medical groups

Study: Patients don't typically use online ratings

Anne Zieger — Mon, 16 Jun 2008 01:02:08 -0400

Though physicians fear that their business will be adversely affected by off-the-cuff online ratings, few patients actually make use of such ratings, according to new research. A Harris Interactive poll commissioned by the California HealthCare Foundation concluded that while more than 80 percent of the state's adults use the web for health information, less than one-quarter have made use of physician ratings sites. More significantly, only 2 percent of those surveyed had changed doctors based on ratings-site information. Even fewer (1 percent) changed hospitals or health plans based on data from ratings sites. All that being said, more people are looking at physician ratings sites than they were three years ago. Harris found that the number of people who looked at physician ratings sites climbed from 14 percent in 2004 to 22 percent in 2007.

Even though consumers aren't heavily influenced by web ratings today, medical groups are well aware that things can change. For that reason, the AMA continues to monitor the practice of physicians ratings online, and has occasionally taken action to oppose such schemes.

To learn more about the study:
- read this AMNews article

Walgreens battles CVS for MA retail clinic market

Thu, 12 Jun 2008 06:59:58 -0400

Over the past year, drugstore chain CVS has engaged in a protracted battle to get permission to open its MinuteClinics in locations across the Boston metro area. The effort involved not only getting permission from state regulators, but also fighting the displeasure of Boston Mayor Thomas Menino, who opposes the retail clinic model. Despite the struggles CVS has faced, fellow drugstore giant Walgreens has decided that it, too, wants a piece of the Boston retail clinic market, seeking state approval to open such clinics inside 16 of its Massachusetts stores. Walgreens' Take Care Health Systems subsidiary has asked permission to build clinics stretching across a broad swath of the state. Its plans also include opening a clinic in Roxbury, a move which is likely to further upset Mayor Menino. Walgreens, which already operates 173 clinics in 14 states, hopes to open its first Massachusetts clinics in the fall. All told, it expects to have 400 clinics running across the U.S. by the end of this year.

To learn more about Walgreens' efforts:
- read this article from The Boston Globe

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Democrats work to impose limits on MD-owned hospitals

Mon, 09 Jun 2008 06:59:56 -0400

Three times in the last 10 months, both levels of Congress have attempted to impose new limits on physician ownership of hospitals, but failed to close the deal. Now, Democrats in Congress are making another effort to do just that--while allowing a select few hospitals to escape the limits they have planned for the rest of the bunch. The current legislation being considered by the Senate generally prevents doctor-owned hospitals from expanding their capacity by adding beds or operating rooms, though it does offer some narrow exceptions based on local population growth and ratio of hospital beds to population.

Among the hospitals that would get a break from planned legislation include Wenatchee Valley Medical Center, whose dispensation was snared by Senator Patty Murray of Washington, a member of the Appropriations Committee. Meanwhile, Senator Herb Kohl (D-WI) got the Senate to agree to language that would help out Aurora BayCare Medical Center in Green Bay--notably by allowing it to build a new cardiac Catha lab.

To learn more about the legislative battle:
- read this article from The New York Times

FTC comes down on IL bill restricting retail clinics

Wed, 04 Jun 2008 06:59:58 -0400

The Federal Trade Commission has let it be known that it isn't thrilled with pending legislation that could place limits on the state's growing retail clinic industry. The agency found that the bill, which is backed by the Illinois State Medical Society, could "excessively restrict retail clinics to the detriment of Illinois healthcare consumers." The 12-page analysis, which was requested by state Rep. Elaine Nekritz, found a number of problems with the bill, including a definition it said could be interpreted to exempt retail clinics owned by hospitals or physicians from the rules.

It also objected to several other provisions, including proposed rules limiting medical directors to overseeing no more than two clinics; prohibiting payers from negotiating lower co-pays and deductibles for retail clinic services; barring retail clinics from opening in establishments that sell alcohol or tobacco; and requiring that retail clinics have a designated receptions and waiting area.

The controversy over this bill is not the first conflict over retail clinic regulations--a few states, including Massachusetts, have already seen heated battles over this issue--and it probably won't be the last. For example, the AMA continues to challenge the safety of retail clinic services, as well as their potential for posing a conflict of interest by being housed where prescription drugs are sold. Other critics (such as Boston's Mayor Thomas Menino) have proposed rules barring clinics from operating where tobacco is sold, which de facto prevents the clinics from operating in drugstores that rely on tobacco income.

To learn more about the FTC analysis:
- read this Modern Healthcare piece (reg. req.)

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Federal spending bill could limit physician hospital ownership

Wed, 04 Jun 2008 06:59:57 -0400

A group of Republican Congress members are raising objections to language in a war supplemental spending bill that they say would harm physician-owned hospitals. Sens. Jon Kyl (R-AZ) and Tom Coburn (R-OK), along with Texas republican Reps. Sam Johnson and Joe Barton, object to an amendment that would prohibit new physician owned hospitals built after this coming September, while offering no protection for hospitals still under development as of that date. They're also unhappy about rules that would force hospitals to meet what they deem "extreme qualifications" to expand, rather than grow as they see fit. In a letter to the Senate Appropriations Committee, the legislators call these provisions "a national certificate-of-need program... access to [which] would likely be denied to almost every physician-owned hospital."

