Filed Under (The Medical) by Admin on 24-10-2009
This was actually a comment on one of my posts relating to the new Tri-Care contracts. As you can see the reader is asking for any comments here so if anyone has anything to add, please feel free. In reference to the physician losing their status with United, there could be a number of reasons and
usually it comes down to contracted rates, although there could be other items as well involved. The physicians office may not be accepting the rates of compensation possibly with his current patient mix, thus would incur a loss, so perhaps negotiations are in the working. Recently I had and MD tell me his compensation was reduced by 12% from the carrier and again that is a statement with no additional facts.
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Filed Under (Health Care) by Admin on 24-10-2009
I regret that it took me so long to find an essay on “Organisational Ethics Policies” by Howard Whitton, available from the European U4 Anti-Corruption Resource Center. While it was written with international non-governmental organisations (NGOs) who “administer aid programs” in mind, it seems applicable to all kinds of NGOs and not-for-profit organizations, including those in health care. In the US, most medical schools and their parent universities, most hospitals and academic medical centers, essentially all medical societies and disease advocacy groups, and some insurance companies and managed care organizations are not-for-profit.
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Filed Under (The Medical) by Admin on 23-10-2009
I hope I am reading this correctly, you get the benefit of an auto populated PHR, but in essence it is not private as payers will have access? This is 
slated to roll out by the year end. Not too long ago I posted about HeatlhVault working with TriZetto. TriZetto is business intelligence for risk management in healthcare.
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Filed Under (Health Care) by Admin on 23-10-2009
In a stunning development:
The essay by an Australian professor of informatics on ED EHR problems in New South Wales that I referenced in my posts “The Story of the Deployment of an ED Clinical Information System Systemic Failure or Bad Luck” and “NSW Nightmare and Overuse of Computers” has apparently been censored, apparently at the level of the Ministry of Health.
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Filed Under (The Medical) by Admin on 22-10-2009
As I can interpret here, it appears that GINA will not allow any family history information to be collected by a Wellness Program, incentive or no incentive as it violates the provision of the law. Also as it explains below, the use of a Health Risk Assessment cannot be used if family medical information is included. This is getting more interesting by the moment. I still say we need algorithmic centric laws or this is going to be the countrys pastime, interpreting laws 24/7. 
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Filed Under (Legal Medical) by Admin on 22-10-2009
Unfortunately, many people chose a lawyer based upon their television, radio, or newspaper advertisements. In my opinion, that is exactly the WRONG way to select an attorney.
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Filed Under (Health Care) by Admin on 22-10-2009
Note to readers referred here from the Oct. 20 NY Times story “Steps to Greater Accountability in Medical Education” by Duff Wilson:
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Filed Under (The Medical) by Admin on 22-10-2009
I think it was around 55% of the hospitals in the US that are operating in the red, so increased pressure for pricing relief to provide medical devices should not come as a surprise, as the same is happening with the pharmaceutical end of the business. Some of the stent manufacturers actually stock
the hospitals with supplies and the hospital is not charged until the device is used instead of paying up front. This consignment arrangement has been going on for a few years now. BD
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Filed Under (Health Care) by Admin on 22-10-2009
Note to readers referred here from the Oct. 20 NY Times story “Steps to Greater Accountability in Medical Education” by Duff Wilson:
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Filed Under (The Medical) by Admin on 21-10-2009
This article states this was a division of United HealthCare that denied coverage. I keep talking about how they run those formulas and heres 
another perfect example, as they are refining these down to where its really going to get difficult to fit the parameters. Was the girl outside the percentiles on a growth chart? What did they use? We need algorithmic laws in place or this will just keep happening, its all done by the computer running code that makes these decisions and humans relay the word. BD
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usually it comes down to contracted rates, although there could be other items as well involved. The physicians office may not be accepting the rates of compensation possibly with his current patient mix, thus would incur a loss, so perhaps negotiations are in the working. Recently I had and MD tell me his compensation was reduced by 12% from the carrier and again that is a statement with no additional facts. 
