MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'blue cross'. Sat, 03 Sep 2011 02:11:52 +0100 http://www.medworm.com/index.php?rid=5096209&cid=t_151590_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Feven-with-insurance-childbirth-is-an-expensive-undertaking%2F2011.08.03 Childbirth hospital costs these days aren’t cheap. Some studies suggest the cost of raising a child exceeds $200,000, not including education expenses.   Most insurance companies charge women of childbearing age more for their insurance because the actuarial tables say so.  Mrs  Happy and I now have a 3 month old Zachary in our wings.  He is a cute little peanut.  His two brothers, Marty and Cooper adore him. Forty-two days after his April 21st, 2011 delivery, we still had not received our explanation of benefits from Blue Cross Blue Shield for the midwife charge.  I had previously received a statement from them saying the charge was under review.  Perhaps they believed that delivering Zachary was not medically necessary.  I can’t explain it. When I called to ask them w... Better Health blogs http://www.medworm.com/rss/comments.php?id=5096209 Wed, 03 Aug 2011 18:00:00 +0100 5096209 http://www.medworm.com/index.php?rid=5062290&cid=t_151590_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2011%2F07%2F25%2Fneed-mental-health-treatment-in-2-weeks-fat-chance%2F This study demonstrates quite the opposite. Read the full article: Medical News: Barriers High in Mental Health Care (Source: World of Psychology) World of Psychology blogs http://www.medworm.com/rss/comments.php?id=5062290 Mon, 25 Jul 2011 20:15:01 +0100 5062290 http://www.medworm.com/index.php?rid=4872476&cid=t_151590_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2Fl6OCIRjRzwE%2F And so another working week is about to come to an end, which means we can daydream about weekend plans. Our modest agenda includes hanging out with the short people and catching up on some reading. What about you? Maybe a dip in the pool? A walk in the park? Perhaps gazing into the future? This side of the pond has a three-day break, of course, so there will be more time to indulge. Whatever you do, have a great time and see you soon… Novartis Found Not Liable For Jaw Disease (Reuters) Medco Loses Blue Cross Blue Shield Contract (Reuters) Trimeris Gets $5M In Roche Settlement (Triangle Business Journal) Pharma Protests UK Pricing Plan (Bloomberg News) AstraZeneca Confirms Endings Payments For Docs To Attend Meetings (Reuters) CMS Proposes Looser E-Prescribing Rules (Internal Medicin... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=4872476 Fri, 27 May 2011 12:09:07 +0100 4872476 http://www.medworm.com/index.php?rid=4820950&cid=t_151590_113_f&fid=34625&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FNeilVerselsHealthcareItBlog%2F%7E3%2F-gmzgCD_78g%2F I’ve just finished my latest post for EMR and HIPAA, based on a session I moderated this week at the the Institute for Health Technology Transformation health IT summit in Fort Lauderdale, Fla. Here’s a taste: The panelists did great job of articulating some of these conundrums and strategies to overcome them, but none better than Kevin Maher, director of clinical innovations for Horizon Healthcare Innovations, a new affiliate of Horizon Blue Cross Blue Shield of New Jersey tasked with testing new care models, and Victor Freeman, M.D., quality director in the Health Resources and Services Administration‘s Office of Health IT and Quality. The patient-centered medical home is a great idea for managing care, promoting prevention and, ultimately reducing costs. “We view the ba... Neil Versel's Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=4820950 Thu, 12 May 2011 21:59:53 +0100 4820950 http://www.medworm.com/index.php?rid=4820952&cid=t_151590_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2FD3BF4RAkszU%2F Healthcare and health IT are plagued by conundrums. Providers long have been the ones asked to make hefty investments in EMRs and other IT systems to help remove costs from the healthcare system, but payers and plan sponsors tend to enjoy most of the financial benefits. Clinicians wish their organizations would share data with others, but those in the executive suite have been reluctant to cooperate with competitors for fear of losing revenue. And, let’s face it, medical errors can be profitable if a routine procedure turns into an expensive inpatient admission. Portions of the American Recovery and Reinvestment Act and the Patient Protection and Affordable Care Act are intended to address these problems by providing financial incentives for “meaningful use” of EMRs (incl... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=4820952 Thu, 12 May 2011 21:45:30 +0100 4820952 http://www.medworm.com/index.php?rid=4592326&cid=t_151590_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F03%2Fsome-dare-call-it-corruption.html We have discussed many cases of health care organizations' leaders reaping rewards disproportionate to any concept of their performance, and especially to any concept of the effect of their conduct on patients' or the public's health.  Most of these cases have been pretty anechoic, but for some reason, the case of the huge golden parachute given to the outgoing CEO of Massachusetts Blue Cross Blue Shield despite a tenure  marked by financial losses and no particularly brilliant advances in patients' care or outcomes, (see this post) continues to generate responses.  