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Too Many Tests – Impact Your Health

 

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Study Suggests Too Many Invasive Heart Tests Given
A troublingly high number of U.S. patients who are given angiograms to check for heart disease turn out not to have a significant problem, according to the latest study to suggest Americans get an excess of medical tests. [ Associated Press | Mar 10,
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March 11, 2010 Posted by | healthcare, hospitals, Overuse, quality, Safety | , , , , | Leave a comment

What Requires Legal Change and What Doesn’t?

Editor’s note: What requires new laws? What requires regulatory intervention? And what will not yield regardless?

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Estimated range of healthcare system waste is $600-$850 billion annually

At President Obama’s Healthcare Summit, SEN. Tom Coburn cited Thomson Reuters’ white paper “Where Can $700 Billion In Waste Be Cut Annually From the U.S. Healthcare System?” The report identifies the most significant drivers of wasteful healthcare spending as follows:

1. Administrative System Inefficiencies: $100-$150 billion

2. Provider Inefficiency and Errors: $75-$100 billion

3. Lack of Care Coordination: $25-$50 billion

4. Unwarranted Use: $250-$325 billion

5. Preventable Conditions and Avoidable Care: $25-$50 billion

6. Fraud and Abuse: $125-$175 billion

Source: Thomson Reuters. “Where Can $700 Billion in Waste Be Cut Annually From the U.S. Healthcare System?” October 2009. http://www.factsforhealthcare.com/whitepaper/HealthcareWaste.pdf

March 9, 2010 Posted by | Cost, Federal Government, Fraud and Abuse, Overuse, quality | , , , | 1 Comment

Study: 26% of referrals for imaging scans were inappropriate

A study of the medical records of 459 patients referred by their primary care physicians for diagnostic CT, MRI or PET scans found that 26% of the referrals weren’t appropriate because they didn’t follow guidelines that closely resemble those created by the American College of Radiology. The study results “suggest a need for tools to help primary-care physicians improve the quality of their imaging decision requests,” the lead author of the study said. Modern Healthcare (free registration) (3/2)

March 3, 2010 Posted by | Cost, healthcare, Overuse, physicians, quality | , , , , , , | Leave a comment

Overuse and Misuse

More PCT testing could reduce unnecessary antibiotic use
If physicians commonly tested patients for procalcitonin, or PCT, it would help them identify those whose respiratory tract infections respond to antibiotics and help prevent prescribing unnecessary drugs, researchers said. The study estimated antibiotic prescriptions for respiratory tract infections could drop by more than 40% if the simple test was used routinely. MSNBC/Reuters (2/25)

February 26, 2010 Posted by | drugs, healthcare, Overuse, quality | , , , , | Leave a comment

Defensive Medicine and Tort Reform

Physicians attribute 26 percent of healthcare costs to defensive medicine

According to a new study released by Gallup and Jackson Healthcare, physicians attribute 26 percent of overall healthcare costs to the practice of defensive medicine. Among survey findings:

  • While physicians attribute an average of 26 percent of overall costs to defensive medicine, 13 percent believe the practice constitutes 50 percent or more of the cost.
  • 73% agreed that they had practiced some form of defensive medicine in the past 12 months.
  • 23% of practicing physicians estimate that defensive medicine constitutes less than 10 percent of their practice while 29% estimate the percentage to be between 10 percent and less than 25 percent.
  • Physicians indicating they had practiced a form of defensive medicine in the last twelve months attribute 21 percent of their practice to be defensive in nature.

Source: Jackson Healthcare, February 19, 2010. “New Gallup poll quantifies U.S. physician opinions on the scope of defensive medicine practices.” www.jacksonhealthcare.com

February 24, 2010 Posted by | healthcare, Overuse | , , | Leave a comment

Leads and Clues to the Ever Increasing Cost of Health Care

State of the Union’s Health Report released

The use of medical technology in the United States increased dramatically between 1996 and 2006, according to “Health, United States, 2009,” the federal government’s 33rd annual report to the President and Congress on the health of all Americans.

