Monday, December 30, 2013

Calling A Code on Codes

As the Ball drops in Times Square, a new coding system will be rapidly approaching. 2014 will be the year of ICD-10.

The changes are unrelated to the Obama administration’s new health care law. But given the lurching start of the federal health insurance website,, some doctors and health care information technology specialists fear major disruptions to health care delivery if the new coding system — also heavily computer-reliant — isn’t put in place properly.
They are pushing for a delay of the scheduled start date of Oct. 1 — or at least more testing beforehand. “If you don’t code properly, you don’t get paid,” said Dr. W. Jeff Terry, a urologist in Mobile, Ala., who is one of those who thinks staffs and computer systems, particularly in small medical practices, will not be ready in time. “It’s going to put a lot of doctors out of business.”
Doctors already spend more time with the computerized EMR than with face to face patient encounters as it is. Switching to an entirely new coding system on top of an already cumbersome EMR is not going to enhance the doctor-patient relationship. What's suitable for large scale health systems and Accountable Care Organizations is not necessarily a good fit for a 3 doctor group in Jamaica, Queens. Top down mandates seem the antithesis of patient centered care. Don't expect great Press-Ganey's, folks.
Of course that's just my opinion. I could be wrong.

Monday, December 23, 2013

Clement Moore - The Reluctant Poet

The other night, we took a tour of some of NYC's finest Christmas light displays. While driving past the Chelsea Hotel, the driver told us the story of Clement Clark Moore.

... TRUTH BE TOLD, the 19th-century author who bequeathed us the image of a fat, jolly, white-bearded St. Nicholas ("His eyes — how they twinkled! his dimples how merry!") was himself a dour, straitlaced academician. As a professor of classics at the General Theological Seminary in New York City, Clement C. Moore's most notable work prior to "A Visit from St. Nicholas" was a two-volume tome entitled A Compendious Lexicon of the Hebrew Language.

Fortunately for us, the man had children.

Legend has it Moore composed "A Visit from St. Nicholas" for his family on Christmas Eve of 1822, during a sleigh-ride home from Greenwich Village. He supposedly drew inspiration for the elfin, pot-bellied St. Nick in his poem from the roly-poly Dutchman who drove his sleigh that day. 

... Moore, stodgy creature of academe that he was, refused to have the poem published despite its enthusiastic reception by everyone who read it. His argument that it was beneath his dignity evidently fell on deaf ears, because the following Christmas "A Visit from St. Nicholas" found its way after all into the mass media when a family member submitted it to an out-of-town newspaper. The poem was an "overnight sensation," as we would say today, but Moore would not acknowledge authorship of it until fifteen years later, when he reluctantly included it in a volume of collected works. He referred to the poem "a mere trifle."
Of course today, Twas The Night Before Christmas  is all Clement Clarke Moore is remembered for.

As Paul Harvey used to say, "And now you know the rest of the story."

Friday, December 20, 2013

Holiday Wishes

Christmas/Holiday Greetings to All Elected Officials - State and National

December 20, 2013

Dear Friends

Thus far, healthcare reform has been a debacle. From website crashes, security breaches, and mass cancellations of insurance plans, the new law has turned hope into anger and despair. Healthcare was supposed to be patient centered, with the doctor patient relationship at the center of everything. Now, patients assured of keeping their doctors are losing them. Patients assured of keeping their healthplans are losing them. In fact more are losing coverage than gaining coverage. No one is happy about any of this. I suspect that deep down, whether D or R, Left or Right, you too are unhappy as well.

Fear not, real help is on the way. A group of motivated physicians are working together to assemble a blueprint for the way forward – a reform of the reform if you will. This time, it is the real healthcare experts, the patients’ physicians who will lead the reform. All we ask for at this time is for your time, your attention and your support. I promise you it will be worth it.

Doctors are not looking for credit. What we are looking for is the solution. During this season of hope and renewal, be of good cheer. We will find the solution. Our patients are counting on it.

Thank you for your attention.



Monday, December 9, 2013

Health Insurance Does Not Assure Access To Care

The Mother of All Patient Access Battles is shaping up.

Americans who are buying insurance plans over online exchanges, under what is known as Obamacare, will have limited access to some of the nation’s leading hospitals, including two world-renowned cancer centres.

Amid a drive by insurers to limit costs, the majority of insurance plans being sold on the new healthcare exchanges in New York, Texas, and California, for example, will not offer patients’ access to Memorial Sloan Kettering in Manhattan or MD Anderson Cancer Center in Houston, two top cancer centres, or Cedars-Sinai in Los Angeles, one of the top research and teaching hospitals in the country.

After January 1, expect to see these signs in many doctors' offices.

Monday, December 2, 2013

It's For The Children

In today's NY Post, I come across this gem.

... Kelly said he was no fan of the Affordable Care Act, but when he received notice a few weeks ago that his current insurance plan was being canceled, he tried the New York State of Health Web site.

Kelly, 41, and his wife, Jennifer, 42, are self-employed and have always had to buy their own insurance. Kelly runs a title insurance business in Westhampton, and his wife is a pediatrician in private practice in Miller Place. “I initially went on with a lot of optimism,” he said.
Kelly said none of the plans offered out-of-network coverage, which was something he wanted. But even worse, they only covered his three older children, who are 3, 5 and 6.
When Kelly called a representative, he was told his daughter had to be 2 before she could be covered under a family plan. He would have to buy a separate plan for her, at monthly premiums that ranged between $117.21 and $369.31. The cost would be on top of a family plan with premiums ranging from $810.84 to $2,554.71 a month.
Let's back up a minute - pre-Obamacare - a family plan covered family members. Now, at least with one insurer in NY State, a family plan doesn't actually cover the family? And this is OK with NY State and the Feds? Who dreams up this mess, Old Man Potter from It's A Wonderful Life?
Head -> Desk.