Information Technology Orientation For Starting Hospital Administrators

Information technology and computer science tools are definitely the most rapidly growing segment of the world ecosystem. The development in the sector permeates every human activity; social, economic, cultural, religious, political, professional, personal and healthcare. Information technology has radically altered the way many people work and think. Information Technology has made a significant difference to the Quality and Standards of Life. Learning some of the common IT application an individual can carry out any activity of your work life simpler and easier.

There is a rising awareness about the need for better healthcare in India. The demand for healthcare is growing with the increasing affordability of Indian middle class, a new breed of patients have emerged with enhanced expectations for better quality of healthcare, both patients and doctors exposed to international healthcare setting demand more, number of insurance players playing a key role, net savvy population, more number of independent hospitals have made the healthcare market more competent and complex.

Over the years, technology has touched a new zenith and now it is not constrained to developed countries. Developing countries such as India have kept pace with the world in modern technology. Healthcare professionals can no longer disregard the application of information technology to healthcare because they are key elements for competing in complex healthcare competition.

The major component that can give an edge in terms of patient care and effective decision making is IT support. Today’s corporate hospitals compete on the basis of the technology with investment in it being the major benchmark.

Technology in healthcare has brought better therapeutic diagnostics delivery of services,  integration to various components of large healthcare providing entity, very similar to that of any other sector like manufacturing and banking sectors. Healthcare IT has huge potential in India as the hospital are emerging, growing up and healthcare workers want to upgrade.

When a fresh post graduate with medical and non medical background entering in the market searching for a job in the healthcare administration side with little or no knowledge on IT, he has to be a part of  following job codes

Job code 1 He joins an ongoing cooperate hospitals that has an established IT infrastructure, enterprise wide software and a well integrated system. The hospitals have already invested heavily on IT applications and using them successfully, the expectations from a fresher to perform in the new setting are high. To deal with this situation the fresher should be oriented with basic operational domain knowledge as well as trained by application specialist.

Job code 2  When a fresh post graduate joins a hospital from the scratch (for a new hospital which is in the inception/ setting up stage). The fresh post graduate has to plan, coordinate, budget, execute, install, and train the employees, built an entire IT system for a new hospital for which he should have a sound knowledge of IT application in his post graduation as a core subject.

Job code 3 When a fresh post graduate joins a consultancy and suppose the consultancy is working on an IT project for an established hospital or a new hospital. The fresh post graduate has to work with IT vendors and make a decision regarding the IT infrastructure. He has to plan, budget, execute, install, and train the employees built an entire IT plan for a new hospital and act as a facilitator, catalyst as a change agent

Job code 4 When a fresh post graduate has mobilized enough funds to start his own hospital as the owner he has to make a  tough decision regarding  IT infrastructure .He  should know his budget, requirement and growth prospect .He can plan the entire schedule by himself or take the help of  IT consultant

Job code 5 This is the toughest of all the jobs codes, you are working with existing software and reported some modifications either want to add new features or replace it you have been assigned this duty to select , administer , execute, train, budget the entire program( he has to act as a change agent, motivate the staff and convince the management ). It is very risky. The individual may have little or no knowledge of new technology and application. The success of the project depends up on you which involves time, money and efforts.

What Are The Software Options?

As a fresh post graduate who is in the future going to be an administrator should understand few basic principals about IT software either to go for (Build software vs. Buy software) or (Make decision vs. Buy decision). This is the most important and curtail of all the decision of IT infrastructure.

If it is Make decision then it is development of software in house which follows SDLC (System Development Life Cycle)

If it is Buy decision then checking out your hospital requirements, listing out various vendors who supply readymade software product on contract basesevaluate their features, select the best from the available, install the software, train the employees with application specialist, have a backend support with vendor.

 

Basic Check List Elements

Check list 1    The first responsibility that the administrator has is to ensure is that the software which is being used has an End-User-Licensing-Agreement. It should not be pirated one

Check list 2 The administrator should instruct the IT manager to have all the detailed about hardware, software, number of computers, date of manufacturing, their warranty period, when was the annual maintenance contract renewal (AMC), when is it to be renewed and so on. This all should be maintained as a hard and soft copy.

Check list 3 The administrator should instruct the IT manager to have total control over the network, support your system with a good firewall which scans each piece of data that goes out or comes in, a good antivirus with daily updates with Malware and spam mail options, a sound multi-level authorisation to ensure what data is viewed only by authorised personal. Site-blocker software should be installed which blocks illegal browsing sites.

Check list 4 A sound backup and recovery program is very important. (Offsite backup is preferred).

Check list 5 Check the various insurance options for IT which include (Insurance for the entire hardware and software installed in the system and even the user is supposed to be insured. (If you are not aware of the insurance policy then hire an insurance broker)

Check list 6 Plan the IT– infrastructure by seeing the existing workload, technology up gradation etc. A definite amount of budget should be allocated to the IT- Manager. A maintenance budget and an operational budget

Check list 7 Regular training programs should be conducted for the new employees, as well as for the existing ones. Eemployee feedback should be taken about IT and evaluated by the administrator and IT manager.

