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Insurers May Be Underpaying Physicians

Insurers May Be Underpaying Physicians

There are not exact numbers as to how often or by how much insurance companies underpay, but experts say it occurs frequently enough that doctors should constantly monitor their reimbursements against each payer's contract.

The Challenge of Compassion in Modern Healthcare Settings

The Challenge of Compassion in Modern Healthcare Settings

A providers' capacity to feel compassion is affected in part by the practice environment.

Reproductive Recourse: Why Are Reproductive Malpractice Claims So Challenging?

Reproductive Recourse: Why Are Reproductive Malpractice Claims So Challenging?

A new generation of DNA tests that analyze fetal DNA are seen as a safe and reliable godsend for expectant mothers because, according to the manufacturers, they achieve "near-perfect" accuracy.

AMA Proposes Policy Opposing Medicaid 'Lockout' Provisions

AMA Proposes Policy Opposing Medicaid 'Lockout' Provisions

The AMA policy came in response to recently approved state Medicaid waivers that block patients from Medicaid for up to six months for not meeting deadlines or paperwork requirements.

Physicians and Practices Should Prepare for Emergencies

Physicians and Practices Should Prepare for Emergencies

Physicians are not as prepared to handle emergencies as they should or could be.

Gender-Based Salary Inequalities Pervasive in Internal Medicine

Gender-Based Salary Inequalities Pervasive in Internal Medicine

Gender-based salary differences were the same regardless of whether or not the respondent was a parent.

Accountable Care Organization Growth Associated With Reduced Physician Work Hours and Self-Employment

Accountable Care Organization Growth Associated With Reduced Physician Work Hours and Self-Employment

Well-performing ACOs make more efficient use of physician time by shifting tasks to other hospital team members.

Mistreatment Programs Reviewed for Reducing Abuse of Medical Trainees

Mistreatment Programs Reviewed for Reducing Abuse of Medical Trainees

The development of a theoretical framework can help prevent the pervasive abuse, harassment, discrimination, and mistreatment of medical trainees.

New Short-Term Health Plans Have Large Coverage Gaps

New Short-Term Health Plans Have Large Coverage Gaps

Short-term health plans are meant to be a low-cost alternative to Obama-era plans with high premiums, but they don't have to cover existing medical conditions and they provide limited benefits.

Three Financial Metrics Can Improve Practice Performance

Three Financial Metrics Can Improve Practice Performance

By understanding three indices and metrics, physicians can change the financial outcome of their medical practice.

More Healthcare Professionals Choose Employment With Organizations Over Self-Employment

More Healthcare Professionals Choose Employment With Organizations Over Self-Employment

In recent years, more healthcare professionals are choosing to work for organizations rather than starting their own practice.

Strategies for Increasing Physician-Scientist Recruitment to Research Careers

Strategies for Increasing Physician-Scientist Recruitment to Research Careers

From 2003 to 2015, funding for the National Institutes of Health declined by 22% due to a nationwide decrease in biomedical research support.

Embezzlement Not Uncommon in Medical Practices

Embezzlement Not Uncommon in Medical Practices

Embezzlement occurs frequently in medical practices and steps should be taken to prevent it.

AMA Aims to Boost Affordability of ACA Marketplace Plans

AMA Aims to Boost Affordability of ACA Marketplace Plans

The American Medical Association (AMA) House of Delegates has adopted policy to increase the number of people who obtain coverage through the Affordable Care Act by making marketplace plans more affordable.

Sound Healing May Be A Simple Solution to Combat Burnout

Sound Healing May Be A Simple Solution to Combat Burnout

Sound healing — a meditation technique that focuses on the power of sound — may offer a solution to physician burnout.

Alternative Payment Models Should Include Precision Medicine

Alternative Payment Models Should Include Precision Medicine

The American Medical Association has committed to working to integrate precision medicine into alternative payment models.

Physician Burnout Tied to Higher Risk for Medical Errors

Physician Burnout Tied to Higher Risk for Medical Errors

Physician burnout, fatigue, and work-unit safety grades are independently associated with medical errors.

