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Louisiana creates loan program for EHR purchases
Louisiana Gov. Bobby Jindal signed into law a bill that would create a loan program for physicians and hospitals hoping to buy an electronic health record system. The Electronic Health Records Loan Program Act, signed July 9, gives the Louisiana Dept. of Health and Hospitals the authority to apply for $25 million in federal stimulus funds in order to administer loans for EHR purchases. The measure also included $5 million in matching funds from the state, a requirement under the American Recovery and Reinvestment Act. The state will learn later this year if it will get the federal grant. "This is another step in updating and improving Louisiana's health delivery system for all Louisianians," Jindal said in a prepared statement. The measure builds on legislation passed in 2007 that helped seven rural hospitals acquire EHRs. The law also established the Louisiana Rural Health Information Exchange. In 2008, additional funding allowed another seven rural hospitals to become connec [Read more]
Fla. Medicaid reform pilot: More efficiency or less care?
New evaluations of Florida's Medicaid reform program found that it reduced or held spending in check during its first two years. But it's not clear if the program improved efficiency or simply reduced the amount of care provided. Florida is in the middle of a five-year Medicaid pilot project designed to encourage enrollees to take a more active role in their health care and to achieve more predictable cost increases. Qualifying enrollees in five counties are offered a choice of health plans with varying benefits. These plans include HMOs and provider service networks, which are owned by physicians and hospitals. More than 200,000 people had enrolled in pilot plans as of June 1. A series of evaluations have criticized the implementation and structure of the Medicaid pilot. In June, the Florida Office of Program Policy Analysis & Government Accountability -- the Legislature's watchdog agency -- advised lawmakers not to expand the pilot until data demonstrate that it has improved bo [Read more]
Practices see slow progress in instant claims adjudication
Real-time adjudication, which allows a claim to be submitted to an insurer and settled before a patient leaves the office, seems like something physicians, patients and insurers can support. Physicians who use it can shorten the revenue cycle and reduce bad debt. Patients like it because they don't get a surprise bill weeks after receiving care. Even insurers like it, because administrative costs of billing and handling inquiries about claims are reduced. But real-time claims adjudication has barely made an impact. By at least one insurer's reading, fewer than 2% of claims are settled this way. While real-time claims adjudication sounds simple, implementing it can be complicated and can require a physician's office to change how it handles billing and collections. Those submitting claims for real-time adjudication find that in almost half the cases, the claim cannot be processed immediately and is handled later by the insurer. Although this might not require additional work [Read more]
Consumer group that wanted Medicare data launches physician ratings site
The same group that unsuccessfully sued the government for access to raw Medicare claims data for individual physicians has launched a patient ratings site that grades individual physicians and uses methodology that the group's president says he hopes will set physicians' minds at ease. Consumers' Checkbook, a Washington, D.C.-based organization that also rates things like auto repair shops, electricians and movers, in July launched physician ratings for Denver; Memphis, Tenn.; and Kansas City, Mo. Consumers' Checkbook President Robert Krughoff said the effort to see Medicare claims data was totally unrelated to developing the new ratings, and he said the group was interested in offering a ratings site that patients and doctors could trust. "My great hope in this is that doctors will appreciate the rigor of this survey and take this survey seriously," he said. Physicians' scores are based on surveys of patients who have seen the physician in question within the last year, a [Read more]
AHA cautions HUD against tightening hospital financing program
The Dept. of Housing and Urban Development should not up the financial standards that health care institutions need to qualify for Federal Housing Administration Section 242 hospital mortgage insurance, according to a letter issued July 27 by the American Hospital Assn. and co-signed by members of a coalition of national health care associations. "It's a bit backwards. This makes it very difficult for hospitals to avail themselves of the program at the very time when they really need it to lower borrowing costs," said Susan Waltman, executive vice president and general counsel of the Greater New York Hospital Assn. The organization is a member of the coalition. HUD announced July 1 that the Section 242 program will be an option for all hospitals looking to refinance debt. The program previously was available only to those institutions using at least 20% of the money gained from a refinance for new construction or renovation. The change was cheered by those in the industry. Ins [Read more]
Medicare Part D premiums to inch up in 2010
The majority of Medicare beneficiaries currently enrolled in a prescription drug plan will only see a minor increase in their premiums in 2010, the Centers for Medicare & Medicaid Services announced Aug. 13. Based on the bids submitted by Part D plans, CMS estimates that the average monthly premium beneficiaries will pay for standard coverage in 2010 will be $30, an increase of $2 over the 2009 premium. "The majority of beneficiaries enrolled in prescription drug plans should see only small changes in their Part D premiums or benefits in the coming year," said Jonathan Blum, acting director of the CMS Center for Health Plan Choices. "Although most Part D plans should have relatively stable premiums, all beneficiaries should compare their current coverage with the plans that will be offered in 2010." That information is expected to be available in October. When open enrollment begins later this year, some seniors may need to take steps to ensure they have the coverage they need. T [Read more]
Part B drug proposal would curtail Medicare pay cuts after 2010
Washington -- The typically bleak outlook that marks the proposed Medicare fee schedule for the upcoming year was significantly brighter this time around for physicians looking for relief from impending pay cuts. In a major policy reversal from the previous administration, the Centers for Medicare & Medicaid Services has proposed removing physician-administered drugs from the calculation of the Medicare physician payment formula. Doctor pay is reduced across the board when spending on all physician services -- a category that includes Part B drugs -- exceeds annual targets. Removing the costs of the drugs would lessen the extent to which spending would exceed targets and trigger cuts. The CMS proposal, announced July 1, would not reduce next year's planned 21.5% across-the-board cut. But it would reduce the number of years after 2010 that physicians face reductions under the payment formula, and it also would decrease the size of the cuts that remain. Over the next five years, [Read more]
Treating celebrity patients not all glitz and glamour
The controversy surrounding the medical care pop star Michael Jackson received before he died at age 50 in late June has drawn attention to the difficulties doctors face when caring for high-profile patients. There is little ethical or clinical guidance for physicians that specifically addresses celebrity patients and how to ensure that their fame does not interfere with delivering the right medical care. The guiding principle is that celebrity patients ought to receive the same quality of care as other patients, regardless of their notoriety. In terms of privacy, celebrities are covered by the same laws and regulations that apply to any patient. Doctors commonly take confidentiality measures, such as allowing famous patients to fill out paperwork in an exam room instead of in the waiting room.r But other questions arise when caring for the rich, powerful and notable. How do physicians prevent special privacy accommodations for famous patients from bleeding over into clinic [Read more]
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