Category Archives: Doctors

California Prop. 46, inspired by tragedy, pits doctors against lawyers

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Bob and Carmen Pack with their children Troy and Alana, who were killed by an impaired driver.

Bob and Carmen Pack with their children Troy and Alana, who were killed by an impaired driver.

This story is part of a partnership that includes KQEDNPR and Kaiser Health News.

Troy and Alana Pack had spent the day at their neighborhood Halloween party in Danville.

Ten-year-old Troy went as a baseball player, and 7-year-old Alana was a good witch.

In the afternoon, they changed out of their costumes and set out for a walk with their mother. Destination: Baskin Robbins 31 Flavors.

“Alana, she liked anything with chocolate,” says their father, Bob Pack. “Troy, for sure, bubble gum ice cream, ’cause he liked counting the bubble gums that he would get.”

Bob Pack stayed home. His family made it only half a mile down the road before his phone rang: “I received a call from a neighbor screaming there’d been an accident. And I raced down there.”

An impaired driver had veered off the road and hit Troy and Alana head-on. Pack was doing CPR on Troy when the paramedics arrived.

“I remember telling them I love them, and hang on. Just praying that they could hang on,” he says

I needed to take action for justice.

Troy and Alana were pronounced dead at the hospital. In the months after their death, Pack’s wife, Carmen, retreated into her Catholic faith. Bob Pack was angry.

“I think, for me to get through, I needed action,” he says, “and I needed to take action for justice for Troy and Alana, and also for doing something that I thought maybe I could change to benefit others in the future.” Continue reading

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Price tags on health care? Now in Massachusetts

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Twenty-dollar bill in a pill bottleBy Martha Bebinger, WBUR
KHN / OCT 09, 2014

This story is part of a reporting partnership that includes WBUR, NPR and Kaiser Health News.

Without much fanfare, Massachusetts launched a new era of health care shopping last week.

Anyone with private health insurance in the state can now go to his or her health insurer’s website and find the price of everything from an office visit to an MRI to a Cesarean section. For the first time, health care prices are public.

“Let the light shine in on health care prices.”

It’s a seismic event. Ten years ago, I filed Freedom of Information Act requests to get cost information in Massachusetts—nothing.

Occasionally over the years, I’d receive manila envelopes with no return address, or secure .zip files with pricing spreadsheets from one hospital or another.

Then two years ago, Massachusetts passed a law that pushed health insurers and hospitals to start making this once-vigorously guarded information more public.

Now as of Oct. 1, Massachusetts is the first state to require that insurers offer real-time prices by provider in consumer-friendly formats.

“This is a very big deal,” said Undersecretary for Consumer Affairs and Business Regulation Barbara Anthony. “Let the light shine in on health care prices.”

There are caveats. Continue reading

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Medicare fines hospitals with high readmission rates

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Medicare is fining a record number of hospitals – 2,610 – for having too many patients return within a month for additional treatments, federal records released Wednesday show.

Even though the nation’s readmission rate is dropping, Medicare’s average fines will be higher, with 39 hospitals receiving the largest penalty allowed, including the nation’s oldest hospital, Pennsylvania Hospital in Philadelphia.

The federal government’s penalties, which begin their third year this month, are intended to jolt hospitals to pay attention to what happens to their patients after they leave.

Last year, nearly 18 percent of Medicare patients who had been hospitalized were readmitted within a month.

Around the country, many hospitals are replacing perfunctory discharge plans—such as giving patients paper instructions—with more active efforts, such as ensuring that outside doctors monitor their recoveries and giving supplies of medication to patients who may not be able to afford them.

Others are still struggling to meet the new expectations. Before the program, some hospitals resisted such efforts because they weren’t paid for the services, and, in fact, benefited financially when a patient returned. Continue reading

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ProPublica’s ‘first dive’ into the Open Payments website

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The government’s data on payments to doctors and hospitals by drug and device makers is incomplete and hard to penetrate – but here’s a first look.


Screen Shot 2014-10-01 at 10.26.19 AMBy Charles Ornstein
ProPublica

The federal government unveiled data Tuesday detailing 4.4 million payments made to doctors and teaching hospitals by pharmaceutical and medical device companies.

The launch of the so-called Open Payments website, mandated under a provision of the Affordable Care Act, was far from glitch-free: Some users encountered long delays and sometimes error messages trying to access its seven data tables.

Also, the site didn’t provide consumers with an easy-to-use lookup tool, a single place to search for a doctor’s name and see all results across data files.

It will take a while to dig deeply into this new trove of data, which covers the period of August to December 2013 and includes general and research payments, as well as payments to companies’ physician investors.

All told, according to officials from the Centers for Medicare and Medicaid Services, companies spent a total of $3.5 billion during that period on 546,000 individual physicians and almost 1,360 teaching hospitals.

