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Helpful information on the world of beauty and aesthetics supplies.
Humana reveals to investors how it pays physicians
As part of what Humana CEO Michael McCallister described as his company’s plans to push an integrated care delivery model “as far and as fast as we can take it,” the insurer said it wanted to satisfy investors by showing its progress in some way. Starting with its fourth-quarter 2012 earnings report delivered Feb. 4, Humana listed for investors the breakdown of how it pays its 180,000 contracted and employed “primary care providers,” including physicians. In its report, the Louisville, Ky.-based health insurer broke down its primary care population by the number of doctors paid by capitation, those who are paid by capitation but have no downside risk, and those paid by traditional forms of payment, such as fee for service. Regina Nethery, Humana’s vice president of investor relations, said the decision was made to share the data with investors because the company is still fairly new in its efforts to implement an integrated care delivery model that includes putting mo [Read more]
Toolkit offers new ideas for preventing hospital falls
Integrating fall-prevention protocols into scheduled rounds, grouping cognitively impaired patients into so-called safety zones and doing post-fall assessments are some new strategies to reduce the number of falls for hospital patients. The ideas are part of a recently released Agency for Healthcare Research and Quality toolkit aimed at cutting the estimated 700,000 patient falls that happen in hospitals each year. Since 2008, the Centers for Medicare & Medicaid Services has denied hospitals payment for complications due to a fall or trauma in the hospital that results in fractures, burns or other serious injuries. Despite the financial incentive, progress in preventing falls has not been easy, experts say. Setting a goal of zero falls is probably unrealistic, they added, given that hospitalized patients often need treatments that may make them unstable on their feet, and yet they need to be mobile to prevent bed-rest complications such as de-conditioning, pressure ulcers, aspiratio [Read more]
Ways EHRs can lead to unintended safety problems
In spring 2012, a surgeon tried to electronically access a patient’s radiology study in the operating room but the computer would show only a blue screen. The patient’s time under anesthesia was extended while OR staff struggled to get the display to function properly. That is just one example of 171 health information technology-related problems reported during a nine-week period to the ECRI Institute PSO, a patient safety organization in Plymouth Meeting, Pa., that works with health systems and hospital associations in Kentucky, Michigan, Ohio, Tennessee and elsewhere to analyze and prevent adverse events. Eight of the incidents reported involved patient harm, and three may have contributed to patient deaths, said the institute’s 48-page report, first made privately available to the PSO’s members and partners in December 2012. The report, shared with American Medical News in February, highlights how the health IT systems meant to make care safer and more efficient can s [Read more]
State forgoes federal funds to go its own way on Medicaid expansion
Wisconsin’s Republican governor wants to expand Medicaid to some of the poorest adults in the state while placing others on the state’s health insurance exchange, but he’s not going to get enhanced federal matching dollars to do so. The Affordable Care Act gives states the option to expand their Medicaid programs to everyone up to 133% of poverty (an effective rate of 138% when certain income is discounted from consideration) starting in 2014. Although some Republican governors — such as Nevada’s Brian Sandoval and Arizona’s Jan Brewer — decided to take up this provision after initial resistance, GOP holdouts remain, including Wisconsin Gov. Scott Walker. Walker has rejected the idea of fully expanding Medicaid under the ACA. Instead, his upcoming budget proposal outlines a plan for Medicaid to cover non-disabled, non-elderly adults up to 100% of poverty. As part of the proposal, Walker would lift a 2009 enrollment cap on the BadgerCare Plus Core program, which cove [Read more]
Has mobile health monitoring hit a wall?
The number of technical tools available to help patients live healthy lifestyles or control chronic health conditions has grown considerably during the past few years. But the percentage of patients who use some form of technology, such as mobile apps, to track health indicators has remained virtually unchanged for three years. The Pew Internet & American Life Project published a report Jan. 28 that found 69% of U.S. adults track at least one health indicator such as diet, exercise or weight. The survey of 3,014 adults conducted between Aug. 7 and Sept. 6, 2012, found that 49% monitor their progress in their heads, 34% track the information on paper, and 21% utilize some form of technology, including mobile apps, which 7% use. The results mirror findings from a Pew survey in 2010. “As a tech industry thought leader, I’m disappointed when I see a survey like that,” said Bill Crounse, MD, senior director of worldwide health at Microsoft Corp. “But as somebody who has served [Read more]
Health plans add financial motivation to wellness programs
As the insurance industry continues to expand wellness programs, it is taking on care-giving roles that health plans believe are meant to complement and not compete with doctors’ efforts. “As a health plan, we don’t want to insert ourselves in the middle of the doctor-patient relationship,” said Cigna spokesman Joe Mondy. “Instead, our role is to support both the doctor and patient with the great health care challenge of the 21st century — helping individuals change unhealthy behaviors and make health a fun and interesting part of everyday life.” Cigna recently developed a wellness info-graphic website that helps members understand what health system reform means to them with a personalized survey. The survey asks members for general demographic and insurance information before telling them how heath reform will affect them specifically. Consultants say they understand doctors’ skepticism, given ongoing battles over coverage, about health plans’ sincerity in [Read more]
Harm of hospital “July effect” further cast into doubt
The country is deep in winter, but attention again is returning to that summertime phenomenon dubbed “the July effect.” That’s the name given to a supposed spike in medical mistakes and poor patient outcomes at teaching hospitals during the seventh month of the year, when newly minted MDs start providing care. Numerous studies have reached conflicting conclusions about the extent of the July effect and whether it even exists. A massive study of spinal surgery outcomes published Jan. 29 online further complicates the picture, finding that patients going under the knife at teaching hospitals in July largely fare just as well as their counterparts during the rest of the year but do slightly worse on a couple of metrics. Researchers examined nearly 1 million spinal procedures between 2001 and 2008, and found that patients who underwent surgery in July had similar rates of in-hospital mortality, adverse reactions to implanted devices and wounds reopening post-operatively. Howeve [Read more]
Medicaid-eligible but not enrolled? ACA a likely stimulus
Near-nudity may not be an obvious strategy to get people insured, but one county agency in California has employed this very approach to grab the attention of people eligible for Medi-Cal, the state’s Medicaid program. The ad campaign shows families minimally dressed and holding up signs urging people to get health insurance. “Our message is that you wouldn’t let your family go without clothes — why let them go without health coverage?” said Lori A. Cox, director of the Alameda County Social Services Agency. County officials estimate that there are thousands of residents eligible for the state’s Medicaid program but not enrolled, including about 15,000 children. The agency also has set up a phone number to provide information about Medi-Cal eligibility, and those interested in applying may do so online. Alameda’s “Cover Your Family” strategy caught the attention of Diane Rowland, executive director of the Kaiser Commission on Medicaid and the Uninsured. At a [Read more]
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