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Some states still prohibit hospitals from hiring doctors; physicians want to keep it that way
Medical associations in California and Texas have been battling legislation that would allow rural hospitals to directly hire doctors -- a move some physicians say threatens to undermine their independent medical judgment and hinder patient care. Most states allow for direct hospital employment of physicians -- a growing trend in recent years as doctors increasingly seek more financial stability. California and Texas, however, are among only a handful of states that generally prohibit hospitals from employing doctors, under long-standing laws aimed at preventing corporate interference with the practice of medicine. Hospitals have sought the right to hire doctors in the Golden and Lone Star states, saying the changes are necessary to recruit doctors to underserved areas. The California and Texas medical associations don't dispute the need to address shortages. But they say there are other ways to recruit doctors without thwarting medical independence, such as reducing medical s [Read more]
Women surgeons want more flexibility with schedules, child care
Although male and female surgeons say they are satisfied with their career choice, women would prefer more flexibility in work schedules and more on-site child care facilities, according to a national survey of 895 surgeons. The survey found that 83% of women and 78% of men who responded said they were well-satisfied with their careers and would choose surgery as a profession again. But female surgeons were far more likely than male surgeons to postpone having children or not have children at all, according to the survey in the July Archives of Surgery ( Significantly more men (55%) than women (33%) disagreed with the survey statement that surgeons should have more part-time work opportunities with call cross-coverage by other surgeons, survey authors noted. Also, 87% of women versus 70% of men said child care should be available at work. Surgery traditionally has been one of the most male-dominated specialties in medic [Read more]
Medical equipment increasingly likely to be leased, financed
The amount of health care equipment being leased or financed has grown, according to an annual survey of Equipment Leasing and Finance Assn. members. "There's less demand for equipment in general, but health care is a growing segment of the industry," said Ralph Petta, vice president of research and industry services for the association. The "2009 Survey of Equipment Finance Activity," released July 14, found that new business in the industry as a whole decreased 2.2%. But the proportion of leasing and financing to the health care sector increased from 8.9%, or $8.2 billion, in 2007 to 9.2%, or $8.6 billion, in 2008. Medical equipment leasing and financing also grew from 6.3% or $6.3 billion of total annual new business in 2007 to 7.2% or $7.2 billion of new business volume in 2008. Experts suspect that health care leasing and financing business is growing because, although the sector has not been immune from the recession, it is still faring better than others. Also, healt [Read more]
Industry gift bans slammed for overreaching
Pressure is mounting on Capitol Hill to reveal the financial relationships among doctors, drug companies and devicemakers through the Physician Payments Sunshine Act. Six states already have enacted payment-disclosure laws or bans on gifts to doctors. Meanwhile, more medical centers are restricting doctors' and students' interactions with industry, as calls grow for medical societies and educators to turn down drugmakers' dollars. But now some doctors and physician organizations say the push to police financial relationships with industry has gone too far. In late July, a new organization called the Assn. of Clinical Researchers and Educators held its charter meeting before a 200-plus crowd in an amphitheater at Brigham and Women's Hospital in Boston. Participants assailed conflict-of-interest rules that they argue impede physician-industry collaboration. Recent statements from organizations representing cardiologists and endocrinologists also have defended the value of ind [Read more]
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]
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