Changes In Medicare Improve Quality Of Care, But At What Cost?

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1. America’s Biggest Health Insurance Providers SOURCE: Forbes – Health – Read entire story here....
2. Linking Uninsured Patients Treated In The Emergency Department To Primary Care Shows Some Promise In Maryland [Improving Care Systems] Use of the emergency department (ED) has increased significantly over the past twenty years, especially among people who lack access to regular care, such as from a primary care provider. Not only are many ED visits avoidable, but receiving care through the ED also may disrupt continuity of care and result in increased overall health care costs. This article analyzes one of the twenty-nine local projects funded by the Centers for Medicare and Medicaid Services: the Emergency Department–Primary Care Connect initiative of the Primary Care Coalition of Montgomery County, Maryland. The initiative linked low-income or uninsured patients with local safety-net...
3. Hospital Closures Had No Measurable Impact On Local Hospitalization Rates Or Mortality Rates, 2003-11 [Access To Care] The Affordable Care Act (ACA) set in motion payment changes that could put pressure on hospital finances and lead some hospitals to close. Understanding the impact of closures on patient care and outcomes is critically important. We identified 195 hospital closures in the United States between 2003 and 2011. We found no significant difference between the change in annual mortality rates for patients living in hospital service areas (HSAs) that experienced one or more closures and the change in rates in matched HSAs without a closure (5.5 percent to 5.2 percent versus 5.4 percent to 5.4 percent, respectively). Nor was...
4. Most Routine Laboratory Testing Of Pediatric Psychiatric Patients In The Emergency Department Is Not Medically Necessary [Value & Quality] We examined the patient characteristics and hospital charges associated with routine medical clearance laboratory screening tests in 1,082 children younger than age eighteen who were brought to the emergency department (ED) for involuntary mental health holds—that is, each patient was brought to the ED to be evaluated for being a danger to him- or herself or to others, for being gravely disabled (unable to meet his or her basic needs due to a mental disorder), or both—from July 2009 to December 2010. Testing was performed on 871 of the children; all patients also received a clinical examination. The median charge...
5. Snapping defeat from the jaws of victory What is it about opthalmologists and cataract surgery? If there were ever a success story in the world of medicine it is this: Better and more consistent quality than years ago delivered at a remarkably lower cost. But it seems like the profession insists on ways to make it more expensive.I have discussed one such "innovation," the femtosecond laser, and the thousands of dollars in direct consumer cost that it entails and that has been authorized by CMS, the Medicare agency.Now Michelle Andrews at Kaiser Health News summarizes a recent NEJM article. Excerpts:Requiring patients to get blood work and other...