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.

The PA/RN/MD/DO will see you now. Consumer Reports

Good article demystifying the medical provider landscape. While I have some small issues with it, it is a good layman overview.  What they say about a seeing a P.A. “avoid relying on them for complicated procedures.” is quite off base. Many P.A.s work right alongside M.D.s in offices, doing all the same procedures that M.D.s do. It is more a matter of how long a P.A. has been working, and the background they came out of, just like any other professional, that determines there effectiveness on more complicated procedures. Some P.A.s came out of EMT work, and they are highly trained in some fields, some have spent extra years of education as orthopedic P.A.s. Some P.A.s have worked in the operating rooms for years, doing surgeries alongside the attending M.D. And the M.D. that they are assigned to is often relying on them to stand on their own and only bring them the more difficult issues. I’m sure there are many younger M.D.s who are still learning their craft and I wouldn’t want to take my complicated procedures to them either! I’d rather see an experienced P.A. than a brand new M.D. any day of the week!

It’s getting harder to see a doctor, but you can still get quality care from a host of other professionals if you know who’s who




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 (

Media Contact:

Casey Calamusa
Washington Health Alliance

SOURCE Washington Health Alliance

Deportation fears have legal immigrants avoiding health care – ABC News

More shame on the Trump administration for it’s ham handed handling of immigrants. Just what the U.S. needs, is sick people, many of  whom are working in our commercial kitchens, waiting on tables, cleaning up commercial facilities at night, and picking our food, are going to remain sick rather than seek out medical care. Does not make me feel
like this is a way to “Make America Great Again.”

The number of legal immigrants from Latin American nations who access public health services and enroll in federally subsidized insurance plans has dipped substantially since President Donald Trump took office, many of them fearing their information could be used to identify and deport relatives living in the U.S. illegally, according to health advocates across the country.

Despite Prod By ACA, Tax-Exempt Hospitals Slow To Expand Community Benefits – Kaiser Health

Interesting article that has implications here on the Peninsula, especially for Jefferson Health Care.

The federal health law’s efforts to get nonprofit hospitals to provide more community-wide benefits in exchange for their lucrative tax status has gotten off to a slow start, new research suggests. And some experts predict that a recent repeal of a key provision of the law could further strain the effort.

The increased emphasis on community-wide benefits was mandated by the Affordable Care Act. The health law required hospitals that meet federal tax standards to be nonprofits to perform a community health needs assessment (CHNA) every three years, followed by implementing a strategy to deal with issues confronting the community, such as preventing violence or lowering the rates of diabetes.

A study released Monday in the journal Health Affairs shows spending in these areas has remained relatively stagnant.

Yellow Flags: U.S. Hospitals Face a Shortage of This Most Basic Necessity – Bloomberg Businessweek

In our race to the bottom as a global leader, we are now becoming unable to ensure that our supply chain of critical medical supplies is secure and able to produce the volumes needed for our hospitals. I was under the impression that capitalism did not allow this to happen as a need is always filled by ready competitors waiting to step in and compete. It would be interesting to know whether JCH CEO Mike Glen has been aware of this, and what his thoughts are on it. Bloomberg Businessweek, a great newsource, had this recent article.

A long-standing problem, the situation worsened when Hurricane Maria slammed into Puerto Rico, knocking out power at factories that make the small bags for Baxter International Inc., the product’s biggest supplier. Another large maker of the bags, B. Braun Medical Inc., is having problems of its own—the U.S. Food and Drug Administration is looking into reports of leaky and moldy intravenous bags. And a third, ICU Medical Inc., hasn’t been able to keep up with the increased demand. The industry has also been swept up in a U.S. Department of Justice criminal probe of possible collusion and price-fixing.

Support real news. Support Bloomberg Businessweek.


We must house homeless to cure health inequities – Seattle Times

This article is a good overview of the issue of homelessness and it’s affects on healthcare. It’s worth a read given the disgraceful behavior of our current Jefferson County Hospital Commissioners Jill Buhler and Tony Deleo in determining that it was not in the interest of our community health,  to even take a stand on Prop  1 after hospital staff worked so hard on identifying it as part of the Community Health Improvement Plan (CHIP).

While Prop 1 failed, it would have been nice to have had the support of the people supposedly supporting healthcare in our county.  It will be interesting to see if Mr. McComas, who is currently leading in the returns, has anything more than the nice words behind his campaign promises of understanding the needs of the less fortunate. We obviously can’t count on our medical society members to give a damn. They demonstrated their ability to buy into misinformation and help spread the fear campaign against Ms. Van Hoover.  Nor expect any criticism of the status quo from the Leader, which derives significant ad revenue from the endless ads that the hospital places every week. It’s all about power and money. As usual. It’s worth noting that marketing costs are outpacing charity care this year at our hospital.

We need a health-care system that recognizes homelessness first and foremost as a medical issue…We need a health-care system that recognizes homelessness first and foremost as a medical issue. People experiencing homelessness are hospitalized at rates four times that of the general population. Yet, the medical community has often sat on the sideline, with homelessness siloed as an issue for the housing authority to address. It is time for the housing crisis to be treated as a public-health crisis and for our health-care dollars to be invested in housing.