Choosing The Most Effective Medicare Supplement Insurance Texas

Posted by:  :  Category: Medicare

An aging population needs more health care attention so as to remain in good health. What this implies is that the veterans are bound to spend more of their retirement savings on the medical expenses. Turning to insurance companies for health insurance can prove very decisive. There are quite a number of health insurers who offer supplements, and at times it can be a challenge to pick the one that suits your interest. It is imperative that before choosing the right medicare supplement insurance Texas people do research to have enough knowledge of the types that are available in the market.
Source: submititr.com

Video: Medicare Supplements in Texas: What to Look For When Choosing a Plan

Asterisk Predictive Dialer

There can be varied Texas Medicare Supplements and it really is can also straightforward method to select 1. The very first step would be to pick up a plan according to the individual’s requirements. Once the coverage is decided, then the premiums and compensated which has a large amount of advantages. The key advantage in the http://www.texasmedigapinsurance.com/texas-medicare-supplement is the fact that the consumer can bear treatment from any on the physicians who take medicare. Men and women can also get in touch with the officials totally free if in situation you can find any obligations. There are actually loads of factors which should be viewed as prior to selecting a program from Texas Medicare Supplements. As these ideas are effortless, very easy and simple to get, people today really should seek out the amount which is past the original capital. Generally, each of the firms can deliver premiums at a very low fee for the consumers along with the premiums may very well boost as they grow old. As the rates may well vary from corporation to corporation, people today can choose the business offering reduce high quality prices. This may perhaps be valuable for consumers these who usually do not come across the best plan inside the right organization, because the similar plan may be available in a distinctive price at a several organization. One can find also lots of agents helping persons for availing the Texas Medicare Supplements. The very best technique to avail the dietary supplements is together with the assist of those brokers, because they may well have make contact with with unique companies and could aid many people in getting the proper health supplement plan. You can find generally two components on the Medicare. One will be the element A plus the other is Portion B. Component A strategy offers medicare supplements for inpatients and hospital treatment. Component B offers the medicare supplemental for out sufferers. Hence the Texas Medicare Supplements are benefitiary for every one of the people since it could cut down the top healthcare costs.
Source: multiply.com

Choosing The Most Effective Medicare Supplement Insurance Texas

As people grow older, they need more medical attention in order to remain in perfect shape, and this normally means that they have to spend more of their retirement savings on medical cost. To avoid this, they can turn to insurance companies. Several supplement programs are available in the market for those seeking health covers. This means that it can be quite overwhelming to pinpoint a single program that meets all your health needs. When choosing the right medicare supplement insurance Texas residents must first understand the different programs that abound.
Source: healthycorners.com

Social Networking Community

Insurance schemes and extra advantages of schemes are topic to transform based upon the country and organization. It was crucial to evaluate each and every scheme before using any kind of insurance coverage like health, vehicle, residence and daily life. Ways to decide finest scheme was briefed in on-line internet site with illustrations and on the internet movies. Wellness problems, injuries, disasters might arise without having any indications to keep track of the daily life with financial help, insurance coverage policy was helpful. Primarily based upon interest of folks, Texas Medigap ideas developers give help and sufficient facts of particular policy. Soon after certain age everybody suffers lot of complications because of pressure, perform pressure and residing atmosphere. As a way to overcome complications attributable to above elements people today have to spend particular health care amount but if they take right insurance coverage it aids to remain absolutely free from financial crisis. General details about Medicare Supplement Texas talked about by well being scientists supports to clarify the health complications alongside strategies to avail the insurance at appropriate time period. Coinsurance procedures give large amount of advantages with cost savings to client. By mentioning the name, deal with, message and well being challenges 1 can converse the well being supporters belong to Medigap supplement team. Prescription medication brochures translated by authors in various languages also in solitary look readers get unique interest on subjects covered below Medicare complement Texas. By creating chart or table with columns like Medicare components, extra charges and deductible array on can fully grasp the benefits of the coverage. Aside from United states, individuals from international countries also favor Medicare supplement due to its supports and ease. Reaction of customer executives plays an important role for enlarging customer assistance. Rankings given by patients about Medigap plans makes straightforward to know the advantages and make use of through emergency time period. Strategies provided by pros are supportive to meet representatives at shorter span and take care of from health challenges.
Source: younetco.com

What Are My Options For a Texas Medicare Supplement?

