A new kind of doctor’s office that doesn’t take insurance and charges a monthly fee is ‘popping up everywhere’ — and that could change how we think about healthcare – Business Insider

Interesting article after the previous post.

Direct primary care is a small but fast-growing movement of doctors who don’t accept insurance and instead charges a monthly membership fee.


In Rural Washington, Pediatricians A Scarce Commodity -KUOW

More on the slow motion collapse of our health care system. The problem, across the board is that medical professionals are getting squeezed by both State healthcare systems and large insurance companies. If you aren’t willing to raise your taxes to cover your physicians costs, you won’t have one. Here’s a case study right here in our state.

For the past 16 years, Jill Hutton has been managing a pediatric clinic in Aberdeen that once treated 70 to 100 children a day. But now it’s empty. She’s working on shutting it down



Hospitals eye concierge medicine to lure patients, boost revenue – Healthcare DIVE

The unfortunate future of healthcare in this country. The rich and middle class get to pay extra to see a doctor the same day and also get  “better care coordination”. Funny, I thought that was the promise of the billions of dollars spent in putting electronic records in place, which forced many smaller practitioners (who incidentally often offered the same services as concierge are claiming) into either closing their offices or joining hospitals such as Jefferson Healthcare.

Perks such as same-day appointments and longer doctors visits are part of the offerings.

Read it and weep.


PT Leader highlights CEO Glenn in special section

In a unique new section in the Port Townsend Leader, reporter Allison Arthur interviewed the CEO of Jefferson Health Care, Mike Glenn. Mr. Glenn answered questions about changes over the years to JHC, the addition of much needed physicians to the mix, employee new hires, the creation of the women’s clinic, and financial viability of the hospital district among other topics.

Missing from the interview was any mention of the community actions behind JHC successes. Glenn states, “Our Women’s Clinic was the result of Jane Albee and several primary care providers who identified the need.” While I’m sure that Ms. Albee (ARNP) helped identify the need, there has been an active group of mainly women in this community that has had to push JHC to make this clinic a reality. The Community Health Improvement Plan (CHIP) and Community Health Assessment (CHA) that was done in the last 10 years, included over 100 community members (including Mr. Glenn and many employees of JHC). The CHA identified women’s health needs in their assessment, as Mr. Glenn knows. Also, the latest sliding scale pricing that the hospital put into practice, which is very commendable, came about from a committee composed of both hospital staff and community members and was formed in reaction to outside public pressure on JHC to change their charity care process.

Speaking of the CHIP and the CHA, Mr. Glenn did not mention that there is a newly hired person to run the next CHA and update the CHIP. Ms. Ewers-Garcia, who was hired jointly by the city, public health and JHC is just now starting up another community health assessment. Mr. Glenn might have mentioned that in the article as it was an opportunity to get the community involved again.

Mr. Glenn mentioned that since 2015 they have added 29 providers, yet failed to mention that in public meetings this reporter has attended, Mr. Glenn identified turnover as the biggest single problem in the hospital.  It’s hard to understand whether this number  was actually net new hires, or simply replacing outgoing staff. Certainly we are seeing a few new providers in the new walk in clinic, and that’s commendable.

This hospital district is somewhat unique, in that it’s a public hospital, owned by the community. The community is very much involved in guiding (and sometimes pushing) the hospital district and it’s commissioners in a direction that answers needs. It’s worth remembering that Mr. Glenn’s salary is about $60,000 more than the governor of the state, and while we are happy overall with his performance, seeing improvements to the hospital facility, a dedication to opening new clinics and the like, it’s important to note that JHC is often pricing these services at much higher rates than competing facilities in Silverdale and Seattle, and as such, if you need services, have a high deductible and are not in an emergency situation, you should shop around.




Bad bedside manner: Bank loans signed in the hospital leave patients vulnerable – Seattle Times/Kaiser Health News

Just when we think the American healthcare system can’t get any worse, hospitals and banks figure out a way to take us further into debt. Just what a person who is brought into the ER wants to see, a banker show up. It’s like a sick joke.

Here’s a very telling stat from this article: In 2016, the federal government estimates, consumers spent $352.5 billion out-of-pocket on health care.

We *think* we have it good. We could have paid for universal healthcare with that amount.  You are essentially being taxed on that money, but it accrues to the sickest of us and the bulk of that money is spent in the last 6 months of life. To put it in perspective the US spent $584 B on defense, $588B on Medicare and $368B on Medicaid.


Bill would help hospital with its financial woes – The Daily World

Insufficient Medicaid reimbursals are helping sink rural hospitals. One of the hospitals this is meant to help is in Grays Harbor, another in Port Angeles.  Senator Van de Wege put it forward with hours just hours before the cutoff. It’s Senate Bill 6601.

OLYMPIA — A bill that would provide temporary funding to ease a financial crisis at Grays Harbor Community Hospital and two other financially struggling hospitals in the state was introduced Tuesday, just hours ahead of the bill cutoff for financial measures.


