Healthcare’s Dangerous Fee-For-Service Addiction

Healthcare's Dangerous Fee-Fo

For its many users, healthcare’s fee-for-service reimbursement methodology is like an addiction, similar to gambling, cigarette smoking and pain pill abuse. Doctors and hospitals in the clutches of this flawed payment model have grown dependent on providing more and more healthcare services, regardless of whether the additional care adds value.

I don’t use this metaphor lightly, nor wish to trivialize our nation’s growing problem with addiction. Rather, as a physician and former healthcare CEO, I am increasingly concerned with the impact this payment structure is having on American health. And I worry about whether providers are willing to “kick the habit” before it’s too late.

Addictive Qualities

The Affordable Care Act, signed into law March 2010, included several provisions encouraging doctors to focus on increasing value (instead of simply maximizing the volume) of healthcare services. And yet, seven years later, between 86% and 95% of U.S. healthcare providers are still paid for each individual test, procedure and treatment they provide, an arrangement that continues to drive up healthcare costs with little to show for it. According to the latest Commonwealth Fund report, the United States spends more on healthcare than any other industrialized country but ranks at or near the bottom in almost every measure of comparative quality.

As with any addiction, America’s dependence on fee-for-service has dire financial and health consequences. This year, the estimated cost of care for an insured family of four will reach nearly $27,000, paid for through a combination of employer health insurance ($15,259), payroll deductions ($7,151) and out-of-pocket expenses at the point of care ($4,534). Year over year, patients are on the hook for a higher percentage of their total healthcare costs, which rose 4.3% compared to just a 1.9% increase in the U.S. GDP last year. This is a major warning sign. If medical costs continue to surge 2% to 3% higher than our nation’s ability to pay, the healthcare system will soon reach a breaking point. Businesses, the government and insurers will have no choice but to ration care or slowly eliminate coverage for the nation’s poor, middle-class and elderly populations.

As with all addictions, the fee-for-service model has mind-altering effects, distorting the perceptions of its users in ways that make them unaware of their growing dependence. When providers are paid for doing more, that’s what they do: They increase utilization of services and ratchet up the cost of care without even realizing they’re part of the problem. According to one study, just 36% of practicing physicians were willing to accept “major” responsibility for reducing healthcare costs. Of course, the first step, as with other habits, is to recognize the problem. Only then can we explore treatment options.

 

Read More: http://snip.ly/hlh5h#https://www.forbes.com/forbes/welcome/?toURL=https://www.forbes.com/sites/robertpearl/2017/09/25/fee-for-service-addiction/&refURL=&referrer=

Mental health staff on long-term stress leave up 22%

Mental health staff on long
Image caption Some trusts saw the number of staff taking long-term leave double in five years

The number of NHS mental health staff who have had to take sick leave because of their own mental health issues has risen by 22% in the past five years.

Those taking long-term leave of a month or more rose from 7,580 in 2012-13 to 9,285 in 2016-17, BBC freedom of information requests found.

The union Unite said cuts to staff and services were putting extra pressure on front-line mental health workers.

The Department of Health said it was transforming mental health care.

Out of 81 mental health authorities in England, Scotland, Wales and Northern Ireland, 58 provided the BBC with comparable information.

Looking after ourselves

One mental health doctor who had to take mental health leave told 5 live anonymously: “I don’t think I realised it was happening until quite a long way down the road.”

She explained that she was getting irritable with her partner, her sleep was disturbed and she couldn’t switch off from work.

“In the end, I went to my GP who offered me a sick note. I was quite taken aback that it was quite so obvious to my GP that I needed to be off work.” she said.

Media captionFormer mental health nurse on why she had to leave the NHS

“As mental health practitioners, we are pretty rubbish at putting our own mental health first. You need to put your own oxygen mask on first before putting it on to someone else.”

5 live also spoke to a group of community mental health nurses at the Leeds and York Partnership NHS Foundation Trust about how they cope with the pressure of the role.

“I think when you’re so passionate about something it’s very easy to overlook just how much you are taking on,” said Kate Ward, an occupational therapist working as a care co-ordinator in the team.

Read More: http://snip.ly/okuj8#http://www.bbc.com/news/health-41172805

Are You Obese but Healthy? You May Still Be 96% More Susceptible to Heart Failure

 

Are You Obese but HealthyObesity is one of the biggest causes of non-communicable, lifestyle diseases today. According to the World Health Organisation, close to 1.9 billion adults were obese in the year 2014. Around 2.8 million people die due to some complications associated with obesity every year. A recent study published in the Journal of the American College of Cardiology notes that obese people who may otherwise be healthy and free from ailments like diabetes, hypertension, et cetera may still run at a high risk of heart failure. Such individuals are 96% more likely to be at a risk of heart failure over people with normal weight who are also metabolically healthy.

