This is a lot better than having to leave the US; however you will still need to see if your health insurance will cover as all policies differ and they are so confusing today.  Earlier this year I wrote about Lowes negotiating surgical procedures for the heart for all their employees who elect to travel to the Cleveland Clinic and Lowes picks up all the bills entirely.  According to this article Lowes had asked their insurers to work on this project with them and got tired of waiting so they went out and negotiated their own contract. 

Lowe's And Cleveland Clinic Strike Up a Domestic Medical Tourism Contract – Heart Surgery for Employees and Dependents

Four other large employers including an airline and a bank are looking a the Lowe’s plan that may soon announce similar agreements with medical providers.  If same city competition is not enough, there may be more for hospitals on the horizon.  One thing to also be aware of too, depending on what type of a procedure you need, don’t low ball for price and make sure the hospital can provide the services an doctors you may need – again this varies based on what type of care and surgery you need and it can be simple or very complicated.  BD 

One company mentioned here in the OC is Newport Orthopedic Institute in Newport Beach and the center started offering flat rates with domestic travel companies 2 years ago.  What is also interesting is to see their notice on the website relative to United Health Care asking patients to ask them to support a new contract as at present it’s not reimbursed at the same levels as other carriers and contains articles about how much the United CEO earns too.  So you can see right here, check with your insurance carrier as United seems to have more issues than most, as that is what I see and hear more of anyway in southern California.  BD

When employee John McNally needed a knee-replacement operation, Alpha Coal West offered to pay his travel expenses if he would have the surgery in Fort Collins, Colo., a five-hour drive from his home near Gillette, Wyoming. 

The Colorado surgery center had data showing good results with such operations, and it charged far less than the hospital in Gillette. Despite feeling "every bump on the way back," McNally was so pleased with the outcome of the operation that he returned to Colorado a few months later to have his other knee done.

A lot is at stake. Hospital care accounts for more than one-third of the nation's $2.5 trillion annual health spending tab. And spending on hospital care — which rose nearly 6% last year — is expected to accelerate, government data show, driven both by increased use and rising prices. Employers with domestic travel programs say they save money in part by negotiating a single rate, which includes fees for surgeons, anesthesiologists and all medical care up until the patient is discharged.

It could shake up the hospital industry by fostering "a truly national competition," says consultant Jim Unland of the Health Capital Group in Chicago.  Still, the domestic travel movement faces challenges. It could backfire, Unland says, if employers and insurers focus solely on cost, rather than quality. While most programs are voluntary, large financial incentives can blur the line between choice and necessity. Medical providers have balked at making their discounts public. And it isn't clear how many workers are willing to travel long distances, particularly those with young children.

James Caillouette, co-owner and surgeon at the Newport Orthopedic Institute in Newport Beach, Calif., says doctors and hospitals had better get over their anger and embrace the new model. Two years ago, the center began signing flat-rate prices with domestic travel companies.

Domestic medical travel is taking off for surgery deals - USATODAY.com

Technorati Tags: Lowes, healthcare, heart surgery, heatlh insurance, Cleveland clinic, cardiology, heart disease, Domestic Medical Travel, Newport Orthopedic Institute

The medication is given in a film format the dissolves in your mouth, thus no need for water.  The drug is to be used for the prevention of Chemotherapy-induced, Radiotherapy-induced, and Postoperative Nausea and Vomiting.  For cancer patients needing treatment from the drug, this could make therapy with chemo and radiation treatments a little easier to stop the nausea without having to dump another medication into the IV.  This is the first such drug approved by the FDA in this delivery system.  BD 

From the website:

“ MonoSol Rx is a leading drug delivery company specializing in the development and commercialization of thin film pharmaceutical and over-the-counter (OTC) drug products. The Company’s thin film formulations offer significant patient benefits, including convenience, taste and potentially greater efficacy. Each thin film strip is small in size — about the size of a postage stamp, utilizes drug taste-masking technology and dissolves rapidly in the mouth without the need for water”

WARREN, N.J. and BALERNA, Switzerland, July 7 /PRNewswire/ -- MonoSol Rx, the developers of PharmFilm® technology and a drug delivery company specializing in film pharmaceutical products, in collaboration with  APR Applied Pharma Research s.a. of Switzerland ("APR") and Labtec GmbH of Germany, today announced that its partner, Strativa Pharmaceuticals, the proprietary products division of Par Pharmaceutical Companies, Inc. (NYSE: PRX), has received approval from the U.S. Food and Drug Administration (FDA) for Zuplenz® (ondansetron) oral soluble film ("OSF") for the prevention of postoperative, highly and moderately emetogenic cancer chemotherapy-induced, and radiotherapy-induced nausea and vomiting.  Zuplenz is the first oral soluble film product approved by the FDA as a prescription medication. 

MonoSol Rx Announces FDA Approval of Zuplenz® Oral Soluble Film... -- WARREN, N.J. and BALERNA, Switzerland, July 7 /PRNewswire/ --

Technorati Tags: MonoSol Rx, medications, pain, nausea, cancer, chemotherapy, FDA

In case you have not heard of this company, they provide physicians for hospitals, in other words doctors that work on staff but are not direct employees of the hospital, contracted instead.  In 2008 the company was awarded the Physician Entrepreneur of the year award.  This is a public company that is traded on the stock exchanges.  As you may or may not be aware, when you are admitted to a hospital you may not be seeing your primary care physician, but rather your treatment and case is turned over to a doctor who works full time at the facility and then coordinates all your records and care back to your primary care MD when you are released.

With the new designation from CMS this means their data is order and accurate and their software is working in compliance with Medicare, so off electronically the information goes.  Just last week they added one more physician’s group in Texas. 