One editorial suggested that should the non-profit health insurance company continue to pay so lavishly, it should lose its tax exemption.  Another noted that the company should start put... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4592326 Mon, 14 Mar 2011 21:50:00 +0100 4592326 http://www.medworm.com/index.php?rid=4575025&cid=t_151590_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F03%2Fmassachusetts-blue-cross-blue-shield.html We have frequently discussed the kind of compensation now frequently given to leaders of health care organizations.  Although often even the most disproportionately outrageous compensation only attracts transient interest, a recent regional story in this genre has really gotten legs.How Big the Golden Parachute?The story was about the severance package given to one Cleve L Killingsworth, the former CEO of not-for-profit health care insurance company Massachusetts Blue Cross Blue Shield.  While first reported as being worth $8.6 million,(1) the estimate of his total severance was soon raised to $11 million.(2)This is a Way to Control Costs?Immediately, that amount was contrasted with the supposed emphasis of the company on controlling costs, and its recent poor performance: K... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4575025 Fri, 11 Mar 2011 22:37:00 +0100 4575025 http://www.medworm.com/index.php?rid=4544970&cid=t_151590_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcdc-campaign-hasnt-slowed-inappropriate-antibiotic-use%2F2011.03.03 High rates of inappropriate antibiotic use continued despite a 15-year campaign by the Centers for Disease Control and Prevention (CDC) aimed at Michigan physicians and consumers on the dangers of antibiotic overuse. The Center for Healthcare Research & Transformation (CHRT) released an issue brief detailing overall antibiotic prescribing for adult Blue Cross Blue Shield of Michigan (BCBSM) members. (The project is a non-profit partnership between the University of Michigan and BCBSM.) While antibiotic prescribing in adults decreased 9.3 percent from 2007 to 2009, it increased 4.5 percent for children during the same time period. The studies found significant differences in prescribing patterns between rural southeast Michigan and the rest of the state, particularly for children. Chi... Better Health blogs http://www.medworm.com/rss/comments.php?id=4544970 Thu, 03 Mar 2011 16:00:00 +0100 4544970 http://www.medworm.com/index.php?rid=4082062&cid=t_151590_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2F0L1HfBXgumw%2F By Michael F. CannonObamaCare has touched off a battle between Regence Blue Cross Blue Shield and Washington State Insurance Commissioner Mike Kreidler. From the commissioner’s press release: Kreidler orders Regence BlueShield to cover children OLYMPIA, Wash. – Insurance Commissioner Mike Kreidler ordered Regence BlueShield this morning to stop illegally denying insurance to children, effective immediately. “Regence is in clear violation of state law that prohibits insurers from denying insurance to people on the basis of age,” said Kreidler. “I was shocked and deeply disappointed when Regence announced its decision last week to stop selling insurance to kids.” The Affordable Care Act requires all health plans to cover kids with pre-existing conditions&#8230... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4082062 Tue, 19 Oct 2010 19:11:59 +0100 4082062 http://www.medworm.com/index.php?rid=4082065&cid=t_151590_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2F81XNKefd6eU%2F Conclusion: “The gutting of Medicare claim goes too far…What this means for seniors is a bit murkier.”  True enough: even if ObamaCare’s implausible Medicare cuts take effect, they clearly would not “gut” Medicare.  (BTW, click here or here for a politically sustainable way to restrain Medicare spending.)  The authors also note that Medicare Advantage enrollees would lose some benefits.  But when the article claims that ObamaCare will not eliminate any “basic” Medicare benefits, it neglects to mention that Medicare’s chief actuary estimates that the law could cause 15 percent of hospitals, home health agencies, and other providers to stop accepting Medicare patients.  If your hospital no longer accepts your Medicare coverage, is th... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4082065 Tue, 19 Oct 2010 17:02:13 +0100 4082065 http://www.medworm.com/index.php?rid=4036628&cid=t_151590_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FER3SAYAz_MI%2F By Michael F. CannonIn this morning’s Charlotte Observer, I explain how ObamaCare is destroying consumer protections.  Exhibit A is Blue Cross Blue Shield of North Carolina’s decision to refund $156 million to its policyholders: BCBSNC’s refunds show that ObamaCare is leaving seriously ill patients with less protection, not more. Health insurance was hardly perfect before ObamaCare, but BCBSNC’s policyholders had insurance that had pre-funded many of their future medical bills. Now, ObamaCare has effectively transferred those reserves from the sick to the healthy. Seriously ill policyholders now have less protection against BCBSNC reneging on its commitments to them. Competition used to discourage skimping; ObamaCare rewards it. Due to space considerations, the edi... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4036628 Wed, 06 Oct 2010 14:22:23 +0100 4036628 http://www.medworm.com/index.php?rid=3998959&cid=t_151590_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FmP4je9Jwvv4%2F By Michael F. CannonFrom the Minneapolis Star-Tribune: Two of Minnesota’s biggest health plans said Thursday they have temporarily suspended sales of individual health insurance policies because of uncertainty related to the new federal health reform law. The moves by Blue Cross and Blue Shield of Minnesota and HealthPartners came on the same day some of the federal government’s most-heralded consumer protections came into effect… The insurers that have suspended individual sales say they are awaiting guidance on new rules, including those around coverage of kids with pre-existing conditions… Pam Lux, a spokeswoman for Eagan-based Blue Cross, said she expects the suspension of individual sales to be brief but could not say if it would be days or weeks. (Source: Cato... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3998959 Fri, 24 Sep 2010 14:09:13 +0100 3998959 http://www.medworm.com/index.php?rid=3980817&cid=t_151590_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2F7wLnv6a_8s4%2F By Michael F. CannonDuring the (initial) congressional debate over ObamaCare, President Obama vilified Anthem Blue Cross of California for a 39 percent rate increase.  On Wednesday, the Hartford Courant reported that ObamaCare itself may increase premiums by similar amounts: Health insurers are asking for immediate rate hikes of more than 20 percent in Connecticut for some plans, citing rising medical costs and federal health reform laws as reasons… In what might appear to be an oddity, companies are citing a huge range of effects that the health care reform mandates will have on plan prices — from near zero to well over 20 percent. The reason is that among all the plans, some already deliver the provisions required by health reform, while others do not… Anthem Blue Cross an... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3980817 Fri, 17 Sep 2010 13:43:45 +0100 3980817 http://www.medworm.com/index.php?rid=3880944&cid=t_151590_113_f&fid=34634&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEmrAndHipaa%2F%7E3%2F1OYcnjqulm8%2F The HITECH Law Blog had a post recently titled “Commercial Payors Implementing EHR Meaningful Use Criteria in P4P Programs.” Here’s a short excerpt: On August 5, 2010, four major commercial health insurance payors participated in the Health Industry Forum in Washington, D.C., to discuss private industry collaboration with the United States Health & Human Services Department (HHS) to support providers in the adoption of certified electronic health records (EHRs). Leading the Forum’s panel discussion was David Blumenthal, M.D., Chief of the Office of National Coordinator of HIT. All four payors will include the Meaningful Use criteria in their pay for performance (P4P) programs. The 4 insurance groups identified are Aetna, Inc and its subsidiary, ActiveHealth Managen... EMR and HIPAA blogs http://www.medworm.com/rss/comments.php?id=3880944 Tue, 17 Aug 2010 16:29:56 +0100 3880944 http://www.medworm.com/index.php?rid=3831431&cid=t_151590_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fthree-more-understated-aspects-icd-10-part-two ICD-10 is a multi-headed beast. As such, there are many faces to the new code sets; some are well known while others, often just as important, are not so understood. In our first installment, ICD10Watch reported the facets that readers likely do not, but really ought to, know more about. That triptych has since proven to be something of a beginning. And so the list of understated ICD-10 aspects continues: (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=3831431 Fri, 06 Aug 2010 12:54:35 +0100 3831431 http://www.medworm.com/index.php?rid=3644726&cid=t_151590_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2010%2F06%2Fkind-of-blackmail-not-for-profit-health.html Here is another case in the annals of over-paid executives of not-for-profit health care organizations, this time from the Burlington (VT) Free-Press,Blue Cross and Blue Shield of Vermont overpaid its former chief executive officer by $3 million over an eight-year period and has been ordered to pay the money back to its subscribers by 2012 in the form of reduced premiums, a top state regulator said Wednesday.The action by the state Banking, Insurance, Securities and Health Care Administration Department follows last year’s disclosure that William Milnes, the nonprofit firm’s former CEO, received a $7.2 million payout when he stepped down in 2008.Furthermore, note that [Commissioner of the Banking, Insurance, Securities and Health Care Administration Department Paulette] Thabault said h... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=3644726 Tue, 08 Jun 2010 21:49:00 +0100 3644726 http://www.medworm.com/index.php?rid=3581571&cid=t_151590_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2010%2F05%2Fpaying-ceos-of-health-care-not-for.html Million dollar plus executives of not-for-profit health care insurance companies seem to be becoming a dime a dozen.  