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. (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.” (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… .” (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.'” (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.” (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.” (more…)

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