Shifting the Blame: Doctors Look To Others To Play Biggest Role In Curbing Health Costs

Blame for increased medical costs is getting tossed around like a political football. Those deeply entrenched into the system are pointing their finger at "the other" party to shift responsibility. This reminds one of when CMS in 1980 urged the passage of the Medical Secondary Payer Act. 

As this process continues, ultimately the US Government will be the final authority as Medicare ultimately rules the medical billing field and outcome based medicine seems to be the new goal.

Workers' Compensation system will ultimate adapt or be subsumed by the Medicare protocols in one fashion or another.  Special interests  will have little opportunity to cut out their specialized markets.

Today's post was shared by Kaiser Health News and comes from capsules.kaiserhealthnews.org

In a study, published Tuesday in the Journal of the American Medical Association, Mayo Clinic researchers surveyed more than 2,500 doctors to assess their views of different approaches to rein in the nation’s health care costs. The doctors were randomly selected from an American Medical Association database.

When it comes to controlling the country’s health care costs, doctors point their fingers at lawyers, insurance companies, drug makers and hospitals. But well over half acknowledge they have at least some responsibility as stewards of health care resources.

Based on their findings, 59 percent of doctors believed they have some responsibility in holding down  health care costs. Only 36 percent thought they have a major role.

Why are there revisions to the jobs numbers?

Workers' Compensation premiums are usually estimated based on anticipated payroll numbers. As those change so does the cost of workers' compensation premiun costs. Basically they are both subject to retroactive audits to verify accuracy. Today's post was shared by BLS-Labor Statistics and comes from www.bls.gov

Why are there revisions to the jobs numbers?

By Thomas Nardone, Kenneth Robertson, and Julie Hatch Maxfield

At the beginning of each month, the Bureau of Labor Statistics (BLS) reports the change in payroll employment for the previous month. This estimate of jobs gained or lost over the month is closely watched by policymakers and those who work in financial markets and the media.

When the estimate is revised in subsequent months, however, data users sometimes perceive a very different picture of the job market than what was initially reported. Data users frequently ask why the number was revised. The short answer is, the revised estimate includes additional information that was not available at the time of the initial release information that makes the revised estimate more accurate.

This Beyond the Numbers article explains the data collection process that BLS conducts every month to produce the estimate of U.S. employment change. The article will also clarify why BLS releases revisions to the initial release, so that users will better understand the change, if any, in the data.

Hospitals May Soon Be Reaching For The Stars

Should injured workers have the opportunity to select the "best rated" medical provider? The Federal government is looking forward to providing outcome base rating information. The workers' compensation system should utilize that information and allow injured workers to be able make an educated choice in seeking medical care. Today's post was shared by Kaiser Health News and comes from www.kaiserhealthnews.org

Star wars may be coming to a hospital near you.

Medicare is considering assigning stars or some other easily understood symbol to hospitals so patients can more easily compare the quality of care at various institutions. The ratings would appear on Medicare’s Hospital Compare website and be based on many of the 100 quality measures the agency already publishes.

The proposal comes as Medicare confronts a paradox: Although the number of ways to measure hospital performance is increasing, those factors are becoming harder for patients to digest. Hospital Compare publishes a wide variety of details about medical centers, including death rates, patient views about how well doctors communicated, infection rates for colon surgery and hysterectomies, emergency room efficiency and overuse of CT scans.

In its proposed rules for hospitals in the fiscal year starting Oct. 1, the Centers for Medicare & Medicaid Services asked for ideas about "how we may better display this information on the Hospital Compare Web site. One option we have considered is aggregating measures in a graphical display, such as star ratings."

Private groups such as Consumer Reports, the Leapfrog Group and US News and World Report already issue hospital guides that boil down the disparate Medicare scores -- along with their own proprietary formulas -- to come up with numeric scores, letter grades or rankings.

But even before it's formally proposed, the possibility of the government rating...

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For over 3 decades the Law Offices of Jon L. Gelman  1.973.696.7900  jon@gelmans.com have been representing injured workers and their families who have suffered occupational accidents and illnesses.

Read more about "medical treatment" and workers' compensation:

Workers' Compensation: What Medical Expenses Are Covered In A ...

Apr 15, 2013

The main difference is in Nebraska, as long as the worker elects a prior treating doctor to treat their injury (for example, the worker's family doctor), that doctor can dictate the medical care and refer them to others for treatment.

http://workers-compensation.blogspot.com/

NJ Bayonne Medical Center - Highest Priced Medicine in the Nation

May 18, 2013

While workers' compensation insurance carriers may set approved fees or contract with providers, hospitals have huge disparities in the cost for medical care provided. Additionally, there appears to be no difference in the ...

http://workers-compensation.blogspot.com/

NY Worker's Compensation Board Proposes New Medical - Workers ...

