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Mal Allison

Despite Additional Dollars, Texas Doc Shortage Is Hard to Fix - Kaiser Health News - 0 views

  • Wright and Blackwell said Texas should encourage more physicians to go into primary care in rural areas by expanding the loan repayment program, which offers some debt relief to doctors who do so.
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    Wright and Blackwell said Texas should encourage more physicians to go into primary care in rural areas by expanding the loan repayment program, which offers some debt relief to doctors who do so.
Mal Allison

'Wildfire' Growth Of Freestanding ERs Raises Concerns About Cost - Kaiser Health News - 0 views

  • Several hospital chains are driving the boom – including HCA Inc., which will open its seventh ER later this year in Florida, and Wake Med Health and Hospitals, which will add its fourth next month in the Raleigh, N.C., metro area. They regard the facilities as a way to expand into new markets, generate admissions to their hospital and reduce crowding at their hospital-based ERs.
  • reater Houston has 150 emergency rooms — twice the number as greater Miami -- even though its population is only slightly bigger, according to a KHN analysis.
  • While the ERs charge insurers double or triple the amount per patient as an urgent care center or doctor's office, patients use them for routine care that could be provided in less costly settings, Ho says. That is the case with standard ERs as well. Yet, insured patients have little incentive to drive past the more expensive, freestanding ERs because their co-payment is only $50 or $100, just modestly more than what it might cost for a visit to an urgent care center or doctor’s office. Their insurers pay the balance generally.
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  • The main reason they are more costly than urgent care is that they charge a "facility fee" on top of a fee for the physician's time—just like traditional ERs. The facility fee was originally intended as a way to help hospitals recoup overhead costs
  • In an effort to protect consumers, Texas in 2009 passed a law to license freestanding ERs that are not owned by hospitals. The law requires facilities be open 24 hours, always have doctors on site and give everyone a medical screening regardless of their ability to pay – all requirements that apply to hospital-based ERs. Many of the clinics, though, don’t accept Medicaid or Medicare and the law did not change that.
  • orried that insurers will eventually cut payments to those unaffiliated with hospitals, Emerus has started converting its facilities into "micro hospitals," with a few beds that treat patients such as those needing drug detox or hospice. The company has also recently partnered with Baylor Health System to jointly operate eight such "micro hospitals" in the Dallas area.
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    "You can never have too much care for patients," says Rhonda Sandel, CEO of Texas Emergency Care Center.
Mal Allison

Health Insurance Within Reach - NYTimes.com - 0 views

  • All health plans offered on a state exchange must provide comprehensive coverage that includes doctors’ visits, lab work, hospital stays, emergency room services, maternity care, prescriptions, mental health services and children’s dental and vision care.
  • Policies with the most generous benefits will be “platinum” plans; they will have the highest monthly premiums but fewer out-of-pocket costs and lower deductibles. The “gold” and “silver” plans will be somewhat less generous, while those in the “bronze” category will have the cheapest premiums but may require high out-of-pocket costs and deductibles.
  • Be aware that the plans may have narrow provider networks — your favorite doctor or the hospital down the street may not be a participant. You’ll need to check to see if a certain provider is in the network, advised Sabrina Corlette, a research professor at Georgetown University’s Center on Health Insurance Reform.
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  • Be prepared for sticker shock. A 40-year-old nonsmoker may be able to buy a plan for about $4,000 annually or less; someone in his or her 50s may pay double. “Health insurance is an incredibly expensive product,” Ms. Corlette warned.
  • People who earn up to four times the federal poverty level — roughly $45,960 a year for a single person and $94,200 for a family of four — can receive subsidies to help pay for the new coverage. Those earning 250 percent of the poverty level are eligible for additional cost-sharing subsidies.
  • Americans who work at minimum wage jobs, earning less than 138 percent of the federal poverty level, which is $15,856 for a household of one and $32,499 for a household of four, will qualify for free government coverage under Medicaid — but only if they live in a state that is expanding its Medicaid program.
  • Open enrollment on the new exchanges will run from October 1 through March 31. Y
Mal Allison

Texas is curtailing health costs with own program | www.statesman.com - 0 views

  • Doctors complain, though, that the savings comes from cutting reimbursement rates, which discourages health care providers from accepting Medicaid patients. The Texas Medical Association also expressed disappointment that Gov. Rick Perry rejected proposals to expand the number of people on Medicaid to include the working poor.
  • But since the poor and uninsured often rely on expensive emergency room care, Lunsford said hospitals will continue to pass on those costs to the public when those patients don’t pay their bills.
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