RedScrubs
The Resource for Medical Professionals

Healthcare transparency is finally spilling over into the insurance market place where the public will begin to see pricing data from Blue Cross and Blue Shield in Wisconsin. The plan is to let policy holders and others see what the insurance carrier is contracting in terms of pricing for certain services between hospitals and providers.

With a wide range of prices in the Wisconsin area

Almost all of the patients over 70 residing in a Melbourne Australia teaching hospital were either malnourished or at risk of becoming malnourished a recent 2008 study showed. Malnutrition in hospitals is not a new entity. Looking at data from 1996, an article was published on the problem at hand in the United States where the study cited a prevalence of malnutrition to be 40-55% of the patients studied in the survey. Over 1,000 patients participated in this 1996 study in the U.S.

In the Melbourne study, 100 patients over the age of 70 were reviewed and 1/3 of them were found to be malnourished and 2/3 were found to be at risk for malnutrition.

Several lines of the page in all sorts of media have been devoted to the evaluative concepts of healthcare organization ratings and physician provider ratings. Many websites dot the web with such databases for patients of all types to delve into and either look for a new provider or submit a subjective evaluation based on their most recent healthcare experience.

Information technology (IT) specific to healthcare has become a hot item on a national scale as well as in the international healthcare community. It is safe to say I think that the electronic medical record (EMR) has come of age and before long all healthcare organizations will be utilizing various software platforms to document clinical findings, patient hospitalization courses, and a host of other patient related items that are now done with ink and paper. Healthcare IT will clearly ensure software engineers job security well into the future and will open several doors for clinicians desiring to make the transition from the bedside to a desk.

Third party payers such as Medicare and Medicaid as well as privately based insurers need to refocus their attention on what is in the best interest of the patient. In an attempt to force industry change payers have restricted their reimbursement rates, increased premium costs for patients and employers, and developed lists of medical conditions that they [payers] feel are avoidable and thus will not provide any remuneration for.

A new level of healthcare transparency is being implemented in Ohio at Alliance Community Hospital where it is paying patients $100 for their hospital bills and explanation of benefits (EOB). The information is put on their web site comparing themselves with other hospitals for patients to view. The goal as reported in amednews is to provide prospective patients that typically use competing hospitals for healthcare services to come over and use Alliance’s healthcare system.

From the New York Times published on May 6th 2008 comes a report that emergency departments (ED) are busy but fewer patients seen in the ED are uninsured. Data was collected from a study in the Annals of Emergency Medicine (AEM) and published on line on the 14th of April 2008. The AEM study specifically looked at a rise in ED use over an eight year period from 1996 through 2004 to see if the rise in ED use was associated with insurance status. Their conclusions showed that while there was a rise in ED usage nationally during the study period it could not be solely attributed to medical indigence.

For years the idea of visiting hours ruled family members and patient visits. Tight controls over times when people could visit friends and families was strictly adhered to like rules of the local community pool - general swim, adult swim. Over the years the rules have become a bit softer, and in some cases the rules i.e. visiting hours hardly exist at all.

Establishing health insurance providers as non-profit entities is an interesting concept in today’s healthcare system. What would happen if the multitude of health insurance companies switched status from for profit to a non-profit status? Putting away multi-million dollar compensation packages for industry executives and replacing them with premium dividends and improved coverage for members, could it really happen?