Late in April, Buffalo Business First reported the pay of executives of some western New York health insurance companies:The top local executives at the region’s three major nonprofit health plans received nearly $23 million in salaries and bonuses last year.More than 70 people received total compensation of $160,000 or more. That’s the level at which insurers are required to report in annual reports to the state Department of Insurance.When you include executives who work for those three health plans but are located outside Western New York, the total compensation for top-paid execs totaled $46.4 million last year.Among the local executives in the Western New York... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=3581571 Wed, 19 May 2010 21:32:00 +0100 3581571 http://www.medworm.com/index.php?rid=3560174&cid=t_151590_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2010%2F05%2Fmore-fat-bigots-in-leader-of.html I am amplifying a post by Roy Poses entitled "Why Pretend An Advertising Executive and Chamber of Commerce Leader Are Public Health Experts?".In that post, Dr. Poses noted a lack of relevant professional credentials in executives making profoundly misinformed and indeed cruel statements about the obese:Obesity as a public health problem has been the subject of considerable discussion. So that luminaries from the prestigious Partners Healthcare system and Massachusetts Blue Cross Blue Shield would weigh in on the issue at a public meeting should surprise no one. But see this report by the Boston Herald:When asked about rising health-care costs, Jack Connors - chairman of the Partners chain, which includes Mass. General and Brigham and Women’s hospitals - said yesterday, 'Taking care of yo... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=3560174 Wed, 12 May 2010 11:54:00 +0100 3560174 http://www.medworm.com/index.php?rid=3556036&cid=t_151590_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2010%2F05%2Fmore-fat-bigots-in-leader-of.html I am amplifying a post by Roy Poses entitled "Why Pretend An Advertising Executive and Chamber of Commerce Leader Are Public Health Experts?".In that post, Dr. Poses noted a lack of relevant professional credentials in executives making profoundly misinformed and indeed cruel statements about the obese:Obesity as a public health problem has been the subject of considerable discussion. So that luminaries from the prestigious Partners Healthcare system and Massachusetts Blue Cross Blue Shield would weigh in on the issue at a public meeting should surprise no one. But see this report by the Boston Herald:When asked about rising health-care costs, Jack Connors - chairman of the Partners chain, which includes Mass. General and Brigham and Women’s hospitals - said yesterday, 'Taking care of yo... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=3556036 Wed, 12 May 2010 11:54:00 +0100 3556036 http://www.medworm.com/index.php?rid=3549275&cid=t_151590_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2010%2F05%2Fwhy-pretend-advertising-executive-and.html Obesity as a public health problem has been the subject of considerable discussion.  So that luminaries from the prestigious Partners Healthcare system and Massachusetts Blue Cross Blue Shield would weigh in on the issue at a public meeting should surprise no one.  But see this report by the Boston Herald:When asked about rising health-care costs, Jack Connors - chairman of the Partners chain, which includes Mass. General and Brigham and Women’s hospitals - said yesterday, 'Taking care of yourself starts at home.''What happened to individual responsibility?' Connors said at a Greater Boston Chamber of Commerce breakfast at the Westin Boston Waterfront. 'Why is obesity such an epidemic (when) we all know that a big part of being healthy is exercising and eating the right fo... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=3549275 Mon, 10 May 2010 16:07:00 +0100 3549275 http://www.medworm.com/index.php?rid=3538245&cid=t_151590_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Ficd-9-icd-10-crosswalks-theres-got-be-better-way At a time when industry bodies and consultancies are trying to figure out how providers and payers can best transform existing ICD-9 data into the imminent ICD-10 code schemes, and the word “crosswalk” keeps being batted around, Dennis Winkler at Blue Cross Blue Shield Michigan is the curious case of an ICD-10 crosswalk contrarian, believing he's found a better path. Winkler, it seems, just might be onto something that appears revolutionary but in practice is not. (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=3538245 Thu, 06 May 2010 12:21:54 +0100 3538245 http://www.medworm.com/index.php?rid=3390722&cid=t_151590_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2010%2F03%2Feffort-to-make-health-insurance.html We previously discussed a legal settlement of charges that UnitedHealth's Ingenix subsidiary manipulated its database of payments to physicians so as to reduce its and other insurers' payments to "out-of-network" physicians.  One aspect of the settlement was a new initiative to better determine such payments.  Now that effort has been caught up in the web of conflicts of interests that has ensnared health care.  As reported by the Syracuse (NY) Post-Standard, [New York state Attorney General Andrew] Cuomo obtained $100 million in settlements from 13 insurers, including Excellus, that used the defective reimbursement data supplied by Ingenix, a subsidiary of United Health, the nation’s second biggest insurer. Cuomo’s investigation showed... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=3390722 Mon, 22 Mar 2010 15:50:00 +0100 3390722 http://www.medworm.com/index.php?rid=3105044&cid=t_151590_105_f&fid=38964&url=http%3A%2F%2Fdrwes.blogspot.com%2F2009%2F12%2Frule-of-twenties.html Heard from a local independent gerontologist tonight who does not accept Medicare or other insurance payments in our state: "When it comes to geriatrics, it's the rule of twenties: 20 problems20 medications20-minute phone calls20 minutes to take their clothes off20 minutes to put their clothes back on.With the initial physical exam, three follow-up visits, and one EKG that Medicare pays for, I would receive only $360 in total. I pay $40,000 per year in malpractice, yet have never had a judgement against me. Think how may patients I'd have to see to cover just that expense. (editor's answer: 111)You wonder why I am not a Medicare provider? I'd never survive at that their payment rate. And Blue Cross? They're no better and often pay less. Funny thing is, Medicare was only too happy to have m... Dr. Wes blogs http://www.medworm.com/rss/comments.php?id=3105044 Sat, 19 Dec 2009 03:54:00 +0100 3105044 http://www.medworm.com/index.php?rid=3023147&cid=t_151590_105_f&fid=38964&url=http%3A%2F%2Fdrwes.blogspot.com%2F2009%2F11%2Fwhen-insurers-dominate-market-share.html Prices rise:One factor that could be driving larger increases locally: Blue Cross & Blue Shield of Illinois, which historically has used its dominant 50%-plus marketshare to undercut competitors' prices, has been more aggressive with rates this enrollment season, brokers say."Blue Cross is the one company that is consistently coming in with higher renewal increases," says Rob Wilson, an insurance broker and president of Westmont-based Employco Group.A Blue Cross spokeswoman declines to comment.Funny that when hospital systems coalesce and raise prices to remain "competetive," the FTC cries foul, but when the insurance industry does the same thing, the FTC can't be bothered.But then, the government knows what's best for patients, right?-WesMusings of a cardiologist and cardiac electrophysio... Dr. Wes blogs http://www.medworm.com/rss/comments.php?id=3023147 Mon, 23 Nov 2009 16:19:00 +0100 3023147 http://www.medworm.com/index.php?rid=2405573&cid=t_151590_113_f&fid=34625&url=http%3A%2F%2Fclinicalit.blogspot.com%2F2009%2F05%2Fbreaking-news-private-sector-health.html There's some fairly significant news coming out of Washington tonight: A CNN Money report via Yahoo! says that six key private-sector health industry groups have agreed to participate in the Obama administration's effort to reform healthcare by pledging to take $2 trillion in costs out of the system over the next 10 years. "Six trade associations representing unions, hospitals, insurers and the drug industry have signed on to the commitment," the story says. An Associated Press story says doctors are participating as well. Based on these stories, we can safely assume that coalition includes the AMA, AHA, AHIP, PhRMA and probably the Blue Cross and Blue Shield Association and the Service Employees International Union. We'll know for sure Monday when representatives from the six participatin... Neil Versel's Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=2405573 Mon, 11 May 2009 04:52:00 +0100 2405573 http://www.medworm.com/index.php?rid=2376497&cid=t_151590_130_f&fid=34938&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FEvidenceInMotion%2F%7E3%2FXYZ4e4AYj6k%2Fa-physical-therapist-in-new-york-goes-public.html About 1 year ago, I attended the Michigan Physical Therapy Association spring meeting and brought up a very valid concern about Blue Cross Blue Shield of Michigan.  Blue Cross Blue Shield of Michigan is a non-profit insurance company that continually increases premiums, continually pays its administrators high annual salaries and by switching most of its insurance plans to PPO plans continues to pay less to providers.  Of course, I haven't heard a darn thing with regard to what the MPTA has done in researching how BCBSM can elevate premiums yet concurrently maintain or decrease the fee schedule.  Providing insurance coverage should be a risk... subscribers pay to reduce their financial medical bill risk and insurance companies should be somewhat gambling in determining their premium amo... MyPhysicalTherapySpace.com blogs http://www.medworm.com/rss/comments.php?id=2376497 Sun, 26 Apr 2009 13:38:15 +0100 2376497 http://www.medworm.com/index.php?rid=2263911&cid=t_151590_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2009%2F03%2Fhealth-care-ceo-who-didnt-put-his-own.html We recently posted about executives at two different not-for-profit health care insurance companies/ managed care organizations whose pay seemed to keep levitating, despite organizational financial losses, and commented on how the compensation of top executives of health care organizations seems always to go up, regardless of the financial fortunes, or quality of the products or services provided by their organizations. (Posts here and here.)Today's Boston Globe, however, provided a contrast. The background is that the Beth Israel Deaconess Medical Center (BIDMC), a renowned Harvard teaching institution, is facing a budget shortfall.Paul Levy, the guy who runs Beth Israel Deaconess Medical Center, was standing in Sherman Auditorium the other day, before some of the very people to whom he m... