Author Archives: LocalHealthGuide

Medical prices higher where large doctor groups dominate


Sign for an emergency room.By Michelle Andrews

Prices for many common medical procedures are higher in areas where physicians are concentrated into larger practice groups, according to a new study.

The October Health Affairs study examined the average county prices paid by preferred provider insurance organizations in 2010.

It focused on 15 high-volume, high-cost medical procedures across a variety of specialties, including vasectomy, laparoscopic appendectomy, colonoscopy with lesion removal, nasal septum repair, cataract removal and knee replacement.

The prices studied reflected the negotiated prices between the PPOs and the physician groups, including payments made by both the plan and the patient. The average price ranged from $2,301 for a total knee replacement to $576 for a vasectomy.

The researchers also used an index to measure competition among physician practices at the county level that is based on the number and size of practices. They then examined the association between procedure prices and the concentration of physicians in larger practices.

In 12 of the 15 procedures, prices were 8 to 26 percent higher in counties with the highest average physician concentration compared to counties with the lowest average concentration, the study found.

The three procedures where there was no significant relationship between physician competition and price were intensity-modulated radiation therapy, shoulder arthroscopy and kidney stone fragmentation. Continue reading


Time to get ready for health insurance sign up


Take a few easy steps now to get ready for November 1

Get ready

First time applying through the Health Insurance Marketplace? Learn more about applying here.

  • Get a quick overview with 5 Health Insurance tips.
  • Use our checklist to gather everything you’ll need to apply.
  • Learn about key dates and deadlines to make sure you’re covered.

Already have a 2015 Marketplace health plan? Learn more about staying covered here.

  • Learn the 5 steps to staying covered.

Note: Plans and prices for 2016 will be available by late October.

The Team


Bill would require drug companies to report their payments to nurses and physician assistants


Twenty-dollar bill in a pill bottleBy Charles Ornstein ProPublica, Oct. 8, 2015, 11 a.m.
This story was co-published with NPR’s Shots blog.

A bill proposed Wednesday by two U.S. senators would require drugmakers and medical device manufacturers to publicly disclose their payments to nurse practitioners and physician assistants for promotional talks, consulting, meals and other interactions.

The legislation would close a loophole in the Physician Payment Sunshine Act, which requires companies to report such payments to doctors, dentists, chiropractors, optometrists and podiatrists.

Companies have so far released more than 15 million payment records, covering August 2013 to December 2014. Continue reading


Number of older prisoners grows rapidly, threatening to drive up prison health costs


StatelineAgingPrisonersLineGraph (1)

By Matt McKillop and Frances Mcguffey

In a year when the nation’s overall prison population dropped, the number of older inmates grew rapidly in 2014, continuing a trend that translates into higher federal and state prison health care spending.

New federal data show that from 1999 to 2014, the number of state and federal prisoners age 55 or older increased 250 percent.

This compares to a growth rate of only 8 percent among inmates younger than 55, according to the Bureau of Justice Statistics, which also reported that the U.S. prison population fell in 2014 to its lowest level since 2005.

In 1999, inmates age 55 and above—a common definition of older prisoners—represented just 3 percent of the total population. By 2014, that share had grown to 10 percent. Continue reading


Raccoon latrines: Yes, they’re a thing, and they are as gross as they sound


You’ve probably not heard the words “raccoon” and “latrine” put together. For instance, it’s doubtful that you’ve heard, “So, what’s up with the raccoon latrine in the corner of your yard?” uttered at the neighborhood block party.

But it is a thing. A raccoon latrine is a site where those furry, masked critters repeatedly deposit their feces in one particular spot. Raccoons prefer sites that are flat and raised off the ground, but they also use the base of trees, and occasionally, open areas.

Common sites for raccoon latrines are roofs, decks, unsealed attics, haylofts, forks of trees, fence lines, woodpiles, fallen logs, and large rocks.

It’s never pleasant to have a latrine on your property, no matter who is using it. But if it was created by raccoons, it’s also a health hazard.

Photo courtesy of Darkone via Wikipedia Creative Commons License Continue reading


VM begins posting online ratings, patient comments about clinic providers


Virginia Mason VM ThumbSeattle’s Virginia Mason Medical Center has begun posting online star ratings for, and patients’ comments about, its clinic physicians and providers.

