The Costs of 10 Top Commercially Insured Readmission Conditions

A Becker Hospital Review article noted: “Of the 10 most common readmissions conditions for patients with private insurance, chemotherapy resulted in the highest costs for hospitals, according to an Agency for Healthcare Research and Quality statistical brief.”

“Here are the costs of the 10 most common readmissions among the commercially insured, according to the AHRQ brief. Note: Costs were defined as the actual expenses incurred in the production of hospital services (such as wages, supplies and utility costs). A readmission was defined as a patient who was hospitalized within 30 days of a previous hospital admission. Read more

Hospitals Boost Patient Safety, but More Work Is Needed

A Kaiser Health News article noted: “Two major safety shortcomings in America’s hospitals—the frequency with which patients get hurt during their stays and the large number who are readmitted—have decreased as government penalties and other programs targeting them kick in.”

“The Obama administration credited the new quality initiatives created by the federal health law. But some of the improvements in patient safety preceded that law. Even with the improvements, one out of eight patients is injured during their time in the hospital.” Read more

“Not Allowed to Die”

The New York Times article noted: “Although most of us claim no desire to die with a tube down our throat and on a ventilator, the fact is, as Katy Butler reminds us in “Knocking on Heaven’s Door,” a fifth of American deaths now take place in intensive care, where 10 days of futile flailing can cost as much as $323,000… .” Read more

Who Really Pays for Health Care? It Might Surprise You

A USA Today article noted: “Eight million people have signed up for subsidized private health insurance under the Affordable Care Act, President Obama said this month. Millions more obtained new coverage through the Medicaid program for the poor. Full implementation of the health law and its wider coverage, new taxes and shifting subsidies have renewed discussions of winners and losers, makers and moochers”

“Here’s a corrective to common misconceptions about who pays for health care. Read more

Let's Put Consumers in Charge of Health Care

A Harvard Business Review article noted: “The health care industry has been shielded from consumer pressure—by employers, insurers, and the government. As a result, costs have exploded as choices have narrowed.”

“There is a way out of this mess—if companies embrace a radical new treatment: consumer-driven health care. This new model places control over costs and care directly in the hands of employees by giving them more health-plan choices, greater control over what they spend on coverage, and more information for wiser choices.” Read more

Advice to Young Surgeons: What 7 Spine Surgeons Have Never Forgotten

The Becker’s Spine Review had “Seven spine surgeons talk about the best professional advice they have received during the course of their careers.”

Sheeraz Qureshi, MD, Chief, Spinal Trauma, Icahn School of Medicine at Mount Sinai, New York City: The best professional advice I ever received was to have strict indications for when to operate and when not to operate, and to make sure patients fully understand the goals of their treatment plan… .” Read more

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