March 6, 2013
Billions in Extra
Cash Fail to Stop Rot in NHS
Premature death rates from
a series of conditions, including heart disease and breast cancer, are
significantly higher in this country than in similarly developed nations such as
France, Italy and Spain, researchers said in a report on Monday.
Although public health has
generally improved, other countries have made greater progress, leaving Britain
"persistently and significantly" lagging behind the EU and other global powers.
Life expectancy increased
by 4.2 years to 79.9 between 1990 and 2010, but the UK still dropped from 12th
to 14th on a list of 19 Western nations
FDA Warns Against Codeine for
Children shouldn't be given
codeine to relieve pain after having their tonsils or adenoids removed because
the medication can cause death, the Food and Drug Administration warned
The FDA said it would
require all codeine-containing products to carry a boxed warning, the agency's
toughest, to instruct doctors against use in children after such
The agency said it received
reports of 13 deaths of children who had surgery and got codeine-containing
drugs afterward. A review of the deaths, which occurred from 1969 to 2012, found
that most took place after surgery to remove tonsils and adenoids, and many of
the children had sleep apnea.
BCBSNC Kicks Off
Blue Cross Blue Shield of
North Carolina has just started testing out its bundled payment model for knee
replacement surgeries, and if performs well, the model could be pushed out to
include hip replacements.
Elaine Daniels, the plan's senior strategic
network consultant, says BCBSNC started modeling orthopedic bundles in 2010,
began a pilot project in 2011, and recently announced two bundled payment
initiatives with physician-owned Triangle Orthopaedic Associates (TOA) and Duke
University Health System.
"When you're looking at doing bundles on a
first pass, orthopedic procedures were easier for us because there aren't that
many complications," says Daniels. "There's not a lot of leakage, you know who
the care team is going to be, so there's more continuity of care for that member
Revenue Can't Fix
Bad Metrics; Only Strategy Can
In the business of
healthcare, it's hard to escape the reality of reduced profitability as far as
the eye can see. That dour outlook is being reflected in the bonds of nonprofit
healthcare organizations. If you owe money to an individual or institution, they
like to keep a close eye on the general health of the business, in addition to
the individual market in which you operate.
And based on their
calculations, all is not well.
A report this week from Moody's Investors
Service revealed that 2012 was a record year in terms of the amount of hospital
and health system debt downgraded. At $20 billion of nonprofit healthcare debt downgraded, 2012
represents the highest amount of downgraded debt since Moody's started tracking
the metric in 1995, and is more than double the amount of upgraded debt (which
is reflected in improving business trends).
ObamaCare and the
Here's a trend you'll be
reading more about: part-time "job sharing," not only within firms but across
It's already happening
across the country at fast-food restaurants, as employers try to avoid being
punished by the Affordable Care Act. In some cases we've heard about, a local
McDonalds has hired employees to operate the cash register or flip burgers for
20 hours a week and then the workers head to the nearby Burger King or Wendy's to log another 20 hours.
Other employees take the opposite shifts.
Welcome to the strange new
world of small-business hiring under ObamaCare. The law requires firms with 50
or more "full-time equivalent workers" to offer health plans to employees who
work more than 30 hours a week. (The law says "equivalent" because two 15 hour a
week workers equal one full-time worker.) Employers that pass the 50-employee
threshold and don't offer insurance face a $2,000 penalty for each uncovered
worker beyond 30 employees. So by hiring the 50th worker, the firm pays a
penalty on the previous 20 as well.
Two Hill Panels to
Examine Medicare Changes
With $85 billion in
automatic federal spending cuts set to take effect on Friday and predictions of
economic disruption, much of official Washington is focused on the "blame game." Publicly, there has been no sign
that Congress or administration officials have made any progress on averting
these cuts or finding common ground on tackling the country's fiscal
But there are small signs
that Democrats and Republicans are beginning to wrestle with the issue of what
role Medicare should play in deficit reduction. Two Capitol Hill committees with
jurisdiction over healthcare have scheduled hearings this week to examine
Medicare's current benefit design and to review provisions in the 2010
healthcare law aimed at making the program more efficient.
GAO Report :
Obamacare Adds $6.2 Trillion to Long-Term Deficit
increase the long-term federal deficit by $6.2 trillion, according to a Government Accountability Office (GAO)
report released today.
Senator Jeff Sessions (R.,
Ala.), who requested the report, revealed the findings this morning at a Senate
Budget Committee hearing. The report, he said, "confirms everything critics and
Republicans were saying about the faults of this bill," and "dramatically proves
that the promises made assuring the nation that the largest new entitlement
program in history would not add one dime to the deficit were false."
President Obama and other
Democrats attempted to win support for the health-care bill by touting it as a
fiscally responsible enterprise. "I will not sign a plan that adds one dime to
our deficits - either now or in the future," Obama told a joint-session of Congress in September
2009. "I will not sign it if it adds one dime to the deficit, now or in the
Trust Their Own Hospitals
Staff at North Cumbria
University Hospitals and United Lincolnshire Hospitals are the least likely to
recommend treatment, according to figures that are being scrutinised closely by
Less than 40 per cent of
those employed at the trusts, both of which have relatively high death rates,
would recommend the treatment available, compared with more than 90 per cent of
staff at the top-rated hospitals.
