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Medical students urge Congress to preserve GME
Hans T. Zuckerman, a third-year medical student at the Philadelphia College of Osteopathic Medicine, painted a grim picture of what may await future students like him if federal support for graduate medical education either is reduced or not expanded. “In the next couple of years, they’re projecting that there may not be enough slots for all the students graduating from medical school to get into a residency,” said Zuckerman, who was one of about 300 medical students from around the country who participated in the American Medical Association’s student advocacy day on Feb. 11. The medical students met with members of Congress during the event to urge lawmakers to preserve Medicare funding for residencies and take additional steps to boost the number of Medicare-supported residency positions. Graduate medical education funds often have been the target for cuts during congressional budget negotiations. There’s concern throughout organized medicine that talks regarding the [Read more]
Summit focuses on alternatives to Medicare pay system
The Medicare program cannot move forward without a plan to change its payment structure to a higher-performing system, physicians and analysts said during a recent policy summit underwritten by the American Medical Association. There has been little movement to transition the program’s payment system away from fee for service and a seemingly endless cycle of pay cuts threatened by the sustainable growth rate formula. Health policy analysts and industry leaders discussed issues preventing reforms to how Medicare doctors are paid and offered insight on what action is needed to bring innovation to the system during the Jan. 29 event, hosted by National Journal. New efforts to change Medicare will not proceed until the hurdle of the Medicare SGR formula is cleared, said AMA Executive Vice President and CEO James L. Madara, MD. The AMA has drafted a framework for a transition plan that starts with eliminating the SGR. The formula is a problem that has lingered for far too long and p [Read more]
Hospitals promote economic role amid talk of federal cuts
As Congress debates ways to cut health care spending, the American Hospital Assn. wants to remind it of the contributions the health care industry, particularly hospitals, makes to the economy and how any threat to the access of health services would have a negative impact on the nation’s financial stability. In a report issued in January, the AHA said the importance of hospitals extends far beyond health care. Hospitals are job creators, the organization said, employing nearly 5.5 million people and generating $2 trillion in annual economic activity, according to the AHA. “The economic contribution of hospitals … is often critical to communities,” the AHA said in a statement. The report said that even during a slow economy, health care continued to add jobs. In 2012, an average of 28,000 jobs per month were added, and the “ripple effect” of hospitals helped support 9.9 million jobs outside of health care, according to the report. The AHA also said its members h [Read more]
Patient respect drops when doctors diagnose with computer
Patients understand that sometimes physicians need help in making a diagnosis, but more evidence suggests that they are less comfortable when that advice comes from a computer. Previous research has found that the use of clinical decision support seems to turn off patients, who grade doctors seeking such computer assistance about 10% lower than physicians who make a diagnosis without electronic aid. Findings published in January demonstrate that it is not merely doctors’ asking for outside help that it is troublesome, but something about the computer interaction that is turning them off. The results are especially surprising, because the research was conducted among college-age students who grew up with technology. Researchers surveyed 543 college students and provided them with three episode-of-care vignettes in which they visited a physician. Everything about the care provided was the same except how the doctor reached the diagnosis: unaided, with the EHR’s help, or consult [Read more]
Health care trends most likely to pressure physicians
PwC’s annual “Top Health Industry Issue” report predicts that the pace of health care transformation will increase in 2013 because of technology, budget pressures and the Affordable Care Act. But an overarching theme in many of the trends is the role of the patient and how consumerism is expected to drive the way health care is delivered, especially in the primary care setting. “The days of a very transactional approach to health care … is getting some pushback from consumers,” said Warren Skea, director in PwC Health Industries Advisory. Consumers are more informed and are demanding from health care the service they can expect in other areas, such as retail. Keeping patients happy will not only help patient satisfaction and retention, it also will help physicians’ pay, Skea said. More payment models are tying patient satisfaction to payment, he said. In addition, population health models will rely on good relationships between physicians and patients and prompt [Read more]
White House to safeguard Medicaid in budget talks
The Obama administration plans to use the health system reform law’s Medicaid expansion provision as a shield against funding reductions to the rest of the program. At a Jan. 31 health policy conference, a top White House official announced that the administration would reject cuts to the Medicaid program during deficit reduction negotiations because “the world has changed and, because of that, our policies are being affected.” Republican lawmakers have been eyeing significant cuts to entitlement programs as one of several mechanisms to reduce federal deficits, said Gene Sperling, director of the White House National Economic Council, who spoke during a conference hosted by advocacy group Families USA in Washington. Such reductions have included $830 billion in proposed reductions to Medicaid, or a third of its budget, he said. Sen. Orrin Hatch of Utah, the ranking Republican on the Senate Finance Committee, has cautioned that Medicaid and Medicare reforms need to be an [Read more]
Quality demo cuts repeat hospital Medicare trips by nearly 6%
A Medicare test project that emphasized care coordination to keep patients from going back to the hospital scored lower readmission rates compared with similar regions without such a program in place. A study on the Medicare quality improvement organization pilot in the Jan. 23/30 Journal of the American Medical Association reported that 30-day readmission rates in 14 communities were reduced by 5.7% over two years beginning in 2008. In an average locale serving 50,000 Medicare beneficiaries, the care coordination model would cost $1 million a year but also save $4 million by preventing return trips to hospitals, said lead author Jane Brock, MD, MSPH. “When you have a bunch of providers trying to function in concert on behalf of the population they already mutually serve, we think that’s the key intervention that explains our success,” said Dr. Brock, who is chief medical officer for the Colorado Foundation for Medical Care. Following the success during the trial period, [Read more]
Quality of e-visits not yet equal to office visits
Research that compares care given through virtual visits with care given in person at a physician’s office rebuts some of the concerns physicians have about e-visits while supporting other worries, says a Jan. 14 study in JAMA Internal Medicine, formerly Archives of Internal Medicine. Study co-author Ateev Mehrotra, MD, assistant professor at the University of Pittsburgh School of Medicine and policy analyst for the RAND Corp., said patients have sought care from places such as retail clinics and emergency departments because they were able to access them immediately, without the wait they would have faced at a primary care physician’s office. Although tele-health has been considered as an option to get those patients back, “the concern I always hear from my physician colleagues about these electronic visits is, ‘Can you really do this? Can you really accurately diagnose someone using these tele-medicine options?’ ” Dr. Mehrotra said the study provides mixed evidence [Read more]
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