A report published last week detailed how much Medicare spends on prescription medications.
In 2013, Medicare spent $103 billion on drugs. (I’m guessing the total will be more in 2014 and 2015, when they get around to publishing that data.)
Federal officials said they hoped that disseminating the data would lead to new revelations about the prescribing patterns of doctors and for particular drugs.
Dan Mendelson, the CEO of Avalere, a Washington, D.C., consulting firm, said the data could provide patients with new questions about their prescription history when they visit their physician. “It’s really important to stimulate conversations
… Continue reading
The last few weeks have been stressful for my family as my 93-year-old father suffered a heart attack, a stroke and other medical problems that led to a 2-week hospital stay (I’m amazed he survived that), a 10-day stay in a skilled nursing facility, and—just this weekend—a move into an adult family home.
He needs round-the-clock care that my 85-year-old arthritic mother can’t provide in their home.
In a few weeks, I’m sure I will be helping her sift through an enormous pile of statements, explanations of benefits (EOBs) and invoices related to my dad’s care.
Sure Medicare will pick … Continue reading
It’s another case in which the right hand of a behemoth government agency doesn’t know what the left hand is doing: In Cancer Wars, It’s Doctors vs. Hospitals
Colliding federal policies are fomenting a nasty money war that’s pitting community oncologists trying to treat patients in less expensive clinic settings against hospitals trying to woo patients in through costlier emergency departments.
The agencies under discussion are the Centers for Medicare and Medicaid Services (CMS) and the Health Resources Services Administration (HRSA) [which both fall under the larger umbrella of the Department of Health and Human Services (HHS)], and their disparate … Continue reading
Lots of data, but not user friendly
Have you ever wondered if your physician receives a substantial amount of money from a pharmaceutical or medical device company?
Is your physician’s decision to write you a prescription for the newest brand-name drug, or replace your knee with a state-of-the-art joint, based on corporate influences? Conflicts of interest run rampant in health care, and it would be nice to know, wouldn’t it?
Earlier this fall, the Centers for Medicare and Medicaid Services (CMS) launched a new website called Open Payments. It’s part of the Sunshine Act, which in turn … Continue reading
When is a hospital admission not an admission?
Answer: When, for Medicare patients, it’s coded as “observation” status only.
Before the days of discharging patients ASAP (or not admitting them at all), doctors used to frequently admit patients “for observation.” It signified that a patient was not critically ill, but his or her condition warranted careful watching, i.e. observation.
Unfortunately for the last decade or so, that term has come to have a very specific meaning with very specific financial consequences. But most patients still consider it a casual phrase that doesn’t mean much, and that ignorance can end up… Continue reading
Farewell to a beloved husband and father
Today I am in Idaho attending the memorial service of my father-in-law.
He passed away two weeks ago at the age of 85, after suffering for several years from declining health and increasing dementia. His wife of 59 years and all four of his children were at his bedside when he died.
Death is not pretty, but neither is childbirth. Both involve pain, fear and uncertainty. And hope. Hope that mother and baby are healthy at the end of the ordeal. Hope that the dying one finds peace and an end to physical … Continue reading
It’s no surprise to anyone in the health care industry, but Medicare just released a report that shows the incredible variation of health care costs across the country.
Many patients are unaware of these price differences because, as I’ve posted about before, it’s nearly impossible for health care consumers to get information about the cost of a procedure before having the procedure done.
Coming so soon after Stephen Brill’s brilliant (yet depressing) Time magazine article, “Bitter Pill: Why Medical Bills are Killing Us,“ the numbers presented in the report will hopefully provoke consumers to demand more fairness and … Continue reading
I mentioned in a previous post that three years ago my husband almost died from a series of medical, um, misjudgments, let’s say. I know sometimes things go wrong for no reason, but I also know his three-day ICU stay could have been prevented.
He never received a “mea culpa” from the doctors or hospital; all we got were the medical bills. Our insurance, a catastrophic/health savings account (HSA) plan, paid 100% of the costs after we met our deductible and out-of-pocket maximum ($10,000). At that point we stopped receiving bills, so I don’t know the exact total of … Continue reading
During the presidential campaign last year, Paul Ryan, the vice-presidential candidate, presented his plan for what we all know is much-needed Medicare reform (too many baby boomers; too little money). Under his plan, seniors would choose a “Medicare certified” private health insurance plan and, depending on the senior’s income, a percentage of the premium would be subsidized.
His plan sounds a lot like the new health insurance exchanges that are set to begin in 2014, doesn’t it?
Yesterday, an article on the National Review Online caught my attention because the author presented a compelling scenario by which the government could … Continue reading