Are New Health Care Partnerships Truly Revolutionary?

Are New Health Care Partnerships Truly Revolutionary?

Healthcare Blog
There has been a thunderous response to the new partnership announced by Amazon, Berkshire Hathaway and JPMorgan Chase, but is this response deserved? When Amazon and its partners announced that they would create a new company to provide health care to U.S. workers at their companies, the stock prices of many major pharmaceutical and health care companies fell dramatically.  Pharmacy manager Express Scripts Holding Co. experienced an 11 percent drop in share prices, while CVS and Anthem saw a 6.4 and 6.5 percent devaluation respectively. Shareholders are obviously afraid that Amazon could do to health care what it has done to retail—completely overtake and reshape the industry.  Although the initial announcement was short on details, it did paint the broad outline of the new organization “that is free from profit-making…
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Defining Value in a Value-Based Healthcare Payment System

Defining Value in a Value-Based Healthcare Payment System

Healthcare Blog
The transition from a Fee For Service (FFS) healthcare payment system to a Value-Based System (VBS) has been gathering steam for years as more payers incorporate reimbursement protocols based on patient outcomes. The Centers for Medicare and Medicaid Services (CMS) has for many years been introducing a variety of “Value Modifiers” that reward providers for superior patient outcomes, and this leadership by the largest payer in the nation has encouraged others to adopt similar payment models. In 2015, almost one-fifth of Medicare reimbursements were made through alternative payment mechanisms. Last month, the value in value-based payments entered the spotlight once again as Amazon, JPMorgan Chase and Berkshire Hathaway announced a new health care partnership.  Although there were few specific details about what this new partnership intended to accomplish, there is…
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Should Health Care Be a Basic Human Right?

Should Health Care Be a Basic Human Right?

Healthcare Blog, Medical-Legal Blog
In February of 2018, an attempt to add an amendment to the Oregon Constitution to declare health care as a basic human right, came to an abrupt halt. Although the state’s House had already voted 35 to 35 in support of the amendment, the Senate Health Care Committee never even brought it up for a vote because they believed it wouldn’t pass in the Senate.  The amendment would have ensured that every resident had access to cost-effective, medically appropriate care. Despite Democratic control of both state legislatures, there were serious concerns that the state could not guarantee universal access to health care and this would leave the state vulnerable to litigation. Lawmakers said that there wasn’t enough time to secure the necessary number of votes during the five-week legislative session.…
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Are Temporary Doctors Less Qualified?

Are Temporary Doctors Less Qualified?

Healthcare Blog
It is only natural to assume that a physician who is only temporarily taking the place of a permanent staffer would be less committed to a higher standard of care.  After all, a locum tenens (temporary doctor) replacement has fewer ties to the community and only a limited time to cement relationships with patients.  They are also new to the working environment, so they possess less experience massaging the system to the benefit of their patients. On top of that, they have no long-term commitment, so they might not be as interested in impressing their peers. At least superficially, it would appear that temporary physicians are riskier than those in it for the long haul.  However, common sense falters in the face of evidence.  A new study published in the…
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Does Medical Liability Tort Reform Work?

Does Medical Liability Tort Reform Work?

Medical-Legal Blog
Medical liability tort reform is an ever-present issue that is often at the heart of any serious health care reform debate.  Both sides have compelling arguments. Health care providers are often shackled by fears of frivolous malpractice suits leading to costly and, often, unnecessary defensive care.  Patients and legal professionals, however, argue that without some form of legal recourse, physician misfeasance would go unchecked. To really understand the issue of medical liability tort reform, one must look a little deeper into the structure of American health care.  In our system, the vast majority of practicing physicians have malpractice insurance which pays some or all of the judgment for a malpractice claim.  In 2015, the U.S. paid out $3.89 billion for malpractice claims, almost all of which came from insurers. This is…
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Amazon Poses Major Threat to Disrupt the Healthcare Industry

