend of mine named Cormac Gordon, wrote a strong piece and the paper played it across the top of the front page.  The very next day, the insurance company calls and tells Maria Falzone they can go ahead and have the surgery done at Sloan Kettering.

APP.COM - Poster child for rotten health care system | Asbury Park Press Online

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Doctors - Managed Care and Health Insurance - Medicine and Health - Wages and Salaries

Good insight here on how physicians are paid...and how they are under the magnifying glass with every procedure they recommend from both an HMO and now Medicare.  BD

“I don’t have a view on whether doctors take home too much money or not enough money,” Dr. Bach said. “The problem is the way they earn their money. They have to do stuff. They have to do procedures.”

Primary care doctors and pediatricians, who rarely perform complex procedures, make less than specialists. They are attracting a declining percentage of medical students, and some states are facing a shortage of primary care doctors.

Doctors are also paid whether the procedures they perform go well or badly, Dr. Bach said, and whether they are crucial to a patient’s health or not..

“Almost all expenditures pass through the pen of a doctor,” he said. So a doctor may decide to perform a test that costs a total of $4,000 in order to make $800 for himself — when a cheaper test might work equally well. “This is a highly inefficient way to pay doctors,” Dr. Bach said.

Private insurers like H.M.O.’s are more aggressive than Medicare in second-guessing physicians’ clinical decisions, and they will refuse to pay for imaging scans or other expensive new procedures.

Doctors - Managed Care and Health Insurance - Medicine and Health - Wages and Salaries - New York Times

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