U.S. Healthcare Spending Slows

With the rocky economy, more individuals and families are spending less on healthcare coverage and costs. The LATimes covers this stating that, the mild slowdown -- due in part to less growth in drug spending -- was a rare bit of good news as Washington policymakers begin to debate how to reshape the nation's healthcare system, a top priority of congressional Democrats and the new administration.

So good news may come out of this minor slow down. What areas of healthcare do you think are slowing the most?

Do you think we'll see a rise in healthcare in 2009? We'd like to hear your thoughts.

PHR Now Available to Arizona and Utah Seniors

PHR, Personal Health Records are now available to Arizona and Utah seniors under a pilot program through Medicare. This program would allow seniors to have an outside organization (one of four) to keep their health records electronically. This program will likely reduce confusion over care and will help hospitals better serve the individual.

Mike Leavitt, secretary of Health and Human Services, stated in a press release, "This pilot is a major step forward for Medicare. It will provide information and tools that will empower consumers to manage their health better. Importantly, the pilot provides beneficiaries with a choice of products to meet their individual needs."

The outside organizations chosen to start the program are

• Google Health
• HealthTrio
• NoMoreClipboard.com
• PassportMD

For more information please click here.

Medicare News: California and Florida Medical Suppliers Cut Off

According to Bloomberg News, nearly 1,139 Californian and Floridian suppliers lost their billing privileges because of suspected or found fraudulent activity. These areas are a particularly prone to fraud as the prevalence of Medicare participants is higher due to an increased population of senior citizens.

Because of this rise in fraud, Medicare has started to initiatives to combat the fraud. Read here for more information on this angle.

So good news and bad news to get us started for 2009. Let's hope that the fraudulent claims and those behind such claims will be swiftly put away before they take more money from a program that serves our greatest population.

Medicare to Docs: Go Electronic in 2012

Medicare, the federal health insurance program for the elderly and disabled, will offer financial bonuses to doctors who prescribe drugs electronically rather than on paper. Doctors who do not will face penalties from Medicare starting in 2012. From Reuters. Medicare states that this is to improve efficiency between doctors and pharmacies and to avoid problems with handwriting, patients who lost prescription notes, etc. However, how much is this going to cost doctors--especially those who are serving low income areas or who are in private practice? I understand that Medicare is now offering monetary incentives to doctors who welcome this program but why bribe doctors into doing something that they will already ahave to do in a few years. Medicare should, if they are mandating that doctors adhere to this new policy, spend money to educate docs and their staff on the new inititative.

Just the Essentials: Deciding on Medicare Coverage

We stumbed across this very informative piece this morning by Allsup on MarketWatch that details the 10 most important things that indivudals/caretakers must ask themselves when figuring out appropriate Medicare coverage. The article stresses that knowing one's healthcare needs is the key to understanding what plans are solid for their needs. We highly recommend that you print out this list, available here.

U.S. Nursing Homes Get "Zagat" Rated by Feds

For a listing of the ratings by state, please click here. By offering ratings to each nursing home, it gives a clear rating of the quality of the home. Though a visit is always encouraged, soon people would be able to choose a nursing home much like choosing a place for vacation. What is particularly interesting about this report is that non-profit oranizations take better care of their clients than for profit organzations. This is probably because non-profits are so tied into keeping their non-profit status that a system of checks and balances in high order. An analysis of nearly 16,000 nursing homes reveals for-profit homes are more likely to provide inferior care than their non-profit rivals, according to a USA TODAY examination of the federal government's first ratings of the homes' performance. The new Zagat-like rating system, released today by the Centers for Medicare & Medicaid Services, assigns homes one to five stars for quality, staffing and health inspections, plus an overall score. What do you think of the rating system? How will it affect U.S. nursing homes?

Brand-Name Drugs are Favored by Medicare Beneficiaries

According to this article in EmaxHealth, brand-name medications account for almost two-thirds of all prescriptions filled by Medicare beneficiaries. Patients are asking for brand-name drugs when the program provides coverage and are asking pharmacists for generic drugs when they have to pay out of pocket.

When patients switch from brand-name to generic drugs, more than likely they’ve reached the coverage gap in which they must cover the full cost of the prescriptions. Woody Eisenberg, Medco Chief Medical Officer mentions that when Medicare beneficiaries become aware of the coverage gap they "become acutely aware of the cost difference between brand-name and generic drugs and most make the switch."

Texas Medicaid Fraud

Oops! More kickbacks for health officials have landed Texan health officials in some serious hot water. What is important about this case, as with all fraud cases, is that it affects the individuals who trusted in others to do their job and to do it well. People don't want to be seen as dollar signs, it grows contempt in the consumer which is just bad business. This case, with phony advocacy groups and false marketing materials is predatorial and wrong and these individuals deserve to be prosecuted by the full extent of the law. J&J’s Janssen Pharmaceutica funneled kickbacks to Texas health officials, distributed false marketing materials and deployed phony advocacy groups to get its Risperdal antipsychotic prescribed to low-income Texans, the state alleges in a new filing in an ongoing fraud lawsuit filed in 2006, according to The Dallas Morning News

Medicare assures patients about access to oxygen

From AP: Medicare officials tried on Monday to quell growing worry by the elderly that they could lose access to lifesaving oxygen supplies with the start of the new year. With a rise in phony marketing scams, which this blog has covered, many less than reputable companies are preying on the elderly for more money to offset their own losses during this economic climate. We must assure people that Medicare, though wacky and seemingly mismanaged will not keep individuals from life saving access to medical supplies. Any individual representing a company that claims to do so is wrong. Always do background checks on any company or individual who contacts you our someone you know about your personal Medicare status. For the rest of this article, please click here.

DaVita gets Department of Health subpoena for documents related to Medicare practices

From CNN/AP
Dialysis services company DaVita Inc. said Monday it is responding to a Department of Health and Human Services subpoena for documents related to Medicare claims for several drugs.
What do you think will come out of this government audit of DaVita? DaVita has willingly given up all of their documentation and files regarding Medicare claims, so perhaps they have nothing to hide. We'll keep you posted on any new developments. For the rest of this article, please click here.