Amazon Poses Major Threat to Disrupt the Healthcare Industry

Healthcare Blog
Amazon has long been the most dominant force in online retail, but a new push to diversify could soon spread that dominance to the healthcare sector as well. Given its enormous resources, broad technical proficiencies and renowned ability to recognize emerging markets, Amazon poses a major threat to many of the traditional players in healthcare. Amazon's Industry-Leading Logistical Capacity The $400 billion company based in Seattle has been developing its highly secret “1492” healthcare division for some time, but it is finally ready to enter the market in a profound way by introducing a suite of disruptive services related to pharmaceuticals. In a bid to increase competition and undercut the traditional drug retailers, Amazon will use its advanced logistical capabilities to speed up drug delivery especially to patient homes. The online portal for…
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The Extinction of Private Practices Is Resulting In Rising Health Care Costs

The Extinction of Private Practices Is Resulting In Rising Health Care Costs

Healthcare Blog
As the health care sector wrestles with an epidemic of consolidation dominated by hospitals (and their parent companies), and large medical groups backed by billion dollar private equity firms, one concern remains paramount—without robust competition, prices for consumers will continue to rise.  Even health care, which is resistant to most free market principles, is experiencing rampant inflation fueled by a shrinking number of regional players.  With less competition, these big healthcare groups are able to negotiate higher rates with insurance companies resulting in higher costs without additional value. Private Practices Cannot Compete At the heart of the matter is a business environment that is strangling small and mid-size provider operations.  These behemoth groups and hospitals are able to negotiate significant rates with the insurance companies that are sometimes 3-4x the…
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Legal Issues Related to Telemedicine

Legal Issues Related to Telemedicine

Medical-Legal Blog
As an emerging technology, telemedicine presents many challenges to patients and providers.  While many of these challenges are technical or financial, there are also some thorny legal issues which have kept some medical professionals from fully embracing this new health care platform.  Whether it is cross-state licensing, malpractice insurance, prescribing medications or reimbursement, there are legal restrictions you should be aware of before you fully integrate telemedicine into your practice. State Definitions A foundational issue for many telemedicine regulatory bodies is defining telemedicine itself. It is critical that the scope of telemedicine is clearly defined so that insurers and payers are reimbursing physicians for appropriate services.  While many industry groups and some state boards may use a broad definition of telemedicine, others, including the Center for Medicare and Medicaid Services…
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Defensive Medicine: The High Price of Malpractice Claims

Defensive Medicine: The High Price of Malpractice Claims

Medical-Legal Blog
A 2010 study performed by the Harvard School of Public Health estimated that the total cost of medical malpractice claims in the U.S. was $55.6 billion, of which $45.6 billion was spent on defensive medicine. The fact that almost 2.4 percent of the nation’s entire health care expenditure is spent on redundant, often ineffective treatments and tests is not surprising to most of the medical community which has decried the scourge of spurious malpractice claims for decades. What is Defensive Medicine? Defensive medicine has long been a fixture in the practice of medicine.  In some cases, it involves performing services that are unnecessary, and, in others, prevents providers from performing potential beneficial procedures that also risk exposure to litigation. Let’s say a healthy 18 year old male is diagnosed with…
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More Americans Want Pricing to Be a Part of the Medical Conversation

More Americans Want Pricing to Be a Part of the Medical Conversation

Healthcare Blog
  The dollars and cents of medical care have long been shrouded in mystery, but renewed efforts by government leaders and consumer groups are compelling more physicians to bring up the issue of cost. A poll conducted by Public Agenda found that almost 70 percent of Americans would like for their doctor to discuss cost with them. In part, this has been sparked by the national debate surrounding health care reform and the continual rise in out of pocket expenses, but it is also being fueled by strengthening consumer activism that empowers patients to shop around. Most medical providers are unwilling to broach the issue of treatment costs, perhaps out of deference to the medical ethic to provide the best care possible regardless of the price tag.  While this idealistic…
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