So what’s interesting at first glance? With the caveats we’ll detail, here’s a few nuggets: Continue reading

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What to be wary of in the government’s new site detailing industry payments to docs

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The government’s new website on drug and device company ties to doctors will be incomplete and may be misleading — for now.

Twenty-dollar bill in medicine bottleBy Charles Ornstein
ProPublica, Sep. 30, 2014, 10 a.m.

The government’s release today of a trove of data detailing drug and device companies’ payments to doctors has been widely hailed as a milestone for transparency.

But it is also something else: a very limited window into the billions in industry spending. Before you dive in and search your doctor, here are five caveats to keep in mind.

Tracking the Money

* The data only covers a fraction of payments

The Physician Payment Sunshine Act, part of the 2010 Affordable Care Act, called for the first public release of this data 18 months ago.

But because of delays writing detailed rules implementing the law, the first release of data will happen today and it will only cover payments for a few months, from August to December 2013.

So if you search for your doctor and you do not find him or her, it doesn’t mean that he or she didn’t receive a payment. Continue reading

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State disciplines health-care providers

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Seal_of_WashingtonPeriodically Washington State Department of Health issues an update on disciplinary actions taken against health care providers, including suspensions and revocations of licenses, certifications, or registrations of providers in the state.

The department also suspends the credentials of people who have been prohibited from practicing in other states.

Information about health care providers is also on the agency’s website.

To find this information click on “Provider Credential Search” on the left hand side of the Department of Health home page (www.doh.wa.gov).

The site includes information about a health care provider’s license status, the expiration and renewal date of their credential, disciplinary actions and copies of legal documents issued after July 1998.

This information is also available by calling 360-236-4700.

Consumers who think a health care provider acted unprofessionally are also encouraged to call and report their complaint.

Here is the September 25th update issued by the Washington State Department of Health: Continue reading

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Drugstore chain teams up with hospitals and doctors: Win-win?

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Neglected to pick up your prescription? Now, there’s a good chance your doctor will know and do something about it, thanks to a slew of new partnerships between CVS Health and various health systems.

One of the most recent, which is slated to begin by early next year, will integrate the electronic medical records from MedStar Health’s 10 hospitals and 4,000 doctors – located in Washington, D.C. and Maryland — with CVS pharmacies as well as the chain’s 900 Minute Clinics located across the country.

It makes coordination easier, said Bob Gilbert, MedStar’s president of ambulatory services. When someone gets care at a pharmacy or retail clinic, it will be entered in the patient’s MedStar records for the doctor to see.

If a MedStar patient receives CVS service in another state, practitioners there will still be able to see the patient’s records.

Counting the MedStar partnership, CVS now has 41 such health-system agreements in place, with the last nine encompassing the retailers’ pharmacies. CVS hopes the other existing arrangements – which linked the systems with the Minute Clinics — will follow this course. Continue reading

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A new look at why surgical rates vary

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surgeons performing surgery in operating roomBy Michael Ollove
Stateline

Several years ago, a California study showed that a half-dozen elective surgeries were being performed far more often in Humboldt County than they were in the rest of the state.

The procedures included hip and knee replacements, hysterectomies and carotid endarterectomies, a surgery to remove plaque buildup in the carotid arteries.

Geographical variation in the delivery of health care can harm patients and increase costs. That is especially true when it comes to surgery, which is usually more expensive and riskier than less invasive treatments.

Medicaid makes up a huge portion of state budgets, so the issue of health care variation is a pressing one for states looking to hold down costs.

In Humboldt County, doctors, hospitals, and others involved in health care wondered why surgeons in their area operated so often, and if they could do anything to get closer to the state norms.

To find out, they launched the Humboldt County Surgical Rate Project, which brought together doctors, health-care advocates, community organizations, unions, colleges and small employers.

As it turned out, a large part of “what was actually happening out there” was surprisingly simple . . .

“We weren’t trying to identify anyone as a ‘bad guy,’” said Betsy Stapleton, a retired nurse practitioner who is the co-director of the Humboldt County Surgical Rate Project. “The idea was to identify what was actually happening out there and to figure out ways to address it. It led to really fascinating conversations.”

As it turned out, a large part of “what was actually happening out there” was surprisingly simple: Patients in Humboldt County weren’t playing a big enough part in their own health care decisions. Continue reading

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County receives $6m grant to improve hepatitis C care

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Hepatitis C by the numbersKing County has received a four-year, $6 million grant to improve testing, treatment and cure rates of people with chronic HCV infection.

Hepatitis C virus (HCV) affects large numbers of people in King County, but it often goes unnoticed until it’s too late.

