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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 ...

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 ...

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 ...