Credentialing has become a recurring nightmare for physicians of all specialties, in every state and in every practice setting. Eager for a fresh start, and energized by new opportunity, we decide to make a job change. Recruiters colorfully praise these openings, as if every job pays more than our current one, is closer to parks and culture, and exists in a region with a lower cost of living and, of course, better weather. After a …
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Prosecutors Vigilant to Questionable Medicare Bonuses
A settlement with a billing company in Massachusetts is just the latest outcome of federal prosecutors going after healthcare companies for return of Medicare bonuses claimed in error. It’s a reminder that filing for claims improperly—even if inadvertently—can have serious consequences for operators. In this case, Medical Reimbursement Systems Inc. has agreed to pay $500,000 to settle allegations that it submitted false claims to the military’s Tricare program on behalf of a medical practice in …
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Optum Vows Continued, Dramatic Growth in Urgent Care Acquisitions
UnitedHealth’s OptumCare division already runs over 160 urgent care centers in 14 states by virtue of having bought MedExpress, but it plans to have “several multiples of that number five years from now.” That’s what Optum CEO and UnitedHealth Group vice chair Larry Renfro told a group of analysts recently, citing provider revenues as a key growth factor for the company. Already the largest payer in the U.S., UnitedHealth joins HCA Holdings and Tenet Healthcare …
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Uncle Sam Picks Up Two-Thirds of the Healthcare Check
Even as private citizens continue to pay a greater percentage of their paychecks for healthcare, new data say that the government is picking up the biggest portion of healthcare spending overall—64.3% as of 2013. Of particular note, Medicare spending rose about 2.5% between 1999 and 2013. The data, which are published online in the American Journal of Public Health, reflect direct government payments for Medicare, Medicaid, and other public programs (eg, the Veterans Health Administration, …
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Forearm Pain in a 12-Year-Old Patient After a Fall
A 12-year-old girl presents to an urgent care center with pain in her right forearm. She reports that the pain started the previous evening when she tripped on a toy left out by her 2-year-old brother. The pain is worse with range of motion. She says she does not have any numbness. She has no other injuries. View the image taken (Figure 1) and consider what your diagnosis would be.
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Balance Billing Takes a Hit in Tallahassee
The Florida legislature’s House Insurance & Banking Subcommittee has put its stamp of approval on a proposal to protect patients from surprise charges after discharge from the emergency room. As written, the bill would make insurers pay for emergency services and include an arbitration process to resolve differences between insurers and healthcare providers; patients themselves would be removed from that process. Several states have already enacted similar legislation, with still more—including Florida—moving toward doing the …
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Think Tank Says Aetna–Humana Deal Would Make Seniors Pay More
The Center for American Progress (CAP), a Washington, DC-based think tank, says senior citizens will be forced to pay higher Medicare Advantage premiums if Aetna’s proposed acquisition of Humana goes through. Aetna currently holds 7% of that market and Humana 19%. While their combined share of the entire current Medicare market would still be just 8%, Anthem has also moved to buy Cigna Corp. The combined effect of such deals could cut competition and result …
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New Study: Youth Sports Injuries Always in Season
Visits to the emergency room for sports injuries in children between the ages of 5 and 18 years rose every year from 2001 to 2013, with three quarters of those injuries attributed to football, soccer, baseball, and basketball, according to new data from the U.S. Consumer Product Safety Commission’s National Electronic Injury Surveillance System. All told, there were nearly half a million emergent injuries in 100 hospital emergency departments during the study period—translating to an …
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Harris Poll is Good News for Docs, Great Intel for Urgent Care
A new Harris Poll found that 88% of patients are “satisfied” with their last visit to the doctor, with 53% saying they are “very satisfied.” Digging deeper, though, you find data that can make or break that perception. A provider’s knowledge, training, and expertise were the most important attributes, but more than half of respondents also said the doctor’s ability to access their medical history, time spent with the doctor, and good communication matter significantly. …
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Can Urgent Care Help Abate Astronomical Spike in Health Costs?
Families in the U.S. could be spending up to 45% of their household income on healthcare costs within the next two decades, according to a new study from the Pioneer Institute of Boston. The best-case scenario, according to the report, would be that health-insurance premiums rise by 4% annually, along with the same rate of increase for out-of-pocket costs. By 2035, those expenses would consume nearly a quarter of the family’s budget, up from 16% in …
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