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  September 27, 2012 Follow us on FacebookFollow us on TwitterJoin us on LinkedInRSS feed

Physicians, Insurers Clash Over Medical Necessity in CA

Joe Cantlupe

Physicians and insurers in California are at legal loggerheads over questions about what constitutes proper medical treatment, and over the definition of a medical necessity. The conflict may have consequences nationwide. >>>

 

Editor's Picks

6 in 10 Physicians Would Quit Today

Downbeat survey results show widespread discontent among doctors, who are are choosing to work less and see fewer patients. If the trend continues, it is expected to amount to 44,250 full-time equivalents lost from the physician workforce over the next four years. >>>

Personalized Cancer Treatments Approach Tipping Point

Significant cost reductions for genome sequencing are bringing personalized medicine into better focus. But payers are lagging and providers may struggle to build up the necessary infrastructure before it becomes the standard of care. >>>

Family Physicians Rap 'Stopgap' Use of Nurse Practitioners

Advocating "independent practice by a single health professional," namely nurse practitioners in place of physicians, "flies in the face" of studies supporting the cost-effectiveness and quality outcomes of the physician-led care team approach, says the American Academy of Family Physicians. >>>

Physicians' Stance on Nurse Practitioners is Dangerous

By saying that 'substituting NPs for doctors cannot be the answer' to the nation's primary care shortage, the American Academy of Family Physicians suggests that there are two classes of care. And therein lies the danger to our system of healthcare. >>>

Antibiotic Use, Costs Show Wide Regional Variations

A report finds large differences in antibiotic prescribing practices in outpatient settings by state and by region, with the highest rates found in the South. The variation may be explained, in part, by the efforts of health plans to reduce the use of antibiotics without indication. >>>

Drug Shortages: 10 Ethics Rules for Hospitals

Clinicians at Duke University Medical Center have created an ethically defensible drug rationing plan which aims to help healthcare providers make fair and equitable choices about how to allocate medications when they are scarce. >>>

Patient Non-Compliance a Pricey Problem

What can hospital and health systems do to drive out patient non-compliance costs? The answer lies in financial incentives and population health efforts—but don't expect too much too soon, say healthcare CFOs. There's still a great deal of debate over how much influence cost really has on a patient's actions. >>>

Rounds: Will Health Systems Do Anything About Health?

Hospital and health system financial executives recognize that the strategic choice facing their organizations is whether they will evolve their focus from sick care to health care. Many are looking to the example set by Kaiser Permanente. >>>

Intelligence Report

Physician Alignment—Integration over Independence

Nearly 70% of healthcare leaders anticipate the number of employed physicians to grow by more than 5% over next three years. Learn how healthcare leaders are ensuring alignment as the shift from independent to employed physicians accelerates. This original research and analysis, produced with support from MedSynergies, offers key insight from top healthcare executives, including new case studies from Memorial Hermann Sugar Land Hospital, Gadsden Riverview Regional Medical Center, and Vanguard Health Chicago.

News Headlines

Patient-generated mobile data improves clinical care

InformationWeek, September 27, 2012

Knee replacements double as aging patients stay active

Bloomberg, September 27, 2012

Patients may suffer as doctors switch practices, health systems

Pittsburgh Post-Gazette, September 27, 2012

US warning to hospitals on Medicare bill abuses

The New York Times, September 25, 2012

Romney: Uninsured can seek care in ER

The Hill, September 25, 2012

Wendell Potter: Dangers of 'captured' regulators

Center for Public Integrity, September 25, 2012

Trauma centers springing up as profits rise

USA Today / Kaiser Health News, September 25, 2012

New system for patients to report medical mistakes

The New York Times, September 24, 2012

Primary care is next frontier for elite med schools

NPR / Kaiser Health News, September 24, 2012

Mandatory Flu Shots Mean You're Serious About Patient Safety

HealthLeaders Media, September 21, 2012



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Multimedia/Events

Avoid 30-Day Readmissions, Improve Care Transitions

Date: Oct. 25, 2012, 1:00-2:30 p.m. ET

Get the tools you need to align care transitions, prevent bounce-back readmissions, and improve overall quality of care, from subacute and postacute experts at Southwest Ohio Care Transitions Collaborative and University of Michigan Health System Sub-Acute Care Rehabilitation Program. This webcast reveals the latest continuum management strategies and proven tactics to align partners, physicians, and nurses.

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From HealthLeaders Magazine

 

Metrics That Matter

Business intelligence and analytics are invaluable tools to power healthcare decision-making. >>>

 

The Promise of mHealth

 

The Business Case for the HIE



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