Check list 8 An easy to navigate, light, perfect, interactive website or portal should be maintained by hospital IT-Department. This can be browsed on any browser.  All the employees should possess an Email for any form of internal communication.

Note: The document has not covered the technical details of various elements like firewall, backup, recovery, browser, portal, insurance broker etc

.

Syed Murtuza Hussain Bakshi

Associate Professor

Department Of Hospital Management

Owaisi Hospital and Research Center

murtuza_in21@yahoo.commurtuzain21@gmail.com

Mobile: – 09948662135

Tags: , , , , , , , , , ,

Loans are not guranteed, even with good credit

In our current economy, banks are turning good businesses away due to stricter guidelines for loan approval. With equipment leasing, although approval does take good credit on your personal of business side, the process is much easier. Something that leasing with ExecuTech offers is a personal relationship, if you have a business that you feel has a story, we are willing to work with you to get you funded.

Read an example about a business owner with good credit being turned down by Three different banks here: [STORY]

Growing Life Expectancy Gap Between Americans And Europeans

Main Category: Seniors / Aging
Also Included In: Public Health;  Medicare / Medicaid / SCHIP
Article Date: 29 Jul 2011 – 3:00 PDT

email icon email to a friend   printer icon printer friendly   write icon opinions  
<!– rate icon rate article




Patient / Public:not yet rated

Healthcare Prof:not yet rated

Forty years ago, Americans could expect to live slightly longer than Europeans. This has since reversed: in spite of similar levels of economic development, Americans now live about a year-and-a-half less, on average, than their Western European counterparts, and also less than people in most other developed nations. How did Americans fall behind?

A study in the July 2011 issue of Social Science Medicine is the first to calculate the fiscal consequences of the growing life expectancy gap over the next few decades. The study also pinpoints the crucial age at which U.S. life expectancy starts to deteriorate.

Specifically, researchers from the University of Southern California and colleagues at RAND Corp. and Harvard School of Public Health find that health in middle-age – around the age of 50 – is overwhelmingly the main contributor to disparities in life expectancy between Americans and Europeans.

In the first half of the last century, average life expectancy increased by saving more babies, explains author Dana Goldman, director of the Schaeffer Center for Health Policy and Economics at USC and Norman Topping/National Medical Enterprises Chair in Medicine and Public Policy at USC. “But now it is reduction in mortality among the elderly, rather than the young, that propels increases in life expectancy.”

“The question is whether ‘being American’ is an independent mortality risk factor,” Goldman said.

Accounting for levels of socioeconomic diversity in the United States and predicted future demographic estimates, the researchers found much of the life expectancy gap would disappear if the United States lowered prevalence of middle-aged obesity and obesity-related chronic diseases such as diabetes and hypertension to European levels.

The researchers also consider the health consequences of smoking on future life expectancy trends. While the prevalence of smoking is likely to continue decreasing in the future, the results of this study correspond to a National Research Council study led by Eileen Crimmins, AARP Chair in Gerontology at the USC Davis School of Gerontology.

Released in January 2011, Crimmins’ research looked at life expectancy over the last 25 years and found that smoking – and to a lesser extent obesity – were the two major reasons why U.S. life expectancy has fallen short of other high-income nations in the past.

Improving American health during middle age in the future to increase life expectancy would increase later-life pension benefits. But this expenditure would be offset by a significant decrease in health care costs – at least $17,791 per person, the researchers estimate.

Though the transition to better health initially raises expenditures, the researchers estimate that by 2050 health care savings from gradual middle-age health improvements could total more than $1.1 trillion.

“The international life expectancy gap appears much easier to explain than gaps within countries: there is no American-specific effect on longevity beyond differences in disease at age 50,” explained author Darius Lakdawalla, Director of Research at the Schaeffer Center at USC and associate professor in the USC School of Policy, Planning, and Development.

The research offers compelling evidence that poor health behaviors among middle-aged Americans – and not inefficiency in the U.S. health care system – are primarily responsible for earlier death. Indeed, prior research has shown that the U.S. does a good job keeping people alive once they are sick, ranking highly in life expectancy among people with chronic or terminal illness.

The researchers looked at a group of Western European countries including Denmark, France, Germany, Greece, Italy, The Netherlands, Spain and Sweden.

Notes:

Pierre-Carl Michaud of the Université du Québec a Montréal, Canada and RAND Corp. is lead author of the study.

The research was funded by the U.S. Department of Labor, the National Institute on Aging, and the MacArthur Research Network on an Aging Society.

Source:
Suzanne Wu

University of Southern California




Bookmark and Share

Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care
professional. For more information, please read our terms and conditions.

  Follow us on Twitter
news icon  Seniors / Aging headlines
email icon  email to a friend
printer icon  printer friendly version
newsletter icon  weekly newsletter
star icon  personalize your news

back to top - icon  back to top


Please note that we publish your name, but we do not publish your email address. It is only used to let
you know when your message is published. We do not use it for any other purpose. Please see our privacy policy for more information.