The Hospitalist Company Acquires Austin Hospital Physicians Group – Contracted Physicians for Hire

There are 90 Qualified Registries for 2010 at CMS and IPC is the only hospitalist company to qualify.  BD 

NORTH HOLLYWOOD, Calif., July 7 /PRNewswire-FirstCall/ -- IPC The Hospitalist Company, Inc. (Nasdaq: IPCM), a leading national hospitalist physician group practice company, announced today that the Centers for Medicare & Medicaid Services (CMS) has approved the Company as a Qualified Registry for certain clinical measures specific to inpatient care in acute and sub-acute facilities. As a Qualified Registry, IPC will submit quality data directly to CMS in compliance with the Physicians Quality Reporting Initiative (PQRI), a quality assurance program established in 2006 by CMS, for the 2010 reporting year.

Adam Singer MD, Chairman and CEO of IPC, commented, "Clearly IPC has demonstrated to the satisfaction of CMS that we have fully integrated quality controls into the workflow of our providers and into the operations of the company. The driving force behind our commitment to building a complete and extensive quality control system is the constant improvement in the quality of care for our patients." 

Medicare Designates IPC The Hospitalist Company as a Qualified Registry for Physician... -- NORTH HOLLYWOOD, Calif., July 7 /PRNewswire-FirstCall/ --

Technorati Tags: The Hospitalist Company, hospital, healthcare, partners, physician, practice group, mergers and acquisitions, Medicare, CMS

Health insurers are now lenders for small financing for capital between $1 and $5 million for smaller healthcare groups or hospitals.  If you do a search you can find other healthcare facilities where United has extended loans.  United pays the cost of the loans with their own internal “grant” program that goes along with the load to cover the costs. 

From the website: 

“The Capital Access Small Issuance Program offers tax-exempt bond financing at interest rates often lower than those of conventional loans, maturity and term structure design flexibility, and a dedicated team of underwriters and program investment professionals that help streamline the overall financing process. Issuance costs are subsidized by UnitedHealth Group and PacifiCare of California through the current Grant Program.”

This is one huge company involved in more than just health insurance premiums and have a lot of financial ties all over the place either directly or through their subsidiaries. 

Consumer Watchdog Warns Sebelius on Health Insurers – Good Reason for This as Insurer Subsidiaries Are in The Game to Play Just As Private Equity Groups Diversify and Collaborate Holdings

Their subsidiary bought a Chinese Gateway company that will help facilitate selling more Chinese drugs/devices here in the US and in other places in the world?  Is this one way the insurer is looking to keep costs for healthcare down in the US?  Remember all these subsidiaries of big companies exchange data and work together today and as such how does the intelligence data they collect I ask sometimes. 

UnitedHealth subsidiary (Ingenix Subsidiary I3) Acquires ChinaGate – Working to Sell Chinese Products Globally

It’s all about the money and investing so the money by all means is a good deal but what happens if payments are not made or get behind?  It is kind of a double edge sword here in a way as the financial folks will want the money.

Hospital Legal Cases And Wall Street – Paying Penalties to Get Out of Derivative Markets Pushing Finances Over the Edge and Into the Red

Also posted today at the link above is a post about larger hospitals and their problems with investors, bonds and Wall Street so remember UnitedHealth Group is openly traded on the stock exchange and the first area of responsibility by law is dividends.  You can read more about that side of the story at the link below on how they are paying out higher dividends as announced in May of 2010.  BD 

UnitedHealth To Pay Out Higher and More Frequent Dividends to Share Holders, No Caps on Earnings for Executives or What Is Spent on Lobbying Says the Board

As a side note, it is interesting how the name has changed from UnitedHealthcare to UnitedHealth Group fairly recently.  BD

Petaluma Health Center, a Federally Qualified Health Center that offers primary care and mental health services, received $5.87 million in capital lending to help the organization deliver quality primary health care services to residents in southern Sonoma County. 

UnitedHealth Group purchased Petaluma Health Center's tax-exempt revenue bonds through the California Health Care Investment Program, which gives California health care entities access to capital at rates that are highly competitive with those of conventional financing. Additionally, given the dollar size of the bond issue, Petaluma Health Center also qualified for a cost of issuance subsidy of about $620,000, which covered nearly the entire amount of the organization's bond issuance costs. The cost of issuance was subsidized by UnitedHealth Group's Capital Access Small Issuance Program.

UnitedHealth Group Invests $5.87 Million in Petaluma Health Center to Enhance Health Care Access in Southern Sonoma County - MarketWatch

Technorati Tags: Ingenix, UnitedHealhtcare, HHS, community health information, NCQA, community health, software, Reach for the Top, Health IT, healthcare reform, algorithms, Petaluma Health

One hospital mentioned here, Tri-City in Oceanside has been one I have been following.  You can read more about their lawsuit at the link below.  As this article states hospitals knew of the risks going into some of the investments but like the rest of us, never thought about the bottom falling out the way it did.  Some of the problems started back in 2007, before the crash of 2008 on Wall Street and that of course made it worse.

Tri-City Medical Center Suing Citigroup – Alleging Banking Misled Hospital Executives with Investments

The big problem is the high interest rates they have been left with and when a facility is already operating in the red it only makes the survival process worse.  In the past hospitals made money on their investments which helped make ends meet when shortcomings from compensation entered the picture from health insurers contracts. 

Tri-City Hospital in Oceanside Working on a New Program and Plan To Stabilize Finances and Pull Out of the Red

You can be “right” as a banker and state that the penalties are due in full but look who you are putting out of business potentially and I think some of the penalties should be negotiable, after all even the folks that work on Wall Street are going to need healthcare and hospitals at some time, but maybe they don’t think of it that way.  With current hospital financials the way they are and appearing to get worse, it seems a little discounting on fees and working with the hospitals would be an act of good faith right now with Wall Street, of course each case would be looked at individually.  A hospital in Florida, Sarasota Memorial, was going to build a new addition but now it probably will never get off the ground due to financials and non profitability. 

