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Imagine health care delivery that maximizes
quality care to consumers, eliminates medical billing snafus, incorporates
modern technology into streamlining practice management, safeguards the incomes
of physicians who can spend more time treating patients--while eliminating the
need for insurance companies. Does
this sound too good to be true? Not
according to a revolutionary proposal offered by a health care executive with
over 30 years’ association with hospitals and physicians.
A physician who has previewed the plan comments: “Finally. The insurance companies are a
brokerage system that does nothing except increase the cost of care. Years ago, before the advent of
HMO’s, the cost of administering health insurance was 2-6%. With HMO’s it is 38-40%. As a practicing physician for 38
years with a degree in health management, I wish you success with your plan.”
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We have delayed publication of this issue of the Jackson & Coker Industry Report until after November 4.
Now that the presidential election is over, we know whose health care reform plan will be the focus of attention. Included in our roster of featured articles is an article selected from The New England Journal of Medicine discussing Senator Barack Obama’s proposal for improving health care in the United States. More detailed information concerning his plan can be accessed here.
Our monthly survey also addresses health care reform from another perspective. Mr. Rick Jackson, CEO of Jackson Healthcare (parent company of Jackson & Coker), has proposed a revolutionary revamping of health care delivery in the United States—beginning with eliminating third-party insurers across the board. Admittedly controversial, Mr. Jackson’s plan is intended to create dialogue concerning three important goals: improving patient care and making it more accessible to consumers, using technology to run medical practices more efficiently and cost effectively, and safeguarding the income of physicians and other health providers.
Along with our regular article content, we trust that Mr. Jackson’s proposal will be thought provoking and challenging to all segments of the medical community.
Cordially,
Calvin Bruce
Managing Editor
Obama’s Health Care Plan
Source: The New England Journal of Medicine
Date: 08/21/2008
In contrast to John McCain’s emphasis on free-market solutions and deregulation, Barack Obama’s health care reform plan relies on an employer mandate, new public and private insurance programs, and insurance-market regulation.
The core of the Obama plan is a requirement that employers either offer their workers insurance or pay a tax to help finance coverage for the uninsured. The plan would also create two new options for obtaining health insurance: a new government health plan and a national health insurance exchange that would offer a choice of private insurance options.
Both would be open to persons without access to group health insurance or other public insurance as well as to small businesses that wanted to purchase coverage for their workers. Income-related subsidies would be provided to help lower-income persons afford coverage, and private insurers would not be allowed to deny coverage because of preexisting conditions or charge substantially higher premiums to sick enrollees.
The Obama campaign says that the insurance exchange, by providing broader pooling and cutting marketing expenses, can reduce administrative expenses in private insurance and promote competition. The plan also calls for a new system of reinsurance.
Other cost-control measures include accelerated adoption of electronic medical records, paying providers on the basis of performance and outcomes, permitting the federal government to negotiate prescription-drug prices for Medicare patients, cutting excessive payments to private health plans contracting with Medicare, and establishing an institute for comparative-effectiveness research to generate information about effective treatments.
Obama has not ruled out adopting an individual mandate in the future if the plan does not produce universal coverage. The new national health plan could control costs, but its effectiveness in slowing spending would depend on its enrollment and the political willingness to restrain provider payments.
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Medical Providers: Are Your “Red Flags” Ready to Fly by November 1, 2008?
Source: Mondaq.com
Date: 09/28/2008
November 1, 2008 is the compliance deadline for the new federal “Red Flag” rules, adopted under the Fair and Accurate Credit Transactions Act of 2003 (FACTA). Although the act is directed at banks, mortgage lenders and other creditors, hospitals and other medical care providers are included in FACTA because health care providers extend credit to some patients, employees and physicians by offering extended payment plans. These payment plans are included in the act’s broad definition of creditors as “any person or business who arranges for the extension, renewal, or continuation of credit” with a “covered account.”
The “Red Flag” rules require health care providers and other creditors to adopt and implement an identity theft protection program that enables the health care providers to:
-Periodically determine whether it maintains covered accounts.
-Identify relevant patterns, practices, and specific forms of activity suggesting identity theft.
-Respond appropriately to any Red Flag that is detected to prevent and mitigate identity theft.
