Kasier / NPR / Harvard Survey

Here’s a link to the summary of The Public and the Health Care Delivery
System survey results

The survey suggests that Americans’ faith in their doctors extends even to the sensitive question of money. According to the survey, two in three (65 percent) say their doctor’s charges are reasonable, and perhaps more importantly, nearly as many (63 percent) say they believe that their doctor is working to keep the cost of their health care down.

Perhaps because of this faith in doctors’ efforts to restrain costs, most are not asking about the cost of medical or lab tests they are getting – twenty two percent say they have done so over the past two years, compared to eight in ten who have not. Not surprisingly, those without insurance are more likely to have asked the price of a treatment (31 percent versus 20 percent of the insured). Overall, nearly four in ten Americans (37 percent) say they don’t think even their doctor knows how much tests cost, while half (51 percent) say they do think their medical
provider is aware of the charges.

Most Americans favor the current system of physician reimbursement. Seven in ten say they prefer having their insurance company pay their doctor a fee for each visit, while 25 percent say they think it would be better for doctors to get paid a yearly amount for care.

Clear!

From Impacted Nurse:

Rural hospitals: Enough stimulus for IT?

A free webinar, through Modern Healthcare:

Wednesday, May 6, 2009 10:00 AM – 11:00 AM CDT

Link to registration

Major differences exist between the healthcare information technology incentives for prospective-payment system, or PPS, hospitals and critical-access hospitals under the economic stimulus package known as the American Recovery and Reinvestment Act of 2009. Meanwhile, the Congressional Budget Office estimates that only half of the critical-access hospitals will be “meaningful users” of healthcare IT by 2019.

A Modern Healthcare editorial webinar will look at the state of IT at rural healthcare organizations.

Rich Donkle, director of financial consulting services at the Rural Wisconsin Health Cooperative, Sauk City, will discuss the differences in IT incentives in the stimulus package and why the critical-access facilities are likely to need assistance beyond that funding to accelerate use of IT.

Sue Severson, drector of health IT services at Stratis Health, a not-for-profit quality-improvement organization based in Bloomington, Minn., will discuss a roadmap and tools she has developed for the nation’s critical-access hospitals.

Where Medical Boards Do and Don’t Crack Down on Doctors

From the Wall Street Journal Health Blog:

About three out of every 1,000 doctors were the targets of serious disciplinary actions by state medical boards last year.

An annual report out from the watchdog group Public Citizen says the nationwide rate of serious actions, such as license revocations and suspensions, was 2.92 per 1,000 doctors last year. That was unchanged from the prior year — but remains below a peak of 3.72 in 2004.

States with the highest rates, averaged from 2006-2008:

Rank	State	Serious actions per 1,000 doctors
1	Alaska	6.54
2	Kentucky	5.87
3	Ohio	5.33
4	Arizona	5.12
5	Oklahoma	5.02

States with the lowest rates:

Rank	State	Serious actions per 1,000 doctors
1	Minnesota	0.95
2	S. Carolina	1.23
3	Wisconsin	1.64
4	Mississippi	1.87
5	Connecticut	1.97

As we noted last year, it’s tough to know what to make of the numbers. Public Citizen sees a drop in the disciplinary-action rate compared with the 2004 peak as a sign of too few resources devoted to policing doctors and lack of vigilance by state medical boards.

Are Electronic Health Records Worth the Risks?

From the Wall Street Journal Health Blog:

Even a booster of electronic systems like David Blumenthal, who just started his Washington post as the national coordinator of health IT, points to a myriad of challenges when it comes to digitizing the nation’s medical records.

Just take a look at his piece this month in the New England Journal of Medicine, in which he cites technical concerns and worries about patient privacy, among other things. In an interview with the WSJ, he said problems can crop up if the systems are installed too quickly and without enough technical support.

Minn. ranked last in disciplining docs; Alaska still first

From Modern Healthcare:

Minnesota was the least-effective state when it came to disciplining physicians, and, for the third-straight year, Alaska was the most effective, according to the annual ranking of serious disciplinary actions taken by state medical boards compiled by the Public Citizen Health Research Group.

Public Citizen creates the rankings by taking a three-year average of the data on medical license revocations, surrenders, suspensions, probations and suspensions compiled by the Federation of State Medical Boards and divides it by the states’ physician populations to come up with a “serious actions per 1,000 physicians” rating. The District of Columbia is also included in the rankings.

Minnesota’s rating was 0.95 serious actions taken per 1,000 physicians, while Alaska had a rating of 6.54 serious actions per 1,000 physicians. What appeared to disturb Public Citizen the most, however, was the appearance of California and Florida near the bottom with ratings of 2.37 and 2.35 and rankings of 43rd and 44th, respectively. The report noted also how California dropped to that level after being ranked 22nd in 2003.

Nationally, there were 2,817 serious actions taken by the medical boards in 2008 against the nation’s 963,084 physicians, which Public Citizen calculates to be a 3.28 rating when the previous two years are taken into account for a three-year average.

Finishing just above Minnesota were South Carolina, with 1.23 serious actions per 1,000 physicians; then Wisconsin, 1.64; and Mississippi, 1.87.

After Alaska, came Kentucky, with a 5.87 rating, followed by Ohio, 5.33; and Arizona, 5.12.