Medicare’s $5 Billion Ambulance Tab Signals Area of Abuse

A Bloomberg article noted: “The U.S. Department of Health and Human Services has identified ambulance service as one of the biggest areas of overuse and abuse in Medicare — companies billing millions for trips by patients who can walk, sit, stand or even drive their own cars.”

“‘It’s a cash cow,’ said Assistant U.S. Attorney Beth Leahy … ‘It’s basically like a taxi service except an extremely expensive one that the taxpayers are financing.’” Read more

Injured Good Samaritan Billed $165,000 by Aetna For “Out-of-Network” Care

An Arizona Central article noted: “Cliff Faraci sustained first-, second- and third-degree burns after trying to save a teen girl after a car accident in March 2013. He stayed in a hospital burn unit for a week to get treatment for his injuries. Days later, Aetna told him it wouldn’t cover the stay.”

“Cliff Faraci suffered first-, second- and third-degree burns trying to rescue girl from a deadly accident last year. His insurance company denied his claims and hit him with a $165,000 bill, saying his injuries were not severe enough to require acute-care treatment for a week.” Read more

Using Data to Treat the Sickest and Most Expensive Patients – “Super-Utilizers”

An article in Marketplace noted: “We can actually take the sickest and most complicated patients, go to their bedside, go to their home, go with them to their appointments and help them for about 90 days and dramatically improve outcomes and reduce cost…”

“That’s the theory anyway. Like many ideas when it comes to treating the sickest patients, there’s little data to back up that it works.” Read more

With Medical Debts Rising, Doctors Are More Aggressive about Payments

The Kaiser Health News article noted: “The recent economic downturn and the increasing use of high-deductible insurance plans ‘has driven patients to want to put off paying their bills…,’ Whether it’s for a hip replacement or a broken bone, he frequently sees patients on the hook for a $3,000 to $5,000 deductible.”

“Between 2008 and 2012, multispecialty practices saw their bad debt go up 14 percent, according to a survey by the Medical Group Management Association (MGMA), a trade organization for doctor practices. That’s money that practices were owed but couldn’t collect. Some of them have begun to change their billing strategies to combat those debts…” Read more

… The Price of Care Can Hurt Health – Should Doctors Consider Medical Costs?

A Boston Globe article noted: “This patient could be a time bomb, Dr. Neel Shah thought. A blood test suggested that she might have an ectopic pregnancy, in which a fertilized egg remains outside the uterus. Left untreated, the condition can cause fatal hemorrhaging. But when Shah, a medical resident at the time, told the woman she needed an ultrasound to confirm the result, she refused. An earlier visit to the emergency room for a bout of stomach trouble had left her with an exorbitant bill. Until Shah could tell her how much an ultrasound would cost, she wasn’t budging.” Read more

Palliative Care Explained

A Cancer Today article noted: “Originating from the Latin word pallium, meaning ‘a cloak,’ palliative care offers relief from the symptoms and stresses of cancer. It’s not a replacement for therapies like chemotherapy, radiation or surgery that treat the illness. Instead, it’s a companion therapy.”

“For someone with a serious condition that affects quality of life, ‘if you want the best care possible and you’re getting cancer care without palliative care, then you’re not getting the best care,’ says Diane Meier, a geriatrician and palliative care specialist who directs the Center to Advance Palliative Care.” Read more

Being Your Own Health Care Advocate – How to Make the Most of Every Doctor Visit

A Everyday Health article noted: “Prevention is key to staying healthy at every age, so it’s important to get the routine health care you need. It might feel as though your doctor has less time to spend with you at office visits, but that’s precisely why you want to make the most of each one.

“Going through a health care checklist during your visit can help you make sure that healthy aging is in your future.

Maximizing Your Health Care Visits. Make a list so you don’t forget to bring up any health concerns that you want to focus on. Read more

Doctors Hesitate to Ask Heart Patients about End-of-Life Plans

An NPR story noted: “Of the 5 million Americans with failing hearts, about half of them will die within five years of getting diagnosed. Given the odds, it seems that people with heart failure should start thinking about how they want to die. But doctors don’t routinely talk to those patients about end-of-life planning.”

“When researchers asked 50 doctors and 45 nurse practitioners and physician assistants how often they discuss preparing for death with their heart failure patients. A third of the providers said they lacked confidence in talking about end-of-life care. Only 12 percent said they have routine yearly discussions about the end of life.” Read more

The Path of Least [Antibiotic] Resistance

The Brookings Institution article noted: “While antibiotics are necessary and crucial for treating bacterial infections, their misuse over time has contributed to a rather alarming rate of antibiotic resistance, including the development of multidrug-resistance bacteria or ‘super bugs.’ Misuse manifests throughout all corners of public and private life; from the doctor’s office when prescribed to treat viruses; to industrial agriculture, where they are used in abundance to prevent disease in livestock.” Read more

Hospitals Put Pharmacists in the ER to Cut Medication Errors

The NPR story noted: “In the emergency department at Children’s Medical Center in Dallas, pharmacists who specialize in emergency medicine review each medication to make sure it’s the right one in the right dose. It’s part of the hospital’s efforts to cut down on medication errors and dangerous drug interactions, which contribute to more than 7,000 deaths across the country each year.”

“Medication errors can be caused by something as simple as bad handwriting, confusion between drugs with similar names, poor packaging design or confusion between metric or other dosing units, according to the Food and Drug Administration. But they’re often due to a combination of factors, which makes them harder to prevent.” Read more