I sit here and write about telling consumers to ask for discounts from the hospitals when they can’t afford it, so shouldn’t this roll downhill, or maybe in this case uphill?  Hospitals can give out discounts to help consumers yet the banks don’t want to seem to bend at all and could care less on whether or  not a community has a hospital to serve them.  Let’s also not forget that EHR system they either need to buy or upgrade as well.  BD   

Hospitals nationwide are tangling with Wall Street to get out of disastrous wagers that have complicated their financial problems.

Some hospitals are paying millions of dollars in penalties to get out of derivatives contracts, after betting incorrectly that interest rates would rise. Other hospitals are paying higher interest rates. At many, these ill-fated financial bets have contributed to layoffs and scuttled projects.

More than 500 nonprofit hospitals—at least one in six—bought interest-rate "swaps" in a bid to lower their borrowing costs, estimates Municipal Market Advisors, a Concord, Mass., consulting firm. The swaps allowed hospitals to act much like homeowners switching from a floating-rate mortgage to fixed-rate one, betting on rising interest rates.

For a fee, the hospitals received a fixed rate to sell bonds, lower than the municipal-bond market at the time. These bets backfired when the Federal Reserve cut interest rates to nearly zero from more than 5% in 2007.

Hospitals Sue Wall Street Over Trades - WSJ.com

Technorati Tags: Citigroup, algorithms, financing, disclosure, bonds, risks, auctions, hospitals, Tri-City Medical, Wall Street, investments

This is a mess to say the least as the investors from Strategic Turnaround Equity Partners are suing Untied American Healthcare too.  Last month United American Healthcare Corporation announced the acquisition of Pulse Systems which provides contract manufacturing services to the medical devices companies.  It looks like the investment partners are not getting along with the board and management of United American.   One of the articles states there has not been a share holder meeting in over 600 days, so that could be a touchy subject. 

From the website:

“United American Healthcare Corporation (UAHC) is a full-service healthcare management company, pioneering the delivery of healthcare services to Medicaid recipients since 1985. UAHC owns and manages UAHC Health Plan in western Tennessee, including Memphis”

Now when I clicked to get more information on their health plan management plan, below is what I received, they care but are not there it appears.  I wonder how many consumers and patients are enrolled here? 

Not too long ago I made another post urging consumers to pay attention to the grouping and acquisitions of companies both by private equity firms and insurance companies sold on the open market, as this is going to get a bit crazy.  United just bought a company that consults with medical devices and then from another side runs an HMO insurance firm.   If you read the link below you will find a number of examples to be aware of.

Consumer Watchdog Warns Sebelius on Health Insurers – Good Reason for This as Insurer Subsidiaries Are in The Game to Play Just As Private Equity Groups Diversify and Collaborate Holdings

Again, it appears investors and the board are not getting along and we have a major power struggle here with the value of the stock at hand and up for controversy.  There will be more actions like this in the future as more disagree to agree and as consumers, we will be stuck in the middle.  As investors take over hospitals and try to run the actual medical/hospital side of the businesses it’s going to be an interesting show down as in this case, the investors are wanting their money.  BD 

United American Healthcare Corporation Announces Lawsuit Against Strategic Turnaround Equity Partners and Postponement of Annual Meeting of Shareholders

United American Healthcare Corporation (NASDAQ:UAHC) announced it intends over the next several days to file a lawsuit for violations of federal securities laws against Strategic Turnaround Equity Partners, LP (Cayman), a Cayman Islands limited partnership and UAHC director Bruce Galloway, and their associates, and for violations of Michigan law against Mr. Galloway in the United States District Court or the Eastern District of Michigan.

"Our Company has determined that Strategic Equity Partners and the other participants in its proxy solicitation, in violation of law and Mr. Galloway's fiduciary duties, have engaged in an outrageous campaign to disseminate false and misleading information about UAHC, the Board of Directors and management," said William Brooks, CEO of United American Healthcare. "From the outset of this proxy contest, we have endeavored to take the high road, making our case to shareholders based on facts and reason, without resorting to the sort of mudslinging taken up by the dissidents.

Unfortunately, our opponents have created an environment of misinformation designed to obscure and denigrate the highly competent work of our Board and management team, and mislead investors as they vote on the future direction of our Company. These actions constitute a betrayal by Mr. Galloway and have caused investor confusion that has necessitated postponement of the annual meeting."

Effective immediately, Galloway has been removed from the Finance and Audit Committee, and the Company has postponed its upcoming Annual Shareholders' Meeting scheduled for Tuesday, June 29, 2010. The Company will reschedule the Annual Shareholders' Meeting and set a revised meeting date and record date for shareholders eligible to vote at the meeting as soon as possible.

Insurance News - United American Healthcare Corporation Announces Lawsuit Against Strategic Turnaround Equity Partners and Postponement of Annual Meeting of...

Technorati Tags: HMO, lawsuit, United American Healthcare, Strategic Tournaround Equipty Partners, healthcare, medicaid, investors, stock

I remember Valeant when it was ICN years ago here in Orange County.  As you can read below the one big reason for the merge and move is not only combining employees but also the tax credits that were about to expire, so we lose one here in the US to Canada. 

Valeant Pharmaceuticals International in Aliso Viejo, which has made 15 acquisitions since 2008, is merging with Canadian drug maker Biovail Corp.

The resulting company will be called Valeant Pharmaceuticals but will be headquartered in Mississauga, Ontario, Canada, where Biovail is based.  Biovail sells Wellbutrin XL antidepressant and GlaxoSmithKline's Zovirax, a treatment for herpes.