“Obese individuals with no metabolic risk factors are still at a higher risk of coronary heart disease, cerebrovascular disease and heart failure than normal weight metabolically healthy individuals,” noted lead author Rishi Caleyachetty, from the University of Birmingham. “Obese patients, irrespective of their metabolic status, should be encouraged to lose weight and that early detection and management of normal weight individuals with metabolic abnormalities will be beneficial in the prevention of CVD events,” suggested Krish Nirantharakumar, senior lecturer from the varsity.

Experts studied electronic health records of close to 3.5 million British adults to assess cardiovascular diseases.

 

Read more: http://snip.ly/qtuw9#http://www.ndtv.com/food/are-you-obese-but-healthy-you-may-still-be-96-more-susceptible-to-heart-failure-1749667

Progress on global poverty and disease at risk, Gates says

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LONDON, Sept 13 (REUTERS) – Proposed United States budget cuts could put in jeopardy great progress in reducing global poverty and disease and lead to 5 million more deaths from AIDS alone, the philanthropist Bill Gates warned on Wednesday.

Gates, whose Bill and Melinda Gates Foundation is a major provider of global health and development funding, said there was currently “more doubt than usual about the world’s commitment to development”.

A global health report by the foundation, co-authored by the Gates and the Institute for Health Metrics and Evaluation at the University of Washington (IHME), analysed progress against diseases such as malaria, HIV/AIDS and tuberculosis.

It also tracked rates of poverty, maternal and infant death, access to contraception, sanitation and other development issues. Forecasting good and bad future scenarios, it found millions of lives hanging in the balance.

In a telephone briefing about the findings, Gates, the co-founder of Microsoft Corporation, said remarkable progress had been made in recent decades but that shifting priorities, instability and potential budget cuts could lead the world to turn away, jeopardising the gains.

Read More: http://snip.ly/c6mbi#https://in.reuters.com/article/health-global-gates/progress-on-global-poverty-and-disease-at-risk-gates-says-idINKCN1BO0JE

Role of ‘technology’ in home health care

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At present, home-based health care is gaining significant traction and poised for transformation. Once recognized as a fragmented and unorganised sector, it is gaining ground through progressively capturing interest of entrepreneurs and investors.

It is a known fact that there is tremendous pressure on hospitals in delivering services at their facility, especially in Critical Care, something that can be easily outsourced today.

However, it has to be recognised that healthcare services being delivered in the home environment are at a remote location – unlike a hospital where it is a centralised facility. Therefore, monitoring and continuous feedback on key parameters, as relevant to the patient, are critical to have an impact on the outcome of the treatment.

This is eminently possible with appropriate use and incorporation of various technology elements.
With advancements in technology, both in IT and integration with Medical Electronics, it is possible to provide high quality care in the vicinity of a known and comfortable environment.

Technology can play an important role and impact the following areas:

1. Creating positive patient experiences

2. Creating an environment and providing data for better outcomes of the treatment

3. Enable home healthcare to be delivered in remote areas

The goal of technology-enabled home care also encompasses helping reduce need for institutional care, while alleviating financial and emotional burden that medical procedures come with. Its kernel of success lies in the common knowledge that chronic diseases can be treated in the home of the patient through appropriate and continuous monitoring. This monitoring could then trigger medical interventions that may be required, most of which can be implemented in a home care setting at a lower cost to the patient.

 

Read More: http://snip.ly/dzc56#http://health.economictimes.indiatimes.com/news/health-it/role-of-technology-in-home-health-care/60419997

Healthcare Compliance Professional Courses @ 10$ from GlobalCompliancePanel

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Healthcare professionals now have a stronger reason than ever before to enroll for professional learning courses and upgrade their knowledge. GlobalCompliancePanel, a highly reputable provider of professional trainings for all the areas of regulatory compliance, will offer a pick of their healthcare compliance courses for just $10.

Healthcare professionals have always been flocking to GlobalCompliancePanel to partake of professional trainings courses that are valuable, relevant and highly interesting. They will now have more reasons for doing so and join thousands of healthcare regulatory professionals who have already benefited from GlobalCompliancePanel’s professional trainings, because it is not every day that one comes across an offer in which the professional gets to pay a mere 5% of the original price of the webinars!

These recorded webinars are on a number of topics concerning healthcare. Healthcare professionals can use these courses to augment the learning they have gained over the years and climb up in their professions with even greater ease. What’s more; healthcare professionals have such a huge number and variety of courses to choose from that they can opt for several courses of relevance to them without burning a hole in the pocket.

Why is GlobalCompliancePanel doing this? Simple: It wants more and more healthcare professionals to take up courses that are relevant and valuable to them, so that the knowledge needed for becoming successful in their careers spreads wider and goes deeper. After all, meeting regulatory compliance requirements is the number one challenge for any healthcare professional, who sees no way out of the regulatory maze without the professional trainings needed to understand them. When such a course is available at a throwaway price of $10, isn’t that a delightful thing to have?

