For patients and physicians, many aspects of the health care and health insurance systems are frustrating and appear to be needlessly complex.
One of the most frustrating processes is prior authorization, the mother-may-I approach health insurers use to ensure that procedures, medications and even certain care processes are appropriate and worthy of coverage. Continue reading
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Should health providers be doing more to screen for fall risk in older adults? New research seems to indicate that fall screenings and risk prevention planning between providers and patients could save the health system millions of dollars, and possibly thousands of lives.
Falls cost the health system about $50 billion annually. It is a serious and growing public health issue, according to the study, “Medical Costs of Fatal and Nonfatal Falls in Older Adults,” by CDC researchers. Continue reading
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The Advisory Board recently asked this question: Are patient-centered medical homes (PCMHs) living up to the hype? As Tomi Ogundimu and Abby Burns wrote, the concept’s popularity has increased since passage of the Affordable Care Act and a shift to value-based payment for health care providers.
Ogundimu and Burns referenced a recent report from the Patient-Centered Primary Care Collaborative, which found that PCMHs can help improve the quality of care can take time to deliver a return on investment. That means this model may not lower costs right away. Continue reading
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Is it worth it to provide more skilled – and higher paying – home health care?
That is the question that New York Times’ economic columnist Eduardo Porter tackled in a recent piece examining whether staffing the nation’s long-term care system with better-trained and higher-paid aides could give them more responsibilities and better address health care gaps. Continue reading
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How often has this happened to you? Over the transom comes a report you believe will be the basis for a section-front story or maybe warrant page one. Many times, you’re right. You read the report, collect the highlights, conduct a few interviews, and fire off the story on deadline.
However, occasionally what you thought might be a solid report leaves important questions unanswered. Continue reading
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High deductibles and out of pocket costs – which are increasing in both Affordable Care Act exchange plans and employer-sponsored coverage – have given new urgency to helping patients (or “consumers” as they’re called nowadays) learn about the cost and quality of care.
If you know both cost and quality, you know more about the value of care. (Assuming the treatment actually is the right and necessary course of care, but that’s a whole other conversation.)
Many programs and experiments are underway to figure out which tools are helpful to patients, how patients are using them, and what are their impact on health spending and utilization. The findings so far can perhaps be summed up as “meh.” Continue reading