Residents of Texas that choose Plan F or Plan G will have their deductible for Medicare Part A paid for hospital stays and coinsurance. Skilled nursing facility coinsurance and travel care for foreign trips is also covered. The selection of Plan K and Plan L will offer a low-cost option to residents that are cost-sharing plans. These plans require paying more for covered costs with premiums that are lower. You may have different plan options from another insurance company.
Source: seniorcorps.org

A Petit Depiction About Texas Medicare Supplements And Some Of Its Essential Positive Aspects

You will find numerous medical insurance coverage companies in Texas and virtually the many firms supply the identical plans. Medigap insurance of Texas gives must improved insurance coverage ideas than other firms. They recognize the complications from the people today and they give healthcare insurance coverage at decrease expense. One particular may also evaluate the prices of any top rated firm with Texas Medigap insurance coverage. When they evaluate the prices people discover that Texas Medigap insurance coverage would be the best one particular. 1 can get a estimate conveniently from your on line formal site. To have a estimate the particular person should specify if he is usually a smoker. The person need to be sixty five or over in age to use the medicare supplemental. It really is difficult to acquire dollars when the person calls for it for healthcare unexpected emergency. The healthcare insurance can help the Texas people to some better extent. The best medicare supplemental insurance schemes could be found in Texas Medigap insurance enterprise. The plans readily available within this heart may also be out there in all the medical insurance corporations. The price of strategy F shall be very same in each of the insurance organizations but Texas Medigap provides the same plan at minimal price. Strategy F has greater premium than plan G. Once the age is more than 70 then they can decide on strategy F. When the income on the particular person is pretty much less then he can pick program F. This insurance organization is started out with a motive to help other folks. Specially the people over 65 are economically weak and so they don’t have a excellent wellness too. The principle motive of Texas Medigap insurance will be to support folks over sixty five years. The telephone quantities on the brokers are readily available within the internet site and one can contact them at anytime to make clear the doubts. The brokers consider duty to explain obviously all of the points about medical insurance coverage.
Source: magniloquent.info

A Petit Depiction About Texas Medicare Supplements And A Few Of Its Vital Benefits

There are actually quite a few healthcare insurance providers in Texas and virtually every one of the companies present the same plans. Medigap insurance of Texas delivers ought to improved insurance plans than other corporations. They understand the challenges on the people today plus they give healthcare insurance coverage at reduced expense. 1 may also evaluate the prices of any leading corporation with Texas Medigap insurance. When they evaluate the rates persons find that Texas Medigap insurance coverage is the best one particular. One can get a quote simply from the on-line official site. To get a estimate the individual ought to specify if he is actually a smoker. The particular person will have to be 65 or over in age to make use of the http://texasmedigapinsurance.com/texas-medicare-supplement. It can be tricky to get cash once the individual needs it for healthcare crisis. The healthcare insurance coverage may help the Texas men and women into a higher extent. The very best medicare supplemental insurance schemes can be found in Texas Medigap insurance coverage enterprise. The ideas readily available in this center are also accessible in the many healthcare insurance coverage organizations. The rate of program F might be same in all the insurance coverage corporations but Texas Medigap offers the exact same plan at very low price. Program F has greater premium than strategy G. When the age is more than 70 then they can decide on plan F. When the earnings in the individual is really less then he can choose strategy F. This insurance coverage company is started having a motive to help others. Particularly the men and women above sixty five are financially weak and so they don’t have a superior well being also. The key motive of Texas Medigap insurance coverage would be to assistance people over sixty five many years. The phone numbers with the brokers are readily available within the web page and a single can get in touch with them at whenever to explain the doubts. The agents take responsibility to explain clearly every one of the points about healthcare insurance coverage.
Source: thatshowthecookiecrumbles.info

MEDICARE SUPPLEMENT INSURANCE, WE PROVIDE THE LEADS, WORK FROM HOME! (FL, TX, MS, LA

*** Become one of our Sales Reps for Medicare Supplemental Insurance over the telephone and work from home. Contact our leads who have requested more information from us. We are currently selling in Mississippi, Louisiana, Texas a […]
Source: telecommuteanywhere.com

California insurance firm over billed Medicare $424 million

Posted by:  :  Category: Medicare

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Source: calcoastnews.com

Video: Medicare Physician Feedback Program: Payment Standardization and RIsk Adjustment

Looking at Medicare Risk Adjustment

The American health system and its associated payers have numerous challenges. Just look at the reports derived from data that has been through Medicare risk adjustment. Going to the doctor or staying in a hospital is just too costly, while quality is only addressed in a moderate manner. Lawmakers in the US recently passed the Affordable Care Act in an effort to curtail costs. Nevertheless, people still need costly procedures. They need them by the millions. Technology helps out more keeping people alive longer and visiting the hospital more often. That is a great blessing, and it is a challenge to afford it—a challenge we can meet.
Source: physiciancodingtraining.com

