Hospitals, nursing homes, pharmacies face changing marketplace

Jan 3 2013

News outlets are covering various aspects of the health care industry.

Bloomberg: For-Profit Nursing Homes Lead In Overcharging While Care Suffer
A report by federal health care inspectors in November said the U.S. nursing home industry overbills Medicare $1.5 billion a year for treatments patients don't need or never receive. Not disclosed was how much worse it is when providers have a profit motive. Thirty per cent of claims sampled from for- profit homes were deemed improper, compared to just 12 percent from non-profits, according to data Bloomberg News obtained from the inspector general's office of the U.S. Department of Health and Human Services via a Freedom of Information Act request (Waldman, 12/31).

The New York Times: Doctors Warned On 'Divided Loyalty'
With hospitals buying up medical practices around the country and seeking to make the most of their investment, the American Medical Association reached out to doctors this week to remind them that patient welfare must always come first and not be overridden by the economic interests of hospitals that now employ doctors in ever-growing numbers (Pear, 12/26).

McClatchy/Milwaukee Journal Sentinel: Aging Boomers Seen As More Of A Market Than Burden
[T]he health care industry is the most obvious benefactor of a longer-living active community. Demand for home health aides is expected to grow 70% in the next decade, according to the Department of Labor. … Concern about a drain on entitlements from retiring baby boomers has increased with worries over the fiscal cliff. … Those projections fail to take into account that boomers are expected to work longer and they've never followed in the footsteps of previous generations, said Matt Thornhill, an author of "Boomer Consumer" (Ordonez and Conley, 1/1).

Kansas Health Institute: Independent Pharmacies Pinched By Preferred Provider Networks
Preferred provider networks can help seniors save money on their prescription drugs. If a senior's Medicare Part D plan includes a network of preferred providers and if they have their prescriptions filled at one of the participating pharmacies, they get a discount. That's how the networks work. But most of the participating pharmacies are large, corporate owned stores in towns large enough to have a Walmart, and owners of smaller, independent pharmacies say the chains' Medicare arrangements are hurting their businesses (Ranney, 12/31)

Los Angeles Times: Medical Field Works To Reduce Number Of Surgical Mistakes
Surgical errors have attracted widespread attention over the past several years, leading to new laws and policies. In 2007, California started requiring hospitals to report certain errors and fining them if the mistakes killed or seriously injured patients. The next year, Medicare stopped paying hospitals for the costs associated with certain errors. In 2011, Medicaid announced that it also would stop paying to fix certain preventable mistakes. Nevertheless, about 2,000 patients nationwide have surgical material inadvertently left behind each year during operations. The errors have occurred during all types of procedures (Gorman, 12/23).