If you write about specific medications or operations, please do not name health care professionals by name.

All opinions are moderated before being included (to stop spam)

Contact Our News Editors

For any corrections of factual information, or to contact the editors please use our feedback form.

Please send any medical news or health news press releases to:

MediLexicon International Ltd Logo

Privacy Policy |
Terms and Conditions


MediLexicon International Ltd
Bexhill-on-Sea, UK
MediLexicon International Ltd © 2004-2011 All rights reserved.

Got The Gout? Self Reported Cases Show Increase In Prevalence

Editor’s Choice
Main Category: Gout
Also Included In: Arthritis / Rheumatology
Article Date: 28 Jul 2011 – 12:00 PDT

email icon email to a friend   printer icon printer friendly   write icon opinions  
<!– rate icon rate article


Patient / Public:not yet rated

Healthcare Prof:not yet rated

Eight million Americans, almost 6% of men and 2% of women have got the gout, a painful affliction in which uric acid crystals are deposited in the joints. In a self reported survey, the prevalence of gout continues to climb along with rates of related conditions such as hypertension and metabolic syndrome, reaching 3.9% in 2008, according to a new study released this week.

The researches stated:


“Better management of these factors could help prevent further rises in the burden of gout, hyperuricemia, and other associated complications in the U.S. These latest prevalence estimates help determine the burden of these conditions on the U.S. healthcare system.”

The small joint at the base of the big toe is the most common site of an acute gout attack of arthritis. An acute attack of gouty arthritis at the base of the big toe is medically referred to as podagra. Other joints that are commonly affected include the ankles, knees, wrists, fingers, and elbows. Acute gout attacks are characterized by a rapid onset of pain in the affected joint followed by warmth, swelling, reddish discoloration, and marked tenderness. Tenderness can be intense so that even a blanket touching the skin over the affected joint can be unbearable. Patients can develop fever with the acute gout attacks. These painful attacks usually subside in hours to days, with or without medication. In rare instances, an attack can last for weeks.

To see the rise in this ailment, scientists analyzed data from the most recent National Health and Nutrition Examination Survey (NHANES), which was conducted during 2007 and 2008, comparing the results with an earlier survey that took place between 1988 and 1994.

In the 2007-2008 survey, participants’ mean age was 47, slightly fewer than half were men, and more than two-thirds were white. A total of 6.1 million men and 2.2 million women reported having been told by a physician or other health professional that they had gout and for people in their 20s, the prevalence was 0.4%, rising to 12.6% among those in their 80s. Gout predominantly attacks males after puberty, with a peak age of 75. In women, gout attacks usually occur after menopause.

While an elevated blood level of uric acid may indicate an increased risk of gout, the relationship between hyperuricemia and gout is unclear. Many patients with hyperuricemia do not develop gout (asymptomatic hyperuricemia), while some patients with repeated gout attacks have normal or low blood uric acid levels. In fact, the blood level of uric acid often lowers during an acute attack of gout. Among the male population in the United States, approximately 10% have hyperuricemia. However, only a small portion of those with hyperuricemia will actually develop gout.

How is gout treated? Well, there are two key concepts essential to treating gout. First, it is critical to stop the acute inflammation of joints affected by gouty arthritis. Second, it is important to address the long-term management of the disease in order to prevent future gouty arthritis attacks and shrink gouty tophi crystal deposits in the tissues.

Most patients with gout will experience repeated attacks of arthritis over the years.

The researchers called for prospective studies evaluating interventions aimed at modifiable risk factors such as obesity and hypertension, and on other factors such as consumption of alcohol and purine-rich foods and the use of loop or thiazide diuretics.

Source: The American College of Rheumatology

Written by Sy Kraft

Copyright: Medical News Today

Not to be reproduced without permission of Medical News Today




Bookmark and Share

Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care
professional. For more information, please read our terms and conditions.

  Follow us on Twitter
news icon  Gout headlines
email icon  email to a friend
printer icon  printer friendly version
newsletter icon  weekly newsletter
star icon  personalize your news

back to top - icon  back to top


Please note that we publish your name, but we do not publish your email address. It is only used to let
you know when your message is published. We do not use it for any other purpose. Please see our privacy policy for more information.

If you write about specific medications or operations, please do not name health care professionals by name.

All opinions are moderated before being included (to stop spam)

Contact Our News Editors

For any corrections of factual information, or to contact the editors please use our feedback form.

Please send any medical news or health news press releases to:

MediLexicon International Ltd Logo

Privacy Policy |
Terms and Conditions


MediLexicon International Ltd
Bexhill-on-Sea, UK
MediLexicon International Ltd © 2004-2011 All rights reserved.

Access Equals Demand; Health Costs Will Be Up 6% A Year Next Decade

Editor’s Choice
Main Category: Health Insurance / Medical Insurance
Also Included In: Medicare / Medicaid / SCHIP
Article Date: 28 Jul 2011 – 11:00 PDT

email icon email to a friend   printer icon printer friendly   write icon opinions  
<!– rate icon rate article

Patient / Public:not yet rated

Healthcare Prof:not yet rated

Healthcare for all may be a good thing, but spending on staying sound will grow almost 6% each year through 2020 according to experts. Researchers estimate that doctor visits, clinical services and prescription drugs will be some of the largest growth areas, because of the comparably young age of the newly insured population.

