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Uncompensated care up significantly at U.S. hospitals, led by Southeast Print E-mail
Written by FHInews   
Monday, 25 November 2019 00:00

Ron Shinkman reports for Healthcare Dive on November 22:

Despite the Affordable Care Act taking hold in recent years, the average amount of uncompensated care reported by hospitals rose to $12.8 million last year, up nearly $1.7 million from 2015, according to a new survey from Definitive Healthcare. Hospitals in the Southeast, where the expansion of Medicaid eligibility has mostly been rejected, saw the greatest growth in uncompensated care between 2015 and 2018. Smaller hospitals were hit particularly hard, with unreimbursed costs rising most among those with 25 beds or less, averaging an 8.5% annual increase between 2017 and 2018. However, hospitals with more than 250 beds had much higher total uncompensated care costs, averaging $39.7 million last year. Definitive surveyed 3,855 U.S. hospitals between 2015 and 2018.

Last Updated on Tuesday, 03 December 2019 19:03
 
The Med Mal Insurance Storm of 2020 Print E-mail
Written by Julie Danna   
Saturday, 16 November 2019 12:24

I was living in Panama City, FL when Hurricane Michael pretty much destroyed the community. It was a storm that hit the Panhandle so quickly that we barely had time to prepare. This experience made me reflect back to the medical malpractice insurance crisis that hit Florida back in the late 1990s early 2000s. It was harsh and destructive. I remember going to many town hall meetings with my partner Matt Gracey where we'd listen to stories and pleas of desperate physicians and surgeons begging for help. How the carriers either pulled out of Florida or made it so hard for us to find coverage that our clients and prospects could afford. Now I go to work each day knowing that we are about to revert back to those days and I can't help but wonder if it will be as quick as Hurricane Michael and will the healthcare providers and facilitates be prepared?

 
MedPAC: Lack of site-neutral payments driving physician-hospital mergers Print E-mail
Written by Jeffrey Herschler   
Tuesday, 12 November 2019 17:46

Robert King reports for Fierce Healthcare on Nov. 7:
Medicare's payment policy is a major driver of physicians linking up with hospitals, a trend that is raising costs for beneficiaries, new data show. The data from the Medicare Payment Advisory Commission examined the rate of consolidation and the reasons behind it. The findings released during MedPAC's meeting Thursday will be part of a report that was requested by Congress in 2018 on physician and hospital consolidation. Since 2012, billing under Medicare has shifted from physician offices to hospital outpatient clinics. For instance, physician offices saw a 16% decline in service volume of chemotherapy administration from 2012 to 2018. But hospital outpatient departments saw an increase of 52%, according to MedPAC's analysis of Medicare claims. 
A big incentive for a hospital to acquire a physician practice is that "the physician's office becomes a 'hospital outpatient facility' and the billing rates for all visits and procedures double or triple," states David Fater, CEO at ALDA and Associates Internationalin Boca Raton. A hospital typically loses $100,000 per physician, per year after an acquisition, according to Mr. Fater. But collecting the hospital outpatient facility fees more than makes up for the losses. This is bad news for a healthcare system struggling to contain costs. Physicians can end up on the short end as well. "The physician's income does not necessarily increase as a result of this," states Mr. Fater. "In fact, in many cases it goes down since the physician is now an employee of the hospital. In many instances after five years, the physician has had enough and terminates the relationship out of frustration and has to start over building his/her practice from scratch."
 
If the Centers for Medicare & Medicaid Services (CMS) adopted site-neutral payments between hospital and physician offices, then it could reduce the incentive for such mergers. Hospitals will argue that consolidation will provide greater efficiencies and lower costs. Furthermore, the hospitals maintain that the extra fees are meant to cover hospitals for overhead that a freestanding physician's office does not carry.

Last Updated on Tuesday, 12 November 2019 17:57
 
Letting go when people let go of their lives Print E-mail
Written by John Dodson, MD | KevinMD   
Tuesday, 05 November 2019 18:46

My 83-year-old patient had outlived peoples' expectations on several occasions. Faced with a critical illness three years ago, she underwent emergency surgery and spent several months in the hospital with a series of complications, including septic shock, renal failure, and hospital-acquired pneumonia. I'd seen her in the office for a new visit soon after she was discharged. It took nearly 20 minutes to go through her history before walking into the exam room. Notes from several doctors during that hospitalization said that she might never become well enough to be discharged home. When I finally walked into the room, I expected to see someone frail, debilitated, with a caregiver answering most of my inquiries. Instead, she appeared robust, completely alert, and cheerfully answered my questions herself. "You look better than your chart," I told her, truthfully. Given the extent of her recent workup, we agreed to keep further testing and medication changes to a minimum. I established that we'd touch base in the office every three to four months - a typical interval at her age.

 
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Wednesday, 04 December 2019 00:00
 
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Last Updated on Tuesday, 03 December 2019 19:04
 


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