“Thousands of people in King County have chronic HCV, but many don’t know they have it,” said Dr. Jeff Duchin, Chief of Communicable Disease & Epidemiology at Public Health – Seattle & King County. “This grant will allow us to make sure that patients with chronic HCV are not just identified, but also seen by a provider, receive follow-up testing, and get the care they need.”

The grant will fund the Hepatitis C Test & Cure Project, which will provide training for clinicians on the diagnosis, evaluation, and treatment of HCV and connect them to specialists. Continue reading

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One-quarter of ACOs save enough to earn bonuses

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Twenty-dollar bill in a pill bottleBy Jordan Rau
KHN

About a quarter of the 243 groups of hospitals and doctors that banded together as accountable care organizations under the Affordable Care Act saved Medicare enough money to earn bonuses, the Centers for Medicare & Medicaid Services announced Tuesday.

Those 64 ACOs earned a combined $445 million in bonuses, the agency said. Medicare saved $372 million after accounting for the ACOs that did not show success, including four that overspent significantly and now owe the government money.

The bonuses, losses and Medicare savings are teensy sums in the context of a program that spends half a trillion dollars a year on care for the elderly and disabled.

But the Obama administration views the results so far as evidence that reorganizing the financial incentives for doctors and hospitals — a key element of the health law – can translate to substantial savings if the program expands nationwide. Continue reading

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Dying in America is harder than it has to be, expert panel says

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It is time for conversations about death to become a part of life.

That is one of the themes of a 500-page report, titled “Dying In America,” releasedWednesday by the Institute of Medicine.

The report suggests that the first end-of-life conversation could coincide with a cherished American milestone: getting a driver’s license at 16, the first time a person weighs what it means to be an organ donor.

Follow-up conversations with a counselor, nurse or social worker should come at other points early in life, such as turning 18 or getting married.

The idea, according to the IOM, is to “help normalize the advance care planning process by starting it early, to identify a health care agent, and to obtain guidance in the event of a rare catastrophic event.”

The IOM plans to spend the next year holding meetings around the country to spark conversations about the report’s findings and recommendations. “The time is now for our nation to develop a modernized end-of-life care system,” said Dr. Victor Dzau, president of the IOM. Continue reading

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In onscreen dramas, health experts inject a dose of reality

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Italia Ricci in "Chasing Life"

Italia Ricci in “Chasing Life” (Photo Courtesy of ABC Family)

This KHN story also ran in .

The questions from producers run the gamut: Could a body be stolen from a hospital? What do infectious disease specialists wear during an outbreak?

Do surgeons really say “Stat!”?

In a bright office building in Beverly Hills, Kate Langrall Folb and her team at Hollywood, Health & Society are on call to field queries from the mundane to the obscure. “Operators are standing by,” Folb, the group’s director, often tells TV and movie writers.

The organization was established with money from the federal Centers for Disease Control and Prevention in 2001 to provide the entertainment industry with free, accurate health information.S

ince then, the group has worked with hundreds of television writers as they tell stories about performing complicated surgeries, coping with depression and fighting insurance companies for coverage. Continue reading

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Plan will keep White Center’s Greenbridge Public Health Center open

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greenbridgeA partnership between City of Seattle and Planned Parenthood will allow the White Center Public Health Center at Greenbridge to remain open, King County Executive Dow Constantine said Monday.

The White Center clinic, which serves West Seattle, Burien, SeaTac, Tukwila, and Des Moines, was under threat of closing due to cut backs in state and federal funding.

Under the new partnership, Planned Parenthood of the Great Northwest will provide family planning services at the facility, while Public Health continues to provide Women, Infant and Children (WIC) and Maternity Support services for the next two years.

Seattle Mayor Ed Murray has committed $400,000 in 2015 to help keep Greenbridge open and preserve a variety of public health services.

Key details of the partnership include: Continue reading

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Are nurse practitioners, physician assistants encroaching on specialists’ turf?

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One of the hopes embedded in the health law was to expand the role of nurse practitioners and physician assistants in addressing the nation’s shortage of primary care providers. But a new study questions whether that’s actually happening in doctors’ offices.

Mid-level providers – PAs and NPs – “are doing invasive procedures and surgery. I’m not sure they were trained to do that.”

Of the more than 4 million procedures office-based nurse practitioners and physician assistants independently billed more than 5,000 times in a year to Medicare – a list including radiological exams, setting casts and injecting anesthetic agents – more than half were for  dermatological surgeries. Continue reading

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Health Care For $4: Are You Ready For Walmart To Be Your Doctor?

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Walmart logoAfter years of “Will they or won’t they?” discussion, Walmart is making its long-awaited move into delivering primary care: The retailer has quietly opened a half-dozen primary care clinics across South Carolina and Texas, and plans to launch six more before January.

via Health Care For $4: Are You Ready For Walmart To Be Your Doctor?.

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