Posts Tagged ‘Healthcare’

FCC Is Connecting Healthcare Providers With Remote Patients Via Computer

Wednesday, September 1st, 2010

National Broadband Plan expands telemedicine to patients who live in rural areas.  Access to healthcare isn’t always convenient for Americans who live in remote rural areas.  To fill the void, high-speed internet connections are being put into place to bring top-quality healthcare to patients via computer. The Federal Communications Commission (FCC) has pledged $400 million a year to connect approximately 10,000 rural healthcare providers under its National Broadband Plan.

A case in point is Redway, CA - a town of 1,200 located 200 miles north of San Francisco - whose Redwoods Rural Health Center and Dr. Wendi Joiner serve 4,000 patients, many of whom do not live within easy driving distance of the clinic.  According to Dr. Joiner, “It’s a special challenge.  I love it, but sometimes I feel like there should be two or three of me.  It happens a lot where we’re asked to do things that we’re not specialists in.”

The FCC’s rural telemedicine plan will make it easier for rural people to access healthcare, according to chairman, Julius Genachowski.  “If you have rural connectivity for healthcare, then patients don’t have to drive two or three or four hours for their treatments - instead, (they) can stay back where they live, consult with a medical professional remotely.”  The FCC’s pilot program has been successful and expanded the reach of the University of California, Davis Medical Center’s telemedicine clinic.

According to Dr. Tom Nesbitt, who heads the UC Davis rural program, his hospital serves 3,000 patients annually who live in remote locations.  “The demand would even be greater if the remote locations had equipment, bandwidth and training.”  The money to make this possible is already available through the Universal Service Fund, which brings telephone service to rural areas.  Genachowski is transferring the money to broadband to improve the availability of healthcare in remote locations.  “One of the greatest forms of savings will come from healthcare spending that we don’t have to make because we catch problems earlier.  We can treat and diagnose remotely,” he said.

Providers Will Be Held to Strict Standards on Electronic Health Records

Thursday, August 5th, 2010

HHS will allow hospitals to adopt electronic health records in multiple stages.  David Blumenthal, the Obama administration’s health information technology czar, recently told a House subcommittee that providers will be held to stricter standards over the adoption and use of electronic health records (EHR).   “We have every intent in the next rule-making, in 2013, to require much more robust exchange as a feature of meaningful use,” Blumenthal, the Department of Health and Human Services (HHS) national coordinator for health IT, said while testifying before a House Ways and Means Committee’s health subcommittee.

According to Blumenthal, the meaningful-use criteria allow providers to adopt EHR in multiple stages.  Each step is increasingly demanding.  “The fact is, we are going to make substantially higher demands of providers in the future,” Blumenthal said.  Representative Wally Herger (R-CA) said “The new HIT regulations are a step in the right direction and should put Medicare on a path to improved quality and efficiency.  However, by watering down the final regulations, we have missed an opportunity to advance healthcare delivery and ensure wise use of taxpayer money.”

Global Healthcare Spending Growing Faster Than GDPs

Tuesday, July 13th, 2010

Blame the Great Recession for sharp increases in the ratio of healthcare spending to GDP.  Real annual per-capita health spending climbed 4.2 percent between 2000 and 2008 in Organization for Economic Cooperation and Development (OECD) countries, according to a new study.  Not surprisingly, the United States led the pack of 31 nations with healthcare spending as a proportion of GDP rising by 16 percent.  Next in line were France (11.2 percent); Switzerland (10.7 percent); Austria (10.5 percent); and Germany (10.5 percent).  Healthcare spending in the United States was $7,538 person.  Compare that to $5,003 in Norway; $4,627 in Switzerland; $4,210 in Luxembourg; and $4,079 in Canada.

According to the OECD, healthcare spending is rising faster than economic growth.  The average ratio of healthcare spending to GDP rose from 7.8 percent in 2000 to nine percent in 2008.  Technological changes, an aging population and high expectations are among the factors driving up costs, a situation that is unlikely to change in the near future.  The Great Recession also led to increases in the ratio of healthcare spending to GDP in several countries.  Ireland, for example, saw an increase from 7.5 percent in 2007 to 8.7 percent in 2008, while it rose from 8.4 percent to nine percent in Spain.

Government pays for healthcare coverage in the majority of OECD nations.  As a result, government spending on healthcare rose from an average of 12 percent in 1990 to 16 percent in 2008.  As a result, nations currently under pressure to reduce budget deficits have some difficult decisions to make to sustain their healthcare systems.  The options are to cut the growth of public spending on healthcare, cutting other expenditures, or raising taxes.

2008 Healthcare Spending Experiences Slowest Growth Rate in 48 Years

Tuesday, February 2nd, 2010

Americans spent an average of $7,681 per person on healthcare during 2008, just a 3.5 percent rise over the previous year - the slowest growth rate in 48 years.  According to a report issued by the Department of Health and Human Services, healthcare spending totaled $2.3 trillion in 2008 and accounted for 16.2 percent of the GDP.Healthcare spending rose just 3.5 percent in 2008.

