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Tufts Health rethinks bariatric surgery policy

Earlier this year, Massachusetts-based Tufts Health Plan took a tough stance on bariatric surgery, imposing strict new limits on which patients it considered appropriate for the surgery. The health plan planned to limit reimbursement for bariatric surgeries to patients with a BMI of 40 or more, and were restricting many patients to laparascopic banding procedures rather than …

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Quality studies proposed for children's healthcare

To date, virtually all of the major studies of healthcare quality have focused on care for adults, partly because children aren't prone to chronic diseases like diabetes whose outcomes can be measured easily. The gap in quality measures is particularly large when it comes to inpatient care, according to a study by the National Association of Children's Hospitals. However, a new bill being considered in the Senate would change the equation, budgeting $100 million over the next five years …

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Mass. health insurer limits bariatric surgery

Massachusetts-based Tufts Health Plan has said that as of early March, it will start imposing stricter limits on bariatric surgeries, in some cases requiring patients to go through a year of counseling and dieting before it will pay for such procedures. The restrictions include denying bariatric surgery to all patients with a BMI of less than 40, and limiting most patients with a BMI of 40 to 50 to less-expensive laparascopic banding surgery. These new criteria are tougher than those …

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Number of cardiac surgery jobs falling

As the use of stents has grown and the number of cardiac bypass procedures has fallen in turn, jobs for cardiac surgeons have taken a hit. These days, cardiac surgeons who keep up active practices are often picking up a lot more heart valve or lung surgeries rather than focusing on bypass procedures. The dip in job opportunity is so pronounced that the specialty is falling out of favor in medical school. According to an article published in the Annals of Thoracic Surgery last …

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NJ sees long-term acute hospital growth

New Jersey is playing host to a growing number of long-term acute care beds, a service designed to fill the gap between standard acute care and nursing facilities. The state now has nine such hospitals, and more are planned. Nationally, there are more than 400 such hospitals currently open. These facilities, which offer no services other than extended care, target patients with serious conditions who will be hospitalized for three weeks or more. Many long-term acute care patients are on …

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ALSO NOTED: Providers build 7% bad-debt reserves; UnitedHealthcare, HealthAlliance keep arguing; and much more...

> According to newly-released research, healthcare providers are setting aside $129 billion annually to cover bad debt, or more than twice their net annual revenues. Release

> Patients continue to wait as UnitedHealthcare and HealthAlliance continue to duke it out over a contract dispute. Report

> Wrong-site surgeries may be 20 …

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Bariatric surgery to increase bottom line?

As obesity rates in America continue to skyrocket, more and more patients are turning to bariatric surgery as a last resort. The growing popularity of obesity surgery has caused many hospitals to explore the option of opening their own surgery program. It can be a very profitable venture: The typical surgery runs $25,000 and is often covered by insurers. Thinking that it could add to its bottom line, Arkansas-based Northwest Medical Center opened a bariatric program in 2004 to serve …

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SPOTLIGHT: Making smart CDHP members


During a speech at the Pittsburgh Business Group on Health, Ann Mond Johnson, president of Chicago-based Subimo, identified employers' responsibilities to their employees if they offer CDHPs instead of traditional health plans. Simply providing the health plans isn't enough: Employers must also make their employees smarter healthcare consumers, which means making sure that they have access to cost and quality data. Ms. Johnson heads a company that compiles publicly-available quality …

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Aging surgeons could endanger patients

A study published in this month's issue of the Annals of Surgery calls into question whether older surgeons should be allowed to continue practicing medicine. With aging comes decreased fine motor skills, worse eyesight and less stamina--all of which are key skills for surgeons. The study found that surgeons over 65 had higher patient death rates than younger surgeons, did not perform as well on recertification exams and were less likely to know about new treatments and techniques. …

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ALSO NOTED: Premier CEO dies; SC agency outsources IT; and much more...

> Premier hospital alliance CEO and founder Robert O'Leary has passed away after a long battle with cancer. Report

> Affiliated Computer Services (ACS) and the South Carolina Department of Health and Human Services have signed a $19.9 million contract for ACS to outsource IT solutions. Report

And …

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