Being a Canadian company lets it obtain a tax friendly corporate structure just as Valeant’s tax credits were set to expire, according to Reuters, which says the new company expects to cut 15% to 20% of its combined workforce of about 4,400.

Both companies have colorful histories, according to Bloomberg Businessweek. ICN was founded by Milan Panic, one-time premier of Yugoslavia who departed the company after losing a proxy fight in 2002. Biovail’s founder Eugene Melnyk, owner of the Ottawa Senators National Hockey League team, lost his own board fight in 2008.

O.C. company merges, moves to Canada - Jan Norman on Small Business : The Orange County Register

Technorati Tags: Valeant pharmaceuticals, Biovail, pharma, mergers and acquisitions, healthcare, drugs

Back in October 2008 the new facility opened, state of the art and now we are less than 2 years later and the hospital is over crowded with patients in the hallways.   At the time of planning both budgets and technologies were studied to determine how many beds were going to be needed and it looks like the plans were wrong and granted a lot has happened since the planning stage and building the facility.  It is a state of the art facility with robots and a top notch lab facility but if it is too small and enough patients can’t be seen the overcrowding persists.  You can read my write up from October 2008 and see how modern and what a great facility it is with all the latest technology at the link below. 

LAC+USC Hospital – New Facility to Open Soon - Los Angeles

With budget cuts it was built for 600 beds instead of 750 and this is the result, another part of the debate issue and small won out.  The hospital has robots and a state of the art lab.  The link above gives some additional details about the facility. 

The health department faces a nearly $600-million deficit unless it can secure more federal funding.  Plans are also in the works to reopen an emergency room and inpatient services in Willowbrook, the former Martin Luther King Jr.-Harbor Hospital that was closed.  BD 

Two Los Angeles County supervisors Tuesday introduced a proposal to study the addition of 150 beds to Los Angeles County-USC Medical Center, the county's overcrowded flagship hospital.
The proposal comes about a week and a half after The Los Angeles Times reported that severe overcrowding was routine at County- USC, which in 2008 moved into a new $1.02-billion facility with 224 fewer beds. In May, the hospital's emergency room was deemed overcrowded about 80% of the time, with conditions considered severe or dangerous for half of that month. 
"The right-sizing of L.A. County-USC Medical Center is unfinished business," Supervisor Mark Ridley-Thomas said. "This is the flagship trauma center of L.A. County … and every single county resident has something at stake in the viability of L.A. County-USC Medical Center."

L.A. County supervisors seek information on expanding County-USC hospital - latimes.com

Technorati Tags: LAC+USC Medical Center, Los Angeles, Hosptials, LA General Hospital, Healthcare, Historical Buildings, Keck School of Medicine of USC, USC Medical School

We are starting to see more discounts given when asking for them at healthcare facilities as the cost and listed prices are in many cases non-affordable, especially when one does not have insurance coverage and doctors and hospitals alike are beginning to realize that discounted payments mean the difference of securing the patient and/or treatments or not.  There are also sites where you can put your treatment/procedure out for bid such as Priceline.com which may work for non emergency types of elective procedures where time is not an element.

Shopping for the Medical Care – New Websites Appearing to Engage the Process

“I was a little nervous at first because the price was so cheap, but when I got there, it was wonderful,” Ms. Kyser said. “Everyone was so professional and helpful.”

HealthcareBlueBook.com compiles prices paid for specific treatments and procedures in ZIP codes throughout the country, then lists what the site determines is a range of fair prices. Consumers can then use these ranges as a jumping-off point for negotiating with their providers.

Another Web site, OutOfPocket.com, combines price information that users send in to determine a going rate for specific health care costs throughout the country.

In the video below you can see where an MRI was negotiated down to $600 from the original quotes of $1800 plus.  Cash is always welcome by all and in itself will open the doors for cheaper pricing.  BD 

http://www.cbsnews.com/video/watch/?id=6654105n&tag=related;photovideo

Technorati Tags: PriceDoc.com, healthcare, health insurance, Washington, websites, physicians, cost, bidding for healthcare, hospitals

The restaurants are saying that their revenues are hurting due to the new state laws that prohibit gifts for doctors from drug and device companies or limit the expenses, in other words no more expensive dinners.  This fact in itself shows there’s a lot of medical business items discussed over nice dinners and lunches. 

As the law currently stands now the companies can still cater in lunch, but no expensive dinners outside the office.  BD

Massachusetts restaurateurs hurting for business in an unsettled economy and frustrated by lawmakers' willingness to exempt casinos from alcohol service limits are pleading with lawmakers to give them a break this week, over the objection of patient advocates.

That break comes in the form of a House proposal to exempt restaurants from a 2008 state law that bars medical device and pharmaceutical companies from wining and dining doctors, which restaurants say has taken a bite out of their business in the two years since.

Under current law, companies may still cater food from local restaurants to doctors' offices but cannot pay for doctors' meals off-premises. Restaurant advocates say device and drug companies have shown little interest in catering, cutting deep swaths out of their function revenue.

During debate, Sen. Richard Moore, co-chair of the Health Care Financing Committee, led opposition to the proposal, saying it would "gut" efforts to control health care costs.

Mass. restaurants seek gift ban exemption | MassDevice - Medical Device Industry News

Technorati Tags: Massachusetts, dinner, free lunch, laws, pharma, device companies, lobbying

Getting a judgment and collecting it are 2 different issues according to this article and the punitive damages could result with additional fines.  The company is expected to appeal.  So now what happens when the company doesn’t have insurance to cover it? 