Avoiding Negligence and Malpractice While On Call: Guidelines for Physicians

Avoiding Negligence and Malpractice While On Call: Guidelines for Physicians

Untimely responses to messages by on-call physicians may make physicians liable for patient death or injury.

Hospitals Participating in 340B Program Offer More Low-Profit Services, Uncompensated Care

Hospitals Participating in 340B Program Offer More Low-Profit Services, Uncompensated Care

The 340B Drug Pricing Program was designed to improve revenue generation among hospitals by allowing participating centers to purchase specific outpatient drugs at a wholesale discount.

Multiple Strategies Help Practices Manage Staff Time Off

Multiple Strategies Help Practices Manage Staff Time Off

Several strategies can be implemented to help address management of staff time off, allowing mutual respect for the employee and employer requests.

Same-Day Appointment System Implemented in Health Network

Same-Day Appointment System Implemented in Health Network

Lessons learned included committing to constant evolution to match the changing needs of the customers.

Trump White House Freezes Billions Earmarked for Insurers Through ACA

Trump White House Freezes Billions Earmarked for Insurers Through ACA

The White House announced earlier this month a plan to freeze billions of dollars of risk-adjustment payments scheduled to go to insurers through the Affordable Care Act.

Wellness Vacations Prioritize a Healthy Lifestyle During Travel

Wellness Vacations Prioritize a Healthy Lifestyle During Travel

Wellness travel comes in many forms: from coastal bike rides to weeklong workout programs with celebrity trainers.

Patient Experience Officers Can Play Key Role in Medical Offices

Patient Experience Officers Can Play Key Role in Medical Offices

Focusing on the patient experience can produce great results for a health care practice.

The Harmful Application of HIPAA: How to Protect Privacy and Patient Care

The Harmful Application of HIPAA: How to Protect Privacy and Patient Care

Despite good intentions, HIPAA is shrouded in myth and misapplication that does more harm than good for both patients and physicians.

Many Non-Emergency Medicine Trained Physicians in ER Care

Many Non-Emergency Medicine Trained Physicians in ER Care

The emergency medicine workforce comprises many non-emergency medicine trained physicians.

Hospital-Owned Practices Associated With Positive Workplace Perceptions Among Staff

Hospital-Owned Practices Associated With Positive Workplace Perceptions Among Staff

Findings suggest that staff may be critical to building overall practice adaptive reserve and for providing the energy for continuing quality improvement.

Association Between Industry Payments and Opioid Prescribing

Association Between Industry Payments and Opioid Prescribing

Non-research industry payments to physicians may be associated with increases in opioid prescribing rates.

Primary Care Physicians Often Not Meeting Needs of Seniors With Chronic Conditions

Primary Care Physicians Often Not Meeting Needs of Seniors With Chronic Conditions

Over 85% of primary care physicians feel unable to adequately address needs of patients with multiple chronic conditions.

Putting Patients in the Physician's Seat: Smartphone Technology Is Changing the Healthcare Landscape

Putting Patients in the Physician's Seat: Smartphone Technology Is Changing the Healthcare Landscape

Apple recently rolled out a new addition to its Health app, granting hundreds of patients access to their medical history.

Practice Management Can Improve Efficiency, Increase Reimbursement

Practice Management Can Improve Efficiency, Increase Reimbursement

Providers can take practical steps to improve practice efficiency and increase insurance reimbursement.

Patient Interest Fairly High for Melanoma Genetic Risk Testing

Patient Interest Fairly High for Melanoma Genetic Risk Testing

There is moderately high interest in genetic testing for melanoma risk among the general population.

Patient Complaints Mainly About Rudeness, Rushing, Reproach

Patient Complaints Mainly About Rudeness, Rushing, Reproach

Complaints from patients were categorized into 3 groups: rudeness, rushing, and reproach.

Measuring Perceptions of Cardiology Among Internal Medicine Trainees

Measuring Perceptions of Cardiology Among Internal Medicine Trainees

A recent study examined trends in career preference for and perception of cardiology among internal medicine trainees.