Capturing Good Encounter Data Makes Risk Adjustment Work

The Department of Health and Human Services works each day to find ways to reduce payment to Medicare Advantage plans by reducing utilization and ensuring they are not paying for unnecessary services or procedures. When the government pays Medicare Advantage insurers less because the firm cannot produce the encounter reporting to justify a higher amount the firm loses dollars. Health plans have become very assertive and smart about making sure they find the encounter data justifying the payments they know they should receive. Now it is increasingly vital that all beneficiaries have the correct codes applied documenting their visits. All procedures and treatments applied to a Medicare patient must be properly recorded and coded. With a major weight upon retrospective risk adjustment for investigating and auditing, all the procedure and diagnostic codes are recorded in a manner to be transmitted to the payer (and eventually to Medicare).
Source: care-continuity.com

Medical Encounter Reporting Ripple Effects

Encounter reporting starts at gathering encounter data. This is all information that is collected and logged onto a patient charts at the time of interaction between healthcare facility or provider and patient. The more extensive and comprehensive this patient medical data is, the more beneficial it can be not only to the patient and their healthcare treatment, but also to the healthcare provider and the medical facility. Encounter data is reported to health insurance firms as well as other government payers as a way to calculate proper reimbursement for services rendered.
Source: medicare-risk-adjustment.com

In Florida, Obama Talks Medicare

Posted by:  :  Category: Medicare

CNN: Medicare Takes Center Stage For Obama Campaign In Florida  In the senior-heavy coastal city of Melbourne on Sunday, President Barack Obama, armed with a new study, continued to hammer the Republican plan to reform Medicare. He highlighted a Harvard analysis, conducted by a former Obama adviser, that found seniors would pay more under the “Romney-Ryan plan,” compared to his plan, which he said will strengthen the entitlement program. Obama said GOP nominee Mitt Romney wants to “give money back to insurance companies and put them in charge of Medicare.” “Their voucher plan for Medicare would bankrupt Medicare. Our plan strengthens Medicare,” Obama told a crowd of 3,050 gathered at a sports and recreation center. “No American should have to spend their golden years at the mercy of insurance companies.” The focus on Medicare on Sunday was the latest effort by the president and his campaign to turn up the noise around the program and throw Romney off his message on jobs and the economy, especially important as the president continues to make a play for the senior vote ahead of the November election (9/9).
Source: kaiserhealthnews.org

Video: How to Apply For Medicaid in Florida Online

South Florida Pharmacy Owner Pleads Guilty to $23 Million Health Care Fraud Scheme

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Source: wordpress.com

Is it a Revolution to Talk About Medicare Means Testing When Medicare is Already Means Tested?

House Minority Leader Nancy Pelosi could also prove an obstacle to new means testing in a fiscal-cliff bill. On Thursday, the California Democrat argued that entitlement reform should not be a part of the lame-duck negotiations. She’s calling instead for Congress to tackle those issues next year as part of a broader tax-and-spending package. “That should be left to next year,” she said. “That’s a longer conversation about where we go [on entitlements].”
Source: reason.com

Florida psychiatrist convicted in $50 million Medicare fraud scheme

Antonio Macli, the owner of Biscayne Milieu Health Center Inc., a mental health care corporation, his son Jorge Macli, Biscayne Milieu’s CEO, and Antonio Macli’s daughter Sandra Huarte, an executive at the company, were each found guilty in U.S. District Court for the Southern District of Florida of one count of conspiracy to commit health care fraud, and one or more substantive counts of health care fraud, conspiracy to commit a health care kickback scheme and conspiracy to commit money laundering and substantive counts of money laundering.   Antonio Macli and Jorge Macli were also convicted of substantive kickback counts.  Dr. Gary Kushner, the medical director at Biscayne Milieu, was found guilty of conspiracy to commit health care fraud and a substantive count of health care fraud.  Rafael Alalu, a therapist, and Jacqueline Moran, who handled Medicare billing for Biscayne Milieu, were each found guilty of conspiracy to commit health care fraud and substantive  counts of health care fraud.  Anthony Roberts and Derek Alexander, two patient recruiters, were each found guilty of one count of conspiracy to commit a health care kickback scheme, and each was convicted of one health care kickback count.
Source: pathologyblawg.com