The report was prepared by the Centers for Disease Control and Prevention’s National Center for Health Statistics from data gathered by state and federal health agencies and through ongoing national surveys.

This year’s edition features a special section on medical technology, and finds that the rate of magnetic resonance imaging, known as MRI, and computed and positron emission tomography or CT/PET scans, ordered or provided, tripled between 1996 and 2007.

Highlights of the special section include:

* The rate of adults aged 45 and over discharged from the hospital after receiving at least one knee replacement procedure increased 70 percent from 1996 to 2006 (26.5 per 10,000 population in 1996 to 45.2 per 10,000 in 2006).

* From 1988-1994 to 2003-2006, use of antidiabetic drugs among adults aged 45 years and over increased about 50 percent, and the use of statin drugs to lower cholesterol among this age group increased almost tenfold.

* The number of new organ transplantations per 1 million people increased 31 percent for kidney transplants (43.7 per 1 million in 1997 vs. 57.2 in 2006) and 42 percent for liver transplants between 1997 and 2006 (15.6 per 1 million in 1997 vs. 22.2 in 2006).

The full report contains 150 data tables in addition to the special feature on medical technology. The tables cover the spectrum of health topics, serving as a comprehensive snapshot of the nation’s health.

* Life expectancy at birth increased more for the black than for the white population between 1990 and 2007, thereby narrowing the gap in life expectancy between these two racial groups. Overall U.S. life expectancy in 2007 was 77.9 years.

* In 2007, 20 percent of U.S. adults were current cigarette smokers, a slight decrease from 21 percent in the previous three years. Men were more likely to be current cigarette smokers than women (22 percent vs. 17 percent).

* In 2005-2006, 30 percent of adults often or almost always had trouble sleeping in the past month.

* In 2007, 20 percent of adults 18 years and over had at least one emergency department visit in the past year, and 7 percent had two or more visits.

* The percentage of the population taking at least one prescription drug during the previous month increased from 38 percent in 1988-1994 to 47 percent in 2003-2006, and the percentage taking three or more prescription drugs increased from 11 percent to 21 percent.

Source

http://www.cdc.gov/nchs/pressroom/10newreleases/hus09.htm

February 22, 2010 Posted by | Cost, diabetes, drugs, healthcare, Overuse | , , , , , , | Leave a comment

Developing Health Care Consumers

According to a recent survey, adults in Consumer Driven Health Plans (CDHPs) were more likely than those in traditional coverage to:
  • Say that they had checked whether the plan would cover care: 61% CDHP vs. 50% traditional
  • Ask for a generic drug instead of a brand name: 56% CDHP vs. 46% traditional
  • Talk to their doctor about prescription drug options and costs: 44% CDHP vs. 35% traditional
  • Talk to their doctor about other treatment options and costs: 40% CDHP vs. 33% traditional
  • Ask their doctor to recommend a less costly prescription drug: 39% CDHP vs. 34% traditional
  • Develop a budget to manage health careexpenses: 32% CDHP vs. 15% traditional
  • Check the price of service before getting care: 35% CDHP vs. 25% traditional
  • Use an online cost-tracking tool provided by the health plan: 24% CDHP vs. 12% traditional

Source: “Findings from the 2009 EBRI/MGA Consumer Engagement in Health Care Survey”, Employee Benefit Research Insitute, December 2009, http://www.ebri.org/pdf/briefspdf/EBRI_IB_12-2009_No337_CEHCS.pdf 

December 8, 2009 Posted by | Cost, drugs, healthcare, Overuse | , , , , | 1 Comment

How is Health Care Paid For

Editor’s note: In the private insurance market insurance is paid for through three streams. There is the employer contribution, the employee premium (or payroll deduction) payment and the patient’s payments at the time of service. (Note: nowhere did I say that the insurer pays the bill. They are simply a conduit for the employer contribution and employee premium/ payroll deduction with some % taken off the top for their services and profit.)