Disrupting the Status Quo: Improving Emergency Care for Transgender Patients Is a Medical Necessity

Disrupting the Status Quo: Improving Emergency Care for Transgender Patients Is a Medical Necessity

Stigma and harassment in a medical setting are not uncommon in the 1.4 million Americans who identify as transgender or gender-nonconforming. It's time for healthcare providers to change the status quo.

Medicaid-Insured Patients Less Likely to Receive Guideline-Recommended Treatment

Medicaid-Insured Patients Less Likely to Receive Guideline-Recommended Treatment

Although the Affordable Care Act reduced the percentage of uninsured Americans from 20.3% to 12.6%, differences in quality of care still persist.

Decline in Medicare Recipients Who Die in Acute Care Hospitals

Decline in Medicare Recipients Who Die in Acute Care Hospitals

The proportion of deaths that occurred in an acute care hospital decreased from 32.6% to 19.8% among Medicare fee-for-service decedents.

Residents Exceeding Duty Hour Requirements Rarely Report Coercion

Residents Exceeding Duty Hour Requirements Rarely Report Coercion

Although most hour flexibility was used voluntarily, resident programs should remain vigilant in preventing coercion from senior personnel.

New Hospital-at-Home Care Model Tied to Better Outcomes

New Hospital-at-Home Care Model Tied to Better Outcomes

Researchers found that hospital-at-home patients were older than controls and more likely to have a preacute functional impairment.

Evaluating the Efficacy of Peer Support Programs for Healthcare Employees

Evaluating the Efficacy of Peer Support Programs for Healthcare Employees

Healthcare providers traumatized by an adverse patient event are commonly referred to as "second victims" and may benefit from institutional and peer support to assist in recovery.

Addressing the Gender Wage Gap in Cardiology

Addressing the Gender Wage Gap in Cardiology

A woman will begin earning an average of $21,900 less in gross income compared with a man during the first year of employment.

Vertical Mergers Could Be Challenging for Primary Care

Vertical Mergers Could Be Challenging for Primary Care

Health care mergers are not new, with recent decades witnessing independent practices being absorbed by multi-group practices.

Coverage Policies Compared for Back Pain Medications

Coverage Policies Compared for Back Pain Medications

Access to opioid alternatives can be expanded through coverage and reimbursement policies.

Insurance Company Sets Goal of Reducing Opioid Overdoses by 25%

Insurance Company Sets Goal of Reducing Opioid Overdoses by 25%

Through their predictive analytics, Cigna can identify customers most likely to suffer from an overdose and can prompt interventions.

Move Over, Mindfulness: Sophrology Is the Newest Stress-Busting Technique

Move Over, Mindfulness: Sophrology Is the Newest Stress-Busting Technique

Based on science and covered by health insurance, sophrology is the latest stress management technique to gain popularity.

More Cash-Pay Patients Means Physicians Need Billing Strategies

More Cash-Pay Patients Means Physicians Need Billing Strategies

Physicians should have a comprehensive policy in place for cash-pay patients.

AMA Vows to Improve Access for Physicians Seeking Mental Health Care

AMA Vows to Improve Access for Physicians Seeking Mental Health Care

The policy aims to further reduce stigma associated with mental health illness to ensure physicians are able to seek the care they need for anxiety, depression, and substance-related disorders.

Transference in the Age of #MeToo: What Counts as Harassment From a Patient?

Transference in the Age of #MeToo: What Counts as Harassment From a Patient?

The psychological effect on psychiatrist victims should be acknowledged even when the behavior of the perpetrator can be explained by diagnosis.

More Hospitals Mandating Influenza Vaccines for Healthcare Workers, Survey Says

More Hospitals Mandating Influenza Vaccines for Healthcare Workers, Survey Says

Results still indicate a trajectory toward stricter infection prevention at hospitals in general, and highlight a possible need for increased vaccine mandates.

How Is Attending Physician Supervision Linked to Resident, Intern Medical Error Rate?

How Is Attending Physician Supervision Linked to Resident, Intern Medical Error Rate?

Researchers recommended that residency programs reconsider the balance of patient safety, learning needs, and resident autonomy.

