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Clinical integration model gets FTC green light
An advisory opinion by the Federal Trade Commission giving the go-ahead to an Oklahoma physician-hospital organization is an encouraging development to physicians looking to join clinical integration health care models, legal observers said. In a Feb. 13 opinion, the FTC's Bureau of Competition said it had no intention of challenging the proposed formation or operation of the Norman (Okla.) Physician Hospital Organization, a partnership between the Norman Regional Health System and the Norman Physicians Assn. FTC staff concluded the network's proposed activities, which include potential pricing agreements, “appear unlikely to unreasonably restrain trade.” The opinion is significant because it is the first FTC ruling about such a network since the enactment of the health system reform law, said Peter A. Pavarini, an Ohio attorney and president-elect of the American Health Lawyers Assn. PHOs are legal or informal organizations that in general form a bond between hospitals and t [Read more]
Primary care still waiting on ACA Medicaid pay raise
Primary care physicians who qualify for higher Medicaid payments under the Affordable Care Act might not see these rate increases as quickly as anticipated this year. The Medicaid program has had a long-standing reputation for paying doctors at rates far below what Medicare pays for the same services. The ACA aimed to address this problem by directing states to bump rates for primary care services provided by primary care doctors up to 100% of Medicare rates for calendar years 2013 and 2014. Because the final rule on the provision was issued in late 2012 with an effective date of Jan. 1, many family doctors were hoping to see an immediate boost in their claims payments. However, “there could be a lag of several months even from now” for the enhanced Medicaid rates to take effect, said Jeffrey Cain, MD, president of the American Academy of Family Physicians. Some physician organizations are concerned that states are missing the opportunity to prop up primary care because they [Read more]
Early alarms sound online when illnesses go viral
As the Centers for Disease Control and Prevention waited for physicians and others to send data on influenza cases, it monitored Google Flu Trends, developed to determine the level of illness based on how often people used the company's search engine to search for flu-related topics. Lynette Brammer, MPH, an epidemiologist with the CDC's influenza division, said Google's flu data, which are supposed to be a real-time measure of flu, followed nearly the same trend as the CDC's figures, normally released one or two weeks after it gets reports on flu cases. Both numbers “went up and went down at the same times,” she said. The promise of Google Flu and other Internet resources, particularly social media sites such as Twitter or other online chatter, has some health experts saying that physicians can use the Web as an early-warning or just-in-time tracking system for outbreaks of not only the flu but also other diseases. By monitoring such sites, physicians could get a sense of [Read more]
Medicaid's mental health emergency
A private psychiatric hospital in Washington says its participation in a new federal demonstration project already is helping alleviate the burden of the most acutely mentally ill on emergency departments in the nation's capital. Since July 2012, the Psychiatric Institute of Washington has stabilized and treated 150 patients with acutely chronic and serious mental health conditions under the Medicaid Emergency Psychiatric Demonstration project. Roughly two-thirds of these patients came from local emergency departments. By responding quickly to their needs, “we have been very helpful to those organizations and helping them unclog their emergency rooms,” said Howard Hoffman, MD, the institute's executive medical director. The hospital stabilizes, evaluates and treats these patients either through therapy or medication, and then provides them with aftercare programs when they're discharged. The type of care provided by the institute is not new. What is new under this demo is tha [Read more]
Mental health minimum benefits bolstered
Doctors navigating their way through the Affordable Care Act's final minimum coverage requirements for 2014 face a complex environment in which more people are obtaining access to mental health care and other services, but doing so through benefits that can vary significantly by insurer and by state. On Feb. 20, the Dept. of Health and Human Services issued a final rule mandating a core package of 10 “essential health benefits” categories that qualified plans on health insurance exchanges — and some plans outside of those marketplaces — will need to cover. Each state has been asked to choose a benchmark plan from a selection of popular existing plans to determine more precisely what benefits must be covered under the categories. Although the affected plans now have a benefits floor that will ensure more uniformity, plans will retain some flexibility, not only in benefits design but also in cost sharing and utilization management, said Sonya Schwartz, program director for [Read more]
2% Medicare pay cut set under sequestration
Deep, across-the-board federal budget cuts officially went live for Medicare and other public health programs after Congress and President Obama failed to reach an agreement on avoiding sequestration before the March 1 deadline. More than $85.4 billion will be cut from the federal budget in 2013. Reductions to Medicare will represent about 12% of the total reductions, or $9.9 billion, in part through lower payments to physicians and other health professionals for providing services. The automatic reductions were written into law in 2011 as part of a deal to raise the nation’s debt ceiling. It was designed to act as a fail-safe mechanism in case lawmakers and the White House were unable to agree on more targeted deficit reduction provisions. Those cuts won’t be evident right away. The reductions in Medicare doctor rates will begin with services provided on or after April 1 even though the sequestration order is issued on March 1, according to the Congressional Budget Office. T [Read more]
Internists call to end “assault” on doctor-patient relationship
Payment and coverage expansion reforms to the health care system won’t succeed unless physician-patient relations can improve, the American College of Physicians concluded in a new policy paper. “Physicians and patients are challenged by seemingly relentless intrusions into their relationship,” said Bob Doherty, ACP’s senior vice president of governmental affairs and public policy. “None of us want our doctors to be rushed from patient to patient, from task to task. If this is the system we have, then the system needs to change.” He spoke during a Feb. 20 conference call to assess the report’s findings. In some respects, it’s the best of times for health care in the U.S., with more people set to obtain coverage starting in 2014 under the Affordable Care Act, Doherty said. However, “resistance in many states to expanding Medicaid and setting up exchanges [is] affecting the poor,” he said. In its paper, the ACP called for a renewed commitment to implement cov [Read more]
Health system brands go national
Some of the biggest brand names in health care delivery are deciding that it’s not enough to be a prestigious place in the distance. Places like Mayo Clinic in Rochester, Minn., Cleveland Clinic and MD Anderson Cancer Center in Houston have established affiliate programs that put their names on systems far afield from their main campuses. Duke University Health System in Durham, N.C., is working with LifePoint Hospitals, a large chain of for-profit community hospitals based in Brentwood, Tenn., to set up joint ventures to buy hospitals. Generally, the prominent organizations are partnering with local institutions that are established, but are often not considered the biggest or most prestigious names in their home area. The motivation by both sides in these deals is stronger branding as a way to increase revenue, marketing experts say. For the name-brand institutions, affiliating with, or buying, a local hospital can formalize existing clinical relationships and allow them to c [Read more]
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