Showing posts with label Health Costs. Show all posts
Showing posts with label Health Costs. Show all posts

Wednesday, April 6, 2011

Accountable Care Organizations: Improving Care Coordination for People with Medicare | HealthCare.gov

The Affordable Care Act includes a number of policies to help physicians, hospitals, and other caregivers improve the safety and quality of patient care and make health care more affordable.  By focusing on the needs of patients and linking payments to outcomes, these delivery system reforms will help improve the health of individuals and communities and slow cost growth.

On March 31, 2011, the Department of Health and Human Services (HHS) released proposed new rules to help doctors, hospitals, and other providers better coordinate care for Medicare patients through Accountable Care Organizations (ACOs).  ACOs create incentives for health care providers to work together to treat an individual patient across care settings – including doctor’s offices, hospitals, and long-term care facilities.  The Medicare Shared Savings Program will reward ACOs that lower growth in health care costs while meeting performance standards on quality of care and putting patients first.  Patient and provider participation in an ACO is purely voluntary.

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Monday, April 4, 2011

Hospital Acquired Infections Becomes A Leading Cause In Patient Deaths | OneMedPlace

Patients today are between a rock and a hard place because when they get sick a hospital may be the last place they want to go. Hospital Acquired Infections, also known as Healthcare-associated infections (HAI) are the 4th leading cause of patient deaths, killing 270 people per day in the USA. Recently the Federal Government and Payers are implementing incentives and penalties on hospitals that are not doing all they can to reduce HAIs.

HAIs are defined as infections not present and without evidence of incubation at the time of admission to a health care setting. Within hours after admission, a patient’s flora begins to acquire characteristics of the surrounding bacterial pool. Most infections that become clinically evident after 48 hours of hospitalization are considered hospital-acquired. Infections that occur after the patient is discharged from the hospital can be considered healthcare-associated if the organisms were acquired during the hospital stay.  There have been several cases of patients going into the hospital for minor surgeries and coming out in coffins, yet limited media coverage has been devoted to this area of concern.

Healthcare-associated infections can be localized or systemic, can involve any system of the body, be associated with medical devices or blood product transfusions. Three major sites of healthcare-associated infections are bloodstream infection, pneumonia, and urinary tract infection. HAIs result in excess length of stay, mortality and healthcare costs. In 2002, an estimated 1.7 million healthcare-associated infections occurred in the United States, resulting in 99,000 deaths.  In March 2009, the CDC released a report estimating overall annual direct medical costs of healthcare-associated infections that ranged from $28-45 billion.

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Andrew Lopez, RN
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Tuesday, March 29, 2011

New Health Insurance Survey: 9 Million Adults Joined Ranks of Uninsured Due to Job Loss in 2010; Few Viable Health Insurance Options Exist for Unemployed - The Commonwealth Fund

An estimated nine million working-age adults—57 percent of people who had health insurance through a job that was lost—became uninsured in the last two years, according to the Commonwealth Fund 2010 Biennial Health Insurance Survey, released today. The survey paints a bleak picture for the 43 million adults under age 65 who reported that they or their spouse lost a job in the past two years, finding that job losses are often compounded by the loss of health insurance, leaving families vulnerable to catastrophic financial losses and bankruptcy in the event of a serious illness or accident.

According to the report, Help on the Horizon: How the Recession Has Left Millions of Workers Without Health Insurance, and How Health Reform Will Bring Relief, the unemployed have great difficulty finding affordable health care. Only 25 percent of people who lost employer health insurance were able to find another source of health insurance coverage, and only 14 percent continued their job-based coverage through COBRA. In addition, purchasing individual coverage was not a viable option for most people. Seventy-one percent of adults who tried to buy individual coverage in the past three years, or 19 million people, either found it difficult or impossible to find a plan that fit their needs; found it difficult or impossible to find a plan they could afford; or were turned down or charged a higher price for coverage because of a preexisting condition.

“This survey tells a story of millions of Americans who lost their jobs during the recession, lost their health benefits too, and had essentially no place to turn for affordable health care coverage—putting their health and financial security at risk,” said Commonwealth Fund President Karen Davis. “The silver lining is that the Affordable Care Act has already begun to bring relief to families. Once the new law is fully implemented, we can be confident that no future recession will have the power to strip so many Americans of their health security.”

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Sincerely,

Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
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Thursday, March 24, 2011

Branded drug prices soar as generic pressure rises | Reuters

Pharmacists in Jordan-based Hikma Pharmaceuticals package generic versions of Ciprofloxacin hydrochloride 750 mg which will be exported to the U.S. and Western markets in Amman February 8, 2011. REUTERS/Ali Jarekji

LOS ANGELES | Wed Mar 23, 2011 11:46am EDT

LOS ANGELES

(Reuters) - U.S. prices for brand-name drugs are rising faster than ever as patents expire on top-selling medicines and the pharmaceutical industry nervously eyes the future of healthcare reform.