The ratings (up to five stars) and comments are based on patient satisfaction surveys and appear with providers’ biographies on the Virginia Mason website,

Screen Shot 2015-10-05 at 2.38.22 PM

Click on image to see the ratings and comments

To find a specific provider, type his or her name in the “Search” field at the top of the homepage. Click here to see an example.

In satisfaction surveys, patients rate physicians and other providers (i.e., physician assistants, advanced registered nurse practitioners) as Very Poor, Poor, Fair, Good or Very Good on these topics:

  • Friendliness/courtesy of the provider
  • Explanations the care provider gave you about your problem/condition
  • Concern the care provider showed for your questions or worries
  • Care provider’s efforts to include you in decisions about your treatment
  • Degree to which the provider talked with you, using words you could understand
  • Amount of time the care provider spent with you
  • Your confidence in the provider
  • Likelihood of your recommending this care provider to others

Ratings and patients’ comments are verified by Press Ganey Associates, an independent company that conducts ongoing satisfaction surveys.

The Virginia Mason Patient Relations and Service Department also uses information from the satisfaction surveys to identify and address issues of importance to patients and their families.

Virginia Mason is among a few health systems across the U.S. that post ratings for, and patient comments about, its providers on the Internet. Others include Cleveland Clinic, University of Utah Healthcare, Stanford Healthcare and University of Pittsburgh Medical Center.

Virginia Mason has launched several other similar initiatives include: implementing the Patient Cost Estimator, which offers comprehensive estimates of out-of-pocket costs for numerous medical exams and procedures; posting online the estimated prices of the 100 most common outpatient surgical procedures; and enabling Virginia Mason patients to see clinical notes about their care on the secure, online patient portal, called


Pesticides and Pot: What marijuana users should know


Cannabis_leaf_marijuana_potBy Jeff Duchin, MD
Health Officer for Public Health – Seattle & King County

The passage of I-502 in 2012 means that marijuana is now a legal crop in Washington State. Growers of most of the fruit and vegetables we eat routinely use pesticides and other chemicals to reduce or eliminate crop destruction.

Because marijuana is considered illegal by the federal government, the crop stands outside the federal pesticide evaluation and oversight system.

In Colorado and elsewhere, pesticides that were not approved for use on marijuana have been reported in product from recreational stores.

Could this happen in Washington?The Washington State Liquor and Cannabis Board (LCB) has tried to address this gap by providing growers with  a list of pesticides that may be used by marijuana growers, along with an explanation of the criteria used to select the pesticides.

These pesticides were selected because their use on marijuana plants would not be in direct conflict with federal law (they are allowed on other food products) and they are considered to pose minimal risk to health when used as directed.

Marijuana retailers are required to document all pesticides used on marijuana products that they sell and provide customers and regulators the information on pesticides used upon request.

The potential for pesticides to be present in marijuana is not new and was a concern before the legalization and regulation of medicinal and recreational marijuana products. Pesticides can pose a risk not only to marijuana users but also to workers who use the products and to the environment.

We don’t know that the problem is worse at this time than before regulation, and given the fact that there are now requirements for growers regarding acceptable pesticide use in  marijuana sold by regulated stores (and soon to include “medicinal marijuana” sold at regulated stores) the risk may be lower at this time than in the past. Continue reading


Want to know what diseases your pet can give you?


From the US Centers for Disease Control and Prevention

Good for you?

To observe World Animal Day (Oct 4) the US Centers for Disease Control and Prevention Has launched a redesigned Healthy Pets Healthy People website, with expanded information about diseases people can catch from pets, farm animals, and wildlife.

Users can now search alphabetically by animal and learn which zoonotic diseases they may carry. It is a unique “one-stop shop” where people can learn simple actions to protect themselves – and their pets.

The redesigned website offers:

  • An alphabetized list and description of diseases that can spread from animals to humans.
  • A list of animal species with the description of diseases associated with the animal.
  • Specific groups of people that may be more susceptible to diseases from animals.
  • Tips for preventing illnesses acquired from pets and other animals.
  • Detailed information about the health benefits of owning a pet.

Continue reading