Category Archives: Doctors

State disciplines healthcare providers — April 16th

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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 April 16th update issued by the Washington State Department of Health: Continue reading

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Health law’s free contraceptive coverage saved US women $483 million in 2013

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Twenty-dollar bill in a pill bottleThe Affordable Care Act provision that requires insurers to cover contraceptives with zero co-pay saved US women $483 million last year — $269 on average, according to a new report from the IMS Institute for Healthcare Informatics.

Overall, 24 million more prescriptions for oral contraceptives were filled in 2013, the first full year the health law’s contraceptive provision was in force, compared to 2012.

“The share of women with no out-of-pocket cost for these forms of birth control increased to 56% from 14% one year ago,” the report says.

To learn more read: 

IMS Institute for Healthcare Informatics. Medicine use and the shifting costs of healthcare: A review of the use of medicines in the United States in 2013. April 2014. LINK:

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FAQ on ACOs: Accountable Care Organizations, explained

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Accountable care organizations are practically a footnote in the health law, but advocates say they’ll be critical to holding down the cost of care while improving quality

By Jenny Gold
KHN Staff Writer
APR 16, 2014

One of the main ways the Affordable Care Act seeks to reduce health care costs is by encouraging doctors, hospitals and other health care providers to form networks which coordinate patient care and become eligible for bonuses when they deliver that care more efficiently.

A doctor walking through a mazeThe law takes a carrot-and-stick approach by encouraging the formation of Accountable Care Organizations (ACOs) in the Medicare program. Providers make more if they keep their patients healthy. About four million Medicare beneficiaries are now in an ACO, and, combined with the private sector, more than 428 provider groups have already signed up.

An estimated 14 percent of the U.S. population is now being served by an ACO. You may even be in one and not know it.

While ACOs are touted as a way to help fix an inefficient payment system that rewards more, not better, care, some economists warn they could lead to greater consolidation in the health care industry, which could allow some providers to charge more if they’re the only game in town.  

ACOs have become one of the most talked about new ideas in Obamacare. Here are answers to some of the more common questions about how they work:  Continue reading

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When naming unwise treatments, doctors overlook lucrative procedures

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Twenty-dollar bill in a pill bottleBy Jordan Rau
KHN Staff Writer

APR 14, 2014

This KHN story was produced in collaboration with the 

 

When America’s joint surgeons were challenged to come up with a list of unnecessary procedures in their field, their selections shared one thing: none significantly impacted their incomes.

The American Academy of Orthopaedic Surgeons discouraged patients with joint pain from taking two types of dietary supplements, wearing custom shoe inserts or overusing wrist splints after carpal tunnel surgery.

The surgeons also condemned an infrequently performed procedure where doctors wash a pained knee joint with saline.

“They could have chosen many surgical procedures that are commonly done, where evidence has shown over the years that they don’t work or where they’re being done with no evidence,” said Dr. James Rickert, an assistant professor of orthopedic surgery at Indiana University. “They chose stuff of no material consequence that nobody really does.” Continue reading

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Doctors who shun insurance, offering care for cash

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200px-Flag-map_of_TexasBy Alexa Ura, The Texas Tribune
APR 11, 2014

This story was produced in partnership with 

LAREDO — For 12 hours a day, the waiting room at Dr. Gustavo Villarreal’s family practice is often packed with patients, people who will pay a flat $50 fee for the convenience — or necessity — of a walk-in, quick-turn doctor’s visit.

Villarreal’s practice, which does not accept any form of health insurance, has thrived despite its location in a city where nearly one-third of the population lives below the federal poverty line. Continue reading

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Doctors’ billing system stays stuck in the ’70s for now

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Medical Records

By Eric Whitney
APR 10, 2014

This KHN story was produced in collaboration with NPR

For doctors, hospitals and insurance companies, all the complexities of medicine get boiled down into a system of codes.

These codes are used to track and pay for every procedure – like an 813.02 for mending a broken forearm, or an 800.09 for treating a concussion.

But this coding system is now four decades old, and it doesn’t meet the needs of the medical system today.

It was scheduled to be upgraded this October, but Congress delayed it last week. JaeLynn Williams, for one, is seriously bummed out.

“It’s kind of like looking forward to Christmas, and it doesn’t come,” she says. Continue reading

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Medicare records provide tantalizing details of payments to doctors

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doctor money examine 300By Jordan Rau
KHN Staff Writer
April 9, 2014

Medicare’s release Wednesday of millions of records of payments made to the nation’s doctors comes as the government is looking to find more cost-efficient ways to pay physicians, particularly specialists.

