News and Commentary
This New York Times article reminds us that we have to be careful how we interpret cancer screening results. Early detection of cancer can lead to unnecessary interventions. The study showed that 15% of men with PSAs below 4 had cancer. The study could lead some doctors and patients to conclude that a biopsy makes sense, even with low PSA. However, the article also says:
Wisconsin and Colorado have released RFPs. Iowa is going to announce decisions by the end of the month about its Medicaid Enterprise Systems & Professional Services contract awards.
The Department of Health and Family Services (DHFS), Division of Health Care Financing, announced issuance of the Request for Proposals (RFP) to procure a new Medicaid Management Information System (MMIS) and Fiscal Agent services contract to meet the informational, operational, and administrative needs of the day-to-day management of the $3.8 billion Wisconsin Medicaid program and other DHFS programs. The RFP was issued on VendorNet on April 29, 2004 and is posted at their website. Proposals are due July 27, 2004 by 4:00 PM CDT.
Studies Question Effectiveness of Artery-Opening Operations - A new and emerging understanding of how heart attacks occur indicates that increasingly popular aggressive treatments may be doing little or nothing to prevent them. [New York Times Healthcare News]
This article helps shine some light on the Tenet case of Redding cardiologists who have been accused of performing hundreds of unnecessary bypass surgeries. In Redding, the cardiology center aggressively marketed heart surgery as preventive care. This article cites studies of the ineffectiveness of bypasses and stents as preventive measures and describes how cardiologists end up putting their financial interests above their patients’ interests.
Tenet is in trouble again. This time it’s about possible kickback arrangement with physicians in Texas. Tenet is the second largest hospital chain in the US. This allegation is just one more of many that have been brought in the past few years. I’ve written several articles about Tenet and talked about some of the issues in an interview on CNBC. Read the other articles
When Your Doctor Goes to the Beach, You May Get Burned - Studies show that most doctors feel they can take advantage of the free offerings of the pharmaceutical companies without being influenced. [New York Times Healthcare News]
If they think this, they can take advantage of drug company perks without feeling guilt. This reminds me of an article earlier in the month Making Drugs, Shaping the Rules where State government officials argued that they are not influenced by pharmaceutical companies funding their disease management programs.
Here’s a good article about fraud control in South Africa.
One of the things they talk about is calling patients when a doctor billed more services in a day than he could possibly perform. A key to making that work well is being able to identify outliers immediately and call patients before they forget the service or move. Often analysis like this is not done for a least a month after the claim was paid, which can be long after the service was provided. Having a report within 24 hours of processing the claims (and before th