Even Outliers winced when we heard Lewis Morris describe the HHS inspector general's massive physician billing audit initiative. Morris, the assistant inspector general for litigation coordination, participated in a July 17 satellite video conference co-sponsored by the Medical Group Management Association and the Association of American Medical Colleges. Outliers recently obtained a videotape of the conference.
It's no wonder academic medicine is wringing its hands over the pending Medicare audits. By Morris' way of thinking, any dollar of improper payment is fair game.
"Is there any tolerable error rate?" asked Brenton L. Saunders, corporate compliance officer of Thomas Jefferson University. Thomas Jefferson's faculty practice plan recently paid $12 million to settle charges of improper Medicare billing (Aug. 26, p. 4).
"In terms of how we're assessing this?" asked Morris. "No. It's our view that if an institution has been overpaid, we want our money back."
Even if the error rate is "one-hundredth of 1%?" Saunders pressed.
"Well, let me put it this way," Morris said. "If you go to a restaurant and you order a meal, and the waiter comes at the end of the meal and hands you a check, and it's for a hundred bucks and you say, `Gee, I had no idea I ordered all this food.' He says, `Well, we allow a 5% error rate, and it takes an awful lot of time to calculate what each table ordered. So, if you'll just take it on face value that more or less you owe me a hundred dollars,' my guess is you would not visit that restaurant again." That's the same approach providers take with Medicare, Morris said.
"Hopefully, one day the regulations will be as easy to read as a menu," Saunders retorted.
Put on the happy face.When HCFA hired an advertising agency to come up with a symbol to adorn promotional materials designed to lure Medicare beneficiaries into managed-care plans, three options emerged: an ice cream cone (designed to show the variety of plans); a montage of happy, elderly faces; and a rocket ship (to connote the endless possibilities of managed care).
Barbara Cooper, HCFA deputy associate administrator for policy, said she "didn't want to use the faces. Every government pamphlet has faces. I wanted to be different, so I chose the ice cream."
But in focus groups seniors didn't like the ice cream because "that is something we aren't supposed to have," as one senior put it. The rocket ship also was rejected because "(seniors) thought it was medical technology (HCFA was) talking about," Cooper said.
That left the previously discarded faces. "(Seniors) said the faces looked happy, (like) they liked Medicare," Cooper said. "I think it looks like a dating service. Maybe that's why they liked it."
Surfing for bucks.First there was the World Wide Web. Then came people in search of content on the World Wide Web. Now we've got people in search of the people in search of content on the World Wide Web.
A New York-based consulting and research firm called Find/SVP said it has "defined and quantified for the first time" a new group of consumers using the Internet as a prime source of health and medical information.
The first of a two-part report, Consumer Health and Medical Information on the Internet, gives a detailed profile of consumers most likely to use the Internet to seek out health-related information, take part in topic-specific discussions, buy health products and services on line, and troll for medical diagnostic, consultative and monitoring services, said author Michael S. Brown.
The attraction of Internet content is it's frequently free, but Find/SVP is saying this identified group is more likely to buy products on line than the general Net-surfing population would be. And the firm claims to have plenty of info on opportunities to fill unmet demand for content and attract even more interest in Internet sites.
Want to know more about it? Well, that's where Find/SVP has identified its own market opportunity. It's charging $2,295 for the report.
Bigger byte.Leaders of the Microsoft Healthcare Users Group could barely contain themselves in showing off their exponential growth as a force in facilitating and showcasing computer advances in healthcare.
Less than 2 years old, the forum for healthcare computer pros has erupted onto the scene much like the miniature volcano outside the Mirage in Las Vegas, where the second Windows on Healthcare conference played out earlier this month.
"(The users group) may be one of the few organizations that's grown faster than Microsoft this year," said J. Michael McCoy, chief information officer at University of California Los Angeles Medical Center, who was finishing a stint as the group's chairman.
The users group, which is officially independent from the software giant that created it, registered 1,327 attendees, more than double the 650 who showed up at the first conference a year earlier. Forty vendors of computer products were turned away because the Mirage couldn't fit more than 100 small booths. Membership in the Ann Arbor, Mich.-based group is up to 1,470 from 498 a year ago.
To Russia, with expertise. Michael E. DeBakey's trip to Moscow last week drew headlines around the world, but the consultation the renowned cardiologist did with Russian President Boris Yeltsin was more routine than news.
Now chancellor emeritus of Baylor College of Medicine and still performing surgery procedures at Houston's Methodist Hospital, the 88-year-old DeBakey consults on surgeries of foreign dignitaries all the time.
DeBakey has operated on a number of prominent Russians over the years and recently advised Russian government officials on updating and revitalizing their healthcare system.
DeBakey already was scheduled to be in Moscow last week for an international conference on heart surgery. He's a longtime friend and mentor of Renat Akchurin, M.D., chief of the Moscow Cardiological Institute, who will lead the team performing surgery on Yeltsin. The procedure is to take place within the next 10 weeks, and DeBakey will return to Moscow to monitor the surgery. and still performing surgery procedures at Houston's Methodist Hospital, the 88-year-old DeBakey consults on surgeries of foreign dignitaries all the time.
DeBakey has operated on a number of prominent Russians over the years, and recently advised Russian government officials on updating and revitalizing their healthcare system.
DeBakey was already scheduled to be in Moscow last week for an international conference on heart surgery. He's a longtime friend and mentor of Renat Akchurin, M.D., chief of the Moscow Cardiological Institute who would lead the team performing surgery on Yeltsin. The procedure is to take place within the next 10 weeks, and DeBakey will return to Moscow to help monitor the surgery.