Stumbled upon this post and video this morning. This is validation of exactly what 1-800MD is doing. Even Mayo Clinic is looking to reduce cost and improve access to care using telemedicine.
Credit to 3GDoctor Blog which is where I found this.
Archive for the ‘Access to Care’ Category
Effective eConsultations
Wednesday, May 19th, 2010Shortage of Primary Care Physicians in Massachusetts
Wednesday, March 17th, 2010Today’s Wall St Journal has an editorial entitled, “The Failure of RomneyCare”. It contains some fascinating statistics about , the average physician availability in the Bay State. In fact, the Massachusetts Medical Society refers to the situation as a “critical shortage” of primary care physicians. “56% of Massachusetts internal medicine physicians no longer are accepting new patients according to a 2009 physician work-force study conducted by the Massachusetts Medical Society. For new patients who do get an appointment with a primary-care doctor, the waiting time is 44 days… ”
Dr. Sandra Schneider, the vice president of the American College of Emergency Physicians, told the Boston Globe last April, “Just because you have insurance doesn’t mean there’s a physician who can see you.”
Once again the issues are pretty clear. Our ongoing medical issues are centered on access and cost containment.
Primary Care Physicians Cut Back Hours
Wednesday, February 24th, 2010You need to read this. Keep in mind that if healthcare passes, it does not create more doctors. It does not automatically give people access to medical professionals. It does give them the means to pay for it, if they can find it. Unfortunately, the shortage of doctors grows.
http://www.msnbc.msn.com/id/35545561/ns/health-health_care/from/ET
How Many Things are Wrong with You??
Wednesday, February 24th, 2010How often do you go to the doctor? If you are like me you don’t go often because it is inconvenient and expensive. Health issues tend to pile up. When something comes along for which I really need immediate treatment, I make an appointment and I go. Now, the national average cost for a visit to the doctor’s office is about $65. That, however, does not tell the whole story. If I go in for a sore throat and I am seeking an antibiotic, I also do a “health care dump”. “Doc I have a sore throat, but there is more. My elbow hurts, I have a mole on my arm I would like you to look at, allergy season is coming and I need a new antihistamine, and I am about out of my asthma medication.” My doctor listens intently and taps away on this little electronic note pad. He then diagnoses and prescribes something for each of my illnesses. Each malady is an International Classification of Disease (ICD). Each prescription is a Common Procedural Terminology (CPT). For every CPT, the doctor is reimbursed. So, when I go in for my sore throat which should cost me $65, I walk out of there with a bill for $300! This leads me to my second observation. Insurance co-pays are going away in all but the most “cadillac” of insurance plans. The co-pay will be replaced by higher deductibles. For most people the significance of this is lost, but when you combine the “health care dump” to the end of co-pays, you get a very significant monetary event. Before, I paid $15 to $25 for my co-pay and I could tell the doctor everything that was bothering me. I would do so because it was convenient and because I was making the best use of my co-pay. The insurance company paid the remaining $285 for the CPTs. Now, if I have failed to exceed my deductible, I have to pay the entire $300. It shifts the cost burden away from the insurance company and on to the consumer. In some ways, this is a good thing. It forces the consumer of medical services to shop for a better deal in health care. However, it could mean that I opt not to have the doctor help me with my elbow or take a look at the mole. Maybe I do without the asthma treatment, which, during an asthma attack, can put tremendous strain on my heart. No, the best solution is not to eliminate care, but to find a more cost effective delivery system. Many telemedicine offerings will do the entire “health care dump” for a flat fee. Viva la consumer!!!!
What is Capitation?
Friday, February 19th, 2010In U.S. health services, capitation refers to a fixed “per capita” amount that is paid to a hospital, clinic or doctor for each person served. It is the basis for the Health Maintenance Organization (HMO). You collect a flat fee to cover a certain number of lives and you hope that you have collected enough to do the job. In fact, you hope you have collected enough to do the job and still have some left over for profit. I will try to tie all of these health models together in a future blog.
Preexisting Conditions II.
Friday, February 19th, 2010Today’s Wall St Journal has a follow up article to the WellPoint attack. It gives an example of what happens when you prohibit insurers from denying coverage due to preexisting conditions. The state of Michigan has a 1980 law on the books requiring nonprofit insurers to accept all applicants. Last year, Blue Cross Blue Shield of Michigan lost $280 million prompting them to ask for a 56% rate increase. Gee, who could have seen that coming???
Health care on CNBC this morning
Tuesday, February 16th, 2010Today David M. Walker from the Peter G. Peterson Foundation was on Squawk Box on CNBC this morning. The foundation is a leading entity in the fight to maintain fiscal sustainability of the United States. Walker rightly pointed out that our success, if not our very survival, will be based on our ability to continue to grow our economy. A large piece of the puzzle is health care. The U.S. spends 17% of Gross Domestic Product (GDP) on health care while the rest of the industrialized world spends about 9% of GDP. That is a huge disadvantage in our global competitiveness and in our ability to attract capital to this country. Our challenge is to contain costs without restricting access or rationing care.
What is Primary Care?
Sunday, February 14th, 2010Primary Care can be considered one of primary healthcare’s core services. I used Barbara Starfield’s definition of primary care. Starfield believes that primary care is the crucial foundation of a healthcare system and defines the key features of primary care as being the first point of entry to a healthcare system, the provider of person-focused care (not disease oriented) over time for all but the most uncommon conditions and the part of the system that integrates or co-ordinates care provided elsewhere or by others. Attached is a White Paper which discusses the great difficulty of bringing Primary Care and Public Health together. The hurdles are staggering.
Past Wall St Journal editorial
Saturday, February 13th, 2010About a month or so back I read an editorial in the Wall St Journal that really shed some light on the health care debate. It was written by a freelance writer in New York and it discussed the impact the bill would have on his personal health decisions. He pointed out that the bill had a mandate to purchase full coverage. For him as a single person in New York the purchase price of a full policy with all of the required coverage would run about $13k per year. Currently, he carried only a catastrophic coverage policy that cost about $2k per year. He figured that left him with $11k per year to cover all of his incidental medical expenses and if he stayed under that limit, he was ahead of the game. He rightly pointed out that this was his health plan, he liked it and that President Obama had repeatedly assured him that if he liked it, he would get to keep it. Unfortunately, that is not the case. The bill would force him to join the insurance pool precisely to utilize his $11k to subsidize others who had no insurance. While I was reading this editorial, it occured to me the efficacy of his plan. The AMA created something called Common Procedural Terminology or CPT codes. It has created a procedural based system. Every procedure has a CPT code and reinbursement is based on the code. The codes effectively dictate what is repaid to the physician. The practice of medicine becomes one long list of procedures. The more procedures, the more repayment. Doctor compensation is not results based, it is procedures based.
How do you feel about being your own doctor?
Thursday, February 4th, 2010Sound crazy? Just read an ARTICLE predicting that members of the public will soon be able to use technologies like smart phones to monitor and even treat their own health conditions. I’m not quite ready to make that leap yet but once again this shows how fast this technology and telemedicine are moving. The goal is not to replace doctors but to help them reduce their workloads, free them up to deal with their seriously ill patients and to reduce costs for everyone. Let’s not get carried away with the technology, let’s use it to help our physicians and to reach the millions of uninsured or under insured who have no access. The are many pitfalls to self-treatment as you will see if you read the article. I would love to call myself Doctor but I’d also like to win the Masters. Just isn’t going to happen!