Unbiased Analysis of Today's Healthcare Issues

Archive for May, 2011

Does WellPoint care about quality…or reducing cost?

One large insurer is planning to begin paying hospitals based on quality. “WellPoint is replacing the system it uses to help offset rising medical and other costs at hospitals in 14 states that serve its Blue Cross Blue Shield plans, which cover 34 million people. In recent years, it has raised its payments to those […]

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On Corruption: Quotation of the Day

“Outside my study window in London stood an old hawthorn tree enveloped in a massive growth of ivy.  Over the years the tree had become an ivy bush in the shape of a hawthorn tree and I saw it as an image of what corruptions does to a country.  Mobutu’s rule in Zaire seemed like […]

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Mid-Week Links

Botox vs. Preventive Care. Hall of famer chooses hospice care. “He sees reminders of Soviet thinking in the United States…” Justin Bieber inhaler? Do nursing homes provide health insurance to their own employees? Are airport body scanners safe? Plus the latest edition of the Cavalcade of Risk is up at Risk Management Monitor.

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The CMS HCC Model

The CMS-HCC risk adjustment model is used to adjust payments for Part C benefits offered by MA plans and Program of All-Inclusive Care for the Elderly (PACE) organizations to aged/disabled beneficiaries. The CMS-HCC model includes both diseases and demographic factors. There are separate sets of coefficients for beneficiaries in the community, beneficiaries in long term care […]

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OB-GYN vs. cosmetic-gyn

Why don’t more doctors choose primary care?  Here’s why doctors are choosing to specialize in vaginal cosmetic procedures rather than more general OB-GYN: …it was clear that patients aren’t the only—or necessarily the primary—driving force behind the cosmetic-gyn boom. Many of the conference’s OB-GYNs groused that even after they’ve amassed hundreds of thousands of dollars […]

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Medicare Vouchers: Not worth it politically

Supporting replacing Medicare with a voucher program may increase the unemployment rate…at least if you are an incumbant politician.  An example from New York. “But the fall in Ms Corwin’s support could be more because of her endorsement of Paul Ryan’s proposal to replace Medicare, the public health-care scheme for the elderly, with diminishing government […]

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Reducing Fraud, Waste and Abuse by Prosecuting Health Care Executives

Many politicians claim that there is much fraud waste and abuse in the Medicare system. Would prosecuting executives accused of wrong-doing decrease the amount of fraud in the system? Some policymakers think so. The recent actions of the health department go further. The Office of Inspector General (OIG) has long barred people convicted of certain […]

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Health Wonk Review: Spring Cleaning Edition

The latest edition of the Health Wonk Review is up at Hank Stern’s InsureBlog.

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Medical Societies and Industry Sponsorships

Maybe money can’t buy you love…but can it buy you influence over physician treatment choices? That’s what many pharmaceutical and medical device firms are betting on. Concerns about the influence of industry money have prompted universities [10] [10] such as Stanford and the University of Colorado-Denver to ban drug sales representatives from the halls of […]

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Mid-week Links

What fraction of Texans along the Mexican border receive medical care in Mexico? Should a diabetic receive treatment at a for-profit or not-for-profit facility? Will Medicare vouchers reduce cost and improve quality?  Yes vs. No. 2001-2008: 15% decline in CABG. Healing the world?

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