"Paramedics branch into home care" by Priyanka Dayal McCluskey | Globe Staff May 31, 2014
Patients of a certain age might remember a time when they didn’t have to leave home to receive basic medical care, like treatment for a fever or cough, and emergency rooms were places to go only in the event of an actual emergency.
Several Massachusetts ambulance companies hope to bring back that quaint concept from long ago by branching into home health care. They plan to send paramedics to treat patients where they live instead of taking them to hospitals, a fundamental shift in how emergency medical services are delivered.
The idea is to expand the paramedic’s role to a provider who not only responds to emergencies but also helps prevent them, treating patients with infections, minor wounds, injuries from falls, and problems associated with chronic diseases like diabetes and congestive heart failure. It could reduce unnecessary emergency room visits and hospital stays, which can cost thousands of dollars.
“We really do believe this is the new house call of the future,” said George Gilpin, chief executive of the Dorchester ambulance service EasCare LLC.
EasCare is poised to become one of the first ambulance companies in the state to provide such home care, launching a pilot program this summer with 2,000 patients of Commonwealth Care Alliance, a Greater Boston network of providers that serves the elderly, poor, and disabled. The program is expected to get approval from the state Department of Public Health soon. Several other ambulance companies are also seeking permission to offer home care services.
The move toward paramedicine, or integrated mobile health care, comes in response to state and federal laws — including the Affordable Care Act — that are pressuring the health care industry to control costs. The Centers for Medicare and Medicaid Services, the federal agency that insures the elderly and the poor, last year imposed penalties of $227 million on hospitals with high rates of patient readmission, down from $280 million in 2012.
Private insurers, also aiming to keep costs down, increasingly offer incentives to providers for keeping patients out of the hospital when possible.
Like a fake appointment list or something?
For ambulance companies, home care represents a new source of revenue at a time when their core business is being squeezed by government and insurance company efforts to discourage costly emergency room visits and hospital stays....
Related: Ambulance services target of Medicare fraud inquiries
Great.
The largest ambulance company in the United States, American Medical Response of Greenwood Village, Colo., has used paramedics to provide home care since 2010, starting in Arlington, Texas. It has since launched similar programs in more than a dozen cities and plans to expand the practice into Massachusetts, where it operates in 11 communities....
--more--"
Looks like you are going to have to accept the visit by a paramedic:
"UnitedHealthcare to cut doctors for Mass. seniors" by Tracy Jan | Globe Staff June 07, 2014
WASHINGTON — National insurance giant UnitedHealthcare plans to cut up to 700 Massachusetts doctors from its physician network for seniors enrolled in its private Medicare plan as a way to control costs, according to company officials.
For elderly patients enrolled in the plan, the cuts mean they will have to find a new doctor or eventually switch to a new health plan that covers their current doctor.
Related:
“Let me be exactly clear about what health care reform means to you. First of all, if you’ve got health insurance, you like your doctors, you like your plan, you can keep your doctor, you can keep your plan. Nobody is talking about taking that away from you.”
Who said that?
Just another "inaccurate promise," 'eh?
The move, effective Sept. 1, follows similar cuts made by the insurer to its Medicare Advantage provider networks in 11 other states, including in Rhode Island and Connecticut, where the reductions drew outrage from patients, doctors, and lawmakers earlier this year.
Something people will be remembering come November.
Say goodbye to the Senate, Democraps.
UnitedHealthcare is the country’s largest provider of privately managed Medicare Advantage plans, and the ongoing cuts have prompted lawsuits by doctors, state investigations, and recent federal policy changes to better protect consumers. There is also pending legislation in Congress to prevent health plans from cutting physicians mid-year.
As if the presidential waivers are not enough! WhoTF wrote that law?
***********
The changes come amid a gradual reduction of reimbursements to private insurers that offer Medicare Advantage plans as a way to offset costs associated with President Obama’s health reform law....
For years the federal government has paid the private plans up to 14 percent more than traditional Medicare for identical services, a benefit to the insurance industry that cost taxpayers an extra $1,000 per beneficiary, according to the National Committee to Preserve Social Security & Medicare, a Washington-based advocacy group. The 2010 federal health law was supposed to close the gap, as well as provide new bonus payments to plans with the highest quality ratings.
You read that right, taxpayers. Government was bolstering the bottom lines of in$urance companies at your expense, and there is no reform. They just created a different name for the distribution formula.
UnitedHealthcare officials say they hope that streamlining the pool of doctors will not just save money but ultimately improve the quality of patient care — and thus improve its chances of receiving bonus payments under a new federal rating system.
I notice the money came first, and for once I'm not a consumer.
Cost savings could translate into more affordable care for patients, the insurer said, with the potential for lower out-of-pocket costs for prescription and office visit co-pays.