Prices for the 15 best-selling drugs rose by much higher rates in 2010 than they did in each of the last five years, according to exclusive data from Thomson Reuters MarketScan, which measured the average cost of a daily dose as shown in medical claims data.

Two thirds of the drugs saw double-digit price hikes, well above inflation of 1.6 percent in 2010 measured by the consumer price index. The analysis indicates drug makers are scrambling to make as much money as possible from blockbuster drugs before their patents expire, while taking advantage of the fact that last year's healthcare reform bill did not cap drug prices.

According to MarketScan, payments for Pfizer Inc's Lipitor rose 11.4 percent last year, compared with 5 percent annually from 2005 to 2010. That meant the cost of a daily dose of the cholesterol drug rose from $3.17 at the end of 2009 to $3.53 at the end of 2010. Lipitor, which will soon lose patent protection, had 2010 global sales of $10.7 billion.

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Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
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856-415-9617, (fax) 415-9618

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Wednesday, March 16, 2011

Sisters accused of health fraud nabbed in Colombia | Reuters

Two sisters accused of falsifying health care claims to defraud the U.S. government of millions of dollars were nabbed in Colombia and returned to the United States, authorities said on Tuesday.

Caridad Guilarte, 54, and Clara Guilarte, 56, ran a clinic in Dearborn, Michigan, that billed about $9 million in claims for treatments patients never received, according to the U.S. Department of Health and Human Services website.

The sisters collected more than $4 million from Medicare for drug therapies that were never provided, according to the HHS website.

After the FBI interviewed them, the two sisters fled, said Barbara McQuade, the U.S. attor

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--

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Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
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Budget Cuts Spell Crisis for Women with HIV « SpeakEasy

Rallies for workers’ rights in Wisconsin and other states have raised critical awareness about the potential implications — and targets — of budget cuts across the US. But in addition to the fate of unions and public sector employees at the local and state level — the majority of whom are women — the battle over budgets will also determine the fate of key social services, many of them on which women and children in particular depend.

Nothing makes this more real for us at the Ms. Foundation than when our grantees report how budget cuts will impact — indeed, threaten — their own programs and their own communities. For example, just a few weeks ago, the Washington Department of Health decided to cut funding for the state’s only women-specific HIV/AIDS education and support program — a program run by Seattle-based BABES Network-YWCA, our longtime grantee. This decision, BABES tells us, along with an additional funding cut at the county level, will result in a 75 percent reduction in their program budget — an untenable outcome that will leave hundreds of women without critical support services.

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Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
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856-415-9617, (fax) 415-9618

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Tuesday, March 15, 2011

$4 drug programs could save economy billions: study | Reuters

U.S. consumers could save billions of dollars by filling prescriptions for inexpensive generic drugs at stores such as Wal-Mart and Target, according to a new report.

A growing number of national chain pharmacies offer the generic form of a range of drugs - including anti-allergy medications, antidepressants, antibiotics and cholesterol-lowering drugs - for $4 for a 30 day supply. However, researchers found that less than 6 percent of people who could use such a program take advantage of it - costing both consumers and the government extra bucks.

All told, the US could save as much as $5.8 billion, according to the study

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Sincerely,

Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
http://www.nursefriendly.com info@nursefriendly.com ICQ #6116137
856-415-9617, (fax) 415-9618

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Sunday, March 13, 2011

Danger of multiple emergency room visits to different hospitals

If you are one of the more than 100 million Americans who visit emergency rooms (ER) at least once a year, you’re not alone.

Americans, insured and not, make ample use of hospital emergency rooms. One out of every five visited an ER at least once in 2007, the latest year for which the National Center for Health Statistics has data. Among the uninsured, 7.4 percent made two or more visits to an ER, but so did 5.1 percent of people with private insurance.

Well if you want to stay safe and receive quality medical care while you’re in the ER, it’s best if you visit the same ER each time.

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Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
38 Tattersall Drive, Mantua New Jersey 08051
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856-415-9617, (fax) 415-9618

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Monday, February 28, 2011

Governors: Medicaid More A Budget Buster Than Ever : NPR

The federal government and the states have shared the cost of Medicaid, the health insurance program for some 60 million low-income Americans, since it was created in 1965.

They've shared something else almost that long — arguments about who should foot how much of the ever-escalating bill.

"Medicaid cost growth has been a problem for time immemorial," says Alan Weil, executive director of the National Academy for State Health Policy.

But this time, he says, things are different.

For one thing, "the program is bigger, so growth on a larger base is more real dollars that's harder to find."

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Andrew Lopez, RN
Nursefriendly, Inc. A New Jersey Corporation.
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Wednesday, February 23, 2011

GOP Counts The Ways To Defund Health Law : Shots - Health Blog : NPR

Did House Republicans keep their promise to defund the health care overhaul as part of their bill to cut more than $60 billion from the federal budget for the rest of the fiscal year?

You betcha. They've come up with more than half a dozen ways to throttle spending on overhaul, in fact.

