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In 2016, health care costs were expected to grow 6.5 percent, far more than inflation. While not as great as in some years, this burgeoning financial responsibility has much of the business community vigorously searching for solutions to keep health care costs in check. While many employers are utilizing tactics like higher deductible plans or increased co-payments, some companies are investing in strategies that cut costs at the source. According to consulting firm Willis Towers Watson, almost 45 percent of employers with a thousand or more employees are granting employees access to health care centers of excellence (COEs), organizations that have high care quality ratings. This is a marked increase from the previous year when only 37 percent of large companies utilized COEs. In the same survey, an additional 32 percent of…

The Centers for Medicare & Medicaid Services announced that one of its advanced primary care projects had produced significant progress.  In only its second year, the Comprehensive Primary Care initiative had virtually achieved almost all of its goals among a pool of 481 participating practices. The Comprehensive Primary Care initiative is a four year project with the goal of improved primary care at lower cost.  Conducted by the Centers for Medicare & Medicaid Services, the CPC initiative involved 481 practices in seven regions around the U.S., including New Jersey, Colorado, Arkansas and Oregon as well as parts of New York, Oklahoma and Ohio. The 2,188 participating providers in 2015 served almost 2.7 million patients, of which 410,177 were Medicare or Medicaid beneficiaries. In 2014, 492 practices, serving 345,000 Medicare and Medicaid…

Data breaches are so common to the health care industry that, except for those national in scope, they hardly merit mention in the news.  It may be surprising to learn that almost 42.5 percent of all data breaches occur in the health care industry, and that 91 percent of all health care organizations have reported at least one breach within a recent two year period. Almost one in eight Americans has had their health records compromised.  There is no secret as to why medical records are so often a target of thieves. Not only is there sensitive personal information that can be used to obtain financial benefits, but there is often enough data to secure highly valuable health benefits including Medicare, Medicaid or prescription drugs. Unlike a stolen credit card which is easily canceled,…

A Side-by-side Comparison: Capitation vs. Bundled Payment A Case for a Population-based Payment (Capitation model):  Inefficiency is an undeniable feature of modern American health care.  Medical professionals recognize that within the current fee-for-service system there are powerful incentives for performing unnecessary services. It is estimated that up to one third of the $3 trillion national expenditure on health care is for unnecessary or suboptimal treatments.  A new study by Brent C. James, MD and Gregory Poulsen entitled “The Case for Capitation” suggests that the most effective strategy for curtailing this waste is to adopt a population-based (or capitation) payment model.  Within the capitation system, providers would obtain a fixed fee per patient to cover all treatments provided within a defined period of time. To ensure high quality of care, these fees would…

The health care sector has been the nation’s top industry for job creation in the past two years.  In 2015, health care created a record 471,600 new jobs, and 2016 is expected to top that incredible figure.  In the first half of 2016, the health care industry saw the creation of 234,600 new positions with 39,000 new jobs in June alone. The majority of these new jobs were in ambulatory services, hospitals and residential care. This robust growth in the industry as a whole has also bolstered the staffing segment.  According to the Staffing Industry Analysts, the health care staffing industry should grow by 13 percent in 2016 and drop to 8 percent in 2017.  The accelerated growth in staffing in 2015 and 2016 is largely attributable to the increased…

There is a myriad of challenges in practicing medicine from the intrusion of third parties to the declining number of medical professionals.  For the most part, these obstacles are a result of some well-intentioned but poorly executed effort, but there are some that arise out of ridiculous circumstances like the nationwide shortage of some medications. In 2010, the Food and Drug Administration reported that 178 drugs were in short supply around the country.  Many of these were for critical care, cancer treatment or antibiotic use.  In 2011, this number rose to 250.   While this number declined in the following years, by May of 2015, the shortage had returned to 250. The problem of life-saving drug shortages has become so pronounced that the U.S. Congress has convened hearings on the matter.…

In the modern medical world, there are a growing number of ways to connect organizations with temporary or permanent medical professionals, so the traditional locum tenens model may appear to be somewhat antiquated.  It can be appealing to many newcomers to avoid locum tenens firms and find a position independently, but there are some compelling benefits to working with an established firm. The foremost reason to choose an agency to manage your locum tenens placement is that it makes the entire process considerably easier.  In order to work in a hospital or practice, you must complete a time-consuming and involved process of license verification and credentialing.  This typically involves documentation of academic and professional achievements, personal references and verification of board certification.  This process must be repeated for each new…

Although it is difficult to accurately assess the financial impact of either presidential candidate’s platforms at this point in the race, the nonpartisan, nonprofit financial watchdog group, the Committee for a Responsible Federal Budget(CRFB), has analyzed each candidate’s health care plan with some surprising conclusions.  Despite a $14 trillion debt that will increasingly consume much of the country’s GDP, it appears that both Republican nominee Donald Trump and Democratic nominee Hillary Clinton are committed to health care reforms that will add hundreds of billions of dollars to that staggering debt. An initial analysis suggests that Clinton’s health care changes would cost almost $150 billion over ten years, if economic returns are factored into the estimate. However, the CRFB estimates Clinton’s proposals could possibly cost about $300 billion if certain mitigating factors…

The ongoing debate about the use of marijuana as a medicinal therapy and recreational drug continues to rage in the halls of power and the public square, but, surprisingly, there is also a continuing back-and-forth among physicians and the scientific community.  Despite its presence in Western society since the 19th century, there is still a dearth of authentic and reliable science on its health effects.  It remains a proscribed substance in 26 of the U.S. states; it is available as a medicinal in the other states, with four allowing recreational use. Among the medical community, the most likely answer to the question, “Is marijuana safe?” is most likely “It depends…” On the spectrum of detrimental substances it probably ranks close to alcohol.  In terms of lethality, marijuana is less dangerous…

Keeping track of the latest drug craze can be exhausting, but occasionally, one of these drugs pushes the boundaries of typical street behavior and creates a serious public health concern. It happened with crack and crystal meth, and now a new drug is poised to shake up the American drug trade and cause an explosion in fatalities—fentanyl.  Doctors should already be familiar with this prescription painkiller often used in cancer treatment, but fentanyl is showing up on streets for the first time. Fentanyl—commonly known on the street as “China White” or “China Girl”—is an extremely powerful opioid that may have caused the recent death of singer Prince.  This is only the most high profile fatality in an epidemic that is still in its early stages, but one that could tax…