Rubio: Ryan’s Medicare Plan Helps Romney in Florida

When Mitt Romney tapped Paul Ryan to be his vice presidential running mate, conventional wisdom dictated that Romney had put himself at a distinct disadvantage in the key battleground state of Florida, where Ryan’s controversial plan to reform Medicare wouldn’t sit well with millions of government-dependent seniors. Florida Sen. Marco Rubio isn’t buying it. In an interview with National Journal, Rubio argued that Ryan’s proposal will help — not harm — Romney’s chances of winning the Sunshine State. He predicted that older voters will support Romney and Ryan because they are trying to “save Medicare” instead of pretending that nothing is wrong with the fiscally unsustainable program. “Look, you have three million people in the state who are on Medicare — one of whom is my mom, one of whom is Paul Ryan’s mom,” Rubio said. “These are people who understand the reality of Medicare: that it’s spending more money than it takes in; that anyone who’s in favor of leaving it the way it is is in favor of bankrupting it.” Rubio praised the GOP ticket for tackling the hot-button topic of entitlement reform at a time when many politicians won’t acknowledge the problems facing the Medicare program. “They’re looking for real solutions on how to solve this,” Rubio said. “Mitt Romney and Paul Ryan are offering a way to save Medicare that doesn’t change it at all for current beneficiaries. And I think people here are going to be excited about that.”
Source: nationaljournal.com

Medicare Mistakes To Avoid

Failing to shop around is the biggest and most common mistake that people make when it comes to Medicare, or any health insurance plan for that matter. An Advantage plan may offer extra coverage for dental care, eyeglasses, health club memberships, hearing aids, or prescriptions. Most Advantage plans do cover medication. Original Medicare rarely does so. You might find a plan that would pay for a lot more of your healthcare than original Medicare, but you’ll never know unless you see what’s available. Also, the benefits offered by an advantage plan can and often does change from year to year.
Source: floridahealthinsurancebroker.com

CMS Reveals First 27 ACOs in Medicare Shared Savings Program

The ACOs span 18 states and will cover roughly 375,000 beneficiaries. Five of the 27 ACOs are participating in the Advance Payment ACO Model, under which each ACO will receive advance payments to help cover the costs of establishing an ACO infrastructure. The names of the Advance Payment ACOs were not disclosed in the news release. CMS is now reviewing more than 150 applications from ACOs seeking to participate in MSSP beginning July 1. Of those applicants, more than 50 are applying for the Advance Payment ACO Model. The first 27 ACOs to participate in the MSSP program are listed here, along with their respective locations: 1. Accountable Care Coalition of Caldwell County, LLC (N.C.) 2. Accountable Care Coalition of Coastal Georgia 3. Accountable Care Coalition of Eastern North Carolina, LLC 4. Accountable Care Coalition of Greater Athens Georgia 5. Accountable Care Coalition of Mount Kisco, LLC (N.Y.) 6. Accountable Care Coalition of the Mississippi Gulf Coast, LLC 7. Accountable Care Coalition of the North Country, LLC (N.Y.) 8. Accountable Care Coalition of Southeast Wisconsin, LLC 9. Accountable Care Coalition of Texas, Inc. 10. AHS ACO, LLC (N.J.) 11. AppleCare Medical ACO, LLC (California) 12. Arizona Connected Care, LLC (Arizona) 13. Chinese Community Accountable Care Organization (N.Y.) 14. CIPA Western New York IPA, doing business as Catholic Medical Partners (N.Y.) 15. Coastal Carolina Quality Care, Inc. (N.C.) 16. Crystal Run Healthcare ACO, LLC (N.Y. and Pa.) 17. Florida Physicians Trust, LLC 18. Hackensack Physician-Hospital Alliance ACO, LLC (N.J.) 19. Jackson Purchase Medical Associates, PSC (Ky.) 20. Jordan Community ACO (Mass.) 21. North Country ACO (N.H.) 22. Optimus Healthcare Partners, LLC (N.J.) 23. Physicians of Cape Cod ACO (Mass.) 24. Premier ACO Physician Network (Calif.) 25. Primary Partners, LLC (Fla.) 26. RGV ACO Health Providers, LLC (Texas) 27. West Florida ACO, LLC
Source: beckersspine.com

Looming Medicare cuts may greatly affect Florida’s hospitals

As I watched the presidential candidates talk about sequestration during their last debate, I couldn’t help but wonder if the average citizen really understands the potential effect of sequestration on healthcare. The sequester, under the Budget Control Act of 2011, is set to begin on January 2, 2013 unless Congress comes up with another solution to cut $1.2 trillion, yes that is trillion with a “t”, in federal spending over the next ten years. Working in healthcare policy, sequester has become a word used on a daily basis as these automatic cuts would have a serious effect on Medicare reimbursement for providers like Orlando Health. However, when I listen to the media, it seems the main focus of the discussion revolves around the military spending cuts rather than the other cuts included in the legislation. Please understand, by no means am I trying to downgrade the significance of the military cuts—a 10 percent cut to mandatory military spending is novel. My goal here is to not downgrade the detrimental power of any of these automatic cuts, but to specifically highlight the threat that these cuts have on Medicare reimbursements.
Source: winniepalmerhospital.com

