57% of Americans have been surprised by a medical bill, most say insurers are to blame

From Becker’s:

Fifty-seven percent of Americans say they’ve received a surprise medical bill they thought would be covered by insurance, according to a recent survey conducted by NORC at the University of Chicago.

NORC polled 1,002 individuals from a nationally representative sample of Americans using the AmeriSpeak Panel, a probability-based panel NORC designed to be representative of the U.S. household population.

The survey also asked respondents which groups — payers, hospitals, physicians or pharmacies — are most responsible for surprise medical bills. Here’s the proportion of respondents that said each group was “very” or “somewhat” responsible:

  • Payers: 86 percent
  • Hospitals: 82 percent
  • Physicians: 71 percent
  • Pharmacies: 64 percent

 

Highmark to pay ambulance companies for treating patients outside hospital

From Becker’s:

Highmark and Allegheny Health Network, both in Pittsburgh, launched a pilot program under which Highmark will reimburse ambulance companies for some calls where patients are not taken to a hospital, according to Trib Live.

Under the new “treat-and-release” program, which the organizations announced Aug. 29, Highmark will contract with 16 emergency medical services. The health insurer will reimburse the companies for treating adult patients with seizure disorders, low blood sugar and asthma attacks outside the hospital. This bypasses a requirement that ambulance companies only receive payment when a patient is taken to an emergency department.

Is the Wage Gap Between Doctors and CEOs Why Healthcare Is So Expensive?

From Motley Fool:

The relatively small proportion of spending on prescription drugs and the absence of widening margins for big insurers raises an important question: What else could be to blame for increasing healthcare costs? According to a recent study, the answer might be wages for doctors and healthcare CEOs.

Analyzing pay trends at 22 major health systems between 2005 and 2015, researchers at University Hospitals Cleveland Medical Center and Case Western Reserve University found that the average compensation for medical center CEOs surged 93% to $3.1 million during the period, a rate that far exceeded the 3% average increase in registered nurses’ pay.

Video games make physicians better in emergency decisions, study finds

From STAT:

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Doctors who played the game Saulnier designed did a better job on a separate virtual simulation designed to test their clinical judgement about trauma transfers than those who used a text-based app or nothing at all, according to new research published Monday in the Proceedings of the National Academy of Sciences. The study found a similar result for doctors who played a story-based adventure game from Schell Games, also for the iPad.

What’s driving America’s rural doctor shortage?

From the Lown Institute:

Salary and lifestyle considerations also play a large role in determining where doctors practice. Residents of rural counties are generally older, lower-income, and in worse health than people who live in urban areas. Therefore doctors in rural areas are more likely to be reimbursed through Medicare or Medicaid, which pays less than private insurance, and could be punished financially for having a sicker and poorer patient pool. Also, counties that have difficulty attracting residents have difficulty bringing in doctors, many of whom are young and may be looking for a more fast-paced lifestyle.

HHS’ OIG ponders new legal protections for value-based care models

From Modern Healthcare:

HHS wants to encourage providers to enter value-based care agreements with each other, and it’s researching whether it can offer new legal protections for those arrangements.

HHS’ Office of Inspector General will accept comments from stakeholders on how it can modify or add new safe harbors to the anti-kickback statute to prevent providers in value-based pay models from facing civil money penalties, according to a notice issued Monday.

“OIG has identified the broad reach of the anti-kickback statute and beneficiary inducements (civil monetary penalties) as a potential impediment to beneficial arrangements that would advance coordinated care,” the agency said in the notice.

Revitalizing Health in Rural Appalachia

From Route Fifty:

“We started talking about potential solutions,” he said. “I thought the best solution, instead of the people from Sequatchie County coming to Erlanger for health care, was Erlanger coming to them. But, initially, people at Erlanger didn’t think what I was suggesting was even feasible.”

Winick, along with county officials, worked to get federal and state authorization to reopen the emergency department. After years of negotiations, investments of $250,000 from ARC and the county, and a long-term lease agreement for $1 per year, Erlanger reopened the 12,000-square-foot facility in July 2014, featuring 24-hour care for children and adults. Doctors could treat common ailments, from broken bones and sports injuries to bouts of the flu, while patients suffering from more serious issues—stroke, heart attack—could be air-lifted to other facilities.