CDC: Office-Based Physician Visit Rates Vary by Patient Age, Sex

CDC: Office-Based Physician Visit Rates Vary by Patient Age, Sex

Physician visiting rates deal with many more characteristics than assumed.

Primary Care Physicians Report Top Administrative Hassles

Primary Care Physicians Report Top Administrative Hassles

Primary care physicians report experiencing difficulty with obtaining and following up on specialty care for patients.

How Do Business Partner Data Breaches Affect Your Practice?

How Do Business Partner Data Breaches Affect Your Practice?

Business associate agreements should be prioritized; collaborative policies can help patch attacks

Growth in Healthcare Employment Has Led to Rise in Healthcare Costs

Growth in Healthcare Employment Has Led to Rise in Healthcare Costs

In an era in which technology constantly evolves and becomes smarter by the day, it's not surprising that healthcare costs continue to climb.

Does Maintenance of Certification Status Affect Patient Care?

Does Maintenance of Certification Status Affect Patient Care?

Researchers used administrative data to compare effectiveness measures in physicians who either did or did not maintain certification in the 20 years following their initial certification.

Continuous Medicaid Coverage Essential for People Living With HIV

Continuous Medicaid Coverage Essential for People Living With HIV

Implementing initiatives to maintain Medicaid enrollment and to expedite Medicaid reenrollment and having alternate resources available in gaps are important to ensure continuous antiretroviral therapy to optimize HIV outcomes.

Medicaid Expansion Ups Access to Rehab in Young Adults With Injury

Medicaid Expansion Ups Access to Rehab in Young Adults With Injury

Medicaid expansion correlated with an increase in Medicaid coverage and an increase in discharge to rehabilitation facilities.

CDC: Prevalence of No Insurance Varies by Occupational Groups

CDC: Prevalence of No Insurance Varies by Occupational Groups

The researchers observed a significant decrease in the prevalence of being uninsured among workers aged 18 to 64 years.

AMA Guide Highlights Importance of Caring for Caregivers

AMA Guide Highlights Importance of Caring for Caregivers

Causes of caregiver burnout include confusion about their new role, unrealistic expectations, lack of control, and unreasonable demands, often placed by caregivers themselves.

In Children's Health Care, Value-Based Payment Reform Needed to Lower Costs, Improve Care

In Children's Health Care, Value-Based Payment Reform Needed to Lower Costs, Improve Care

Clinicians involved in children's health care can drive changes in payment models to improve the quality, cost-effectiveness, and the degree to which care is child-focused.

Comprehensive Primary Care Initiative Improves Care Delivery

Comprehensive Primary Care Initiative Improves Care Delivery

The Comprehensive Primary Care Initiative improves primary care delivery but does not reduce Medicare spending enough to cover care management fees.

A Few Bad Apples: Managing Malpractice Claims

A Few Bad Apples: Managing Malpractice Claims

Ranking or otherwise gauging physician quality isn't just a way to assign bragging rights — performance metrics can be used to set reimbursement levels, tailor insurance, and identify physicians who are falling behind.

Older Adults Often Reluctant to Set Up Secure Patient Portal

Older Adults Often Reluctant to Set Up Secure Patient Portal

Some adults who had not set up a patient portal expressed concerns about doing so, including 27 percent who were very concerned about the chance of error relative to talking to someone by phone or in person.

ACP: Delay, Denial of H-1B Visas Disruptive to Training, Patient Care

ACP: Delay, Denial of H-1B Visas Disruptive to Training, Patient Care

The denial or delay of visas for international students is disruptive to both the training program and to patient care.

Health System Expansions Place Patients at Risk for Safety Concerns

Health System Expansions Place Patients at Risk for Safety Concerns

System expansions in the current healthcare environment are making clear impacts on clinical care and patient safety.

Rates of Major Depression Up Among US Insured, Especially Youth

Rates of Major Depression Up Among US Insured, Especially Youth

Diagnoses of major depression have increased since 2013, particularly among adolescents and millennials.