The increase is partly due to a percentage of the 30 million people gaining health insurance through President Barack Obama’s healthcare overhaul joining government programs. According to the new report, the average annual growth in national health spending is expected to be 5.8%, or 0.1% point higher than it would be without the Affordable Care Act, outpacing annual GDP growth.

Sean Keehan, an economist at the government’s Centers for Medicare and Medicaid Services (CMS) said:


“We are projecting a decline in the out-of-pocket share [for consumers], but that doesn’t mean that the consumer’s burden is going to be substantially reduced. Especially since we’re projecting health spending to grow at a faster rate than economic growth and disposable personal incomes.”

The largest increase in healthcare spending in a single year is expected in 2014, when CMS forecasts a rise of 8.3 percent as much of the new U.S. health law is implemented. The law’s provisions include introducing state-based insurance exchanges and increased access to the government’s Medicaid insurance plan for the poor.

For 2010, the researchers estimated health spending grew at a historically low rate of 3.9% to $2.6 trillion. They attributed this to a weak economy that has led many consumers to delay medical treatment.

The report estimated spending growth will average 6.2% annually from 2015 through 2020.

Large employers with low-wage employees are expected to stop offering health insurance in 2014. An estimated 13 million employees will then likely seek insurance in the new exchanges or by enrolling in Medicaid.

The relatively new law puts in place comprehensive health insurance reforms that will roll out over four years and beyond, with most changes taking place by 2014. The adjustments are many, and the public still has questions as they attempt to decipher the nuances of each item, and how it affects themselves and their families. Health insurance agencies will make the most changes to their systems, but the public needs to understand these adjustments and be clear on their new coverage parameters.

Today, Medicare pays Medicare Advantage insurance companies over $1,000 more per person on average than is spent per person in Original Medicare. This results in increased premiums for all Medicare beneficiaries, including the 77% of beneficiaries who are not currently enrolled in a Medicare Advantage plan. The new law eliminates this discrepancy. People enrolled in a Medicare Advantage plan will still receive all guaranteed Medicare benefits, and the law provides bonus payments to Medicare Advantage plans that provide high quality care.

Also currently, The Independent Payment Advisory Board begins operations to develop and submit proposals to Congress and the President aimed at extending the life of the Medicare Trust Fund.

The Board is expected to focus on ways to target waste in the system, and recommend ways to reduce costs, improve health outcomes for patients, and expand access to high-quality care. Funding will become available for these proposals October 2011.

Sources: Healthcare.gov and The Centers for Medicare and Medicaid Services

Written by Sy Kraft

Copyright: Medical News Today

Not to be reproduced without permission of Medical News Today




Bookmark and Share

Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care
professional. For more information, please read our terms and conditions.

  Follow us on Twitter
news icon  Health Insurance / Medical Insurance headlines
email icon  email to a friend
printer icon  printer friendly version
newsletter icon  weekly newsletter
star icon  personalize your news

back to top - icon  back to top


Please note that we publish your name, but we do not publish your email address. It is only used to let
you know when your message is published. We do not use it for any other purpose. Please see our privacy policy for more information.

If you write about specific medications or operations, please do not name health care professionals by name.

All opinions are moderated before being included (to stop spam)

Contact Our News Editors

For any corrections of factual information, or to contact the editors please use our feedback form.

Please send any medical news or health news press releases to:

MediLexicon International Ltd Logo

Privacy Policy |
Terms and Conditions


MediLexicon International Ltd
Bexhill-on-Sea, UK
MediLexicon International Ltd © 2004-2011 All rights reserved.

Families Shifting From Private To Public Health Insurance For Children

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Pediatrics / Children’s Health
Article Date: 28 Jul 2011 – 0:00 PDT

email icon email to a friend   printer icon printer friendly   write icon opinions  
<!– rate icon rate article

Patient / Public:not yet rated

Healthcare Prof:not yet rated

Families are increasingly relying on public health insurance plans to provide coverage for their children, a growing trend that researchers say is tied to job losses, coverage changes to private health insurance plans, and expanded access to public plans, according to new research from the Carsey Institute at the University of New Hampshire.

The trend is particularly pronounced within rural and inner-city areas, which traditionally have had lower coverage rates than suburban areas.

“When people become unemployed, not only do they lose their employment-based private insurance, but, with the loss of income, families may become newly eligible for public plans. In addition, the generally poor economy and expanded eligibility for public plans may also play less direct roles in the shifting rates of health insurance among children,” the researchers said.

Public health insurance for children is provided principally through Medicaid and the State Children’s Health Insurance Program (SCHIP). Congress is considering a wide range of significant funding cuts to both programs as part of the negotiations over the budget deficit, with proposals ranging from cutting $100 billion over ten years to $1 trillion over the same period.

