by PWeekly | Nov 15, 2016
Following the election of Donald Trump as the next U.S. president, Physician’s Weekly Managing Editor Christopher Cole received the opportunity to ask select physicians and healthcare experts what a Trump presidency could mean for the U.S. healthcare system. Speaking with Cole were Pawan Grover, MD, an interventional spine specialist and patient advocate who has served as a medical correspondent for CNN, NBC, CBS, and PBS; Mache Seibel, MD, author of The Estrogen Window, former and soon-to-again-be Harvard Medical School faculty member; Carolyn Rosenblatt, RN, elder law attorney and co-author of The Family Guide to Aging Parents: Answers to Your Legal, Financial, and Healthcare Questions; and Chris Orestis, CEO of Life Care Funding, former Washington, DC, lobbyist, senior-care advocate, and author of Help on the Way and A Survival Guide to Aging. What do you think will happen to “Obamacare”? Trump has said he’ll put an end to it, but information is lacking on what, if anything, he’d replace it with. Mache Seibel (MS): If President-Elect Trump wants to make America great again, he will have to make America healthy again. And that requires healthcare coverage for as many U.S. citizens as possible. With rampant obesity, diabetes, and other chronic illnesses, a great deal of prevention needs to be put into play. Obamacare took 2-3 years to implement. For these reasons, I believe that with 22 million people currently depending on Obamacare, the new administration is less likely to abolish it than to modify it. There are many areas that could be addressed, and which of those President-Elect Trump will address will depend on his closer look at the...
by SkepticalScalpel | Sep 24, 2012
As new Medicare rules kick in, some 2,200 hospitals nationwide are facing financial penalties for 30-day readmission rates for myocardial infarction, congestive heart failure and pneumonia. Medicare payments will be lowered by as much as 1%. Investigators at the Skeptical Scalpel Institute for Evidence-Based Outcomes and Advanced Research (SSIEBOAR, catchy acronym, don’t you think?) have come up with a plan that is certain to lower readmission rates across the board. Some have said the idea should be patented, but the institute is not-for-profit and thus is willing to share. The solution is quite simple — let the patients die. Yes, death reduces readmission rates for all diseases, not just MI, CHF and pneumonia. Oh, there may be some resistance and relatives of the patients may complain, but at least Medicare will be satisfied and after all, isn’t that why we became doctors? Another outcome measure, hospital length of stay, is also positively impacted by death. For example, if the average length of stay for a patient with a heart attack is 4 days, a patient who dies on hospital day #2 would lower the hospital’s average. Death also results in fewer resources being utilized, which saves the hospital money for patients whose reimbursement is based on the DRG. I confess. I’m not serious, and the idea is not original. There are many issues. In most cases, as length of stay is ratcheted down, readmission rates will rise. One way to reduce readmissions is to keep patients in the hospital longer. And what about the things the hospitals and doctors can’t control? A recent study found that only 63% of...
by Physicians Weekly | Apr 16, 2012
The quality of care coordination is important to the United States healthcare system as hospital readmission rates are being further scrutinized. When hospital readmission rates are high, it is often the result of poorly coordinated care across the full continuum of care settings, from EDs and ICUs to primary care and outpatient settings. As care is better coordinated, it is more likely that these rates will be reduced. “Improving the coordination of care for patients is also important to Medicare and to hospitals,” says David C. Goodman, MD, MS. “Medicare patients who return to hospitals shortly after they’ve been discharged add substantial costs to Medicare that could be avoided with better post-discharge care.” CMS estimates that the cost of avoidable readmissions is more than $17 billion per year. In the coming months, there are plans in place to reduce Medicare payments for readmissions if hospitals have higher-than-expected 30-day readmission rates for patients with acute myocardial infarction (AMI), congestive heart failure (CHF), or pneumonia. In 2013, hospitals face a penalty equal to 1% of their total Medicare billings if an excessive number of patients are readmitted. The penalty rises to 2% in 2014 and 3% in 2015. Hospitals Currently Struggling In September 2011, the Dartmouth Institute for Health Policy & Clinical Practice released the Dartmouth Atlas report, which analyzed readmission rates among Medicare patients for AMI, CHF, pneumonia, and other hospital discharges between 2003 and 2009. Researchers examined the records of 10.7 million Medicare patient hospital discharges and found little progress during the study period. Patients hospitalized for CHF, pneumonia, surgery, hip fractures, or other medical conditions had 2009 readmission...