Addressing Compassion Fatigue as a Cost of Caring: Interview With Anita Everett, MD: Part 3

Addressing Compassion Fatigue as a Cost of Caring: Interview With Anita Everett, MD: Part 3

Anita Everett, MD, recent past-president of the American Psychiatric Association, discusses physician burnout and compassion fatigue.

Interventions to Prevent Physician Burnout: Interview With Anita Everett, MD: Part 2

Interventions to Prevent Physician Burnout: Interview With Anita Everett, MD: Part 2

Anita Everett, MD, recent past-president of the American Psychiatric Association, discusses physician burnout and compassion fatigue.

Combating Compassion Fatigue and Burnout: Interview With Anita Everett, MD: Part 1

Combating Compassion Fatigue and Burnout: Interview With Anita Everett, MD: Part 1

Anita Everett, MD, recent past-president of the American Psychiatric Association, discusses physician burnout and compassion fatigue.

Language Used in Medical Record Can Affect Patient Care

Language Used in Medical Record Can Affect Patient Care

Stigmatizing language used in medical records to describe patients can influence medical students and residents in terms of their attitudes towards the patient and their clinical decision-making.

Congress Approves Bill Expanding Private Care for VA Patients

Congress Approves Bill Expanding Private Care for VA Patients

The bill was passed in the Senate on a 92 to 5 vote.

CDC: No Change in Level of Uninsured in United States in 2017

CDC: No Change in Level of Uninsured in United States in 2017

The uninsured rate in 2017 was similar to the uninsured rate in 2016.

Tips on Improving Communication With Older Patients

Tips on Improving Communication With Older Patients

Communication with older patients can be complicated for several reasons.

Novel Purchasing Strategy Could Cut Medicaid Costs for Hepatitis C Prescriptions

Novel Purchasing Strategy Could Cut Medicaid Costs for Hepatitis C Prescriptions

A new purchasing strategy may dramatically increase access to drugs for HCV infection in the Medicaid program without increasing state and federal costs.

Nonprofit Manufacturer Could Keep Generic Drug Costs Down

Nonprofit Manufacturer Could Keep Generic Drug Costs Down

Project Rx may drive other nonprofit and for-profit manufacturers to enter generic drug markets.

White House Unveils Plan to Lower Cost of Prescription Drugs

White House Unveils Plan to Lower Cost of Prescription Drugs

FDA Commissioner Scott Gottlieb MD, said, "The FDA shares the goal of ensuring that American patients have access to quality and affordable care that meets their needs."

Direct Primary Care Rivals Fee-for-Service Models in Improving Care Quality and Costs

Direct Primary Care Rivals Fee-for-Service Models in Improving Care Quality and Costs

The direct primary care model is a potential alternative to the traditional fee-for-service payment model.

Making Alternative Payment Plans Mandatory: Inherent Risks and Pitfalls in Reducing Healthcare Costs

Making Alternative Payment Plans Mandatory: Inherent Risks and Pitfalls in Reducing Healthcare Costs

The Center for Medicare and Medicaid Innovation (CMMI) program was created by the Affordable Care Act to identify and test new strategies for reimbursement in an effort to reduce growing healthcare costs.

Many Organizations Not Meeting Trial Reporting Requirements

Many Organizations Not Meeting Trial Reporting Requirements

Final Rule compliance date for organizations was April 18, 2017.

Health Care for Undocumented Immigrants Is Complex

Health Care for Undocumented Immigrants Is Complex

Undocumented immigrants are not allowed to obtain Medicaid or Medicare coverage or purchase plans as part of the Affordable Care Act.

When Sparks Stop Flying: How Is Clinician Burnout Tied to Patient Outcomes?

When Sparks Stop Flying: How Is Clinician Burnout Tied to Patient Outcomes?

Physician burnout has gained traction as a public health concern because more physicians are leaving medical practice altogether, resulting in decreased patient access and continuity of care.

Practices Should Be Aware of Correct Way to Fire Employees

Practices Should Be Aware of Correct Way to Fire Employees

One suggestion includes compiling an employee handbook that details practice policies, including a section on termination.