Nationally, almost 40 per
cent of NHS staff would not recommend the treatment available at their hospitals
to their friends and family.
New Deals With Insurers
Hospitals and health
insurers are locking horns over how much health-care providers will get paid
under new insurance plans that will be sold as the federal health law is rolled
The results will play a
major role in determining how much insurers will ultimately charge consumers for
these policies, which will be offered to individuals through so-called exchanges
in each state.
The upshot: Many plans sold
on the exchanges will include smaller choices of health-care providers in an
effort to bring down premiums.
Blog: Changing the Way Physicians Are Paid: Report of the National
Commission on Physician Payment Reform
The loud cries warning that
rising health care costs are going to destroy the nation's economy have been
shouted so often that the will to move firmly in any one direction has almost
halted. We've all heard them: health care costs are unsustainable, excessive
spending is fueling our nation's debt, and despite high costs, health outcomes
are behind much of the world and aren't improving.
The way doctors are paid is
one of the most significant drivers of escalating health care costs. The National Commission on Physician Payment Reform,
which we chair, was formed by the Society of General Internal Medicine to
provide the public and private sector with recommendations for transforming the
way we pay doctors in order to rein in spending and improve quality.
Massachusetts' Health Overhaul, What Can the Nation Expect in 2014?
For providers, payors,
patients and politicians gearing up for changes called for in the Patient
Protection and Affordable Care Act taking place next year, Massachusetts may
offer some clues into what they can expect, according to a webinar led by Judith
Bentkover, PhD, academic director of Brown University executive master 's
program in healthcare leadership and president and CEO of healthcare consulting
firm Innovative Health Solutions.
Four years before the PPACA was passed
in 2010, Massachusetts signed its own massive health reform law, unprecedented
anywhere else in the country at that point. That law, similar to the PPACA,
required nearly every adult to purchase health insurance and introduced heavy
government subsidies to help the poor afford coverage.
says Massachusetts has since achieved near universal coverage - 98 percent of
its residents are insured, she says, higher than any other state - with only
"moderate" added cost to taxpayers, around $91 million per year after
reimbursements. She adds much of that money goes to fund private subsidies to
pay for private insurance, but that expense is largely offset by increased
payments for uncompensated care by providers across the state.
Empowered by ACA,
Old Fraud Law Puts New Scrutiny on Doctors
With the Affordable Care
Act giving the government more power and dedicating more money to improving
federal efforts against health care fraud, waste and abuse, physicians' business
practices are under the microscope like never before.
While only a small fraction
of physicians are engaged in fraudulent activity, all doctors face the new
reality of increased scrutiny over billing, referral and coding activity, legal
But recognizing federal
False Claims Act risks and enacting a strong compliance program can help doctors
come through such reviews unscathed and thwart violations before they occur,
said attorney Julie E. Kass, a principal in the Ober|Kaler Health Law Group
based in Maryland. She spoke about the FCA and compliance steps for physicians
at the American Health Lawyers Assn.'s Physicians and Physician Organizations
Law Institute meeting February in Phoenix.
CMS: No More
Delays with Move to ICD-10
mandated transition by billers throughout the health system to the more complex
ICD-10 diagnosis codes will go forward without any further delays, the Centers
for Medicare & Medicaid Services stated in a Feb. 6 letter to the American
Acting CMS Administrator
Marilyn Tavenner made the case for moving forward with ICD-10 to modernize the
health care system. Halting its implementation, which has been ongoing since
2009, would mean relying on outdated ICD-9 codes that soon will be incompatible
with general health care needs and new technologies, she stated.
"Many in the health
industry are under way with the necessary system changes to transition from
ICD-9 to ICD-10," Tavenner wrote. "Halting this progress midstream would be
costly, burdensome, and would eliminate the impending benefits of these
investments. Many private and public sector health plans, hospitals and hospital
systems, and large physician practices are far along in their ICD-10
implementation and have devoted significant funds, resources and staff to the
Newer Sleep Meds
Still Carry Fall Risk in Elderly
The use of
nonbenzodiazepine sleeping medications -- intended to be a safer alternative
than older hypnotics -- continues to place patients at risk for falls and hip
fracture, a case-crossover study found.
The risk of a hip fracture
among residents of nursing homes was 66% higher during the month after patients
were given one of the newer insomnia medications (OR 1.66, 95% CI 1.45 to 1.90),
according to Sarah D. Berry, MD, of Harvard Medical School, and
ASIPP Offers Pain
Medicine and Anxiety Medicines Brochure to Members
ASIPP Marketing Services will
be releasing a series of Interventional Pain brochures for purchase in the near
At this time ASIPP is offering a
Pain Medicine and Anxiety Medicines brochure that you can tailor to your
practice and make available to your patients and referring physicians.
We will send the brochure
materials to your or to your printer and they can print and deliver them to you.
Either option offers an
inexpensive and effective way to communicate medication Information to your
patients and promote your practice. Brochures are copyrighted by ASIPP.
Contact Ray Lane via email at
email@example.com for ordering information.
Copyright © 2008
American Society of Interventional Pain Physicians ®
81 Lakeview Drive, Paducah, KY 42001
Phone 270.554.9412, Fax 270.554.5394