Let us feature a couple of the topics on which GlobalCompliancePanel is offering these courses to healthcare regulatory professionals:

The HITECH Acts Impact on HIPAA

HIPAA enforcement is a matter of serious concern to many healthcare professionals. Many of them, even highly experienced ones, are clueless about some of the aspects of this enigmatic law. When HITECH combines with HIPAA; the confusion is doubled. The two laws intersect at many places, thus compounding the complexity of enforcement. This webinar from GlobalCompliancePanel offers clarity and helps them ease the confusion about this law.

Further, the nature and roles of a host of HIPAA-related items such as breach notification, business associate contracts, training of staff and security of PHI for Business Associates can be daunting to understand and implement. Webinars such as this are designed to help healthcare professionals steer clear of the stumbling blocks that they could encounter in implementing these.

Preparing a Medical Product Regulatory Requirement Plan

What happens when healthcare companies fail to meet regulatory requirements set out by the FDA and other regulatory agencies? The consequences are disastrous, and can range from penalties to having their business shut down. One of the foundations to avoiding this sort of situation is to develop a medical product regulatory requirement plan.

A medical product regulatory requirement plan charts out the regulatory requirements  that need to be met from step one, which is quite literally Day One of the start of the process of making healthcare products. A detailed and organized medical product regulatory requirement plan is indispensable to ensuring in the end that the healthcare product meets the regulatory requirements.

It is this priceless learning that this webinar from GlobalCompliancePanel imparts. And yes, at $10!

Drug Safety and Pharmacovigilance

Pharmacovigilance, a crucial area of healthcare, needs to be implemented in full according to the requirements set out in regulations from the FDA, EMA and other regulatory agencies. Drug safety being deeply tied to PV; the proper implementation of the latter is needed to ensure the former.

PV is essentially about ensuring drug safety by implementing measures throughout the process of production. A healthcare company has to comply with directions from a number of regulatory agencies in order to have its products passed by them and to gain permission to enter different markets. They cannot afford to take one wrong step in the whole process. A number of areas such as clinical trials, marketing, disease management and government are just some of the areas in which pharmacovigilance is indispensable.

This webinar from GlobalCompliancePanel is a great means to getting a complete understanding of this intricate topic. The topic is of great relevance to healthcare professionals, but what’s more; it comes at this unbelievable price tag of just $10!

Contact Details:

http://www.globalcompliancepanel.com/webinars_home

John.robinson@globalcompliancepanel.com

Support@globalcompliancepanel.com

+1-800-447-9407

 

How Americans get their health insurance

With Obamacare firmly in the crosshairs of Republican lawmakers, the debate around U.S. healthcare is at a fever pitch.

While there is no shortage of opinions on the best route forward, the timeliness of the debate also gives us an interesting chance to dive into some of the numbers around healthcare – namely how people even get coverage in the first place.

How Americans get healthcare

The following infographic shows a breakdown of how Americans get healthcare coverage, based on information from Census Bureau’s surveys.

Put together by Axios, it shows the proportion of Americans getting coverage from employers, Medicaid, Medicare, non-group policies, and other public sources. The graphic also includes the 9% of the population that is uninsured, as well.

visual 1Axios via Visual Capitalist

The following definitions for each category above come from the Kaiser Family Foundation, a non-profit that uses the Census Bureau’s data to put together comprehensive estimates on healthcare in the country:

Employer-Based: Includes those covered by employer-sponsored coverage either through their own job or as a dependent in the same household.

Medicaid: Includes those covered by Medicaid, the Children’s Health Insurance Program (CHIP), and those who have both Medicaid and another type of coverage, such as dual eligibles who are also covered by Medicare.

Medicare: Includes those covered by Medicare, Medicare Advantage, and those who have Medicare and another type of non-Medicaid coverage where Medicare is the primary payer. Excludes those with Medicare Part A coverage only and those covered by Medicare and Medicaid (dual eligibles).

Other Public: Includes those covered under the military or Veterans Administration.

Non-Group: Includes individuals and families that purchased or are covered as a dependent by non-group insurance.

Uninsured: Includes those without health insurance and those who have coverage under the Indian Health Service only.

Healthcare mix by state

Here’s another look at how Americans get healthcare coverage on a state-by-state basis.

This time the graphic comes from Overflow Data and it simply shows the percent of buyers in each state that receive health coverage from public sources:

Oddly, the state that gets the highest proportion of public health coverage (New Mexico, 46.6%) is kitty-corner to the state with the lowest proportion of public health coverage (Utah, 21.3%).

Why the debate is paramount

If you ask some people what is going on with U.S. healthcare, they will tell you that things are going “sideways” – that costs are going up, but care is not improving anywhere near the same pace.

Here’s a graphic we published last year from Max Roser that puts this sentiment in perspective:

us healthcare systemVisual Capitalist via Our World in Data

It’s fair to say that care has been going sideways in the U.S. for some time, and the stakes couldn’t be higher.

So, what needs to be done to fix the problem?

Read the original article on Visual Capitalist. Get rich, visual content on business and investing for free at the Visual Capitalist website, or follow Visual Capitalist on TwitterFacebook, or LinkedIn for the latest. Copyright 2017. Follow Visual Capitalist on Twitter.