Or NOT because we have seen premiums and out-of-pocket costs skyrocket since Obummercare became law!
“Network restructuring is the new normal. It’s not just UnitedHealthcare, but that’s the way health plans will be operating in the future,” said Dr. Sam Ho, UnitedHealthcare’s chief medical officer, in an interview. “Healthcare is going through so many significant changes that it’s no longer a matter of doctors providing services and health plans paying claims, but a focus on the quality and cost effectiveness of those services.”
That term means you are screwed, citizen.
*********
In total, UnitedHealthcare will have cut about 35,000 doctors across the country over the past six months, the insurer said; that represents roughly 10 percent of the insurer’s national provider network....
Get ready for rationing, Americans. VA already doing it.
--more--"
Related: Medicare ban on sex reassignment surgery lifted
Cutting down care so they can pay for that?!?! This government is sick!
Obummercare Emergency!
Not even the administrators can figure it out even though she was brought in to fix the problems and supply the campaign narrative and defend the health care law.
"Now application ‘inconsistencies’ vex health law" by Ricardo Alonso-Zaldivar | Associated Press June 05, 2014
WASHINGTON — Another large paperwork problem for the government could also be jeopardizing coverage for some of the millions of people who recently received health insurance under the Affordable Care Act.
But, but, but.... I was told by this government 8 million signed up and all was well!
Of course, I already knew that the information entry portal that led to premium payments had been fixed, and that's all. Many reading this are under the impression they have coverage because they have been paying premiums. Wait until you try and access it.
A government document provided to the Associated Press indicates that at least 2 million people enrolled for taxpayer-subsidized private health insurance have data discrepancies in their applications that, if unresolved, could affect what they pay for coverage or even their legal right to benefits.
In other words, that website is so f***ed up the people who run it don't even know what the f*** is in there.
The final number affected could well be higher. According to the administration, the 2 million figure reflects only consumers who signed up through the federally administered HealthCare.gov website and call centers. The government signed up about 5.4 million people. State-run websites signed up another 2.6 million.
For consumers, a discrepancy means that the information they supplied, subject to perjury laws, does not match what the government has on record.
Next thing you know, government will be prosecuting you for their f***-ups.
For example, someone who underestimated income and received too generous a subsidy as a result could owe the Internal Revenue Service money.
What, you think we are all bankers out here?
The seven-page slide presentation from the Health and Human Services Department was provided to the AP as several congressional committees investigate the discrepancies. Most of the data conflicts involve important details on income, citizenship, and immigration status — which affect eligibility and subsidies.
I'm feeling ill over this.
Ensuring that health care benefits are delivered accurately is a priority for HHS nominee Sylvia Mathews Burwell, whose confirmation as department secretary is before the Senate this week.
Yeah, she will fix everything (blog editor's eyes roll skyward).
Responding to the document, administration officials expressed confidence that most of the discrepancies can be resolved during the summer. Nonetheless, the department has set up a system to ‘‘turn off’’ benefits for anyone who is found to be ineligible.
UNREAL!
--more--"
Time to lock up the house for the night, sorry. I had intended to get so much more done today. Sorry I once again failed you, dear readers.
NEXT DAY UPDATE:
"Upgrade delayed for Vermont health care website
A plan to upgrade the Vermont Health Connect website to allow users to make small changes to their health insurance accounts is being delayed while officials try to make sure it will work properly. The state’s contractor for the website was supposed to have the change-of-function live on the health insurance website by May 21, which was later pushed back to this week. The system will be delayed further while it is tested. Currently, corrections and changes to insurance applications are processed by hand. There is a backlog of 10,000 applications awaiting changes. The state is planning to bring in another contractor to help clear up the backlog (AP)."
Apparently the only good software programs are written for bank ATMs.
And how much will this $elf-$erving fix that is needed cost taxpayers?
I mean, I've been told tech jobs are the answer and we have to import a bunch of cheap foreign labor to fill the positions. This is the result of such efforts? $hit web$ites requiring con$tant corrections?
NEXT DAY UPDATE:
"Upgrade delayed for Vermont health care website
A plan to upgrade the Vermont Health Connect website to allow users to make small changes to their health insurance accounts is being delayed while officials try to make sure it will work properly. The state’s contractor for the website was supposed to have the change-of-function live on the health insurance website by May 21, which was later pushed back to this week. The system will be delayed further while it is tested. Currently, corrections and changes to insurance applications are processed by hand. There is a backlog of 10,000 applications awaiting changes. The state is planning to bring in another contractor to help clear up the backlog (AP)."
Apparently the only good software programs are written for bank ATMs.
And how much will this $elf-$erving fix that is needed cost taxpayers?
I mean, I've been told tech jobs are the answer and we have to import a bunch of cheap foreign labor to fill the positions. This is the result of such efforts? $hit web$ites requiring con$tant corrections?