To learn more about the legislators' challenge to physician-owned hospital regs:
- read this Modern Healthcare piece

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Hospitals, practices using locum tenens physicians more often

Wed, 04 Jun 2008 06:59:56 -0400

In what some deem a troubling sign that the primary care physician shortage is getting worse, a growing number of hospitals and practices are working through temp agencies to get their staffing needs met. As has always been the case, physicians are choosing the locum tenens option for their own reasons, including the flexibility of not having to maintain their own office, the ability to experiment with different regions and facilities, and the ability to limit how many hours they work.

However, hospitals and medical practices seem to be facing a new squeeze forcing them to change their habits. According to a survey by doctor temp-agency Staff Care, spending on temp doctors across the U.S. has more than doubled since 2001, and the number of days worked by physicians as temps has grown by 20 percent between 2006 and 2007 alone. Observers say a growing demand for primary care physicians is helping to fuel this boom.

To learn more about this trend:
- read this Chicago Tribune piece

CIGNA launches site offering doctor, hospital rankings

Fri, 23 May 2008 06:59:57 -0400

CIGNA has launched a national website ranking doctors and hospitals by cost and quality measures, along with providing its beneficiaries with several additional tools to help them obtain care. Not only does the site rank providers, it also names hospitals in specific regions with the lowest death and complication rates. In addition, it offers lists of questions patients can ask their doctor in regards to specific conditions, and offers patients tools to help them locate nearby pharmacies with the lowest prices.

At least where New York physicians are concerned, Cigna's program will be under the scrutiny of a fierce watchdog. New York Attorney General Andrew Cuomo has investigated several of the state's health plans as they rolled out rating and ranking programs, and Cigna was one of the plans asked to sign an agreement detailing the practices it would adhere to in establishing ranking programs. Cigna has since hired the National Committee for Quality Assurance to oversee its ratings program for the entire U.S.

To learn more about CIGNA's rankings program:
- read this Atlanta Journal-Constitution article

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Case study: NY health plan, group test 'medical home' model

Fri, 23 May 2008 06:59:54 -0400

While there's much discussion of the "medical home" model at industry meet-ups, few health plans have gotten to the point where they're actually putting their money where their mouth is. Albany, NY-based Capital District Physicians Health Plan (CDPHP), however, has decided to make a commitment to the medical home approach.

The regional health plan has put aside $1 million to mount a pilot program testing out its theory that a medical home approach can make practices more efficient, improve outcomes, raise doctor and patient satisfaction and cut costs.The plan includes three medical practices--Latham Medical, Community Care Schodack and Capital Care Family Practice--that will begin offering the program in January 2009. To build the it, CDPHP is working with TransforMED, an affiliate of the American Academy of Family Physicians that just completed a major study of medical homes. TransforMED will begin helping the practices prepare for the transition this month.

What makes the CDPHP program unusual not only is the care model, which stresses team care lead by a physician, but also the fact that physicians are compensated differently than they have been in the past, including pay for phone calls and paperwork. Not only that, physicians' pay service fees would be based on a risk-adjusted model based on a patient's condition, with additional pay for good outcomes and strong patient satisfaction.

To learn more about the CDPHP program:
- read this piece from The Business Review of Albany

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MA physician group files suit over rankings

Thu, 22 May 2008 06:59:58 -0400

The Massachusetts Medical Society has filed suit to stop a scheme under which doctors are ranked using cost and quality metrics by health plans working with an agency overseeing health insurance plans for public employees. The MMS says that the Group Insurance Commission (GIC), which works with thousands of state and local employees, defamed doctors that it arbitrarily ranked lower, and defrauded patients who pay higher co-payments based on their doctor's ranking.

The medical society had worked with the GIC for four years to improve its methods, and concedes that the agency made some changes. However, it still ranks individual physicians "using inaccurate, unreliable, and invalid tools and data," according to Dr. Bruce Auerbach, MMS's president.

To compile its individual physician rankings, the GIC runs an analysis on a claims database drawn from six insurance companies. However, the MMS says this approach has many flaws, including that it penalizes doctors that take on complex, expensive cases. Also, the data itself may reflect, for example, full expenses for cases in which a doctor read a chart but didn't participate in care, skewing the individual's cost results dramatically.

To learn more about the dispute:
- read this article from The Boston Globe

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FL system settles federal claim over MD overpayments

Tue, 13 May 2008 06:59:56 -0400

Baptist Health South Florida has agreed to pay the federal government $7.75 million to settle allegations that it paid an oncology group excessive compensation to generate referrals for two of its hospitals.The payments flowed out of a contract under which the Oncology Hematology Group of South Florida provided radiation-related services to the Baptist Hospital of Miami and South Miami Hospital between 2003 and 2005.

The deal comes from voluntary disclosures by Baptist Health, which discovered, investigated and voluntarily disclosed the overpayment to the Department of Justice. Since discovering the problem, the system has bolstered its screens to make sure such overpayments can't take place again, according to CEO Brian Keeley.

To learn more about the settlements:
- read this piece in The Miami Herald

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