We read about individuals having inadequate insurance and now it flows over to the nursing home companies.  Keep in mind though that this is a publicly traded company and dividends to shareholders come first so should nursing home facilities and care units be traded or should this be an area for non profits to better serve seniors?  Are seniors being neglected with care standards in the interest of profits you might wonder and why do they not carry enough insurance if they are traded on the stock market for investors?  BD 

July 7 (Reuters) - U.S. nursing home operator Skilled Healthcare Group Inc (SKH.N) said a California jury ruled that the company has to pay $671 million in damages to patients for violating the state's health and safety code.

The jury has yet to hear the punitive damages phase of the trial and will continue to further deliberate on the class action lawsuit, which was filed more than four years ago.

Skilled Healthcare said its primary professional liability insurance coverage had been exhausted for the policy year.

"Even if the company is successful in obtaining insurance coverage for this matter, the amount of the jury verdict far exceeds the policy limits of its insurance," the company said.

UPDATE 1-Skilled Healthcare told to pay $671 mln in damages | Reuters

Technorati Tags: Skilled Healthcare, California, nursing homes, insurance, stock market, for profit, patients, neglect, jury, fines

With the growing diagnosis of autism in children, the website offers information, assistance and treatment options as well as representation with helping to get insurance coverage.  BD

LOS ANGELES, July 7 /PRNewswire/ -- At a time when most companies are downsizing, Wellspring is expanding and continuing to grow and flourish. Recently, Wellspring constructed a new 4,200 square foot Corporate Headquarters in Los Angeles to centralize all of their corporate departments. This new space will allow more meeting space for high profile meetings, think tank sessions and centralized office space for executive and management staff.  "We are finally able to bring all our corporate staff under one roof and have creative synergies amongst all support teams to better service our rapidly expanding provider network needs around the country," commented Leo Landaverde, CEO at Wellspring.
Wellspring is one of the fastest growing companies in United States in the field of Autism Treatment.  Wellspring has pioneered the first national preferred provider network dedicated to Autism treatment by working with insurance companies and health plans to expand behavior therapy services using the principles of Applied Behavior Analysis (ABA). Wellspring employs ethical and experienced professionals throughout the U.S. who are passionate about meeting the behavioral needs of their clients and improving their quality of life. Wellspring is committed to being at the forefront of the behavioral health services industry and a leader of autism treatment. The company is on the cutting edge of the latest research, updated educational plans, business trends and technology to ensure the success of its employees and its clients.

Wellspring Expands and Opens Corporate Headquarters in Los Angeles -- LOS ANGELES, July 7 /PRNewswire/ --

Technorati Tags: Wellspring, Autism, children, behavior, treatment, healthcare

The City of Oakland has done this and raised over a million dollars last year and the best part of it is that nobody seems to object either and will gladly pay the taxes.  This hedges on proposal 19 to be ready in case legalization takes place.  BD  

 

Long Beach is looking to join a handful of California cities seeking to boost city funds by taxing medical marijuana.

The City Council on Tuesday will consider a proposal to place a measure on the November ballot that would place a 5% tax on medical marijuana purchased in city collectives. There would also be an additional tax of up to 10% on other marijuana businesses if California voters pass Proposition 19.

Long Beach's proposal also calls for taxing medical marijuana cultivation sites at .0075 cents per square foot.

With the city facing an $18.5-million budget deficit the tax would be a welcome boost to the strapped city.

Long Beach looking to cash in on medical marijuana | Comments Blog | Los Angeles Times

Technorati Tags: Long Beach, medical marijuana, healthcare, taxes, budgets, revenue Cycle Software, pain management

Whether your knew it or not, Lipitor has been approved for use with children for a number of years here in the US as well.  Lipitor is due to come off patent at the end of 2011 and it appears we are seeing some interesting marketing here to try to ensure the blockbuster drug’s continued use.  What’s coming next an inhaled version of the drug or maybe chewing gum? 

Part of the reason for the chewable version goes back to allowing the drug company to get an additional 6 months of patent protection if they test with children, so no big surprise here with the reasoning as to why children may have been included.  I wonder myself how many children are actually taking Lipitor?  BD

TRENTON, N.J. – The European Union has approved a new chewable form of cholesterol blockbuster Lipitor for children 10 and up with high levels of bad cholesterol and triglycerides, a type of blood fat, Pfizer said Tuesday.

The approval includes children whose high blood fats are due to an inherited disease that causes extremely high cholesterol levels, familial hypercholesterolemia.

New York-based Pfizer Inc. won U.S. approval for Lipitor use in children 10 to 17 with that condition in 2002.

Until recently, cholesterol drugs have been primarily taken by adults with heart disease, but their use has expanded to younger patients as more obese, sedentary teenagers and adolescents develop heart disease and diabetes.

Pfizer gets EU approval for kids' cholesterol drug - Yahoo! News

Technorati Tags: Pfizer, Lipitor, drugs, children, pediatrics, chewable, cholesterol, heart disease, diabetes

I would say this study  may stand to have some effect on prescribing drugs for blood pressure control and over 120 is considered to be reaching up there to the high side with 130 of course being at the small end and 140 being considered high.  As the article states diabetics need to keep blood pressure under control like the rest of us but in the end a tighter control was not having any effect on strokes, heart attacks, etc. so there’s not a big additional endangerment.  BD

They found that using a combination of drugs to keep diabetic patients' top blood pressure readings below 130 offered no benefit over those whose top reading was below 140 -- the cutoff point for high blood pressure.

Normal blood pressure for healthy people is considered to be 120/80 or lower.

The study is the latest to look at whether treating diabetics aggressively with drugs to control their risk of a heart attack or stroke has any benefit. Several teams have found it in fact can be dangerous for some patients.

Those with tight control had blood pressure under 130; those with average control had blood pressure under 140 and those whose blood pressure was over 140 were considered uncontrolled.

