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Stem cell research is definitely in the news. A recent ABCnews.com story spotlighted an injured policeman in Texas who regained physical strength and mobility as a result of adult stem cell injections he received in China. (Click here for the online video.) Despite the actual and potential benefits of stem cell research, many healthcare professionals disagree on key issues related to its advancement and practical application. Our survey frames the debate from several different perspectives. More…
Pushing the limits of medical research |
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Stem cell research is like universal health care. Almost everyone has an opinion about it, but sometimes the debate generates more heat than light. Most proponents view stem cell research as a tremendous boon to medical technology that can prolong lives, reverse congenital diseases, restore damaged tissue, and actually regenerate lost limbs.
In fact, the Pentagon recently announced a massive project, budgeted at $250 million, to advance stem cell research specifically aimed at harvesting cells from military personnel prior to their being deployed into war-torn areas. The expectation is that upon their return, any service person that has experienced physical injury or trauma could receive restorative medical treatment derived from their own harvested stem cells. It remains to be seen how quickly or effectively that research initiative will pay off.
The actual or potential benefits of stem cell research notwithstanding, serious questions remain.
This month’s survey, “The Stem Cell Research Debate,” sheds some light on the ongoing, often-polarizing debate. Particularly noteworthy are the comments of respondents who have strong opinions on the subject. In complementary fashion, our Special Report, “Embryonic Stem Cell Research—Promise and Controversy,” addresses other concerns that are being discussed by persons knowledgeable of the issues.
As always, the Jackson & Coker Industry Report spotlights the critically important issues voiced by different sectors of the healthcare community. Informed readers can draw their own conclusions.
Cordially,
Calvin Bruce
Managing Editor
‘Robodoc’ Coming to a Hospital Near You
Source: San Diego Union-Tribune
Date: 08/14/2008
“Remote-presence robots,” wireless human-sized computers capable of transmitting voice and video data over long distances and controlled remotely by joysticks, are the latest approaches to the field of telemedicine, enabling doctors to evaluate patients from afar. At Pomerado Hospital in North County, CA, one such robot is employed by Dr. Ben Kanter to check on patients and to chat with patients’ family members, usually accompanied by a nurse. These robots first appeared in 2002, and the technology is now on its seventh generation. The robot is on lease from Santa Barbara-based InTouch Health and is one of 200 in use globally according to the company.
Remote-presence robots are no substitute for doctors, Dr. Kanter points out, but can greatly enhance patient care. For example, a doctor at a children’s hospital may evaluate patients at other hospitals, assessing the need for transfer and recommending appropriate treatment. Hospitals without specialists on staff will find the technology useful as it enables specialists from distant hospitals to quickly evaluate patients and consult with doctors on-site.
Regarding telemedicine in general, new medical education facilities are being built, equipped to train medical students in the field. Doctors, nurses, and patients alike are impressed with the new technology and have expressed interest in working with remote-presence robots.
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Opinion: Is There Really a Physician Shortage?
Source: Contemporary OB/GYN
Date: 08/01/2008
With the AAMC calling for a 30% increase in medical school admissions, numerous states accrediting new medical colleges, and numerous state, federal, and industry organizations predicting shortfalls of anywhere from 80,000 to 200,000 physicians over the next fifteen years, the consensus seems clear: America faces a physician shortage which will only get worse with time. But how reliable is this consensus? An article in Contemporary OB/GYN examines the underlying evidence and posits a different conclusion.
The author questions the need of even the current medical workforce. Citing stats indicating a climb in per capita physician populations of 47% from 2001 to 2010, the author says the current shortage is really more of a distribution disparity. In the past two decades, non-metro areas have had higher proportional growth in per capita physicians than have metro areas. The author states that this deficiency does not lead to adequate care, citing patient satisfaction surveys and Medicare composite quality scores indicating that per capita physician populations have little effect on quality of care. Further, he notes that rural areas have the best ratios of generalists to specialists.
The author blames the shortage fears on specialty societies, whose connections to trade unions, in addition to public health concerns, lead to simplistic models of physician need adjusted for projected demographic trends. Further, the projections do not take into account the cloud of physician extenders currently saturating the marketplace.
In general, the author says that concerns about a physician shortage are overblown generally and could lead to unsustainable programs, as the requested increases in enrollments and residencies will necessitate state and federal funding, and he predicts an increased physician supply will actually drive up the costs of healthcare. The author concludes that the solution is a comprehensive plan for health care access coupled with efforts to undo the disorganized and fragmented delivery system that is really at the heart of the “shortage.”
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CMS Finalizes Stark Rule Changes in Final 2009 Inpatient PPS Rule
Source: Mondaq.com
Date: 08/14/2008
The Centers for Medicaid and Medicare Services released its final 2008 inpatient PPS rule on July 31, 2008. The rule includes important revisions to the Stark Regulations, including finalized revisions to the Physician’s “Stand in the Shoes” provisions and proposals to restrict “under arrangements” transactions, per unit space/equipment lease transactions, and percentage based compensation arrangements, among other regulatory aspects.
-Physician “Stand in the Shoes” provisions—The final rule provides that SITS does not apply to arrangements satisfying the Academic Medical Center Exception.
-Per Unit/Percentage of Revenue Leases—CMS clarified that prohibitions on “click” fees are not limited to space/equipment leases between physician-owned leasing companies and DHS entities. CMS also finalized its prohibition on percentage based compensation in space and equipment leases.
-Set in Advance Requirement—CMS’ new position is that amendments to compensation terms between a DHS entity and a physician or physician organization will not cause the agreement to fail the Set-in-Advance requirement if it fits the necessary criteria detailed further in the rule.
-Alternative Exception for Obstetrical Malpractice Insurance Subsidies—This exception protects the subsidy paid by a hospital, federally qualified health center or rural health clinic if ten requirements are met, including the requirement that the physician's medical practice is located in a primary care Health Professional Shortage Area.
-The new ruling places the burden of proof in appeals of Stark-based payment denials on the entity appealing the denial.
-Disclosure of Financial Relationships Report (DFRR)— The final rule announces that CMS is proceeding with its proposal to send the DFRR to 500 hospitals.
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N.J.’s Biggest Insurer May Turn For-Profit
Source: Philadelphia Inquirer
Date: 08/16/2008
Horizon Blue Cross Blue Shield has filed for a move that could turn the New Jersey healthcare giant for-profit. The company is New Jersey’s largest healthcare payer, covering fully 40% of New Jersey residents. The conversion is expected to add a billion dollar windfall to the state budget. This influx of cash would go to funding a charity to serve the underserved in New Jersey’s population.
Proponents of the proposed status alteration for Horizon say that the for-profit model will maximize operational efficiency and possibly result in lower cost coverage to residents. Opponents predict that the company’s priorities will shift immediately from customers and employers to future shareholders.
Non-profit payers generally convert to for-profit when they are looking to expand. Some fear that a merger with another company would shift Horizon’s focus from New Jersey residents to larger markets. Horizon took in $7.5 billion in revenue in 2007, of which $2.5 billion was from for-profit subsidiaries.
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22% of Americans Surveyed Cut Visits to Doctor
Source: San Francisco Chronicle
Date: 08/13/2008
Nearly one in four Americans have reduced the number of times they’ve gone to see the doctor in order to save money, according to a new poll by the National Association of Insurance Commissioners.
The poll, which surveyed 686 consumers in July of 2008, found that 22% of respondents had lessened their trips to the doctor in response to the economy. Furthermore, |