 

Most of the attention went to the amendment to the spending bill offered by Rep. Denny Rehberg (R-MT). Rehberg, who chairs the spending subcommittee that oversees the Department of Health and Human Services, offered language to the bill that would bar the use of funds to pay the salaries of any HHS "employee, officer, contractor, or grantee" to implement the health law. It passed on a 239-187 vote, almost exclusively along party lines.

But just in case that doesn't work, House Republicans passed several other amendments as well.

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Andrew Lopez, RN
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856-415-9617, (fax) 415-9618

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Tuesday, February 22, 2011

Obama administration asks states to cut costs without dropping Medicaid coverage

By Marilyn Werber Serafini
Kaiser Health News
Tuesday, February 22, 2011; 12:58 PM

The Obama administration is deploying squadrons of in-house experts to help budget-strapped states figure out how to save money on Medicaid, the health program for the poor that has been a source of rising tensions between state capitals and Washington.

In recent weeks, both Democratic and Republican governors have been pressing the administration to be flexible in enforcing a requirement in the new health-care law that bars states from tightening eligibility for the program between now and 2014, when an additional 16 million people will be eligible for the program. Some states want to tighten eligibility now to curb spending.

Health and Human Services Secretary Kathleen Sebelius has a difficult balancing act. The former governor of Kansas wants to improve relations with the governors, who are due Saturday in Washington for a big meeting. But she also wants to expand Medicaid, not shrink it.

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Andrew Lopez, RN
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856-415-9617, (fax) 415-9618

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Women and the Affordable Care Act - Health Care for You | HealthCare.gov

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Andrew Lopez, RN
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Friday, February 18, 2011

Released hospital patients' many unhappy returns

Patients who are released from the hospital too early or without proper planning and instructions often wind up back in the hospital after a few days, a problem that's costly to taxpayers and distressing to patients.

A study released today calculated that reducing hospital stays by a single day for Medicare and Medi-Cal patients in California adds up to $227 million a year.

An estimated 81,000 Medicare patients in California - or 20 percent - end up back in the hospital within 30 days of being discharged for some reason related to the same condition, the study found.

"Right now, when you go to the hospital, it's the do-it-yourself model. It's up to you to figure out what to do," said David Grant, author of the study for the California Discharge Planning Collaborative, a group of labor, senior and other advocacy organizations.

Patients, especially those who are elderly and lack social support, are often readmitted because they don't understand their discharge instructions, fail to take their medications or have complications that they can't handle.

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Andrew Lopez, RN
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Wednesday, February 9, 2011

Many Emergency Department Visits Could Be Managed At Urgent Care Centers And Retail Clinics — Health Aff

Americans seek a large amount of nonemergency care in emergency departments, where they often encounter long waits to be seen. Urgent care centers and retail clinics have emerged as alternatives to the emergency department for nonemergency care. We estimate that 13.7–27.1 percent of all emergency department visits could take place at one of these alternative sites, with a potential cost savings of approximately $4.4 billion annually. The primary conditions that could be treated at these sites include minor acute illnesses, strains, and fractures. There is some evidence that patients can safely direct themselves to these alternative sites. However, more research is needed to ensure that care of equivalent quality is provided at urgent care centers and retail clinics compared to emergency departments.

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Saturday, February 5, 2011

U.S. Sees Slowdown in Spending on Mental Health

The amount of money spent on psychiatric drugs in the United States continues to grow but at a much slower rate than in previous years, a new federal government study has found.

From 2004 to 2005, spending on psychiatric drugs rose 5.6 percent, compared with an increase of 27.3 percent between 1999 and 2000, according to the Substance Abuse and Mental Health Services Administration.

The agency's analysis of health-care costs from 1986 to 2005, the latest year comparable data is available, also found that spending on behavioral health accounts for a decreasing portion of overall health-care costs.

Of the $1.85 trillion spent on all health-care services in the United States in 2005, behavioral health spending accounted for 7.3 percent ($135 billion). During the 20 years analyzed in the study, spending for mental health and substance abuse health care grew more slowly than all other health spending: 4.8 percent a year for substance abuse; 6.9 percent a year for mental health and 7.9 percent a year for all health-care services.

From 2002 to 2005, spending rose 5 percent for substance abuse, 6.4 percent for mental health and 7.3 percent for all health-care services, according to the study, published Feb. 3 in Health Affairs.

Among the other findings:

  • Spending on addiction medications grew from $10 million in 1992 to $141 million in 2005. However, the $141 million represents only 0.6 percent of the $22 billion spent on substance abuse treatment in 2005.
  • In 2005, behavioral health treatment accounted for 4.8 percent of private health insurance spending, compared with 11.5 percent of total Medicaid spending. The agency said that the figures can be used as a baseline for evaluating the effect of the Mental Health Parity and Addictions Equity Act and the Affordable Care Act.
  • Unlike overall health spending, the largest portion of behavioral health spending is publicly funded. In 2005, public money paid for 79 percent of spending on substance abuse treatment and 58 percent of mental health services spending, compared with 46 percent of all health spending.

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