-Ensure the program is updated periodically to reflect changes in risks.
Health care providers must keep abreast of trends in identity theft including e-mails and voice communications that attempt to convince consumers into revealing private information as part of the regulations. Another component of the new rules is the requirement that the health care provider’s board of directors must become involved in the “Red Flags” program oversight.
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Study Polls Physician Views on Universal Healthcare
Source: MarketWatch
Date: 08/28/2008
A new study from DoctorDirectory.com assessed the attitudes of more than 850 physicians of all specialties on universal healthcare as it relates to the upcoming election.
Regarding the upcoming election, 81.3% have formed party and/or candidate preferences based upon the candidate’s stand regarding key issues.
While physicians have indicated that the economy, not health care, is the most important issue facing voters in the upcoming election, they are fairly evenly split with regard to the efficacy of universal healthcare as a means of improving health care in America. They were also split as to whether health insurance should be mandatory for all Americans.
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FDA Starts Reporting Drugs Under Safety Investigation
Source: Medical News Today
Date: 09/08/2008
On September 5, 2008, the Food and Drug Administration (FDA) posted its first quarterly report on the drugs it is investigating due to post-marketing problems reported by patients and doctors.
The reporting of FDA drug investigations is required under a new law, the Food and Drug Administration Amendments Act, which was passed in 2007. Patients, health care professionals and drug companies can report potential drug safety issues to the FDA through its Adverse Event Reporting System (AERS), and the FDA may choose to investigate certain drugs if AERS data warrant investigation.
The first quarterly report lists 20 drugs under investigation along with their potential safety issues, as revealed by AERS data. The FDA asserts that drugs listed in the report are only on the list because of a potential safety issue and have not necessarily been determined to be unsafe. FDA officials want to emphasize that doctors should not stop prescribing a drug just because it is on the list and patients should not stop taking their medications.
The FDA will release a new list every quarter, meaning it will not name any drugs that appeared on previous lists, even if they are still under investigation. Though the FDA has a system in place for drugs it determines to be linked to potential risks, it is not yet clear how the FDA will inform the public when an investigation “clears” a drug that appeared on the list.
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Course Teaches Medical Students Ways of Business
Source: Modern Physician
Date: 09/11/2008
For the second year, Northwestern University is offering an interdisciplinary course that brings together students and faculty from its schools of medicine, law, engineering and business. The course, called NUvention, instructs students on the medical product- and business-development process over two academic quarters, affording students a hands-on experience that reveals what it takes to bring medical advances to the market.
Northwestern receives financial backing from healthcare companies in order to provide the course. In its first year, NUvention included 82 students divided into 11 teams, each tackling an area such as cardiology, neurosurgery, orthopedics or urology. By the end of the course, teams had developed prototypes and full business plans.
Doctors at Northwestern’s Feinberg School of Medicine assert that the benefits of the course go far beyond the classroom. Patrick McCarthy, M.D., chief of cardiac surgery at Northwestern and NUvention’s medical director, says that the patients benefit as much as the students do, if not more so, as the course promotes bridging the clinical knowledge of physicians with the technical, legal and business strengths of students and professionals from the other fields. Feinberg School of Medicine professor and practicing cardiologist Randall Williams praises the course as a way to help physicians who are frustrated in their roles within a challenging healthcare system that does not make it easy to implement change.
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Diversity at Medical Schools Makes Stronger Doctors, Study Shows
Source: ScienceDaily
Date: 09/10/2008
While “diversity” is a value that has been much lauded by institutions of higher education, concrete data has yet to be produced on its benefits in the medical school context. The September 10th edition of the Journal of the American Medical Association contains a study of 20,000 graduating medical students from 118 medical schools that aims to do just that. This study, led by the UCLA Higher Education Research Institute, “explored whether the proportion of minority students within a medical school made a difference in three outcomes: First, whether students said they felt prepared to care for diverse patient populations; second, their attitudes about access to healthcare; and third, their plans to care for patients in areas that are traditionally underserved by the healthcare system.”
The study found that white students who attend racially diverse medical schools said they felt better prepared to care for patents from racial and ethnic groups other than their own than did students at less diverse schools. In addition, students at more diverse schools are more likely to view health care as a societal right rather than a privilege. As to the third question on the relationship between the diversity of a medical school and whether white students intended to provide care in underserved areas, no association was found.
