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Medicaid hospital stay rate grows faster than privately insured
The number of hospitalizations paid by Medicaid went up at a faster rate than those covered by private insurance, according to a statistical brief issued Jan. 19 by the Agency for Healthcare Research and Quality. And that was before the full force of the recession had hit. Researchers analyzed data from the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample, which includes information on 95% of hospital discharges. Hospital stays among those with private insurance grew from 13.4 million in 1997 to 14.1 million in 2008, an increase of 5%. The numbers for patients on Medicaid went up by 30%, from 5.6 million to 7.4 million, and hospitalizations among the uninsured expanded 27%, from 1.7 million to 2.1 million. Patients on Medicaid tended to stay in the hospital longer than those on private insurance or without coverage. Medicaid patients had an average length of stay of 4.3 days. The privately insured and uninsured stayed an average of 3.8 days. The report did [Read more]
Senate rejects health reform repeal
Washington -- The Senate, as expected, failed to adopt a House-passed repeal of the national health system reform law on Feb. 2 by a vote of 47-51. Senate Minority Leader Mitch McConnell (R, Ky.) offered the repeal as an amendment to a bill reauthorizing the Federal Aviation Administration. However, the repeal amendment did not receive the 60 votes required under Senate rules to overcome Democratic parliamentary objections based on the repeal's estimated budgetary impact. McConnell said the vote was a chance for Senate Democrats who supported the health reform law last year to reconsider their stance on it. "It's not every day that you can get a second chance on a big decision after you know all the facts." But no Democrats in the upper chamber voted in favor of repeal. Two Democrats were absent for the vote. However, the Senate voted 81-17 on a separate amendment, written by Sen. Debbie Stabenow (D, Mich.), to undo a tax reporting mandate in the health reform statute that man [Read more]
Minnesota insurer unveils doctors' ratings over their objections
Minnesota physicians are fighting an effort by the state's second-largest insurer to assign stars to doctors in its network listings based on quality and efficiency scores on its new Premium Designation program. Medica, based in Minnetonka, Minn., launched its ratings program Jan. 19 as planned, despite a request from the Minnesota Medical Assn. to delay and address what it said were errors and inaccuracies in the program. Medica has 1.6 million members in Minnesota, as well as in North Dakota, South Dakota and Wisconsin. The company said 96% of Minnesota physicians and other health care professionals are in its network. The Medica program uses a modified version of UnitedHealthcare's Premium Designation program, which United spokesman Daryl Richard said the company uses in 138 markets. United, which is based in Minnetonka as well, doesn't sell insurance in Minnesota because state law prohibits for-profit HMOs. Medica contracted with United to rate its network physicians, Medi [Read more]
Michigan health system paying doctors for their advice
Some doctors at a Detroit-area hospital will start being paid for advice on how to improve patient safety and satisfaction, as well as care quality and efficiency. St. John Macomb-Oakland-Hospital, Oakland Center in Madison Heights, Mich., in January signed a two-year management services agreement with the new Oakland Physician Professional Management Group. More than 50 physicians, out of the several hundred on the medical staff, are part of this group. Most are in private practice, and both specialists and primary care physicians are included. Those participating will be paid for their time working on various projects. The hospital sees the agreement as a means of achieving greater alignment with physicians, as well as meeting various quality and outcome goals, such as reducing bedsores and falls. "This is just another way to work with our physicians and to engage our medical staff," said Terry Hamilton, senior vice president of operations with St. John Providence Health Sys [Read more]
Nonprofit hospitals' profits rise amid declining revenues
Nonprofit health care institutions improved their fiscal shape in 2009, according to an annual report issued by Moody's Investors Service. Analysts at the credit ratings service, however, predict that hospital systems won't be able to continue to improve their margins because they are still seeing revenues decline. Their improved margins for 2009 were a result of cost-cutting. "If you don't have revenue growth, it is hard to grow the organization," said Kay Sifferman, vice president and senior credit officer at Moody's in Dallas. The Aug. 25 report, "Not-for-Profit Healthcare Medians for Fiscal Year 2009 Show Improvement Across all Major Ratios and all Ratings Categories," included information gathered from 401 nonprofit hospitals. The report said median operating margins improved from 1.8% in 2008 to 2.3% in 2009. Larger entities fared better than smaller ones. The operating margins of the 50 largest institutions in the survey grew from 2.8% in 2008 to 3.5% in 2009. The op [Read more]
Large-scale adverse events deserve disclosure, study says
Hospitals, physician practices and other health care organizations should disclose adverse events that affect numerous patients, even when most patients may not be harmed, a new study shows. These large-scale adverse events -- usually involving poor infection-control practices or defective equipment -- are ones in which some patients may experience harm while most escape unfavorable consequences, said the study, published Sept. 1 in The New England Journal of Medicine. "We think disclosure should occur in virtually every case," said study lead author Denise M. Dudzinski, PhD, associate professor in the Dept. of Bioethics and Humanities at the University of Washington School of Medicine. "There are some cases in which the risk of harm is higher, and there's a greater obligation to disclose, because of the high likelihood that some patients will need treatment." There also may be "a higher obligation to disclose if the case involved a breakdown that was a deviation from standard [Read more]
20-state health reform lawsuit likely to go forward
A federal judge says he is likely to rule that a 20-state lawsuit against the national health reform has legal grounds to go to trial. Attorneys for the federal government asked U.S. District Judge Roger Vinson of the Northern District of Florida to dismiss a lawsuit filed by a coalition of 20 states. They argued that the lawsuit is premature because states cannot prove they will be harmed by the health reform law's requirement for individuals to have health insurance, which takes effect in 2014. The states' complaint asks the court to block the individual insurance requirement because they argue that Congress does not have the constitutional authority to penalize citizens for not having health insurance. After hearing arguments from both sides on Sept. 14, Vinson said he would rule on the motion to dismiss the lawsuit as soon as Oct. 14, said Ryan Wiggins, spokeswoman for Florida Attorney General Bill McCollum, one of the attorneys arguing the states' case. She said McCollum doe [Read more]
Diet and exercise counseling may help prevent recurrent strokes
Treating patients with metabolic syndrome and counseling them on diet, exercise and weight loss might help prevent a recurrent stroke or a transient ischemic attack, according to new recommendations by the American Heart Assn. and the American Stroke Assn. The secondary stroke prevention guidelines were published online Oct. 21 in the AHA's journal Stroke. The recommendations, updated from 2006, aim to prevent recurrent incidents in stroke survivors and patients who had transient ischemic attacks. Suggestions for metabolic syndrome are among the key updates for primary care physicians, said AHA President Ralph Sacco, MD. Metabolic syndrome is characterized by a group of risk factors, including abdominal obesity, elevated blood pressure and insulin resistance. The syndrome increases patients' risk for vascular disease and affects about half of those who have an ischemic stroke, according to the guidelines. "We want clinicians to begin to recognize [metabolic syndrome], to know [Read more]
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