Medicare Pay Cuts Will Hurt Seniors’ Care, Doctors Argue

January 1, 2023 Vera

[UPDATED at 11 a.m. ET for news developments.]

Doctors are urging Congress to call off cuts scheduled to take effect on Jan. 1 in the reimbursements they receive from Medicare.

In what has become an almost yearly ritual, physician groups are arguing that patients will have greater difficulty finding doctors who accept Medicare if lawmakers allow the pay cuts to happen.

A more than 4,000-page draft government spending bill released by lawmakers early Tuesday morning proposed much smaller-than-planned cuts to Medicare payments. But the bill, which Congress hoped to pass by the weekend to keep the government funded and avert a shutdown, would not go as far as doctors wanted.

“Despite overwhelming bipartisan, bicameral support to stop the full Medicare physician payment cut, Congress failed once again to end the cycle of harmful Medicare cuts, showing a disregard for vulnerable seniors,” the Surgical Care Coalition, an organization representing surgeons and anesthesiologists, said in a statement.

The doctors’ lobbying campaign had gained traction on Capitol Hill. A bipartisan group of 115 House lawmakers rallied behind doctors in a letter to congressional leaders and President Joe Biden last week, urging them to prevent cuts that they argued would “only make a bad situation far worse” for Medicare patients.

In recent years, the Centers for Medicare & Medicaid Services scheduled the pay cuts to offset the cost of increasing payments for underpaid services, like primary care. Physicians also stand to see reductions tied to broad cuts implemented by Congress in recent decades to try to control government spending.

Some Republicans have pushed to wait on passing the spending package until their party controls the House of Representatives next year and can have a greater say over what they call out-of-control spending. One priority of the incoming House Republican majority is curbing Social Security and Medicare, a federal health insurance program for people age 65 and older, among others.

“We’re mortgaging our kids’ futures,” Sen. Ron Johnson of Wisconsin, a Republican on the Senate Budget Committee, told reporters, referring to overall spending. “This is killing us from a financial standpoint. It’s got to stop.”

Despite concerns about ballooning government spending, for years doctors have been successful in delaying or softening proposed pay cuts, arguing that there would be dire consequences if the cuts kicked in.

Physicians carry a lot of political weight in Washington. The American Medical Association, the professional organization that represents and

GAO appoints 7 healthcare leaders to HITAC

December 29, 2022 Vera

Seven new healthcare leaders from diverse industry backgrounds will be joining the Health Information Technology Advisory Committee, the federal group working to implement a health IT infrastructure that advances the electronic access, exchange and use of health information in the U.S. healthcare system.

WHY IT MATTERS

Established by the 21st Century Cures Act, HITAC and its subcommittees provide recommendations to the Office of the National Coordinator for Health Information Technology on policies, standards, implementation specifications and certification criteria.

The new members, appointed by the Government Accountability Office, have served healthcare in both public- and private-sector capacities at organizations across the United States.

Dr. Kikelomo Belizaire, the chief medical officer at Pegasystems, is also a practicing hospitalist in the Charlotte, North Carolina, region. She previously served as the medical director of Anthem’s commercial unit and as a physician treating high-acuity patients in several hospital systems in North and South Carolina, and as a healthcare consultant.

Dr. Shila Blend is the health information technology director of the North Dakota Health Information Network, a statewide HIE. She also serves as a subject-matter expert with the Rural Emergency Medical Services Counts project, which is working to develop quality measures for emergency medical services in rural areas. She previously served the state in a number of preparedness and coordination roles, including as the deputy chief of staff for COVID-19 response.

Dr. Hannah Galvin is the chief medical information officer of Cambridge Health Alliance, an academic public safety net health system, where she leads the division of clinical informatics and practices as a pediatrician. She is the co-chair of the board of directors of Shift, an independent task force focused on enabling patients to manage how their health data is shared to promote equitable interoperability. Previously, Galvin was the medical director of informatics at Lahey Health and cared for underserved and vulnerable populations at hospitals in Massachusetts, New Hampshire and Rhode Island.

Dr. Bryant Thomas Karras, the chief medical informatics officer and senior epidemiologist with the Washington State Department of Health, guides informatics and HIE efforts. He has spearheaded state healthcare initiatives, including efforts to increase adoption of health information technology, detect disease outbreaks in their early stages and more. Previously, Karras served as an internal medicine physician at a number of hospitals in Connecticut, Oregon, Washington and Wisconsin.

Anna McCollister is a patient advocate, entrepreneur and advisor on various health technology, data use

Longtime Pardee surgeon retiring; Four Seasons has two honored

December 26, 2022 Vera

HENDERSONVILLE — Longtime local orthopedic surgeon Amal Das, M.D., is retiring on Dec. 31 after serving the community for more than 30 years. He was honored at Pardee UNC Health Care Board of Directors’ meeting in December.

He’s worked with Southeastern Sports Medicine and Orthopedics (SESM), a department of Pardee Hospital, doing hip and joint replacement surgeries.

According to a news release, Das joined the medical staff at Pardee in 1989 and has been a leading voice on arthritis and joint replacement and reconstruction for more than three decades. He served as the Chair of the Pardee Department of Surgery from 2004-05 and was instrumental in establishing the Pardee Center for Joint Replacement in 1999.

In addition to newspapers across the US citing his research, Dr. Das wrote the foreword to the No. 1-New York Times bestseller, “The Arthritis Cure.” He also authored several groundbreaking academic papers on complex hip revision, glucosamine and chondroitin sulfate treatment for knee arthritis, the release said.

Over the course of his career, Dr. Das has performed more than 8,000 hip and knee replacements.

