Struggling to make it through in the midst of an ever-worsening budget impasse over Medicare reimbursement, the Center for Medicare & Medicaid Services (CMS) couldn’t wait any longer. CMS is now implementing a 21% cut in physician payments, which will affect an estimated 50 million claims. Claims that were held back since June 1 will be the first to feel the effects of the cuts.

In the late 1990’s the funding formula for Medicare reimbursements was first enacted in conjunction with the Balanced Budget Act. However, even at that time it was thought by some to be flawed. Today the formula is thought to be seriously flawed, and is growing more and more out of sync with its original intended purposes with each passing year.

Medicare Cuts Could Affect Quality of Care

Even though Medicare has instituted this drastic cut it too may stand to be on the losing side of the board as well, considering there are already a huge number of medical practices that currently do not take on Medicare’s elderly patient population.

Participating physicians will see a direct impact of the 21% cut with the average office visit now being reimbursed at about $8.00 less than what they were in 2007. Medicare may also feel the brunt of this unresolved state of affairs.

If a resolution is indeed reached, and the cuts reversed, they are looking at having to swallow about .30 cents per claim that is reprocessed. This translates out to a staggering potential of $15 million dollars for the first 50 million claims alone.

Only time will tell how it will all play out in the end, if there ever will be an end. In the meantime, there is no way for anyone, including physicians, patients and even Medicare to avoid the huge impact of this monumental move.

California has one of the highest rates of uninsured citizens in the country with more than 6.4 million people currently without health insurance coverage. That said, it stands to reason that any additional coverage at the federal level is a huge plus for not only the California government but for the residents as well.

Positive effects of health care reform in California

When it comes to California, the federal overhaul would help those who can afford health insurance but are currently unable to get it. It will assist those who aren’t able to obtain coverage by providing them with a means to acquire health care benefits. Additionally, the bill will also go a long way in tackling the desire to provide Californians with the preventative means to uncover unhealthy conditions in the early stages, where they can be addressed promptly, and thus help everyone get more affordable California health insurance. There is a downside of this bill, however; read below to learn what it is.

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Advocates of measures to improve the efficiency of health care have been advocating electronic prescribing for many years, and if recent efforts in this area are anything to go by, as many as 75% of doctors might be using e-prescriptions in just five years. E-prescriptions are paperless prescriptions, written electronically by your doctor and sent electronically to your pharmacy. No print-outs are involved at all – your doctor doesn’t print you a copy, and a copy isn’t faxed to your pharmacy. All the work is done electronically.

What Are the Benefits of Electronic Prescriptions?

Adopting an e-prescribing system has a number of benefits for both doctors and patients. The system is more efficient, potentially saving millions of dollars in health care expenditure, and meaning shorter waits for people getting prescriptions filled. More importantly, it could completely eliminate the harmful errors that can result when a doctor’s handwriting is misread by a pharmacist. (more…)

President-elect Barack Obama should take note – health reform is about the little things just as much as it is sweeping changes to the system.

Information gathered from a batch of more than 8,500 meetings held around the country in December will be compiled and used to help design the healthcare proposal that has been in the news as of late. Obama’s transition team plans to post some of the material at change.gov.

One particular meeting took place late December 2008, between newly appointed secretary of health and human services, the former Senate Majority Leader Tom Daschle, and more than two dozen seniors During this meeting, seniors told Daschle that they placed more importance on certain things such as waiting times to see their doctor, the increasing cost of prescription drugs, and the narrow range of Medicare coverage for certain medical procedures, equipment, and treatments.

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It’s not just the unemployed facing healthcare insurance problems, according to a new Robert Wood Johnson Foundation report compiling research carried out by the State Health Access Data Assistance Center at the University of Minnesota. Nearly 20% of American workers have no health insurance, up from around 14% in the mid-1990s.

During the mid-1990s, one in seven American workers had no insurance. Just ten years later, that figure has increased to one in five workers uninsured, or around six-million more people over the mid-1990s total.

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Fibromyalgia is a devastating disease that causes chronic pain and other symptoms for those who are affected – but it’s a disease with no known cause and no standard treatment. Many people haven’t even heard of the condition, but if that’s the case it’s not because the drug industry isn’t trying hard enough.

Drug Companies’ Hundreds of Millions Help Raise Awareness of Fibromyalgia

Last year, drug industry giants Pfizer and Eli Lilly spent hundreds of millions of dollars in advertising to “raise awareness” of fibromyalgia. The companies donated more than six million dollars to non-profit organizations for educational campaigns and medical conferences, too.

That’s more than the companies donated for Alzheimer’s, and diabetes. And only donations made for cancer, depression, and AIDS were higher than the donations made to further the cause of fibromyalgia.

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Many of us rarely ponder what our health and life are worth. It’s often assumed that life is priceless, but that doesn’t do justice to the stratospherically rising health care and insurance costs; in fact health bills are now the leading cause of bankruptcy.

One common way to calculate the value of our life is to use the same equation used by many health care providers. That cost was once $50,000 per year of quality life, according to the international standard for government-run health insurance plans across the globe. This number has been disputed by economists at Stanford and they were able to calculate that a year of quality life is actually $129,000! That is a lot of money for a year of life, but of course: life is priceless!

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photo credit: DerrickT

The shocking truth is that nursing homes in America are not safe, and for-profit nursing homes are even less safe.  This comes from the latest report issued by the Department of Health and Human Services, Office of Inspector General.

In fact, 2007 saw a number of states report unprecedented rates of nursing home violations – Idaho, Alaska, Washington D.C. , and  Wyoming had a %100 violation rate. The most common violations included infected bed sores, inadequate treatment of urinary tract infections, deficient housekeeping, and improper nutrition. One in six nursing homes, posed “actual harm or immediate jeopardy” to residents.
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