While a diverse student body is a necessary step toward achieving the aforementioned benefits, the authors of the study note that a diverse composition is not sufficient for students to realize the full benefits of diversity. They found that positive interaction must be promoted in order to realize its full benefits.
By offering evidence for the benefit of diversity in medical schools, this study provides support for medical school policies and programs aimed at achieving racial diversity.
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The Doctor’s Hands Are Germ-Free. The Scrubs Too?
Source: The New York Times
Date: 09/22/2008
Amid growing concerns about hospital infections and a rise in drug-resistant bacteria, the attire of doctors, nurses and other health care workers — worn both inside and outside the hospital — is getting more attention. Though the importance of hand washing and equipment sterilization in hospitals has been well documented, little is known about the role that professional and casual clothing may play in the spread of bacteria.
Earlier this year, the British National Health Service imposed a “bare below the elbows” rule barring doctors from wearing ties and long sleeves, both of which are known to accumulate germs as doctors move from patient to patient. At most U.S. hospitals, physicians are asked to wear “professional” dress and told not to wear scrubs to and from the hospital, but have no strictly defined rules like those recently enacted in the U.K.
While the role of clothing in the spread of infection hasn’t been well studied, some hospitals in Europe have adopted wide-ranging infection-control practices that include provisions for the clothing that health care workers wear both in and out of the hospital. Stringent bacteria contamination precautions appear to have worked in Denmark, where fewer than one percent of staph infections involve resistant strains of the bacteria. Meanwhile, in the United States, the numbers have surged to fifty percent in some hospitals.
For American hospitals on tight budgets, implementing comprehensive clothing provision and laundry plans does not seem feasible and are unlikely to take hold while there is no conclusive evidence of their necessity.
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Traveling for Care – in the U.S.
Source: The Wall Street Journal
Date: 09/10/2008
Medical tourism, defined as the practice of traveling abroad to receive less expensive medical care, has become an increasingly common phenomenon. Recently, a new variant has arisen. As U.S. hospitals have begun trying to match lower foreign prices to stem the prospect of losing revenue overseas, U.S. employers are encouraging workers to travel domestically for medical care, especially surgical procedures such as hip and knee replacements and cardiac bypasses, in an effort to find new ways to manage medical costs.
In order to encourage such travel, employers are offering financial incentives including no out-of-pocket costs, money for travel expenses, and access to concierge services. For instance, Hannaford, a Scarborough, Maine-based company that has negotiated a deal for hip, knee and spine surgery with a hospital in Boston, has promised to pick up the entire tab for the procedure if employees go in the next year.
Healthplace America, a company that offers access to a specialty network of U.S. hospitals for various procedures, indicates that such networks can offer employers savings of 30% to 50% on rates negotiated by insurers because the company pays the providers upfront in cash based on fixed per-case rates. With soaring gas and food prices are pummeling their pocketbooks and the complications involved with traveling overseas for medical care, odds are that such arrangements will begin to appeal to employees as well.
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Academic Sites Adopt Conflict-of-interest Policies More Easily
Source: ModernHealthcare.com
Date: 09/02/2008
While relationships with medical companies can be of great benefit both to medical centers and medical researchers, academic freedom and scientific standards require that conflict-of-interest policies be instituted to protect against bias in teaching and research. It has been suggested that the stricter a conflict-of-interest policy becomes, the more likely it will be that centers will lose good faculty and staff--that is, individuals who wish to pursue relationships with the private sector.
A report that appeared in the September 3rd edition of the Journal of the American Medical Association indicates that this does not seem to be the case. According to Columbia University researchers David Rothman and Susan Chimonas, academic medical centers adopting strenuous conflict-of-interest policies have seen little loss of faculty and staff in reaction to the new standards.
This study of roughly 25 medical centers that have implemented new conflict-of-interest policies, most often in response to a conflict-of-interest policy recommendation published in January 2006 by an American Board of Internal Medicine and Institute on Medicine as a Profession joint task force, found that most often the result of a change in conflict-of-interest is a heated debate between healthcare providers and administrators.
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