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Insurance coverage, provider preference affect who gets bariatric surgery, report finds

3:45 pm, Sep. 16 |

Wide variations in whether Medicare patients undergo bariatric surgery to treat obesity suggest that insurance coverage and provider preference are heavily influencing who has access to the procedure, a new report indicates. What the report didn't find, however, was a correlation between the bariatric surgery rate and the rate of diabetes and obesity in the community.
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County health department takes major tech step forward on privacy

Five behavioral health patients in Maryland, picking and choosing what information they want to share with their primary healthcare physicians, are among the vanguard of a paradigm shift going on in healthcare privacy, a public health official there says.

These five Maryland patients affirmed what studies have indicated elsewhere, that people want more control over the disclosure of their health information than they're commonly afforded under the Health Insurance Portability and Accountability Act privacy rule, and they want more options to choose from than the simple opt in or opt out they're typically offered by regional, statewide or private health information exchanges today.
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Consumer access to online health data spotty, usage low

Only about 1 of every 4 consumers has online access to their medical records with less than half of that group using such access, according to a report released Monday by the Office of the National Coordinator for Health IT.

Among the 28% of patients who have been offered online access to their records, 54% did not access them, according to a 2013 survey conducted by NORC, a social research institute at the University of Chicago, according to the report. Among the major reasons cited for not using online access is a lack of interest (74%), concerns about privacy (28%) and lack of Internet access (23%).
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MedPAC disputes that half of new Medicare enrollees pick Advantage

Half of new Medicare beneficiaries are opting for private plans over the traditional fee-for-service program. That's a statistic that's been reported by Modern Healthcare and other publications in recent years. Healthcare consultant John Gorman, one of the foremost experts on Medicare Advantage, has frequently touted it.

It's a startling figure given that roughly 10,000 individuals are aging into Medicare every day and helps explain why health plans with significant Medicare business have fought so tenaciously (and often successfully) against proposed cuts to the program in recent years.
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Sunshine Act's financial disclosure policy drawing more frowns

The chorus to delay or change the types of financial disclosures required by the Physician Payments Sunshine Act is getting louder.

Now, a group of 64 patient-advocacy groups led by the National Health Council is asking the CMS to exclude medical-device and drug companies from reporting indirect payments to these organizations.
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More hospitals shunning furniture with flame retardants

A few months ago, Kaiser Permanente said it would stop buying furniture with flame retardants because the chemicals are believed to be toxic. Now several other large hospital systems are following suit.

A group of hospital systems—Advocate Health Care, an 11-hospital based in Downers Grove, Ill.; Beaumont Health System, a three-hospital system based in Royal Oak, Mich; New Jersey's 685-bed Hackensack University Medical Center; and University Hospitals, a six-hospital system in Ohio—said this week they will buy upholstered furniture only if the pieces do not contain flame retardant chemicals.
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Some providers already taking Medicare's RAC appeal deal

It's been about two weeks since the CMS told hospitals and health systems it would pay a portion of appealed inpatient-status claims, and at least a few have taken Medicare up on its offer.

As of Sept. 9, four unnamed providers submitted paperwork that would result in the CMS paying 68% of inpatient-status claims that are sitting idly in the appeals process, according to a document posted on the CMS website.
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Uninsured rate for children holds steady after ACA

7:30 pm, Sep. 10 |

While millions of uninsured adults have received health insurance coverage since the implementation of the Patient Protection and Affordable Care Act, the uninsured rate among children has remained relatively unchanged, according to new research.

Because of previous efforts to cover children under Medicaid and the Children's Health Insurance Program, the uninsured rate among children was well below the rate for adults before the reform law was enacted.
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Blues plans dominated ACA exchanges in a dozen states

Pearson (AP Photo)
WellPoint and other Blue Cross and Blue Shield plans enrolled the largest number of consumers through the insurance exchanges during the initial open-enrollment period in 12 of 15 states and the District of Columbia, according to an analysis released Wednesday by Avalere Health.

The numbers add to increasing evidence that many new entrants to the individual market struggled to attract customers during the first year of the marketplaces. In some cases, those carriers are aggressively cutting prices to be more competitive in 2015.
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Berwick falls short in Mass. gubernatorial bid

Former CMS Administrator Dr. Donald Berwick, the noted healthcare quality guru and vocal advocate of a single-payer health insurance system, will not be the next governor of Massachusetts. Berwick finished third in Tuesday's Democratic primary, which was won by Massachusetts Attorney General Martha Coakley.

Berwick, 68, who founded the Institute for Healthcare Improvement, drew support from 21% of primary voters, compared to 42% for Coakley and 36% for state Treasurer Steve Grossman.
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