Four Seasons Chief Clinical Officer named 2023 Fellow in Palliative Care Nursing

FLAT ROCK — Four Seasons’ Chief Clinical Officer Richelle (Rikki) Hooper, MBA, MSN, FNP, ACHPN, NE-BC, has been named a 2023 Fellow in Palliative Care Nursing, according to a news release from Four Seasons.

Awarded by the Hospice and Palliative Nurses Association (HPNA), the designation of HPNA Fellow in Palliative Care Nursing is given to HPNA members who have “made significant contributions to HPNA, the Hospice and Palliative Credentialing Center (HPCC), and/or the Hospice and Palliative Nurses Foundation (HPNF), while also impacting the field of hospice and palliative nursing,” the release said.

“We are very proud of Rikki being acknowledged by this significant honor. It not only demonstrates her commitment to personal learning and growth but also to that of advancing learning and growth in others,” said Four Seasons President & CEO, Dr. Millicent Burke-Sinclair, Ed.D, MBA, MLAS, SPHR®, SHRM SCP in the release. “Over the 19 years Rikki has worked with us, she has positively impacted the lives of patients, families and staff with our organization as well as regionally and nationally. Daily she engages from a place of openness and excellence, always striving to co-create the very best care for our employees and for those whom we serve. Rikki, we are grateful for you and so very

Mistaken identity leads to big hospital bill mix-up : Shots

December 22, 2022 Vera

In 2013, Grace E. Elliott spent a night in a hospital in Florida for a kidney infection that was treated with antibiotics. Eight years later, she got a large bill from the health system that bought the hospital. This bill was for an unrelated surgical procedure she didn’t need and never received. It was a case of mistaken identity, she knew, but proving that wasn’t easy.

Shelby Knowles for KHN

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Shelby Knowles for KHN

Earlier this year, Grace Elizabeth Elliott got a mysterious hospital bill for medical care she had never received.

She soon discovered how far a clerical error can reach — even across a continent — and how frustrating it can be to fix.

During a college break in 2013, Elliott, then 22, began to feel faint and feverish while visiting her parents in Venice, Fla., which is about an hour south of Tampa. Her mother, a nurse, drove her to a facility that locals knew simply as Venice Hospital.

In the emergency department, Elliott was diagnosed with a kidney infection and held overnight before being discharged with a prescription for antibiotics, a common treatment for the illness.

“My hospital bill was about $100, which I remember because that was a lot of money for me as an undergrad,” said Elliott, now 31.

She recovered and eventually moved to California to teach preschool. Venice Regional Medical Center was bought by Community Health Systems, based in Franklin, Tenn., in 2014 and eventually renamed ShorePoint Health Venice.

The kidney infection and overnight stay in the E.R. would have been little more than a memory for Elliott.

Then another bill came.

The Patients: Grace E. Elliott, 31, a preschool teacher living with her husband in San Francisco, and Grace A. Elliott, 81, a retiree in Venice, Fla.

Medical Services: For Grace E., an emergency department visit and overnight stay, plus antibiotics to treat a kidney infection in 2013. For Grace A., a shoulder replacement and rehabilitation services

Do You Have the Holiday Spirit? How (and Why) the Holidays Impact Our Mood

December 16, 2022 Vera

If Scrooge and the Grinch can find the holiday spirit, can you?

Research shows that holiday images, memories of childhood, songs and even Hallmark movies can all help contribute to a sense of happiness that can be dubbed the “holiday spirit” or “good cheer.”

“There is a subconscious code of generosity, kindness and charity that the holidays promote, known as ‘holiday spirit,’” notes Carla Schnitzlein, DO, medical director of Natchaug Hospital, part of the Hartford HealthCare Behavioral Health Network.

> Connect with the Behavioral Health Network

But where does that ‘holiday spirit’ come from?

This, research shows, is due to a variety of factors, including:

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If your holiday memories are happy, your brain will be too.

Several years ago, a researcher performed brain scans on one group of people who celebrated Christmas and another that did not. When shown holiday images, those in the former group showed activity in the front of the brain, where happiness registers.

“Many of us associate the holidays with positive memories and our brains are wired to respond in certain ways when we view certain images, either pleasant or unpleasant,” Dr. Schnitzlein says. “If the holiday memories you have are happy, your brain is more likely to respond in a way that represents happiness or joy.”

It works for music, too, she adds.

“Musical concepts like tempo, rhythm and key impact mood,” she notes. “Major keys, in which many holiday songs are written, are considered happy sounding and can put us in the holiday mindset and spirit.”

This, research indicates, might be why retailers start playing holiday tunes early, hoping they encourage spending.

Not feeling so happy? This might explain why.

The music, lights and trappings of the holidays don’t feel joyous to everyone, however.

“Certainly, may people have strong family connections and wonderful family traditions, which helps promote a positive outlook during the holidays,” Dr. Schnitzlein says. “That said, not everyone has these connections, and they can feel isolated during the holidays.”

Another consideration, she adds, is the 38% of people who, when surveyed, reported increased stress, anxiety and other mental health concerns.

“We have to remember that, although the holidays can spark joy in a large part of the population, it can also be challenging to those with strained family relationships or limited financial means,” Dr. Schnitzlein says.

Tuesday, November 22, 2022 | Kaiser Health News

December 12, 2022 Vera

Health Systems, Patient Care Impacted By Rising Claim Denial Rates

Modern Healthcare draws attention to a “significant” rise in denied insurance claims over the past year, which has increased administrative work, reduced hospital cash flow, and delayed patient care. Separately, Axios reports on how medical inflation is affecting big employers.

Modern Healthcare:
Insurance Claim Denial Rates Rising As Health Systems Struggle

Health systems across the country have experienced a significant rise in denied claims over the past year, leading to more administrative work for providers, less cash flow for hospitals and, in some cases, postponed patient care. (Devereaux, 11/21)