In government run insurance, it is much the same. The government payment otherwise known as your tax dollars. The premium that the individual pays to have the coverage and the amount of money that the individual pays at the time they receive medical services.

So there are no magically appearing dollars. You can change the relative contributions of the three streams, but in the end it has to add up to the cost of the medical services delivered.

In order to change the sum total of the three streams you have to address the cost of the services. Anything else is simply shifting cost from on revenue stream to another.

And this is why there is so much consternation over the federal government’s health care reform. A lot of cost shifting (mostly to the taxpayer – at least $1.2 trillion) and little to no effort to reduce the actual cost of the care being delivered.

If your business could simply increase revenue and not demonstrate that it has improved its products, services and delivery you’d be satsified as the business owner. Hmmm… Have you ever wondered why providers of all types (hospitals, physicians, etc.) oppose any sort of measurement of the quality of their services? Until the consumer gets engaged that will be slow to change.

Ever wonder why we don’t have system that gets the consumer directly involved in the selection and payment of the the lion’s share of their health care? You thought it was because it cost to much. Well it does, but the reason it costs too much is that someone else is paying for it, so why not consume all you can?

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House Provision Boosts Cost Of Younger Policyholders’ Premiums. The Wall Street Journal (11/10, Mathews, subscription required) reports that a provision of the House bill that limits how much extra insurers can charge older policyholders is proving controversial because it is likely to result in higher premiums for younger policyholders. The House bill limits the cost ratio for the oldest people versus the youngest at 2 to 1, but the Senate has approved a top ratio of 3 to 1. The Journal notes that the personal insurance mandate also affects younger Americans disproportionately. Rep. Joe Barton said, “‘We are going to tell every young American who has decided that they don’t want to pay those premiums, they want to save up to get married or to buy a home, that, by golly, they are going to have to take insurance. And they are going to pay three to four times what they would under the current system because there is only a 2-to-1 ratio.”

November 10, 2009 Posted by | Affordability, Cost, Federal Government, healthcare, Overuse | , , , , , , , | Leave a comment

Waste in Health Care Identified

The report identifies the most significant drivers of wasteful spending —
including administrative inefficiency, unnecessary treatment, medical errors,
and fraud — and quantifies their cost. It is based on a review of published
research and analyses of proprietary healthcare data.

“The bad news is that an estimated $700 billion is wasted annually. That’s
one-third of the nation’s healthcare bill,” said Robert Kelley, vice president
of healthcare analytics at Thomson Reuters and author of the white paper. “The
good news is that by attacking waste, healthcare costs can be reduced without
adversely affecting the quality of care or access to care.

According to a new report , the U.S. healthcare system wastes between $600 billion and $850 billion annually, categorized as follows:
  • Unnecessary Care: 40%, or $250 billion to $325 billion
  • Fraud: 19%, or $125 billion to $175 billion 
  • Administrative Inefficiency: 17%, or $100 billion to $150 billion 
  • Healthcare Provider Errors: 12%, or $75 billion to $100 billion 
  • Preventable Conditions: 6%, or $25 billion to $50 billion
  • Lack of Care Coordination: 6%, or $25 billion to $50 billion

Source: “WASTE IN THE U.S. HEALTHCARE SYSTEM PEGGED AT $700 BILLION ,” Reuters press release, October 26, 2009, http://www.reuters.com/article/pressRelease/idUS78128+26-Oct-2009+PRN20091026 

November 3, 2009 Posted by | healthcare, Overuse | , | Leave a comment

Blood Transfusions

The number of hospital stays for patients who received blood transfusions increased by 140% (from 1.1 million to nearly 2.7 million) between 1997 and 2007, representing the largest increase in procedures not involving pregnancy or childbirth over the 11-year period.

Blood Transfusions More Than Double Since 1997,” AHRQ News and Numbers, Agency for Healhcare Research and Quality, September 24, 2009, http://www.ahrq.gov/news/nn/nn092409.htm

October 5, 2009 Posted by | healthcare, Overuse | , | Leave a comment