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WellPoint expands telemedicine opportunities for doctors
WellPoint is offering some physicians the chance to be paid, without having to submit claims, for evaluations when on call. Software provided by the health plan would allow them to see patients on online video. The program, made available through a website called LiveHealth Online, is an extension of a previously announced plan that would allow WellPoint members to have online video consultations with any physician in their state who is contracted by the health insurer. The company said the program would be launched in California and Ohio over the first half of 2013 and would be expanded to other states later. Physicians would be hooked up to the system for free, and would be paid an unspecified fee for each visit. But they would be required to pay an undisclosed licensing fee to do online video consults with established patients. WellPoint would pay doctors for each consult, with the claim automatically generated through LiveHealth Online. The patient fee would be based on an [Read more]
ACA multistate plans must not fly under regulatory radar, AMA says
To protect physicians and patients, multi-state plans offered on upcoming health insurance exchanges should be held to the same regulatory standards as other private insurance offerings, the American Medical Association wrote in a Jan. 4 comment letter to the U.S. Office of Personnel Management. The Multi-State Plan program was established by the Affordable Care Act to promote competition and encourage the availability of high-quality, affordable products in the insurance exchange marketplaces. At least two multi-state plans, one of which should be from a nonprofit insurer, must be offered on the exchanges starting in 2014. Such plans would be able to offer insurance to small businesses that operate in — or families that reside in — more than one state. In November 2012, the Office of Personnel Management issued a proposed rule establishing standards for these multi-state plans and sought public comment from stakeholders. In the AMA’s letter, Executive Vice President and [Read more]
IOM stresses: Vaccine schedule for children is safe
A new Institute of Medicine report confirms what many primary care physicians have been telling parents for years — it’s safe to follow the recommended childhood immunization schedule. Under the schedule, children receive as many as 24 vaccines by their second birthday and get up to five injections during a single doctor’s visit, the IOM said. The immunizations are timed to protect children from 14 pathogens by inoculating them at a point in their lives when they are most vulnerable to disease, according to the IOM. But some parents worry that administering the immunizations in such a short period could cause negative health effects in their children. The IOM report, issued Jan. 16, said there is no evidence that the schedule, recommended by the Centers for Disease Control and Prevention, is unsafe. “The evidence repeatedly points to the health benefits of the recommended schedule, including protecting children and communities from serious and life-threatening disea [Read more]
Death certificates present final medical complication
Death certificates are vital documents that serve as the primary source of information for families, insurance companies and authorities about a patient’s cause of death. The information also helps policymakers set public health goals and research funding priorities. But signing a death certificate is not always a straightforward process. Physicians often face uncertainties about an individual’s cause of death or how to answer the portions of certificates they are responsible for. Although the basic format has changed little in the last few decades, doctors face difficulties as some states attempt to convert from paper to electronic certificates. Doctors need to recognize the importance of the documents and be as specific as possible, said Gregory McDonald, DO, chief deputy coroner of Montgomery County in Pennsylvania. Information on death certificates is reported to the CDC and used in compiling national mortality data. “Their duty doesn’t end when the patient die [Read more]
Unresolved liability suits cast long shadow over physicians
The average physician spends nearly 11% of his or her career with an unresolved medical liability claim, says a study in the January Health Affairs. Speciality plays a significant role in how long a claim remains open, according to the study, which examined claims data for about 40,000 physicians covered by an unidentified national insurer. Neurosurgeons spent 27% of their careers with an open claim — the longest of the specialties studied. Psychiatrists had the shortest span — 3% of their careers with an unresolved claim. Internists had an open claim for 10% of their career, while family/general physicians had one for 8%. A doctor’s average career is 40 years. The findings are unfortunate, considering that the majority of medical liability claims end in favor of physicians, said Richard E. Anderson, MD, chair and CEO of The Doctors Company, a physician-owned liability insurer in Napa, Calif. “It is a national disgrace that physicians must bear the enormous cost [Read more]
RAND points fingers after health IT predictions fizzle
Researchers at the RAND Corp. say their 2005 prediction that health information technology could save the U.S. more than $81 billion annually has not come to pass. But the organization isn’t placing the blame on itself for its inaccurate prognostication. Instead, in a report in the January Health Affairs, researchers from the policy think tank placed the blame on “shortcomings in the design and implementation of health IT systems”. They blamed vendors for creating systems that are difficult to use and can’t connect with other electronic health records, echoing physician complaints about them. However, the researchers also said doctors and hospitals have not invested the “considerable” time and effort necessary to learn how to use the systems, and adapt their workflow to ensure that technology is smoothing processes, not hindering them. While various studies show some “marginal” success by health IT in increasing quality and efficiency of patient care, and while [Read more]
Economists outline strategy to counter primary care shortage
Greater use of several physician practice reform strategies that are growing in popularity could help stem the primary care physician shortage, according to a study in the January Health Affairs. Using simulation methods to estimate the projected need for primary care doctors, researchers from the Columbia Business School in New York and the University of Pennsylvania’s Wharton School in Philadelphia highlighted various operational changes that are becoming more widely adopted. These include the use of health care teams, more reliance on non-physicians and improved information technology methods. Taken together, they could help to eliminate shortages by increasing access to care, the study suggests. Primary care teams, for example, are in sync with the objectives of patient-centered medical homes, which aim to boost access, the study said. The researchers cited Geisinger Health System’s “shared practice” approach, which is part of the health system’s medical home model, [Read more]
Keys to drug compliance may be trust and pill shape
Patients who give their physicians low grades are likelier to have lapses in drug adherence, said a study of nearly 10,000 Northern California patients with diabetes. Thirty-nine percent of patients who said they never or only sometimes have confidence in their primary care physicians skipped their cardio-metabolic medicines at least 20% of the time, the study said. That is a non-adherence rate 11 percentage points higher than for patients who said they usually or always trust their doctors. Similar drug compliance gaps were found for patients who said their doctors did not involve them in decisions or understand their problems with treatment, or put the patient’s needs first, said the study. The findings shed light on the critical role the patient-physician relationship plays in achieving the optimal drug compliance essential to attaining treatment goals, said Neda Ratanawongsa, MD, MPH, lead author of the study, which was published online Dec. 31, 2012, in Archives of Inte [Read more]
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