The federal government published data tracing the $77 billion that Medicare paid to physicians, drug testing companies and other medical practitioners throughout 2012, and what services they were being reimbursed for.

The data cover 888,000 different practitioners. More than 6,000 procedures are included, and the full database is so large that it requires statistical software to analyze it.

While the database provides tantalizing details, showing for instance the huge amount ophthalmologists are paid to treat a common eye disorder, experts cautioned that the data can be easily misunderstood and could lead to some doctors’ incomes being unfairly pilloried.  Continue reading

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Primary care Shortage? Not for the insured, study finds

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stethoscope doctor's bag chest x-rayBy Elana Gordon, WHYY
April 9, 2014

Researchers posing as nonelderly adult patients made nearly 13,000 calls to primary care practices across Pennsylvania, New Jersey and eight other states between fall 2012 and spring of last year.

What they found may provide some comfort amid growing concerns of doctor shortages, especially as more people gain coverage through the Affordable Care Act, potentially straining the health system.  Continue reading

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Top academic hospital begins to tackle readmissions problem

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Refresh ThumbBy Rachel Gotbaum

Beth Israel Deaconess Medical Center is a highly regarded teaching hospital in Boston, but in 2012, the hospital found out it had one of the highest rates of readmissions among Medicare patients in the country.

That meant federal fines of more than $1 million—and a lot of soul searching for the staff, says Dr. Julius Yang, the head of quality for the hospital.

“Patients coming to our hospital, getting what we believed was high quality care, were coming back at an alarmingly high rate,” says Yang.  Continue reading

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Burnt out primary care doctors voting with their feet

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doctorburnout 2 300

Illustration by Doug Chayka

By Roni Caryn Rabin
APR 01, 2014

This KHN story was produced in collaboration with wapo

Janis Finer, 57, a popular primary care physician in Tulsa, Okla., gave up her busy practice two years ago to care full time for hospitalized patients.

The lure? Regular shifts, every other week off and a 10 percent increase in pay.

Lawrence Gassner, a Phoenix internist, was seeing four patients an hour.

Then he pared back his practice to those who agreed to pay a premium for unhurried visits and round the clock access to him.

“I always felt rushed,” said the 56-year-old. “I always felt I was cutting my patients off.”

Tim Devitt, a family physician in rural Wisconsin, took calls on nights and weekends, delivered babies and visited his patients in the hospital. The stress took a toll, though: He retired six years ago, at 62.

Physician stress has always been a fact of life.  But anecdotal reports and studies suggest a significant increase in the level of discontent-especially among primary care doctors who serve at the frontlines of medicine and play a critical role in coordinating patient care.

Just as millions of Americans are obtaining insurance coverage through the federal health law, doctors like Finer, Gassner and Devitt are voting with their feet. Continue reading

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State disciplines health care providers – March 28th update

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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 March 28th update issued by the Washington State Department of Health: Continue reading

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Doctors say Obamacare rule will stick them with unpaid bills

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doctor xray money 300By Roni Caryn Rabin
KHN
MAR 19, 2014

Doctors groups fear their members won’t get paid because of an unusual 90-day grace period for government-subsidized health plans and are urging physicians to check patients’ insurance status before every visit. Continue reading

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Can Congress put an end to the annual Medicare payment ritual?

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United States Capitol BuildingBy Susan Jaffe
KHN

Congress is still searching for money to avoid a 24 percent cut in pay for doctors who treat Medicare patients.

But seniors are already paying their share of the cost in premiums, as if the pay cut — scheduled to kick in on April 1 — won’t happen. Continue reading

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Washington 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. Continue reading

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Drug company agrees to pay $27.6 million to settle allegations involving Chicago psychiatrist

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ProPublica Logoby Kara Brandeisky
ProPublica, March 12, 2014

Teva Pharmaceutical Industries Ltd. has agreed to pay more than $27.6 million to settle state and federal allegations that it induced Chicago psychiatrist Michael Reinstein to overprescribe clozapine, a powerful antipsychotic drug.

Reinstein has twice figured into ProPublica investigations.

Four years ago, ProPublica and the Chicago Tribune spotlighted Reinstein’s prescribing pattern, findingthat in 2007 he had prescribed more clozapine to patients in Medicaid’s Illinois program than all of the doctors in the Medicaid programs of Texas, Florida and North Carolina combined. Continue reading

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