New Study Finds Hundreds of Thousands of Washington Patients Receive Unnecessary Tests, Procedures, and Treatments – WA Healthcare Alliance

– In one year, an estimated $282 million was spent on “wasteful” health care for 622,000 Washington patients

– Washington becomes just the third state in the nation to use a new tool called the MedInsight Health Waste Calculator to measure health care waste and put a price tag on overuse

To anyone familiar with the healthcare industry, this is no news. Doctors overuse tests and procedures because they are worried about lawsuits, and the insurance industry demands they do them. And just to point out, the use of “Big Data” again shows that we can learn much from studying the vast arrays of data being collected in our new world of electronic records, etc.

SEATTLE, Feb. 1, 2018 /PRNewswire-USNewswire/ — In a groundbreaking analysis of 1.3 million patients across the state who received a health care service known to be commonly overused, the Washington Health Alliance found that nearly half of the patients received care that is considered low value, or wasteful. That overuse of care amounted to an estimated $282 million in unnecessary health care spending in one year.

The report, First, Do No Harm: Calculating Health Care Waste in Washington State utilizes the new MedInsight Health Waste Calculator from the actuarial consulting firm Milliman, to produce an analysis of low-value health care services across the state. The services measured include 47 common tests, procedures, and treatments that clinician-led national initiatives such as Choosing Wisely® and the U.S. Preventive Services Task Force have determined are overused.

Low-value health care services, also called overuse or waste, refers to medical tests and procedures that have been shown to provide little benefit in particular clinical scenarios and in many cases have the potential to cause physical, emotional, or financial harm to patients. Preventing harm associated with the delivery of health care is essential to improving patient safety. While harm is not intentional, it is particularly troublesome when it results from tests, procedures, and treatments that were unnecessary.

“This is a pioneering report for Washington state’s health care community,” said Nancy A. Giunto, executive director of the Washington Health Alliance. “Being able to measure specific areas of waste in the health care system is an important step forward. The results are stunning and provide a clear opportunity to educate patients and engage health care stakeholders on areas of improvement.”

Highlights from the report:

  • This report examined 47 common treatment approaches known to be overused.
  • More than 45% of the health care services examined were determined to be of low value.
  • Approximately 1.3 million individuals received one of these 47 services; among these individuals, almost one-half (47.9%) received a low-value service.
  • 36% of spending on the health care services examined went to low-value treatments and procedures. This amounts to an estimated $282 million in unnecessary spending.
  • Of the 47 treatments and services analyzed, 93% of overuse was attributed to just 11 common tests, procedures and treatments. These include such things as preoperative tests and lab studies prior to low-risk surgery, too frequent cancer screenings, eye imaging tests for people without significant eye disease, annual EKG tests or cardiac screening for people with low risk of heart disease, and imaging for uncomplicated conditions such as low back pain.

Many areas of overuse are individually low cost, but when they are used in high volumes they add up to tremendous waste. “Overuse in the healthcare system has become so common that we frequently don’t even think to question it,” Giunto said. “However, preventing harm to patients is critical, in addition to the fact that everyone pays the price because overuse contributes to higher insurance premiums across the board.”

The MedInsight Health Waste Calculator is an analytic tool powered by Milliman’s MedInsight software and encapsulates VBID Health’s market knowledge on wasteful healthcare spending. The tool identifies and quantifies the use of unnecessary or potentially harmful clinical services, including those defined by national initiatives such as the U.S. Preventive Services Task Force and Choosing Wisely®.

Only two other states in the country have utilized the MedInsight Health Waste Calculator, and only one of them has released results publicly. The public release of the Alliance’s Washington state findings will enable a much-needed community dialogue among key stakeholders about low-value care.

“The MedInsight Health Waste Calculator is a critical tool in the MedInsight suite of analytic products,” said Marcos Dachary, director of product management at Milliman. “We are proud to have worked with the Alliance to produce this vital report about the overuse of health care services in Washington state.”

To help reduce low-value care, physicians and patients should have conversations about appropriate medical care that is both necessary and evidence-based. The national Choosing Wisely® program, an initiative of the ABIM Foundation, offers the following tips to patients.

What can patients do to avoid overuse? Ask these 5 questions before you have a medical test or procedure:

  1. Do I really need this test or procedure?
  2. What are the risks and side effects?
  3. Are there simpler, safer options?
  4. What happens if I don’t do anything?
  5. How much does it cost, and will my insurance pay for it?


  • The measurement year used for the results in this report include services delivered between July 2015 and June 2016.
  • The results in this report are based on an analysis of 47 specific health care services and approximately 2.4 million commercially insured people, and therefore should be viewed as a strong estimate rather than a comprehensive analysis of all health care received by all Washingtonians during the measurement period. Extrapolation of these results to other populations or types of care is not advised.

About the Washington Health Alliance

The Washington Health Alliance is a place where stakeholders work collaboratively to transform Washington State’s health care system for the better. The Alliance brings together organizations that share a commitment to drive change in our health care system by offering a forum for critical conversation and aligned efforts by stakeholders: purchasers, providers, health plans, consumers and other health care partners. The Alliance believes strongly in transparency and offers trusted and credible reporting of progress on measures of health care quality and value. The Alliance is a nonpartisan 501(c)(3) nonprofit with more than 160 member organizations. A cornerstone of the Alliance’s work is the Community Checkup, a report to the public comparing the performance of medical groups, hospitals and health plans and offering a community-level view on important measures of health care quality (www.wacommunitycheckup.org).

Media Contact:

Casey Calamusa
Washington Health Alliance

SOURCE Washington Health Alliance