Insight, analysis & opinion from Joe Paduda
There’s been so much activity on the national health care scene involving managed care, medicare, provider reimbursement, consumer-directed health plans and Part D, I’ve neglected another loyal readership, the brave souls who toil in the workers comp managed care business. … Continue reading The latest on the work comp managed care world…
Read More...A study released by the Mayo Clinic, reports that there is far too much money spent on end-of-life care. The study is paralleled by a newly released Dartmouth study , reports that indicates Medicare spent about $40 billion more than … Continue reading End of life care costs too much
Read More...Physicians choose surgical implants and devices, hospitals order and pay for them, patients get whatever the docs choose, device manufacturers make lots of profits, and payers foot the bill. A process that is seemingly designed to completely avoid any price … Continue reading Surgical implants – who’s paying?
Read More...Everyone’s losing in America’s health care mess. Premiums for family coverage are doubling every ten years, and will hit $20,000 per family per year before 2015. While insurance costs are going up, physicians are actually making less. Physician income decreased … Continue reading How does physician income drop while costs increase?
Read More...Prices on branded drugs increased 3.9% in Q1 2006(registration required), the largest increase in six years. Coincidentally, the Medicare Part D drug coverage program went into effect 1/1/2006. Part D has resulted in somewhere around ten million new customers for … Continue reading Big pharma v big government
Read More...Ohio’s Bureau of Workers Compensation will no longer be subsidizing indigent care at the state’s hospitals. The recent announcement that BWC is cutting reimbursement for inpatient care to Medicare plus 15% is one of the positive outcomes of the Hydra-headed … Continue reading Ohio’s BWC to cut payments to hospitals
Read More...URAC, the national body that is the self-described “leader in promoting health care quality through its accreditation and certification” of managed care firms, processes, and programs, is getting into the PBM certification business. According to a recent press release, URAC … Continue reading URAC is getting into drugs
Read More...The Fresno Bee editorial page picked up on a study published in the New England Journal of Medicine about the impact of deductibles and copays on compliance. The study analyzed what happened to seniors once they met their coverage limit … Continue reading Watch out for that hole…
Read More...Hospitals in Ohio are complaining that proposed cuts in reimbursement by the Bureau of Workers Compensation are unfair, even though the proposed reimbursement level is Medicare +15%. According to one spokeswoman for the hospitals, “There is a misconception that a … Continue reading Ohio hospitals’ misguided complaints
Read More...To much fanfare, CMS released several data files containing hospital charge and payment data by state, county, (but not by individual facility) for the 30 most common DRGs and elective procedures. National, state and county financial ranges are included, and … Continue reading CMS data release – and their point is…?
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