The key findings of this research show:

  • Health insurance coverage among children increased 1.3 percentage points from 2008 to 2009 in the United States, with the most growth in central cities and rural areas.
  • The Northeast continues to have the highest rate of coverage, with more than 95 percent of children covered. The South has the lowest coverage rates, at 89 percent.
  • Forty-four states plus Washington, DC and Puerto Rico had a significant increase in the number of children covered by public health insurance.
  • Twenty-seven states saw a decrease in private health insurance coverage for children.
  • Children in Midwestern central cities experienced the largest shift from private to public insurers in 2009; private insurance coverage fell 4.3 percentage points, while public coverage rose by 6.5 percentage points.

Approximately 9 percent of children nationwide are not covered by any form of insurance. More than half these children are eligible for coverage through Medicaid or SCHIP.

“Research demonstrates that most of these eligible children come from states with low participation rates and are disproportionately Hispanic. Because those who have health insurance are healthier overall and, more importantly, because healthy children are more likely to become healthy adults, focusing on covering eligible children should remain at the forefront of the nation’s agenda,” the researchers said.

This research is based upon U.S. Census Bureau estimates from the 2008 and 2009 American Community Survey released in September 2009 and 2010, and on Bureau of Labor Statistics data from 2009.

Source:
Lori Wright

University of New Hampshire




Bookmark and Share

Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care
professional. For more information, please read our terms and conditions.

  Follow us on Twitter
news icon  Medicare / Medicaid / SCHIP headlines
email icon  email to a friend
printer icon  printer friendly version
newsletter icon  weekly newsletter
star icon  personalize your news

back to top - icon  back to top


Please note that we publish your name, but we do not publish your email address. It is only used to let
you know when your message is published. We do not use it for any other purpose. Please see our privacy policy for more information.

If you write about specific medications or operations, please do not name health care professionals by name.

All opinions are moderated before being included (to stop spam)

Contact Our News Editors

For any corrections of factual information, or to contact the editors please use our feedback form.

Please send any medical news or health news press releases to:

MediLexicon International Ltd Logo

Privacy Policy |
Terms and Conditions


MediLexicon International Ltd
Bexhill-on-Sea, UK
MediLexicon International Ltd © 2004-2011 All rights reserved.

Elderly Medicare Beneficiaries With Limited Prior Drug Coverage Spend Less On Nondrug Medical Services Today

Editor’s Choice
Academic Journal
Main Category: Medicare / Medicaid / SCHIP
Also Included In: Seniors / Aging
Article Date: 27 Jul 2011 – 12:00 PDT

email icon email to a friend   printer icon printer friendly   write icon opinions  
<!– rate icon rate article

Patient / Public:not yet rated

Healthcare Prof:not yet rated

After the implementation of Medicare Part D, elderly Medicare beneficiaries spend considerably less money on non-drug medical services, including skilled nursing facility and inpatient care, researchers from Harvard Medical School reported in JAMA (Journal of the American Medical Association).

The authors wrote:

“Implementation of the Medicare prescription drug benefit (Part D) in January 2006 was followed by increased medication use, reduced out-of-pocket costs, and improved adherence to essential medications for elderly persons. The effects of Part D on nondrug medical spending for Medicare beneficiaries have not been clearly defined.”

J. Michael McWilliams, M.D., Ph.D. and team set out to compare how much Medicare beneficiaries spent on nondrug medical items before the implementation of Part D and after it. They gathered data from nationally representative sources and linked Medicare claims from 2004 to 2007.

Comparing nondrug medical spending before and after Part D implementation was done by self-reported generosity of prescription drug coverage (the degree of how much medication costs were covered) before 2006. Their data included 6,001 seniors from the Health and Retirement Study, all of them Medicare beneficiaries, including 2,538 with generous (total) and 3,463 with limited drug coverage before 2006.

Those with limited drug coverage spent 7.6% more on nondrug medical items compared to those with generous coverage before Part D implementation.

After Part D implementation, those with limited prior drug coverage spent 3.9% less than those with generous previous drug coverage – a total reduction of minus 10.6% for those with limited drug coverage when compared to what they were spending before implementation.

The authors wrote:

“This differential reduction in relative terms corresponded to an average absolute difference of -$306/quarter between observed and expected spending for participants with limited prior drug coverage.”

Part A inpatient and skilled nursing facility spending made up most of the reduction (minus $204 per quarter), the authors found.

The researchers wrote:

“Part D implementation was also associated with small differential reductions in spending on Part B physician and ancillary services for participants with limited prior drug coverage (-$67/quarter). These differential reductions in spending on Part B services were not associated with differential changes in outpatient visits (-0.06 visits/quarter) and were thus likely attributable to reduced use of inpatient rather than outpatient physician services.

In concert with previous studies, these findings suggest that increased medication use and adherence achieved through expanded drug coverage for seniors have been associated with decreased spending for non-drug medical care.