Nov 16, 2012

New York Worker's Compensation Board's proposed new medical treatment guidelines that will modify 2010 previously implemented. Adopt the new carpal tunnel syndrome (CTS) medical treatment guidelines (MTG) as the ...

http://workers-compensation.blogspot.com/

Obama Administration Delays and Simplifies Rules on Health Care

Jul 03, 2013

Read more about The Affordable Health Care Act: Workers' Compensation: Protecting Healthcare Workers. May 06, 2013. Kerri A. Thom, MD, MS, Assistant Professor of Medicine at the University of Maryland School of ...

http://workers-compensation.blogspot.com/

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WHEN IS THE RIGHT TIME TO APPLY FOR SOCIAL SECURITY DISABILITY?

Today's post comes from guest author Susan C. Andrews from Causey Law Firm.

     We get many calls from folks who have been off work for a while, and are wondering if the time is right to place an application for Social Security Disability benefits. There are several program rules that should be kept in mind in making this decision.

Applications for Social Security Disability
now can be filed online.

      The first thing to know about Social Security Disability is that it is a program for people who have one or more health issues that prevent the person from working for a period of at least 12 continuous months. If you have not yet been off work for that length of time, but anticipate that may be the case, you may want to go ahead and apply, since the entire process can take months and, in some cases, a year or more, before a final decision is made. On the other hand, if you are fairly confident you will be able to get back to work before 12 months has passed, then holding off makes more sense.

  ...benefits can go back no more than one year from the date of the application. This is a matter of concern for those who hold off too long and, as a result, lose out on benefits to which they are entitled.

      To collect any benefits at all, one must satisfy the above-described 12-month duration requirement. That said, once a person has satisfied the 12-month rule, it also is helpful to know that benefits cannot begin until five full months after the date of the onset of disability. So, for example, if I am diagnosed with a cancer and, because of my treatment, I must stop working on June 7, 2013, (and I know, because of the course of proposed treatment, that I am likely to be off work for more than 12 continuous months), then I could apply right away, but benefits would not begin until December of 2013. The five full months that I must wait for benefits to begin (in this example, July through November) is called the waiting period. The month of June cannot be counted because it is not a full month.  Thus, if there is some possibility I might be able to return to work before 12 months has passed, depending on how my treatment goes, then I might want to hold off initially, to see how it goes.

Transportation Accidents: Data Recorders Will Soon Define Compensability of Accidents

Workers' compensation claims are often defined by whether the accident arose out of and in the course of the employment. New technology in the coming years maybe become critical evidence in determining the casual relationship of transportation accidents as well as whether the employee deviated from the employment at the time of the event.

Event Data Recorder

"....at the center of a growing debate over a little-known but increasingly important piece of equipment buried deep inside a car: the event data recorder, more commonly known as the black box.

"About 96 percent of all new vehicles sold in the United States have the boxes, and in September 2014, if the National Highway Traffic Safety Administration has its way, all will have them.

"The boxes have long been used by car companies to assess the performance of their vehicles. But data stored in the devices is increasingly being used to identify safety problems in cars and as evidence in traffic accidents and criminal cases. And the trove of data inside the boxes has raised privacy concerns, including questions about who owns the information, and what it can be used for, even as critics have raised questions about its reliability.

Click here to read the entire article, "A Black Box for Car Crashes" NY Times

OSHA announces outreach campaign to protect health care workers from hazards causing musculoskeletal disorders

The U.S. Department of Labor's Occupational Safety and Health Administration today announced a campaign to raise awareness about the hazards likely to cause musculoskeletal disorders among health care workers responsible for patient care. These disorders include sprains, strains, soft tissue and back injuries.

"The best control for MSDs is an effective prevention program," said MaryAnn Garrahan, OSHA regional administrator in Philadelphia. "Our goal is to assist nursing homes and long-term care facilities in promoting effective processes to prevent injuries."

As part of the campaign, OSHA is providing 2,500 employers, unions and associations in the health care industry in Delaware, Pennsylvania, West Virginia and the District of Columbia with information about methods used to control hazards, such as lifting excessive weight during patient transfers and handling. OSHA is also providing information about how employers can include a zero-lift program, which minimizes direct patient lifting by using specialized lifting equipment and transfer tools.

Fashion Safety: US Endorses Bangladesh Action Plan

The following is a joint statement from the Department of Labor, Office of the United States Trade Representative, and the State Department:

"Today, the United States is outlining next steps in a longstanding effort to address in a meaningful way worker safety problems in Bangladesh — the severity of which were exemplified in the tragedies of the November 2012 Tazreen Fashions factory fire and the April 2013 Rana Plaza building collapse — and, more broadly, the ability of Bangladeshi workers to exercise their full range of labor rights.

On June 27, 2013, President Obama announced his decision to suspend Bangladesh's trade benefits under the Generalized System of Preferences (GSP) in view of insufficient progress by the Government of Bangladesh in affording Bangladeshi workers internationally recognized worker rights. That decision followed an extensive, interagency review under the GSP program of worker rights and worker safety in Bangladesh during which the U.S. Government encouraged the Government of Bangladesh to implement needed reforms. At the time of the announcement, the Administration provided the Government of Bangladesh with an action plan which, if implemented, could provide a basis for the President to consider the reinstatement of GSP trade benefits.