Articles Posted in Medical Practice Management

primary-care-300x199The U.S. health system is in dire need of dramatic reforms to put patients first, most notably by ensuring that everyone in this country has a formally designated primary care physician to help monitor, navigate, and oversee their medical treatment.

That is the latest recommendation of yet another blue-chip experts’ group: the National Academies of Sciences, Engineering and Medicine, a self-described collective of “private, nonprofit institutions that provide expert advice on some of the most pressing challenges facing the nation and the world.”

An expert panel from the academies, after deep research and in issuing a 448-page report, has expressed disappointment that policy makers seemingly ignored the 1996 recommendations of its independent, nonpartisan sister group, the respected Institute of Medicine. The institute offered a blueprint for moving Americans into an approach, built on primary care, that has shown major benefits elsewhere in the world.

bucksfloating-300x167Who wouldn’t want $352 billion in health care savings in 2021?

Insurers — and more importantly employers — could see that hypothetical big chunk of change staying in their pockets, if somehow they could persuade hospitals to forgo their sky-high and ever-increasing prices, tying those charges instead to rates established and paid in the federal Medicare program that covers millions of the nation’s seniors, a new study reported.

The independent Kaiser Family Foundation (KFF) concedes it is unlikely that hospitals, insurers, and businesses would adopt the nonprofit organization’s newly published research any time soon.

autonomouscrash-300x173The race to deal with the existential threat of climate change by making millions of vehicles smarter, more efficient, and environmentally friendly may be on a collision course with safety concerns.

As the Los Angeles Times reported, concerns are rising among consumer advocates that makers have zoomed ahead with entrepreneurial and engineering advancements in vehicles, even as expert regulators went AWOL in the era of the business-enthralled 45th president.

Whither the future of road- and product-safety in an era of autonomous or self-driving and all electric vehicles?

candidacdcauris-300x135Patients long have dreaded the possibility that — when already seriously ill or hurt — they also would be hit with debilitating or deadly hospital- or health care-associated infections, aka HAIs. The most nightmarish of these cases involve bacteria or fungi difficult to subdue, even with powerful treatments.

Now, with care institutions overwhelmed by coronavirus pandemic cases, drug-resistant HAIs are increasing — and in worrisome fashion because they are so difficult on their own for patients, doctors, and hospitals to deal with, the New York Times reported:

“’Seeing the world as a one-pathogen world is really problematic,’ said Dr. Susan S. Huang, an infectious disease specialist at the University of California at Irvine Medical School, noting that the nearly singular focus on the pandemic appears to have led to more spread of drug-resistant infection. ‘We have every reason to believe the problem has gotten worse.’ A few data points reinforce her fears, including isolated outbreaks of various drug-resistant infections in Florida, New Jersey, and California, as well as in India, Italy, Peru, and France. Overall figures have been hard to track because many nursing homes and hospitals simply stopped screening for the germs as resources were diverted to Covid-19. When even modest screening picked up again early in the summer, the results suggested that certain drug-resistant organisms had taken root and spread. Particularly troublesome have been growing case counts of a fungus called Candida auris [shown in CDC photo, above], which authorities had tried to fight before the pandemic with increased screening, isolation of infected patients and better hygiene.”

documentsigning-300x156Wealthy investors want to enrich themselves yet more, partly by pushing doctors to oust patients from their practices unless they sign away invaluable constitutional rights. These rights can protect them if they are harmed while receiving medical services.

Patients’ safeguards, however, too often vanish when businesses compel customers to sign on to “forced arbitration,” Bloomberg Businessweek reported, noting that this consumer menace is rising in medicine as hedge funds buy up physician groups. Rich investors see lucrative profits in these practices, particularly in specialties like dermatology, gastroenterology, and obstetrics.

It seems that doctors like practicing medicine and dislike the billing, managing, paper shuffling, and other bureaucratic aspects of their profession, the story reported. Some aren’t good at it. Many are struggling, especially as the coronavirus pandemic has slashed patient demand for all kinds of medical procedures, sending doctors’ revenues plummeting. As Bloomberg reported:

compare-202x300A lot of people in health care across the country are firing up their computers to dig into long-sought, confidential information from hospitals about their prices and deals they cut on them with an array of parties.

