December 27th, 2011 by GruntDoc in Health Policy, Opinion
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This article and its graph (from the NEJM), and its interesting, informative but probably useless graph, was referenced today on twitter, via the Washington Post’s Wonkblog,
Recently, the Centers for Medicaid and Medicare Services announced a scheduled cut in Medicare physician fees of 27.4% for 2012. This cut stems from the sustainable growth rate (SGR) formula used by the physician-payment system. …
To illustrate the level of inequity in this system, we broke down the national spending for Medicare physician services by state and by specialty and determined which states and specialties have contributed most to the SGR deficit between 2002, when the program was last balanced, and 2009. Although SGR spending targets are set on a national level, we computed state targets by applying the SGR’s national target growth rate to each state’s per capita expenditure, using 2002 as the base year. Our analysis is an approximation, because, unlike the SGR, we do not adjust for differential fee changes. …
We compared the state targets for the years 2003 to 2009 to actual state expenditures and added the annual difference between these figures to get a cumulative difference between the state’s spending and the SGR target. This cumulative difference was Read more »
*This blog post was originally published at GruntDoc*
December 22nd, 2011 by GruntDoc in News
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Aah, the French:
The idea of putting maggots into open flesh may sound repulsive, but such a therapy might be a quick way to clean wounds, a new study from France suggests.
via Maggots Clean Wounds Faster Than Surgeons | Wound Healing | LiveScience.
I kid. I think this is a good idea, and it’s natures’ way of saying ‘cleanup on aisle three’. Patients not infrequently will be brought to the ED with awful, non-healing wounds infested with maggots.
We typically kill them off, more because a) the staff is completely grossed out and b) if you’re living at home and have maggots in your wounds, let’s just say your personal hygiene is deeply suspect. Rank, in fact. Needs a decon level bad.
However, there is a legitimate role for biological wound cleaning; I have a WWII surgical book with a chapter in it on growing your own sterile maggots. It’s not an ER thing, but it’s yet another tool in the armamentarium of bad wounds.
*This blog post was originally published at GruntDoc*
December 16th, 2011 by GruntDoc in Opinion, Research
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I read this headline and said, “Wow!, finally I won’t need to CT all those patients’ heads!”
FDA permits marketing of the first hand-held device to aid in the detection of bleeding in the skull
Helps to determine if immediate CT scan is needed
The U.S. Food and Drug Administration today allowed marketing of the first hand-held device intended to aid in the detection of life-threatening bleeding in the skull called intracranial hematomas, using near-infrared spectroscopy.
via Press Announcements > FDA permits marketing of the first hand-held device to aid in the detection of bleeding in the skull.
But then, wait, said I, is it any good? Read more »
*This blog post was originally published at GruntDoc*
November 30th, 2011 by GruntDoc in Opinion, Research
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I really like this idea, but … well, see after the quote.
It’s easy to compare prices on cameras, vacations, and homes. But in the United States, patients fly blind when paying for health care. People typically don’t find out how much any given medical procedure costs until well after they receive treatment, be it a blood draw or major surgery.
This lack of transparency has contributed to huge disparities in the cost of procedures. According to Castlight Health, a startup based in San Francisco, a colonoscopy costs anywhere from $563 to $3,967 within a single zip code. EKGs can range from $27 to $143, while the price for a set of three spinal x-rays varies from as little as $38 to as high as $162.
When someone else is picking up the tab, mystery pricing is not much of a problem. But these days, Read more »
*This blog post was originally published at GruntDoc*
November 25th, 2011 by GruntDoc in Health Policy, Opinion
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Update: this happened 2 years ago. So, I wrote this thinking it was a new development, but it isn’t. Anyone know how this experiment has played out?
I’ve wondered for years if hospital organizations (and big organized clinics) had done the math on whether they could do without Medicare, and apparently Mayo has. More after the quote
President Obama last year praised the Mayo Clinic as a “classic example” of how a health-care provider can offer “better outcomes” at lower cost. Then what should Americans think about the famous Minnesota medical center’s decision to take fewer Medicare patients?
Specifically, Mayo said last week it will no longer accept Medicare patients at one of its primary care clinics in Arizona. Mayo said the decision is part of a two-year pilot program to determine if it should also drop Medicare patients at other facilities in Arizona, Florida and Minnesota, which serve more than 500,000 seniors.
Mayo says it lost Read more »
*This blog post was originally published at GruntDoc*