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=2263911 Thu, 12 Mar 2009 20:17:00 +0100 2263911 http://www.medworm.com/index.php?rid=2232511&cid=t_151590_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2009%2F03%2F43-million-dollar-ceo-for-not-for.html The US stock markets are at lows unseen for more than 10 years, unemployment is rising, around the world national deficits are increasing, and times are tough for ostensibly not-for-profit Blue Cross and Blue Shield of Massachusetts, the state's largest health care insurer/ managed care organization. Per the Boston Globe:Blue Cross-Blue Shield's business was affected by the stock market decline, the recession, and the increasing cost of medical care.Membership at the state's largest health plan declined about 40,000 to just over 3 million.'The decline in membership had an impact on results,' said chief financial officer Allen Maltz. 'In addition, many of our customers changed their benefits plans to products that have much lower margins.'Blue Cross-Blue Shield insures employees of national... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=2232511 Mon, 02 Mar 2009 22:12:00 +0100 2232511 http://www.medworm.com/index.php?rid=2170628&cid=t_151590_113_f&fid=38236&url=http%3A%2F%2Fwww.healthcareitnews.com%2Fblog%2Fwhy-clinical-groupware-may-be-next-big-thing-health-it What would you call health care software that: (Source: Healthcare IT News Blog) Healthcare IT News Blog blogs http://www.medworm.com/rss/comments.php?id=2170628 Mon, 09 Feb 2009 14:44:46 +0100 2170628 http://www.medworm.com/index.php?rid=2086898&cid=t_151590_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2009%2F01%2Fto-whom-did-scorpions-in-bottle-owe.html In 2000, an important meeting took place between two men.The first was a member of the board of directors of Merck Inc, the global pharmaceutical company, and of the board of Charles River Laboratories, which helps "our global partners accelerate drug discovery and development by providing them with tailored research models and preclinical, clinical, support services." The second was a member of the board of IMH Health, which advertises that it provides "global information, analytics and consulting" to support "the life cycle of medicines," from "the earliest stages of research and development through product launch, product maturation and patent expiration," and on the board of BankBoston Corporation, a national and international bank holding company. What might they have talked about?It ... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=2086898 Wed, 07 Jan 2009 19:49:00 +0100 2086898 http://www.medworm.com/index.php?rid=2079027&cid=t_151590_122_f&fid=36582&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FSharpBrains%2F%7E3%2F495728856%2F This article provides is a very good market overview. The reporter and I also discussed in depth the need for better consumer education and professional development, so people can make informed decisions, and for cognitive assessments to serve as independent baseline, help identify priorities and measure results. Please note that our market estimates do include revenues of computerized cognitive assessments, today mostly used in clinical trials, and wthin the military and sports teams. 2) Navigating the brain fitness landscape: do's and don'ts (McKnight's Long Term Care News) Comment: "Choosing the right cognitive fitness product or program for senior living residents is harder than it sounds. But understanding residents' needs, identifying your objectives and considering the total c... SharpBrains blogs http://www.medworm.com/rss/comments.php?id=2079027 Fri, 26 Dec 2008 18:03:07 +0100 2079027 http://www.medworm.com/index.php?rid=1947960&cid=t_151590_122_f&fid=36582&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FSharpBrains%2F%7E3%2F447995271%2F My apologies for not writing in a few days...the Global Agenda Summit in Dubai has required all my attention - I will summarize the great experience when I land back in San Francisco tomorrow night. The concepts of night and day do become challenging when working for a few days in a place with a 12-hour time difference with one's home base. Sleep is indeed very important to maintain top cognitive shape...which leads me to a fascinating news announcement: Health insurance firms offering online cognitive therapy for insomnia (Los Angeles Times) - "helping consumers get a good night's sleep has become a priority for most of the top-tier U.S. health insurance companies, including WellPoint, Aetna, Cigna, Kaiser Permanente and several Blue Cross plans. Their new programs don't involve slee... SharpBrains blogs http://www.medworm.com/rss/comments.php?id=1947960 Mon, 10 Nov 2008 03:52:44 +0100 1947960 http://www.medworm.com/index.php?rid=1726323&cid=t_151590_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2008%2F08%2Fmerger-mania-redux-combination-would.html The Philadelphia Inquirer published a story about what seems to drive merger mania in health care. In Pennsylvania, the two largest health insurance companies in the state, both not-for-profit, Highmark and Independence Blue Cross, have been pushing to mergeHighmark Inc. and Independence Blue Cross would pay their top executives as much as $4.2 million more if they were allowed to merge.Kenneth Melani, the chief executive of Highmark, who is expected to have the same job at the combined companies, would get a 31 percent raise, to $3.9 million from $2.97 million, including incentives, according to documents filed with the Pennsylvania Insurance Department.Independence Blue Cross' CEO, Joseph Frick, who is slated for the role of chief operating office after the merger, would earn $2.94 milli... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=1726323 Fri, 22 Aug 2008 18:32:00 +0100 1726323 http://www.medworm.com/index.php?rid=1537804&cid=t_151590_113_f&fid=34625&url=http%3A%2F%2Fclinicalit.blogspot.com%2F2008%2F06%2Ffiercehealthit.html Just a quick note: I'm the guest host, as it were, of FierceHealthIT this week. I wasn't sure until it was too late if I was supposed to write a commentary, so I didn't, but four of the top five story summaries this week carry my byline:"Study: Physician adoption of EHRs continues to lag""MI, WI advance health information exchange""PHRs make inroads with health plans""WellPoint says e-prescribing could be a Trojan horse for HIE"The one I didn't write, "Top P4P hospitals to score $7m in bonuses from CMS," ran in the daily FierceHealthcare last Thursday. (Source: Neil Versel's Healthcare IT Blog) Neil Versel's Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=1537804 Mon, 23 Jun 2008 18:10:00 +0100 1537804 http://www.medworm.com/index.php?rid=1419287&cid=t_151590_115_f&fid=34680&url=http%3A%2F%2Fcoolmristuff.blogspot.com%2F2008%2F05%2Fthoracic-aorta-disection.html Aortic dissection is the most common catastrophe affecting the aorta. The aorta is the largest artery of the body through which blood leaves the heart to deliver oxygenated blood to the rest of the body. It occurs in about 24 people per million each year in the U.S. It is caused when the inner layer of the aortic wall tears and then peels or separates away from the next layer of the aorta. This creates two channels; the original aortic channel for blood flow (the true lumen) is still present while the peeling away of the outer layer in the dissection creates a new additional flow channel (the false lumen).Symptoms of Aortic DissectionLocation of Pain:Chest painBack painFlank painAbdominal painLeg painQuality of PainPain that is tearing or sharpAbrupt onset of painPain that migrates or radi... MRI LINKS AND OTHER COOL THINGS blogs http://www.medworm.com/rss/comments.php?id=1419287 Sun, 04 May 2008 13:54:00 +0100 1419287 http://www.medworm.com/index.php?rid=1231811&cid=t_151590_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2008%2F02%2Fblue-cross-of-california-wellpoint-to.html I commented on the "irrational exuberance" over healthcare IT here. Health IT is a double-edged sword. It can be used, and it can be misused. In the hands of the wrong people, it will "revolutionize healthcare" all right ... but not in the direction health informaticists and clinicians would desire.The title of this post seems the logical outcome based on the self-initiated debacle of Blue Cross of California, as posted at Wellpoint Halts Attempts to Have Doctors "Rat Out Patients":Blue Cross of California is sending physicians copies of health insurance applications filled out by new patients, along with a letter advising them that the company has a right to drop members who fail to disclose 'material medical history,' including 'pre-existing pregnancies.''Any condition not listed on the ... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=1231811 Thu, 14 Feb 2008 15:35:00 +0100 1231811 http://www.medworm.com/index.php?rid=1215697&cid=t_151590_122_f&fid=36582&url=http%3A%2F%2Ffeeds.feedburner.com%2F%7Er%2FSharpBrains%2F%7E3%2F231123917%2F Not a day goes by without a significant depression-related announcement. Yesterday, one could read that Older Women More Likely to Suffer Depression (than Older Men; in the Washington Post). Today, we see that St. Jude Starting Trial On Brain Stimulation For Depression (CNN). A few days ago, Blue Cross of California Launched Maternity Depression Program (press release). Time to step back and ask ourselves questions such as, "What is going On", "What is Depression", "What Treatments Work, and What is the Latest Research". Fortunately, thanks to our collaboration with Greater Good Magazine, Jill Suttie offers a fascinating answers to those questions-and more. Enjoy. --------------------------- Closing the Circuit Helen Mayberg's research could revolutionize ... SharpBrains blogs http://www.medworm.com/rss/comments.php?id=1215697 Thu, 07 Feb 2008 18:10:34 +0100 1215697 http://www.medworm.com/index.php?rid=1196710&cid=t_151590_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2008%2F02%2F02%2Fthink-social-networks-are-harmless-think-again%2F We’ve been beating the patient privacy drum here for years, and will continue to do so because we don’t think the message is being fully understood. When you share and disclose aspects of your personal health with the world, it is something very different than when you share and disclose your favorite books or hobbies or musical groups. They are not the same thing. Books, music and your favorite movie star can’t be used against you (well, at least not until Big Brother takes hold). But your personal health information can. Think we’re overstating things? Well, the New Jersey Law Journal published a story yesterday that might make you think again: Litigation over an insurer’s refusal to pay health benefits for anorexia or bulimia may turn on what is reveal... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=1196710 Sat, 02 Feb 2008 13:20:38 +0100 1196710 http://www.medworm.com/index.php?rid=1182766&cid=t_151590_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2008%2F01%2Fmore-managed-care-management-mumbo.html A number of news items about managed care organizations/ health insurers published last week make for an interesting juxtaposition.Innovative Physician Reimbursement?First were articles about managed care proposals for innovative physician reimbursement. First, from the Boston Globe, an article about a proposal to resurrect capitation.Massachusetts' dominant health insurer is proposing to overhaul the way it pays doctors and hospitals, in what company officials said is an attempt to slow runaway healthcare costs and improve the quality of care.Blue Cross and Blue Shield of Massachusetts wants to stop paying doctors and hospitals for each patient visit or treatment, a common arrangement that most experts agree has led to unnecessary, inefficient, and fragmented care that is sometimes harmfu... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=1182766 Mon, 28 Jan 2008 18:34:00 +0100 1182766 http://www.medworm.com/index.php?rid=1093040&cid=t_151590_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2007%2F12%2Fanother-day-another-deferred.html As I mentioned earlier, a major impetus for setting up this blog was finding out that most physicians knew local examples of badly or corruptly run local health care organizations, and felt that their core values were threatened by the actions of these organizations. However, the doctors all felt they were peculiarly unlucky to practice in such a uniquely sleazy environment. They did not realize that things were likely just as bad in the next town, and thus, that the problems were systemic. When I have taken my Health Care Renewal talk on the road, only a few people in the audiences have ever heard of some of the most vivid examples of bad health care organizational governance, e.g., the collapse of the Allegheny Health Education and Research Foundation (see post here).So it may be easy to... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=1093040 Thu, 13 Dec 2007 20:32:00 +0100 1093040 http://www.medworm.com/index.php?rid=944519&cid=t_151590_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2007%2F10%2Fhealth-care-policy-found-to-be-holding.html This is a local Rhode Island tale, but one with some ramifications. Mike Stanton, the Providence Journal's well-known investigative reporter, just broke the story of yet another legislative leader pleading guilty to selling his office. In this case, he sold his office to prominent local and national health care organizations, for the purposes of influencing health policy.Gerard M. Martineau was the bag man of Blue Cross [and Blue Shield of Rhode Island] and CVS — but he was 8 million bags short.Now, the former Rhode Island House majority leader is the second ex-legislator, after John Celona, to admit to selling his office in the federal State House corruption probe known as Operation Dollar Bill.As part of a $900,000 corruption scheme that the longtime Woonsocket Democrat has admitted to... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=944519 Thu, 11 Oct 2007 14:33:00 +0100 944519 http://www.medworm.com/index.php?rid=782913&cid=t_151590_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2007%2F08%2Fafter-wellmark-college-of-public-health.html We previously posted, here and here, about a proposal to name the school of public health at the University of Iowa the Wellmark Blue Cross Blue Shield College of Public Health, or something like that, after that for-profit insurance company's foundation offered to donate $15 million to the school.The Des Moines Register is continuing to follow the story. And although the faculty voted against the naming rights, negotiations are underway to keep the idea alive, perhaps letting the school's name be shorted to just the "Wellmark College of Public Health," as if leaving "Blue Cross Blue Shield" off would conceal the ties to a large commercial health insurer with which the university's teaching hospital does considerable business.It is notable that this story, perhaps because of its vividness,... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=782913 Mon, 06 Aug 2007 18:32:00 +0100 782913 http://www.medworm.com/index.php?rid=747118&cid=t_151590_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2007%2F07%2Fnaming-school-of-public-health-after.html We previously posted about a proposal to name the new school of public health at the University of Iowa after a local health insurance company. But the faculty roundly rejected the notion of a "Wellmark Blue Cross and Blue Shield College of Public Health," and that seemed to be the end of the idea.But maybe not. On Inside Higher Ed was a report that the faculty reconsidered.Earlier this month, professors at the University of Iowa decided that they’d rather not work at the 'Wellmark Blue Cross and Blue Shield College of Public Health' — even if it meant potentially losing a donation of $15 million, which the insurance company’s nonprofit philanthropic arm promptly rescinded.But it looks like a significant proportion of the university’s faculty members are having second thoughts. At ... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=747118 Fri, 20 Jul 2007 20:13:00 +0100 747118