In Florida, Medicare is not a senior

The law does not lower the bottom-line of future Medicare spending but reallocates some of what would have been spent under old rules. The reductions come mostly from payments to providers and private insurers who offer plans in lieu of traditional Medicare. The money will cover annual physicals, preventive care and more generous prescription drug coverage. Republicans argue that fewer physicians and hospitals will accept Medicare, meaning fewer services. Obama argues that better access to preventive care and drugs will prevent more expensive hospitalizations.
Source: dailycaller.com

UniCare to Reimburse AHIP Online Certification Course Fee

Posted by:  :  Category: Medicare

[…] UniCare recently announced that we would be using the new AHIP Certification Course to meet CMS requirements for marketing representative certification. The cost of this course is $149. However, UniCare was able to secure a negotiated rate of $100 which we pass on to you.Source: ritterim.com […]
Source: ritterim.com

Video: Unicare Medicare Advantage Plans – Compare to 180+ Companie

Medicare Targets Health Plans With Low Ratings

Medicare officials are encouraging 525,000 beneficiaries to switch out of these 26 Medicare Advantage and drug plans that have received low ratings for three consecutive years and enroll in better plans for next year. The poor performing plans will have this warning symbol next to their names on Medicare’s plan finder website to steer shoppers to other plans.
Source: kaiserhealthnews.org

CMS Letter on Poor Performing Medicare Advantage Plans

CMS has also created an SEP allowing beneficiaries one chance to move from a “poor” performing plan to one that is rated 3-Star or higher after January 1, 2013.  This SEP is not agent driven however, so in order for someone to take advantage of this, the individual must call 1-800-MEDICARE. There are no timeframes, end dates, etc. associated with this SEP and CMS will be granting the SEP on a case-by-case basis. Beneficiaries will be receiving letters regarding this as well.
Source: agentpipeline.com

UniCare MedicareRx Rewards Part D

Alabama, Alaska, Arizona, Arkansas, Connecticut, Delaware, Florida, Hawaii, Idaho, Illinois, Iowa, Kansas, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Montana, Nebraska, New Jersey, New Mexico, New York, North Carolina, North Dakota, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Washington, Washington D.C., West Virginia and Wyoming.
Source: affordablemedicareplan.com

WellPoint To Transfer UniCare Blocks

The old WellPoint Health Networks Inc., Woodland Hills, Calif., one of the companies that merged to form WellPoint Inc., created the UniCare business in 1995 to hold health insurance operations outside of California. Much of the business in the unit was acquired from Massachusetts Life Insurance Company, Springfield, Mass., in 1996 and from John Hancock Mutual Life Insurance Company, Boston, in 1997. Also today, WellPoint:
Source: lifehealthpro.com

insurance: MEDICARE ADVANTAGE/MEDICARE HEALTH PLANS

Medicare Advantage/Medicare Health Plans SHIIP Publications: Frequently Asked Questions About Medicare Advantage PFFS Plans Is A Medicare Advantage Private-fee-for-service Plan Right For Me Medicare Advantage Comparison Guide (2008) Your Guide To Medicare Private-fee-for-service Plans Medicare Advantage Summaries of Benefits SHIIP Publications: Aarp Medicarecomplete Choice Aarp Medicarecomplete Plus Plan 1 Aarp Medicarecomplete Plus Plan 2 Advantra Freedom – Plan 1, Plan 2 (005), Plan 5 (001) Advantra Freedom – Plan 2 (010),plan 3 (006-013), Plan 5 (002) Advantra Savings (msa) – Plan 1 Aetna Medicare Open Plans America’s 1st Choice – Patriot Plus And Presidential Plus America’s 1st Choice – Patriot-presidential Blue Medicare HMO Plans Blue Medicare PPO Plans Cigna Medicare Access Plans One, Two And Three – Version A Cigna Medicare Access Plans One, Two And Three – Version B Cigna Medicare Access Plans One, Two And Three – Version C Cigna Medicare Access Plans One, Two And Three – Version D Evercare – Dh – Special Needs Plan Evercare – Ih – Special Needs Plan Evercare – Mh – Special Needs Plan Fidelis – Secure Comfort – Special Needs Plan Fidelis – Secure Comfort Plus – Special Needs Plan Fidelis – Secure Independence – Special Needs Plan Health Net Pearl – Plans 009-014-015 Healthmarkets Care Assured Plans Humana – Special Needs Plan Humana Goldchoice – H1804 -216 Sb08 Humana Goldchoice – H1804-007 Sb08 Humana Goldchoice – H1804-016 Sb08 Humana Goldchoice – H1804-217 Sb08 Humana Goldchoice – H1804-278 Sb08 Humana Goldchoice – H1804-279 Sb08 Humanachoiceppo – H3405-001 Sb08 Humanachoiceppo – H3405-002 Sb08 Humanachoiceppo – Regional – R5826-003 Sb08 Securehorizons Medicaredirect Plan 3 Securehorizons Medicaredirect Plan 3a Securehorizons Medicaredirect Rx Plan 51 Securehorizons Medicaredirect Rx Plan 51a Securehorizons Medicaredirect Rx Plan 54 Securitychoice Classic-enhanced-plus-enhance Plus – Area A – Securitychoice Classic-enhanced-plus-enhanced Plus – Area B Securitychoice Essential-essential Plus Southeast Community Care – Dual Plus Plan – Special Need Plan Southeast Community Care – Plus Plan Sterling Option I Sterling Option Ii Sterling Option Iii Sterling Option Iv Today’s Options – Basic Plus, Value Plus, Premier Plus Today’s Options – Basic, Value, Premier Today’s Options Powered By Ccrx Unicare 2008 Msa Summary Benefits WelLCare Benefit Summary A WelLCare Benefit Summary B WelLCare Benefit Summary C WelLCare Benefit Summary D WelLCare Benefit Summary E
Source: blogspot.com