The economic and clinical benefits suggested by these reductions may be enhanced by further expansions in prescription drug coverage for seniors, improvements in benefit designs for drug-sensitive conditions, and policies that integrate Medicare payment and delivery systems across drug and nondrug services. “

“Implementation of Medicare Part D and Nondrug Medical Spending for Elderly Adults With Limited Prior Drug Coverage”
J. Michael McWilliams, MD, PhD; Alan M. Zaslavsky, PhD; Haiden A. Huskamp, PhD
JAMA. 2011;306(4):402-409. doi: 10.1001/jama.2011.1026

Written by Christian Nordqvist

Copyright: Medical News Today

Not to be reproduced without permission of Medical News Today




Bookmark and Share

Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care
professional. For more information, please read our terms and conditions.

  Follow us on Twitter
news icon  Medicare / Medicaid / SCHIP headlines
email icon  email to a friend
printer icon  printer friendly version
newsletter icon  weekly newsletter
star icon  personalize your news

back to top - icon  back to top


Please note that we publish your name, but we do not publish your email address. It is only used to let
you know when your message is published. We do not use it for any other purpose. Please see our privacy policy for more information.

If you write about specific medications or operations, please do not name health care professionals by name.

All opinions are moderated before being included (to stop spam)

Contact Our News Editors

For any corrections of factual information, or to contact the editors please use our feedback form.

Please send any medical news or health news press releases to:

MediLexicon International Ltd Logo

Privacy Policy |
Terms and Conditions


MediLexicon International Ltd
Bexhill-on-Sea, UK
MediLexicon International Ltd © 2004-2011 All rights reserved.

Blue Collar Workers Work Longer And In Worse Health Than Their White Collar Bosses

Main Category: Arthritis / Rheumatology
Also Included In: Seniors / Aging;  Public Health
Article Date: 25 Jul 2011 – 0:00 PDT

email icon email to a friend   printer icon printer friendly   write icon opinions  
<!– rate icon rate article


Patient / Public:not yet rated

Healthcare Prof:not yet rated

While more Americans are working past age 65 by choice, a growing segment of the population must continue to work well into their sixties out of financial necessity. Research conducted by the Columbia University’s Mailman School of Public Health and the University of Miami Miller School of Medicine looked at aging, social class and labor force participation rates to illustrate the challenges that lower income workers face in the global marketplace. The study used the burden of arthritis to examine these connections because 49 million U.S. adults have arthritis, and 21 million suffer activity limitations as a result. The condition is also relatively disabling and painful but not fatal. The researchers found that blue collar workers are much more likely to work past 65 than white collar workers and are much more likely to suffer from conditions like arthritis, reducing their quality of life and work productivity.

The study findings are reported online in the American Journal of Public Health.

The investigators calculated estimates and compared age-and occupational specific data for workers with and without arthritis, merging data from the U.S. National Health Interview Survey (NHIS), Medical Expenditure Panel Survey (MEPS) and National Death Index. They studied 17,967 individuals for the analysis out of 38,473 MEPS participants.

“Arthritis serves as a powerful lens for looking at these convergent phenomena,” said Alberto J. Caban-Martinez, DO, PhD, MPH, Department of Epidemiology and Public Health at the University of Miami Miller School of Medicine and first author. “We found that blue-collar workers with arthritis are in much worse health than are all other workers, suggesting that they are struggling to stay in the workforce despite their health condition.”

At all ages, blue-collar workers in the workforce are in worse health than white-collar workers. By age 65, 19% of white-collar workers with arthritis remain in the workforce compared with 22% of blue-collar workers. But employed blue-collar workers have more severe disease than employed white-collar workers, and look forward to fewer years of healthy life — approximately 11 for blue-collar workers and 14 for white-collar workers.

The investigators reported that lower-income workers of older age in the service and farming sectors – two job types that are unlikely to come with pension plans – are more likely to have arthritis than not, with 58% of service workers and 67% of farm workers continuing to work despite struggling with the painful health condition. Sixteen percent of all blue collar workers are over 65 and 47% report they have arthritis. By contrast, 14% of white collar workers work beyond the age of 65, and 51% of these workers reporting arthritis. Overall, approximately 15% of all workers remain in the workforce at or past retirement age, and 44% have arthritis.

“The increasing age of the U.S. workforce presents new challenges for government, employers and working families,” observes Peter Muennig, MD, MPH, associate professor of Health Policy and Management and senior author. “It is estimated that by the year 2030 approximately 67 million adults aged 18 years and older will have arthritis. Because the ‘graying’ workforce will be disproportionately represented by people from middle and lower occupational classes that also suffer from a higher prevalence of arthritis and a shorter life expectancy than wealthier Americans, Dr. Muennig points out that additional enhancements to federal programs such as better disability, health and unemployment insurance will be needed to maintain a higher quality of life for all workers, particularly for those with chronic conditions such as arthritis. “As the population ages in the face of expanding budget deficits, we face politically difficult choices if the U.S. is to prevent significant declines in its standard of living.”

This study was funded by in part the National Institute of Arthritis and Musculoskeletal and Skin Diseases and the National Institute for Occupational Safety and Health.