"What we found was that the tight control group -- those with systolic blood pressure of 130 -- did no better with regard to the overall outcome of death, heart attack or stroke. There was no difference, and in fact those they may have done a little worse," Cooper-DeHoff said in a telephone interview.

Blood pressure goals for diabetics -- too tough? | Reuters

Technorati Tags: Diabetes, blood pressure, systolic pressure, healthcare, study, drugs

Again, I thank ScrubsGallery.com for advertising with the Medical Quack. 

This month they are offering a discount on Hospital Scrubs with the special code below.  BD 

For a limited time, you can get a 10%  with hospital scrubs by using the code “white_onsale"” on your order!

Next time you need to order scrubs or other healthcare apparel, please check out their website and compare. 

Thanks again to ScrubsGallery.Com for supporting the Medical Quack!!

Technorati Tags: MedicalQuack, ScrubsGallery.com, Advertising, lab coats, scrubs, healthcare, apparel, sponsored ads

It has only been since 2006 since the agency has been without a director, 4 years and I agree right now more than ever someone needs to fill those shoes.  He was nominated back in March so a few months have already passed.  Dr. Berwick is a pediatrician and Harvard University Professor. 

Update: Dr. Don Berwick Will Be Nominated as CMS Administrator – Featured Expert From “Money Driven Medicine” – The Book and Movie (Videos)

What is nice too is that you can hear him speak on camera in the documentary, Money Driven Medicine which is really helpful to get an idea of where he stands and his thoughts.  I found it helpful by all means. 

Money Driven Medicine – Taking Back Healthcare from the Bill Moyer Show

DVDs of Money-Driven Medicine can be purchased now for institutional use at www.newsreel.org or by calling 877-811-7495.  Home use DVDs are not offered.
Digital rental for home use will be available at Newsreel.org/Amazon after August 28 for $2.99.

Here’s a video where he talks about what is patient centered care all about.  I certainly can’t blame the President for taking the shortcut around as we have to begin moving on healthcare issues.  Dr. Berwick is a mover and a shaker and we need those folks in office where they can make a difference.  BD  

Obama will make the appointment on Wednesday of Dr. Donald Berwick, a healthcare expert he nominated in April to run the vast federal medical programs for poor and elderly Americans, according to White House Communications Director Dan Pfeiffer.

"Many Republicans in Congress have made it clear in recent weeks that they were going to stall the nomination as long as they could, solely to score political points," Pfeiffer said in a blog posted on the White House website.

Obama to bypass Senate to fill Medicare post: White House | Reuters

Technorati Tags: CMS, Medicare, Senate, Congress, Berwick, appointments, White House, Obama, Money Driven Medicine

The device is for advanced macular degeneration, which is mostly going to be seniors as it is related to age.  A cataract surgeon is the doctor who does the implant.  The device is not a cure but rather restores sight back to where it was before AMD began and will not completely correct vision 100% but will improve it.

The website has a couple patient stories/video you can read and watch here.  The one eye without the telescope is used for peripheral vision and it requires a little time to get used to using one eye just for that purpose. 

The telescope is not even visible and glasses are required.  The eye with the telescope is used for central vision.  This looks very cool and can offer some vision alternative solutions for those with AMD.   The implant is the size of a pea.  This is totally fascinating technology.  BD 

From the website:

“The telescope implantation surgical procedure is performed on only one eye. It involves removing the eye's natural lens and replacing it with a tiny telescope implant. This part of the treatment process is done in a relatively short outpatient surgery by a specially trained ophthalmologist who performs cornea and cataract surgeries (cornea/cataract surgeon). You won't have to stay in a hospital and will return home the same day.

The surgery involves several steps:  

• Your eye will be numbed at the beginning of the procedure so you will not feel any pain
• Special eye drops will be administered to temporarily enlarge your pupil
• Your eye will be held open with a special instrument called a lid speculum, and an operating microscope will be placed in front of your eye
• The surgeon will remove you eye's natural lens 
• The telescope prosthesis will be placed in the same position where the natural lens was located
• The surgical incision will be sutured closed

The surgical procedure will take approximately 1 hour.

If there are complications during your surgery, your surgeon may not be able to finish the procedure. This means that you may undergo surgery, but not be able to receive the telescope implant and the potential benefits you could gain with it. If this is the case, your surgeon will attempt to implant a standard intraocular lens (IOL), as in any procedure for cataract removal.

Before the surgery, be sure to discuss any questions you might have with your surgeon. After surgery, you will have follow-up visits with your surgeon and eye drops to take for several weeks.” 

WASHINGTON — U.S. health officials have approved a first-of-its-kind technology to counter a leading cause of blindness in older adults — a tiny telescope implanted inside the eye.

The Implantable Miniature Telescope aims to help in the end stages of incurable age-related macular degeneration, a creeping loss of central vision that blocks reading, watching TV, eventually even recognizing faces.

The idea: Surgically insert the Implantable Miniature Telescope into one eye for better central vision, while leaving the other eye alone to provide peripheral vision. The brain must fuse two views into a single image, and the Food and Drug Administration warned Tuesday that patients need post-surgery rehabilitation to make it work.

The Associated Press: FDA clears first implantable telescope for vision

Technorati Tags: FDA, vision, CentraSight, heatlhcare, eyesight, surgery, telescope, medical devices

I have been using Google Voice and I can see why a desktop application would be popular as there are mobile phone applications for the I Phone and Blackberry so why not the desktop.  You can configure your phone number different ways.  I have mine configured as a place to leave messages right now but have had it  forwarded to both my cell phone and landline.  This is what mine looks like now, no following:)  This works for me though as I love getting the “transcribed text” message.  This is what made me think about doctors with using a cell phone, get a transcribed message from the patients on the phones.  It is not perfect but does pretty good. 