As the Wall Street Journal reported, the Trump Administration successfully battled with hospitals to get them to disclose previously secret pricing data, in the hopes that disclosing this key information will benefit the U.S. health care system, notably in curbing costs. Here’s why, as the newspaper reported:

“T]hose who pay for health-care premiums and medical bills — employers, workers and patients — were long in the dark about wide price differences among hospitals for the same service in the same city, according to research and efforts by large employer groups to compare prices. Hospital prices are under intense scrutiny as the sector consolidates and research points to price increases after mergers, but without the quality gains that hospitals often cite as rationale for the combinations.

billsurprisemedica-300x167The do-little U.S. Senate and the House gave Americans an unexpected cause for glee at year’s end. Lawmakers approved long sought relief from “surprise medical bills,” the charges, too often whopping in size, that individuals and families rack up for care from all kinds of providers that their health insurers have not approved.

Multiple legislative committees and influential lawmakers compromised so Congress could mostly resolve this consumer nightmare as part of the 5,600-page bill that both provides desperately needed coronavirus relief and funds the government.

The legislative action exempted one costly area considered still too complex and fraught for Congress to deal with — pricey emergency transport by ambulances. The vehicular services, for which consumers can get staggering bills, are run by so many different providers, including local governments, and operate under such a patchwork of regulations that lawmakers decided against dealing with this extreme expense.

bentcostcurvekff-300x147The nation has gotten some long-desired, important health care economic news: The country  has “bent the cost curve,” seeing 2020 as the first year in at least six decades in which America’s health care spending went down. But this may not be a good thing.

As Drew Altman, president and chief executive officer of the Henry J. Kaiser Family Foundation (KFF), reported of his organization’s economic data:

Year-to-date spending on health services is down about 2% from last year. Health spending for the calendar year may end up lower than it was in 2019.  Adding spending for drugs, which are less affected by Covid-19 and have not fallen, total health spending is still down by about 0.5% from last year. At its low point in April when the pandemic first really hit, spending on health services had fallen an eye popping 32% on an annualized basis. This is the first time expenditures for patient care have fallen year-over-year since data became available in the 1960s. The largest drop-offs were in outpatient care as people put off elective services or [visits to] doctors’ offices and outpatient clinics shut down. Telehealth visits increased dramatically but did not make up all of the difference.”

dopeweighing-300x200Drug policy and treatment in this country is shifting in notable ways, even as the nation wrangles with a resurgent crisis in opioid abuse and overdose deaths and awaits a political transition that will determine a new response to drug harms.

As an indicator of the changing views on illicit substances, consider that the U.S. House has just approved “sweeping legislation that would decriminalize marijuana and expunge nonviolent marijuana-related convictions,” the New York Times reported. The newspaper said this of the bill, which for now also faces certain failure:

“The 228-164 vote to approve the measure was bipartisan, and it was the first time either chamber of Congress had ever endorsed the legalization of cannabis. The bill would remove the drug from the Controlled Substances Act and authorize a 5% tax on marijuana that would fund community and small business grant programs to help those most impacted by the criminalization of marijuana. The legislation is, for now, almost certainly doomed in the Republican-led Senate, where that party’s leaders have derided it as a superficial distraction from the work of passing coronavirus relief, as lawmakers inched toward bipartisan compromise after spending months locked in an impasse.

oighhslogo-150x150Buh-bye? Arrivederci? Sayonara? Can it be that the coronavirus pandemic puts an end to one of the disgraceful ways that Big Pharma and medical device makers push their wares on all-too malleable doctors — with big-money speaker programs?

The inspector general’s office of the giant federal Health and Human Services (HHS) agency has warned drug- and medical device-makers that these pandemic-paused marketing shams should not resume. The $2 billion that industry players have forked out for the in-person gab fests in the last three years looks sketchy at best to federal watchdogs and prosecutors, the HHS inspector general warned in a rarely issued “special fraud alert.” It reported this:

“The Office of Inspector General (OIG) and Department of Justice (DOJ) have investigated and resolved numerous fraud cases involving allegations that remuneration offered and paid in connection with speaker programs violated the anti-kickback statute. The Federal government has pursued civil and criminal cases against companies and individual [health care providers] involving speaker programs … Our enforcement experience demonstrates that some companies expend significant resources on speaker programs and that some [health care providers] receive substantial remuneration from companies. This Special Fraud Alert highlights some of the inherent fraud and abuse risks associated with the offer, payment, solicitation, or receipt of remuneration related to company-sponsored speaker programs.”

Patrick Malone & Associates, P.C. listed in Best Lawyers Rated by Super Lawyers Patrick A. Malone
Washingtonian Top Lawyer 2011
Avvo Rating 10.0 Superb Top Attorney Best Lawyers Firm
Contact Information