The culprit is the recession, which achieved what a generation of public officials attempted without success.  Federal officials said the slowdown in health spending resulted from the soft economy, people delaying elective procedures, for example, and did not cite any factors that will alter the long-term outlook for continued increases as baby boomers age and physicians rely more on new technologies to treat patients.

According to Micah Hartman, a government statistician who contributed to the report, federal spending for health services and supplies grew 10.4 percent in 2008 and equaled 36 percent of federal receipts, up from 28 percent in 2007.  “In 2008, federal Medicaid spending increased 8.4 percent - the highest rate of growth since 2003 - while state spending declined by 0.1 percent, the first decline in these expenditures in program history,” Hartman said.  “Spending for healthcare by private businesses grew just 1.2 percent in 2008, in part because of a drop in the proportion of employer-sponsored insurance paid by employers.  Private business’ health spending remained relatively flat as a share of compensation at 7.9 percent.”

In other findings, the report noted that “private health insurance premiums and benefits grew in 2008 at their slowest rate since 1967, 3.1 percent and 3.9 percent respectively.”  The slowdown reflects a drop in the number of Americans with private health insurance.  That fell to 195.4 million in 2008, compared with 196.4 percent in 2007.

New York Senator Charles Schumer Rejects Healthcare Reform Failure

Thursday, December 10th, 2009

Declaring that “failure is not an option” on healthcare reform, Senator Charles Schumer (D-NY)  said that the legislation will be passed with or without Republican support. “We’re not going to not pass a bill,” Schumer said, pointing to a healthcare system that is broken because some 47 million Americans lack any kind of insurance coverage.

Before this can happen, Senate Majority Leader Harry Reid (D-NV) has the task of resolving issues within his own party regarding abortion, taxes and allowing the government to sell health insurance in competition with private insurers.  Democratic leaders are working to persuade Senator Olympia Snow (R-ME) to cross party lines and vote in favor of the ultimate bill, even though she sided with her fellow Republicans on the recent procedural vote to move the debate to the full Senate floor.

Both the Senate and House of Representatives bills require all Americans to have healthcare insurance, and plan to make government subsidies available to help pay premiums.  Insurance companies would be banned from denying coverage or charging extra for individuals with pre-existing conditions.  New insurance marketplaces would be created for those Americans who have difficulty finding affordable coverage - such as the self-employed and those who own small businesses.  Americans who currently have employer-provided coverage won’t see any big changes in their coverage.  Senior citizens will see improvement in their prescription coverage.

As for paying for these bills?  The House bill depends primarily on an income tax hike on upper-income individuals.  The Senate bill would tax Cadillac insurance plans, increase the Medicare payroll tax for the wealthy and mandate fees on medical industries.

A Tale of Two Samaritans

Tuesday, November 3rd, 2009

Two health plans - both called Samaritan - offer interesting alternatives to traditional health plans.

samaritan-health-planOne is Samaritan Health Plans (SHP), a private healthcare initiative, that could serve as a model to assure community-based coverage for all.  Licensed by the state of Oregon, SHP is a fiscally and socially responsible healthcare service contractor that creates value through comprehensive managed care for Medicare Advantage beneficiaries and the public.  A division of Samaritan Health Services, SHP serves more than 25,000 residents of Linn, Benton and Lincoln Counties in the Mid-Willamette Valley and along the Central Oregon coast.  Contrary to most managed-care programs - which are accountable to shareholders - Corvallis-based SHP reports only to a board of directors whose members come from the communities it serves.

The second is Samaritan Ministries, a Peoria, IL-based faith-based alternative to health insurance where Evangelical Christians join together to pick up the cost of each other’s significant medical bills. Participants pay a regular monthly premium, with the money going to pay for other members’ healthcare.  To be eligible for membership, people must be church-going evangelicals who promise not to smoke, drink heavily or have sex outside of marriage.Samaritan Ministries

Because the plan is not technically insurance, it lacks government oversight.  According to Michael Mcraith, director of the Illinois Department of Insurance, “These are companies run on a cash flow basis so that claims are paid on available cash, not based on any contractual obligation.  When you are paying for these programs, there are no guarantees that a claim will be paid.  There is no certainty or protection for the consumer.  Faith alone will not solve the problem.”

Physicians Line Up To Support A Public Option

Monday, September 21st, 2009

A random survey of 2,130 physicians found that 73 percent support a public option as one element of healthcare reform legislation.  That breaks down to 63 percent of physicians supporting both public and private options; 10 percent supporting a public option only; and 27 percent favoring private options only.  The poll was conducted by New York’s Mount Sinai School of Medicine internists and researchers Dr. Salomeh Keyhani and Dr. Alex Federman.nmrally20in20support20of20public20option20and20bingaman20july2015

The majority of physicians who favor giving their patients a choice of public or private insurance are in tune with President Barack Obama’s position and that of many congressional Democrats.  Polls of average Americans have found that between 50 and 70 percent support a public option.  In other words, physicians support the public option more strongly than the general population.  This contradicts one of the canards of the healthcare debate - that doctors will resist reform for fear of seeing their incomes erode.