You can send a text message back.  The reason I use no following is so I have a number where people can message me if not urgent without ringing the phone.  Also there’s an option to use Google Voice as a replacement for your cell phone carrier voice mail, and that works great too. 

No more lost messages as you have a back up on your computer/web.

Below is a message from my Mom, who dictated the voice mail and Google transcribed it.  Now once you are on the computer you can forward that voice mail to someone else or embed it on a web site, obviously user discretion here by all means.  Doctors could occasionally find this useful with emergency type situations to relay information.  As you can see on the web there’s no phone number listed as to where the message came from.  The message can also be downloaded in an MP3 format, so lots to do here.

I really like the transcription services as I used to pay for this with other software and now it is free.

Again instead of that old pager a doctor may carry around, why not get your messages saved in this fashion.  If a message is accidentally deleted, it’s backed up.  No wonder everyone wants a desktop application for Google Voice and I’m happy with it.  When I signed up on the beta I probably didn’t use it as much as I should have but now am in high gear. 

You can use the Google Phone number as one universal phone number to give out and by contact determine which phones to forward to as well, so good way to perhaps keep family and friends close while sending others directly to voice mail if needed.  Having the site open makes it easy to send a text message anywhere too.

This is also interesting as you can type in a phone number, select which phone you want to use and Google will do the rest, call the other party and connect with your selected phone, home work or cell phone.  I tried this one out and it works well. 

I think Google Voice is a winner in my book and so far have had no problems or issues at all.  BD 

Thousands of Google Voice users have signed an online petition asking the search engine to release a desktop application that would enable them to make telephone calls over the Internet.

The petition, posted over the July 4th holiday weekend, was started after the blog TechCrunch reported that the company was testing a voice-over-IP desktop app internally. The site, however, reported that Google may scrap the project because founders Larry Page and Sergey Brin want all applications from the company to work from inside a browser.

Google Voice today primarily offers call forwarding, voicemail, and a voicemail-to-e-mail transcription service. The service, which is available at no charge, was made generally available last month and has more than a million active users.

Google VoIP App Draws Petition -- Google -- InformationWeek

Technorati Tags: Google Voice, technology, Google, cell phones, voice mail, transcription, email, phone calls, VOIP, texting, messages, patients, doctors

There are stories on both sides of the fence here but the big privacy issues and breaches today all seem to revolve around heath insurance breaches with their systems and not the providers.  Provider breaches are pretty much paper records that don’t get shredded.  You can’t help but think that providers are a bit shy about the entire electronic exchange and integration with new stories appearing each month with insurers.  Most of the EHR software companies by comparison seem to have a pretty good lock on security and privacy although they are not 100% perfect, but we are seeing less exposure from the medical records software and more from the insurers.  

In the news lately we had the vendor of Blue Cross that basically had some bad programming that exposed personal records and were met with a lawsuit from an individual who found her records online.

Anthem Blue Cross Security Breach Occurred During System Upgrade – Information Accessed by Attorneys Looking for Information Relative to Lawsuits With Carrier

Last year Blue Cross had exposed the identities of doctors all across the US.  We are into the data age like it or not and when errors and miscalculations happen from their side of the fence, we get to hear “whoops” and we will fix it, so what other part of healthcare gets away with this?

My Algorithm Didn’t Do That, Did It? Is There a “Department of Algorithms” in Our Future?

When it comes to privacy, something also being over looked is the actions and use of data with health insurance company subsidiaries, and they will share somehow  is this means profit dollars to have information available from one subsidiary that does one thing to another that does something else.  You might be surprised to see where health insurers are going today with their investments, like buying a Chinese Gateway company to bring more Chinese drugs/devices to the US.  The link below has a pretty good summary of some of the subsidiary actions, which all lay money down to their bottom line profits.

Consumer Watchdog Warns Sebelius on Health Insurers – Good Reason for This as Insurer Subsidiaries Are in The Game to Play Just As Private Equity Groups Diversify and Collaborate Holdings

I think until the payer side reaches a higher level of competency with security to build confidence, the providers and patients will continue with the standard mode of not trusting and for good reason.  We have a glut of analysis/medical billing organizations taking big chunks of money that goes from point A to point B and yes some of this is needed, but about 25% of what we use today for medical processing might be sufficient.  Granted people would lose jobs, but in the long run we would end up with less spending on transactions for each claim and everyone would win there.  This is the side of healthcare that really needs to be addressed both for security and for saving money.  BD 

Last year’s HITECH Act toughened the rules and enforcement penalties health information handlers must follow to protect patient privacy.

Under the new policy regime, providers will have to pay more attention to the confidentiality and safety of patient information as they move more of their operations toward electronic health record-keeping

Without sound security policies and practices, privacy “will be just a principle,” said Sue McAndrew, deputy director for privacy in the Office of Civil Rights, the Health and Human Services Department office that was given responsibility for health privacy and security policy under the new law.

Even so, such practices must now be the order of the day under the new privacy and security framework. “The security rule says wherever you have electronic health information, you need to protect it,” said HIMSS’s Gallagher. “You may not even apply for meaningful use incentives. But if you’re keeping data in electronic form, you have to comply with the security rule.”

http://www.govhealthit.com/newsitem.aspx?nid=74167

Technorati Tags: Health IT, technology, privacy, patients, providers, healthcare reform, HHSInsurance, HIPAA, profits, HIMMS, transactions, healthcare reform certification

Back in April things were already stirring relative to to charges from hospitals and in Germany they can also opt for additional private health insurance as well as contributing to the government system.  With the new increases the poor will be protected and their payments will be subsidized by the government. 