Getting Insured at Home & World

Many companies offer CIGNA insurance as part of their group coverage. This is because the company is widely accepted throughout the United States and has a variety of different coverage available. CIGNA offers both a HMO and a PPO by way of coverage. The PPO coverage allows the insured to choose their own doctor and not have to rely on doctors that are in the network. HMO coverage only allows the insured to choose doctors that are in their own network.
Source: 4healthinsurance.com

Medicare Updates for 2011

What article on Medicare Part D would be complete without mentioning Humana.  There I have just mentioned it. Just kidding, Humana has good news also.   The Humana Value plan which was priced at $18.60 in 2010 has been rebranded and repriced for 2011.  It is now the Humana Walmart Preferred Rx Plan with a reduced price of $14.80. I guess the little yellow price slasher at Walmart has been at work once again. The plan ID numbers are the same, so technically it is the same plan but the benefits are totally different from 2010. For example, it has a $310 deductible for all drug tiers, but then many generics are priced at only $2 for a 30 day supply at Walmart or $10 at any other local pharmacy. When I first saw that I thought “What, that is a huge advantage for Walmart.” Then I read the fine print. The $2 co-pay is only for the generics on the Walmart $4 drug list, and other stores either have their own $4 list like QFC, or will match prices. But I still applaud Humana and Walmart for innovative thinking.
Source: wordpress.com

edelweiss tokio life insurance: Pingback: unicare Serwis

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Source: blogspot.com

Deadline looms for Medicare enrollment

Posted by:  :  Category: Medicare

The Medicare Advantage disenrollment period runs Jan. 1 to Feb. 14. During that time you can leave your Medicare Advantage Plan to switch to original Medicare. If you switch to original Medicare during this period, you’ll have until Feb. 14 to join a Medicare Prescription Drug Plan to add drug coverage. Your coverage will begin the first day of the month after the plan gets your enrollment form. However, during this period, you cannot switch from original Medicare to an advantage plan or from one advantage plan to another; join, switch or drop a Medicare medical savings account; or change the prescription drug plan.
Source: superiortelegram.com

Video: SHIIP Medicare Enrollment Basics.flv

Medicare Open Enrollment: last chance to review and compare plans

With the holiday season upon us, it’s easy to get busy this time of year. Some pretty important tasks can get left to the last minute. One of those important tasks is ensuring you are in the right health insurance plan in Medicare.  Selecting the right plan is a personal choice, and a lot of thoughtful consideration goes into finding the right match.  But just like the holidays, those key dates come whether or not you are ready.
Source: medicare.gov

Resource Center for Religious Institutes: Medicare Open Enrollment Period Closes Tomorrow!

Note that you can join a health or drug plan under Medicare when you first get Medicare (initial enrollment periods for Part C & D), such as when you turn age 65. Each year, you have a chance to make changes to your Medicare Advantage or Medicare prescription drug coverage for the following year. There are 2 separate enrollment periods each year. According to the Medicare website:
Source: blogspot.com

Office of Statewide Benefits provides information on Medicare Parts A, B enrollment

Failure to enroll and maintain enrollment in Medicare Parts A and B upon eligibility may result in the subscriber being held financially responsible for the cost of all claims incurred, including prescription costs. Retirees and spouses enrolled in Medicare Parts A and B must provide a copy of their Medicare Identification Card to be enrolled in the state of Delaware Special Medicfill plan.
Source: udel.edu

With 3 days left in Medicare’s Annual Enrollment Period, what can you do to save money on Medicare in 2013?