Source:
Stephanie Berger

Columbia University’s Mailman School of Public Health




Bookmark and Share

Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care
professional. For more information, please read our terms and conditions.

  Follow us on Twitter
news icon  Arthritis / Rheumatology headlines
email icon  email to a friend
printer icon  printer friendly version
newsletter icon  weekly newsletter
star icon  personalize your news

back to top - icon  back to top


Please note that we publish your name, but we do not publish your email address. It is only used to let
you know when your message is published. We do not use it for any other purpose. Please see our privacy policy for more information.

If you write about specific medications or operations, please do not name health care professionals by name.

All opinions are moderated before being included (to stop spam)

Contact Our News Editors

For any corrections of factual information, or to contact the editors please use our feedback form.

Please send any medical news or health news press releases to:

MediLexicon International Ltd Logo

Privacy Policy |
Terms and Conditions


MediLexicon International Ltd
Bexhill-on-Sea, UK
MediLexicon International Ltd © 2004-2011 All rights reserved.

$23M Savings In Program Integrity For Iowa Medicaid

Main Category: Medicare / Medicaid / SCHIP
Article Date: 22 Jul 2011 – 5:00 PDT

email icon email to a friend   printer icon printer friendly   write icon opinions  
<!– rate icon rate article

Patient / Public:not yet rated

Healthcare Prof:not yet rated

A new Iowa Medicaid program integrity initiative saved taxpayers more than $23 million in cost avoidance or recoveries in its first year of operation, according to Medicaid Director Jennifer Vermeer.

“We’ve shown that aggressive oversight can result in substantial savings or paybacks of public dollars without jeopardizing essential healthcare for some 400,000 Iowans who rely on Medicaid,” Vermeer said.

She said the savings are the result of numerous strategies such as making sure that paid services are medically necessary, preventing “upcoding” of claims by providers, and making sure Medicaid is reimbursed if the health service is eventually covered by another insurer.

The savings come from a program integrity contract that was awarded to OptumInsight (formerly Ingenix) of Eden Prairie, Minn. The first-year savings exceeds the total three-year contract cost of $14 million and also exceeds the $20 million first-year target set by Iowa Medicaid. The previous year savings were about $8.6 million.

About two-thirds of the savings are recoveries due to analysis of paid claims, including some $6.5 million from an innovative program that reviews situations in which a provider, usually a hospital, is paid by both Medicaid and other insurance payers for the same patient visit or procedure.

Hospitals process thousands of transactions daily and many have limited staff resources to help them detect credit balance overpayments that need to revert to Medicaid.

OptumInsight provides Iowa Medicaid with onsite assistance at several major Iowa hospitals, working side-by-side with hospital staff to identify overages and duplicate payments for which Medicaid should be reimbursed. Duplicate payments can occur due to the timing of reimbursements by insurance companies, a provider’s financial reconciliation schedule, or administrative error.

“This is a new area of oversight for us and it has proven to be very helpful, especially in these days of limited public funds,” said Vermeer.

She said OptumInsight also has a process to help identify “upcoding” in which a provider, often unwittingly, claims reimbursement for a more expensive service than was actually provided. For example, she said, it was learned that some claims to treat “respiratory distress syndrome” in newborns were actually services to assist the child with less serious breathing problems.

Vermeer said the company also helps to make sure that claims paid by Medicaid are for medically necessary procedures. For example, a review determined that some chiropractic services for children under age 5 were not necessary, resulting in successful paybacks.

A separate review determined that in some cases, hospitals were discharging patients too early, causing readmission within days. Instead of reimbursing hospitals for two separate stays, Medicaid treated the second hospitalization as an extension of the first, generating about $500,000 in paybacks.

In another example, OptumInsight analysts discovered that Iowa Medicaid’s reimbursement rates for durable medical equipment such as wheelchairs and adjustable beds were consistently higher than federal Medicare rates.

This caused some vendors to bill Medicaid even though Medicare is obligated to pay for beneficiaries 65 and older. Iowa Medicaid subsequently adopted Medicare’s price ceiling for such equipment, thus saving hundreds of thousands of dollars.

Iowa Medicaid has been ranked one of the nation’s most accurate systems by the Centers for Medicare and Medicaid Services. In the most recent payment error rate audit, Iowa’s error rate was approximately half the national average.

“OptumInsight and Iowa Medicaid share the same philosophy when it comes to payment accuracy, and that’s to ensure that every care provider is properly paid for the critical work they do and that every taxpayer dollar is properly spent,” said Shelby Solomon, President, OptumInsight Government Solutions. “We are pleased that our program integrity initiative is helping Iowa achieve financial benefits rapidly, while at the same time strengthening the state’s relationship with care providers.”

Source:

Iowa Department of Human Services




Bookmark and Share

Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care
professional. For more information, please read our terms and conditions.

  Follow us on Twitter
news icon  Medicare / Medicaid / SCHIP headlines
email icon  email to a friend
printer icon  printer friendly version
newsletter icon  weekly newsletter
star icon  personalize your news

back to top - icon  back to top


Please note that we publish your name, but we do not publish your email address. It is only used to let
you know when your message is published. We do not use it for any other purpose. Please see our privacy policy for more information.