Current Performance Measures Lack Appropriate Validity for Clinical Use

Current Performance Measures Lack Appropriate Validity for Clinical Use

Currently there are 2500 performance measures for US physicians listed by the National Quality Measures Clearinghouse.

PCP eConsult Specialty Referral System Improves Care Access but Increases Workload

PCP eConsult Specialty Referral System Improves Care Access but Increases Workload

Although the eConsult system expedites patient access to specialty services, it can lead to increased workload — and subsequent burnout — among physicians.

Medicare Requiring Hospitals to Post Prices Online

Medicare Requiring Hospitals to Post Prices Online

Currently, hospitals must make their prices public, but a new Medicare rule requires that information to be easily accessible online.

Retail Clinics Aim to Improve and Transform Healthcare Access

Retail Clinics Aim to Improve and Transform Healthcare Access

Retail clinics can be more economically feasible for patients when compared with traditional medical clinics.

Patients Prefer Physicians Who Engage in Face-to-Face Visits

Patients Prefer Physicians Who Engage in Face-to-Face Visits

Face-to-face visits with patients resulted in better scores for physician compassion, communication skills, and professionalism.

Talking Politics With Patients

Talking Politics With Patients

Sooner or later, everyone in the healthcare field will have to think about how to approach a politically divisive conversation with a patient.

First Opioid Lawsuit Targeting Pharmacy Benefit Managers

First Opioid Lawsuit Targeting Pharmacy Benefit Managers

A south Texas county included the 3 largest pharmacy benefit managers in a nationwide lawsuit focused on the opioid epidemic

Most Practices Don't Offer Flexibility for Uninsured

Most Practices Don't Offer Flexibility for Uninsured

Approximately 80% of uninsured callers received appointments, provided they can pay the full cash amount.

ACP: Recommendations to Combat Negative Hidden Curricula in Medicine

ACP: Recommendations to Combat Negative Hidden Curricula in Medicine

In medicine, there is often a disconnect between what is taught in the classroom and what students observe in clinical practice.

Recent Years Saw Increase in Burden of Prior Authorization

Recent Years Saw Increase in Burden of Prior Authorization

Eighty-six percent of physicians reported that prior authorization burdens increased over the past 5 years.

Improved Care Efficiency Requires a More Manageable System

Improved Care Efficiency Requires a More Manageable System

As technologic tools in clinical practice becomes more standard, it is easy for physicians to become burdened.

Does Immunity from Medical Malpractice Lead to Improved Patient Care?

Does Immunity from Medical Malpractice Lead to Improved Patient Care?

Results showed that the average post-SI incidence rate of harmful events at JMH was 13% lower compared to the 2 pre-SI years on record.

Navigating the Waters of Medical Malpractice and Defensive Medicine

Navigating the Waters of Medical Malpractice and Defensive Medicine

Malpractice liability reform would best be analyzed on a specialty-by-specialty basis.

ACA Marketplaces Expand Coverage for People With Chronic Illness

ACA Marketplaces Expand Coverage for People With Chronic Illness

Insurers within the ACA marketplace covered a disproportionate share of non-elderly adults with high healthcare risks from 2014 to 2015.

Department of Health and Human Services Resource Improves Patient Health Information Access

Department of Health and Human Services Resource Improves Patient Health Information Access

The new HSS Resource encourages patients to request — and use — their health record information.

Linguistic Barriers Continue to Create Care Concerns, Affect Patient Outcomes

Linguistic Barriers Continue to Create Care Concerns, Affect Patient Outcomes

Language education and assistance services can increase 2-way communication between physicians and non-native English speaking patients.

Physicians Engage Little to Coordinate Medicare Home Health Care

Physicians Engage Little to Coordinate Medicare Home Health Care

Forty-seven percent of survey respondents reported spending less than 1 minute reviewing CMS-485.

Transactional Roles vs Personalized Care: Is a Shift Needed to Improve Patient Care?

Transactional Roles vs Personalized Care: Is a Shift Needed to Improve Patient Care?

Tasks like data gathering and entry can take away from the time physicians spend on patient care.

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