Did I Produce a Catastrophic Claim or Am I a Victim of Fraud?
by Michael L. Frank
aquariuscapital.com – It was a sunny day on December 11, 2015 when I woke up ready for a partial hip replacement. By the end of the day, I was a catastrophic claimant… or maybe a victim of fraud. You’ll be the judge. The surgery lasted less than two hours and required a one night hospital stay. In summary, I was in the hospital for less than 24 hours after the surgery. The hospital bill came to about $140,000.
The health insurance and reinsurance industries have seen a significant increase in catastrophic claims as well as overall health insurance costs. Is healthcare fraud a driver of this trend? Well, I believe fraud accounts for one- fourth to one-third of total costs. I challenge you to take the quiz below and come to your own conclusions. When you do, if your reaction is similar to mine—read on—I urge you to share your views with politicians and regulators, to encourage them to take meaningful action against healthcare fraud, which arguably is the main driver of high medical costs and insurance premiums in the United States.
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NASEM report offers 4 focus areas to improve global health
fiercehealthcare.com – The United States has spent decades at the “forefront of shaping the international policy agenda,” and a new report offers four areas where the government can use that power to better global health.
The National Academies of Sciences, Engineering and Medicine released its report Monday and in it, the academies argued that a systems-based approach is essential to creating partnerships with other nations to avoid the spread of disease and improve health.
“The United States must preserve and extend its legacy as a global leader, partner, and innovator in global health through forward-looking policies, country and international partnerships, and, most importantly, continued investment,” Jendayi Frazer, Ph.D., adjunct senior fellow for Africa studies at the Council on Foreign Relations and co-chair of the committee penned the report, said in announcement.
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New Approach Helps Health Information Exchanges Cross State Lines
by Jennifer Bresnick
healthitanalytics.com – In the era of value-based care, the ability to understand how a patient moves between providers and what happens to them during those visits could be the difference between a performance bonus and a missed benchmark.
But as most providers are now well aware, the challenges of seamless and reliable health information exchange are many.
Even organizations that are willing to collaborate with their peers face innumerable technical and regulatory barriers, from patient privacy concerns and variations in state law to proprietary EHR data standards and patient matching issues.
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Large gap in perceptions of health and healthcare between rich and poor in U.S.
by Matt Kuhrt
fiercehealthcare.com – The difference in how high- and low-income individuals see health and healthcare in the United States is larger than in most other countries, per a new study.
Writing in Health Affairs, Joachim O. Hero, a doctoral candidate in health policy, Alan M. Zaslavsky, Ph.D., and Robert J. Blendon, all of Harvard University, described their examination of income gaps in 32 middle- and high-income countries between 2011 and 2013. They reported that the difference between high-income and low-income Americans when it comes to their history with the healthcare system and their confidence in continuing access to care proved to be among the highest in any country they surveyed.
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China’s Ill, and Wealthy, Look Abroad for Medical Treatment
by Sui-Lee Wee
nytimes.com – Hospitals and a new generation of medical tourism companies are luring
well-heeled Chinese patients away from an overburdened health care system.
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Zika testing recommendations changed for pregnant women
by Helen Branswell
statnews.com – There’s never been anything easy about the Zika virus outbreak, and a new complication is now coming to light.
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China’s Hawaii Plans a $3 Billion Medical Tourism Hotspot
by Jonathan Bernstein
bloomberg.com – On the hilly and tropical island of Hainan, local officials and companies are investing billions of dollars to transform a string of riverside villages into a medical tourism destination.
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Life expectancy differs by 20 years between some US counties
by Susan Scutti, CNN
cnn.com – Life expectancy at birth differs by as much as 20 years between the lowest and highest United States counties, according to new research published Monday in the medical journal JAMA Internal Medicine.
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New analysis of GOP health-care bill says 13 million more would become uninsured, fewer than CBO estimate
by CNBC
cnbc.com – Trump and Congressional Republicans campaigned on a promise to repeal Obamacare, but have found doing so is taking longer than expected.
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More than 2 billion are overweight or obese globally, new study says
by Doyle Rice
usatoday.com – Among the 20 most-populous countries, the highest level of obesity among children and young adults was in the U.S., at nearly 13%.
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