Health Insurers In Germany Claiming Over Charges from Hospitals - Insurance Agents Just Happen to be the #1 Least Desired Profession

You can read at the link above though how an “insurance agent” is the bottom feeder job of all times and sadly “doctor” also makes the number 9 spot on the survey conducted in Germany.  In other recent healthcare news in Germany, the move to have a PHR (personal health record) is also alive and well with Microsoft HeatlhVault.  

Microsoft HealthVault and Siemens Bringing PHR Platform to Germany – And a Look at a German EHR

Last year I spent a bit of time chatting with Dr. Kunhardt from Germany, from the University of Deggenndorf and we compared notes on the cost of various surgeries here in the US and the same in Germany and actually in some procedures there was not a huge difference and when adding travel/airfare to some, it was pretty close.  We also talked about medical record systems and here’s a brief summary of what we talked about.  Almost everything in Germany is all electronic medical records by far. 

“This is the work of Mr. Prof. Dr. Horst Kunhardt, Department of Business Informatics, University of App. Sc. Deggendorf and you can use the link here to a live demo to see how it works.  I was curious having written an ambulatory EMR years ago myself just to see how it all came together.  The system is created with open source software with my SQL and PHP for the demo shown.   If you want to read up a bit more on German Medical Tourism, here’s a link to follow.”  BD

BERLIN (AP) -- Faced with a ballooning deficit in Germany's health care system, Chancellor Angela Merkel's government decided Tuesday to raise premiums and cut into the profits of doctors, dentists, hospitals and pharmaceutical manufacturers.

The decision comes after months of wrangling within Merkel's coalition over a fundamental overhaul of the system and after a series of political blows to the chancellor and plummeting support in the polls.

While government officials said Tuesday's decision was an achievement reached harmoniously, the opposition immediately criticized the reform saying it basically consists of everybody paying more.

Health Minister Philipp Roesler said the world is still envious of the German system because of its high quality and only average cost compared to other countries.

"However, our system is facing a challenge brought on by demographic changes and progress in medical technology," he said.

The idea behind the highly complicated split-revenue system is to free employers from rising health care costs. To save the poor from being overwhelmed financially, the government is to subsidize their extra premiums if they exceed 2 percent of their income.

http://hosted.ap.org/dynamic/stories/E/EU_GERMANY_HEALTH_CARE?SITE=TXDAM&SECTION=HOME&TEMPLATE=DEFAULT

Technorati Tags: health insurance, heatlhcare, patients, politics, Germany, insurance agent, medical tourism, medical billing, healthcare, cost, Dr Horst Kunhardt, EHR, PHR, HealthVault

Last week I took to task this survey done by a group that invests heavily with healthcare technology, one big area that could be reduced substantially to save money in healthcare as it is completely over crowded with transactions fees, up to 2-3 being taken from processing a single healthcare claim when one should be adequate.  Consolidation in the analysis department would stand to save a ton of money and more of these firms should merge to get part of that burden out of our cost that we pay, it’s a race as to who has the best payment algorithms and too much competition, duplication of efforts and we all pay in the end.  Anyway, this study last week that was released showed a group that was “literate” in healthcare?  I just wonder where the found those folks?

Trizetto Group (Wholly Owned Subsidiary of Apax Partners London Based Private Equity Firm) Says Their Study Indicates the US Healthcare System is Ready to Adopt Value Based Insurance Designs – Marketing At Its Best

A big part of the problem here is the “non participants” that create our laws, as if they participated and “shared” valuable information themselves, we would not need half the studies we do as they “would get it”, and that is the reason surveys and studies are done anyway, to find out who doesn’t get it when people are not participants themselves.  According to research from the U.S. Department of Education, only 12 percent of English-speaking adults in the United States have proficient health literacy skills.

HHS National Plan to Improve Health Literacy – Not Going To Happen Until We Focus on Using Technology (The Tool for Literacy) Which Includes Role Models at HHS And Other Places in Government

Long and short of all of this is that we have government officials that live in “tech denial” and don’t participate, so we get “Magpie” healthcare, repeating the same things over and over with no real results and little progress.  Public officials take notice, your lack of computer literacy is showing big time today and you can definitely fix that if you want things to move along faster and be the role models everyone is looking for out there and not the magpies. 

It’s vastly becoming a learn and help yourself world out there so directing consumers in the right direction is important as we are finding out even our leaders don’t have time to deal with it either.  Most providers certainly don’t have the time today either other than to send the patient in a direction whereby they can locate information with a schedule that sees a patient every 15 minutes.  BD   

When it comes to understanding medical information, even the most sophisticated patient may not be smarter than a fifth grader.

Even if a patients is able to understand sophisticated medical lingo, Mr. Sousa says, "most [medical] providers are too busy to take the time to sit down and explain the risks and benefits and potential complications, so we have to try and make patients better understand what they are consenting to."

Nearly nine out of 10 adults have difficulty following routine medical advice, largely because it's often incomprehensible to average people, the Centers for Disease Control and Prevention says. And that's bad for health care: Confused by scientific jargon, doctors' instructions and complex medical phrases, patients are more likely to skip necessary medical tests or fail to properly take their medications, the agency says. Studies show that poor health literacy drives up costs to the health-care system and worsens patient outcomes.

And some health insurers, doctors' practices and hospitals have begun using specialized software that scans documents looking for hard-to-understand words and phrases and suggests plain-English replacements. A patient-consent form warning of hyperpyrexia after a procedure, for example, might be translated to an abnormally high fever.

"People who have only limited ability to understand their choices in health care are more likely to have serious health problems and more likely to have their treatment delayed, which leads to higher costs," says Sara Rosenbaum, chair of the department of health policy at the George Washington University Medical Center, who participated in the study with the University of Connecticut.

Taking Medical Jargon Out of Doctors' Visits - WSJ.com

Technorati Tags: health literacy, particiaption, non participants, Congress, providers, health insurance, healthcare reform, surverys, patients