When we looked at the customers who used PlanPrescriber.com during the first three weeks of this year’s AEP, we found that only 8% were in the Medicare prescription drug plan (PDP) or Medicare Advantage prescription drug plan (MAPD) plan with the lowest total out-of-pocket costs available to them.
Source: ehealthinsurance.com

NHMSP: The Day has Arrived

Visit www.nhcoa.org/medicare for more information about Medicare fraud and how to get involved with the National Hispanic Seniors Medicare Patrol (NHSMP), or call us at 1-866-488-7379. Also remember you still have a day to take advantage of Medicare Open Enrollment. Call Medicare at 1-800-MEDICARE or visit www.medicare.gov to make an informed decision using the Medicare Plan Finder.
Source: nhcoa.org

Medicare open enrollment: Did Obamacare secretly increase Part B premiums?

Here’s what’s happening. The 2003 law that set up these high-income premium surcharges also stated that the income thresholds were to increase every year to account for general inflation. But the Affordable Care Act freezes the thresholds at their current level through 2019, which will over the next six years snare more and more beneficiaries as incomes in general rise (or at least we hope they do). The Kaiser Family Foundation estimates that by 2019, about 14 percent of Medicare beneficiaries will be paying these higher premiums.
Source: consumerreports.org

More Time to Enroll in Medicare If You Live in Storm Areas

Thanks to the marvels of medical science, our parents are living longer than ever before. Adults over age 80 are the fastest growing segment of the population; most will spend years dependent on others for the most basic needs. That burden falls to their baby boomer children. In The New Old Age, Paula Span and other contributors explore this unprecedented intergenerational challenge. You can reach the editors at newoldage@nytimes.com.
Source: nytimes.com

Part D Offers Enrollment Flexibility for People Affected by Hurricane Sandy

If you, or someone you rely on for help with Medicare decisions, were affected by Hurricane Sandy, Medicare can help. If the storm caused you to miss the enrollment deadline, you can still make a plan choice for 2013. Medicare will help you enroll in a plan. If you call before December 31st, your coverage will start January 1, 2013.
Source: phrma.org

I’m an MS Activist: REMINDER: MEDICARE OPEN ENROLLMENT ENDS DEC. 7TH

If you are a Medicare beneficiary who was impacted by Hurricane Sandy, the Centers for Medicare and Medicaid Services (CMS) is making accommodations to ensure that all Medicare beneficiaries can enroll in the health and drug plans that are best for them.
Source: blogspot.com

Medicare Open Enrollment: Seize Your Opportunity

Your health and medication needs can change from year to year and health plans may also change their benefits and costs. That’s why it’s important to evaluate your Medicare choices during open enrollment. A good first step is to learn more about the available plans and how they can best meet your current and future prescription drug and health needs.
Source: sundaynewscape.com

Medicare Home Health: Medicare Supplement Insurance

Posted by:  :  Category: Medicare

For all others, the standard Medicare Part B monthly premium will be $115.40 in 2011, which is a 4.4% increase over the 2010 premium. The Medicare Part B premium is increasing in 2011 due to possible increases in Part B costs. If your income is above $85,000 (single) or $170,000 (married couple), then your Medicare Part B premium may be higher than $115.40 per month. For additional details, see our FAQ titled: “2011 Part B Premium Amounts for Persons with Higher Income Levels”.
Source: blogspot.com

Video: Choosing A Medicare Supplement in Fl in 2011

Future Growth of Medicare Supplements

First off, if you sell Medicare Supplements, you should read this report.  CGS does a great job of explaining the market.  It’s packed with easy to understand information, graphs and data tables.  It only takes about 15 minutes to read and it gives you a better understanding of who is buying Medicare Supplements and why.
Source: agentpipeline.com

Aetna to buy Genworth’s Medicare Supplement business

In an important move in the Medicare Supplement market, Aetna has announced today that they have entered into an agreement with Genworth Financial to acquire Genworth’s Medicare Supplement block of business.  According Aetna’s CEO and President, Mark T. Bertolini, “By acquiring this business, Aetna will significantly expand its footprint in the Medicare Supplement business”.  
Source: wordpress.com

2011 Medicare Supplement Coverage: Medigap Plan Numbers A

In 2011, Plans K, L and M do not cover 100% of all benefits at all times. Plan K covers 50% of Part B coinsurance/copayments, blood, Part A coinsurance/copayments for hospice care, coinsurance for skilled nursing facility care and the Part A deductible. Plan L gives 75% coverage for these benefits. Both of these options have yearly out-of-pocket limits of $4,640 (K) and $2,320 (L). Once you meet these limits (and any annual Part B deductible), plans will pay 100% for the rest of the year. Plan M restricts coverage of the Part A deductible to 50%.
Source: suite101.com

How Do I Get Started in Selling Medicare Supplements?