“Whether they lived in southern regions of the United States or traditionally liberal parts of the country, we found that physicians - whether they were salaried or they were practice owners, regardless of whether they were specialists of primary care providers, regardless of where they lived - the support for the public option was broad and widespread,” Dr. Keyhani said.

The survey was published Monday, September 14, in the online New England Journal of Medicine. It was funded by the Robert Wood Johnson Foundation, a healthcare research organization that supports reform legislation.

We All Need a Chief Wellness Officer

Thursday, September 17th, 2009

The prestigious Cleveland Clinic has taken a proactive stance on preventative healthcare by creating a Chief Wellness Officer position and putting Dr. Michael Roizen in the job.  Dr. Roizen is well known for his appearances on the “Oprah” show and as the co-author of health and lifestyle books with Dr. Mehmet Oz.  His impressive resume lists the position as the past chair of the Food and Drug Administration’s advisory committee.

small_clevelandmag_docsDr. Roizen has taken on the cause of preventive wellness through the Cleveland Clinic’s Lifestyle 180 program. Lifestyle 180 provides patients with chronic diseases with a proactive approach to improving their health.  Patients are closely monitored and coached to improve their health and well-being through diet, exercise and stress management.  Interestingly, the program has a dedicated space in an old corporate headquarters building  in Lyndhurst, OH.

By all indications, Lifestyle 180 appears to be an excellent approach to educating patients so they can attain improved health.  This raises a question.  Once patients complete the program, where do they go to maintain and continue to put into action the valuable information and lifestyle tools they have received?  Although patients are encouraged to come in for follow-up appointments - which are important - where do they go?

This is exactly where a medically based wellness and fitness center fills this void.  Patients need a comfortable, unintimidating medically directed facility that provides them with the information, tools and resources they need to continue their journey to improved health.

We all could use a chief wellness officer to pave the way to improved health, no question.  We also need a medically directed facility to put into action and maintain the life lessons that we have learned.  Kudos to the Cleveland Clinic for recognizing the need to improve health through comprehensive wellness strategies.  Now, let’s take it a step further and apply this proactive strategy to a comprehensive medically directed wellness and fitness center so we can live this healthy lifestyle forever.

Insurer Preauthorization Doesn’t Guarantee Payment for $148,000 Back Surgery

Thursday, September 10th, 2009

balancing-a-checkbook-paying-billsHere’s a story that illustrates one way that our healthcare delivery system is broken.  Michael Napientek has been through healthcare insurance hell - and survived the ordeal. Last fall, the doorman underwent back surgery after obtaining a preauthorization number for payment from his insurance company.  Napientek’s health insurance is provided by his wife Sandie’s employer, Accelerated Health Systems.  The policy is a self-insured plan funded by Accelerated Health Systems, and which is administered by Wausau, WI-based UMR, a UnitedHealthcare subsidiary.

Imagine the Napienteks’ surprise when bills totaling $148,000 started appearing in their mailbox.  The insurer was refusing to pay for the surgery, even though it had preauthorized the procedure.  Three appeals against the claim were denied on the grounds that Napientek had not exhausted all means of pain relief.  Sandie Napientek complained to a UMR representative and was told that preauthorization did not guarantee payment because they had not provided documents that proved the “appropriateness” of the surgery.

Frustrated, the Napienteks turned to the Chicago Tribune’s “What’s Your Problem?” columnist Jon Yates to see if he could intervene.  Yates contacted UMR, who referred him to United Healthcare.  The Napienteks’ next communication from UMR was a letter saying it would pay the entire $148,000.  According to the letter, UMR changed its mind “based on additional information submitted and the opinion of an independent physician.”

This story represents a classic example of an insurance company bureaucrat standing between the patient and his physician - after preapproved surgery had been performed.

Wanda Jones: Time to Reinvent Hospitals and Medical Office Buildings

Wednesday, September 9th, 2009

great_ormond_st_readyHospitals and medical office buildings must undergo a complete rethinking to move them functionally and architecturally from the 1970s to models that make sense for the 21st-century.  Wanda Jones, healthcare futurist and president of the New Century Healthcare Institute, believes that we need to reinvent hospital design and construct linear-spine facilities that provide patients with more personalized medicine.  This anticipates expansions, contractions, removal and replacement of patient towers by dividing the number of patient beds into two, three or four towers.  This way, they can be incrementally changed without interrupting the others and are readily adaptable to specific programs.

In a recent interview for the Alter+Care Podcasts on Healthcare, Wanda Jones discusses the paradigm shift in terms of new technologies that will make obsolete the knowledge base on which healthcare systems, hospitals and physicians have made money up until now.  Every surgical specialty will use robotics, and cures for cancer will be based on technology that has arisen out of the human genome project.  The New Century Healthcare Institute is a research-and-development and educational foundation devoted to population-based planning and adaptation of the healthcare system to future conditions.

 
icon for podpress  Wanda Jones on Revolution in Hospital and Office Design: Play Now | Play in Popup | Download