If you write about specific medications or operations, please do not name health care professionals by name.

All opinions are moderated before being included (to stop spam)

Contact Our News Editors

For any corrections of factual information, or to contact the editors please use our feedback form.

Please send any medical news or health news press releases to:

MediLexicon International Ltd Logo

Privacy Policy |
Terms and Conditions


MediLexicon International Ltd
Bexhill-on-Sea, UK
MediLexicon International Ltd © 2004-2011 All rights reserved.

AARP: Generic Drug Prices Fall For Fifth Consecutive Year

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Pharma Industry / Biotech Industry
Article Date: 21 Jul 2011 – 9:00 PDT

email icon email to a friend   printer icon printer friendly   write icon opinions  
<!– rate icon rate article

Patient / Public:3 stars

3 (1 votes)

Healthcare Prof:not yet rated

Prices for widely used generic drugs fell by an average of 7.8 percent in 2009-the fifth consecutive annual price decrease-while general inflation fell by 0.3 percent, according to AARP’s latest Rx Price Watch report. The report by AARP’s Public Policy Institute comes as many seniors are reaching the coverage gap in Medicare prescription drug coverage, known as the doughnut hole.

“This report highlights an important opportunity for people with Medicare Part D plans-and anyone taking a prescription drug-to reduce their prescription drug costs,” said AARP Senior Vice President Cheryl Matheis. “Switching to less-costly generics now can dramatically cut your pharmacy bills and might help keep you out of the doughnut hole.”

The Centers for Medicare and Medicaid Services report that up to 4.5 million seniors will reach the Medicare Part D coverage gap-or doughnut hole-this year. On average, seniors who reach the drug coverage gap fall in during late July.

While in the coverage gap, Medicare Part D plans do not cover seniors’ prescription drug costs but they must continue to pay their premiums. Under the Affordable Care Act, Part D enrollees are now receiving discounts on their brand name and generic drugs while they are in the coverage gap. These discounts will gradually increase until the gap is closed in 2020, but generic drugs typically cost a fraction of brands, even after the discounts.

AARP’s Doughnut Hole Calculator can help seniors and their loved ones sort through the numbers and find lower cost alternatives to their prescriptions. Customized for each user’s Medicare Part D plan and drug regimen, the calculator produces a list of possible drug options and a personalized letter to help seniors start a conversation with their doctors.

Matheis added: “More and more seniors will reach the doughnut hole in the second half of the year. If you or an older loved one is still taking a brand name drug, it’s time to have a conversation with your doctor. We know that Americans begin skipping doses and refills when faced with high drug costs, which can lead to more serious health problems down the road, so switching to a generic now can save you money at the pharmacy and help keep you healthier.”

Today’s report is one in a series produced by AARP’s Public Policy Institute examining price trends for brand name, generic and specialty prescription drugs widely used by people participating in the Medicare Part D program. AARP’s last report, released in March, noted that prices for widely used brand name drugs increased by an average of 8.3 percent in 2009.

The Rx Price Watch report studied retail prices between 2005 and 2009 for 185 generic drugs widely used by people in Medicare Part D plans. For the 164 generic drugs that were on the market for the entire five year period, retail prices dropped cumulatively by an average of 35 percent. Generics with the largest price decreases included popular antidepressantssertraline (generic version of Zoloft) and paroxetine (generic version of Paxil), as well as cholesterol reducer simvastatin(generic version of Zocor). In 2009, retail prices for sertraline 100 mg and 50 mg tablets fell by 44.5 percent and 42.2 percent, respectively; the retail price of paroxetine 40 mg tablets fell by 32.5 percent; and the retail price of simvastatin 80 mg tablets fell by 32.9 percent.

The list of prescription drugs analyzed in the AARP Rx Price Watch reports is based on the drug products most widely prescribed to people in Medicare Part D. Price changes are measured using retail prices as reported by the Thomson ReutersMarketScan® Research Databases.

Source:

AARP




Bookmark and Share

Note: Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care
professional. For more information, please read our terms and conditions.

  Follow us on Twitter
news icon  Medicare / Medicaid / SCHIP headlines
email icon  email to a friend
printer icon  printer friendly version
newsletter icon  weekly newsletter
star icon  personalize your news

back to top - icon  back to top


Please note that we publish your name, but we do not publish your email address. It is only used to let
you know when your message is published. We do not use it for any other purpose. Please see our privacy policy for more information.

If you write about specific medications or operations, please do not name health care professionals by name.

All opinions are moderated before being included (to stop spam)

Contact Our News Editors

For any corrections of factual information, or to contact the editors please use our feedback form.

Please send any medical news or health news press releases to:

MediLexicon International Ltd Logo

Privacy Policy |
Terms and Conditions


MediLexicon International Ltd
Bexhill-on-Sea, UK
MediLexicon International Ltd © 2004-2011 All rights reserved.