Are you an Insurance Agent Forum member yet? To sign up for your FREE INSTANT account, fill out the form below! Username:     Password:   Confirm Password:     E-Mail:   Confirm E-Mail:     Question of the day:   Which holiday is on Dec.25-th ? Agree to forum rules 
Source: insurance-forums.net

Senior Benefit Services, Inc.

Effective November 1, 2012 on new business & in force business for Family Life Insurance Company 1990 and 2010 Modernized Medicare Supplement plans in Georgia. The Rate Adjustment will affect ALL Plans.
Source: srbenefit.com

MedicareIsSimple: UHC Maintains Medicare Supplement Growth

The Solution to Your Healthcare Needs Us Here at Medicare is Simple, we understand your needs. It is our mission to educate and enable you to choose among the best Medicare plans to find the policy that fits your requirements. Get free quotes instantly using our advanced quoting technology. You will receive multiple quotes from the most reputable carriers for you to compare online. Medicare Is Simple 233 W Main St Lewisville, TX 75057 800-442-4915 inf@medicareissimple.com
Source: blogspot.com

Medigap: Providing Financial Security and Peace of Mind for Medicare Beneficiaries

Proponents of limiting first-dollar coverage in Medigap often cite the findings from a 1970’s RAND experiment to make the case zero cost-sharing leads to higher health care spending.  AHIP commissioned a white paper to examine the relevance of this study to current Medicare beneficiaries. The white paper found that the RAND study “was set in a reimbursement environment far different from today’s Medicare,” and noted that “a higher proportion of Medicare beneficiaries are low income (and low wealth), and so the impact of higher cost-sharing may be magnified for this population.” The authors conclude that “an across-the-board ban on first-dollar coverage Medigap plans is an overly blunt tool for lowering healthcare expenditures and invites adverse, unintended consequences.”
Source: ahipcoverage.com

Exclusive Medicare Supplement Leads

Speaking of Medicare supplement leads, let’s just take a moment to mention exclusive Medicare supplement leads. Maybe you have already heard about exclusive Medicare supplement leads, and not in a good way. Perhaps a colleague told you about the time they got ripped off by some company that said their leads were exclusive, but really sold them to at least seven other agents. Those are NOT exclusive Medicare supplement leads. But YES, there IS such a thing as exclusive leads. You just have to know where to find them. Shop around for a company that knows what it is doing, check out their programs, and ask lots of questions, after all, it’s your money. If you don’t get something they are telling you, then keep asking even more questions, until you understand how their lead system works and what the differences are between regular leads and the exclusive ones. In other words, you want to buy your leads from a company that when it says “exclusive” leads, they MEAN exclusive to ONLY you.
Source: benepath.net

Common Questions About Medicare Supplement Plans

Enrollment is Not Always Guaranteed: Medicare Supplement insurance is regulated by the states, so there will be eligibility differences based on where you live. For example, in New York, most applicants must be accepted anytime, while in other states all applicants must be accepted only within their first six months of eligibility for Medicare Part B and in a few other situations. Outside of the eligibility periods, carriers are allowed to reject an applicant based on adverse health conditions. This means that if you apply at the wrong time, you may not be eligible for a Medicare Supplement policy.
Source: ehealthinsurance.com

Labor’s Edge Blog : State

Posted by:  :  Category: Medicare

San Diego, CA by Oggie DogDecember 2012 November 2012 October 2012 September 2012 August 2012 July 2012 June 2012 May 2012 April 2012 March 2012 February 2012 January 2012 December 2011 November 2011 October 2011 September 2011 August 2011 July 2011 June 2011 May 2011 April 2011 March 2011 February 2011 January 2011 December 2010 November 2010 October 2010 September 2010 August 2010 July 2010 June 2010 May 2010 April 2010 March 2010 February 2010 January 2010
Source: calaborfed.org

Video: California Medicare Supplement Insurance Plans 1-800-243-8100

Medicare allies take their message to Parliament Hill

The delegates were briefed by communication experts and the Canadian Health Coalition on our asks for the 2014 Health Accord: home and community care, pharmacare, and the enforcement of the Canada Health Act to protect universal health care from those looking to make a profit off sick Canadians. They also took a message to the Hill to stop the $36-billion cuts that the federal government will be taking from the Canadian Health Transfers, and the need to take pharmaceutical patent extensions out of CETA. Public health care needs federal leadership to ensure everyone has access to the full spectrum of care from cradle to grave.
Source: rabble.ca

A Need for Free Market Competition in Medicare

While limited government advocates would be expected to cheer this change, it would in fact have far greater negative impacts on the size of government.  Medicare’s prescription drug benefit (“Part D”) is notable in that it has come in over 40 percent under budget.  By making drug companies compete for seniors, market forces have delivered a far more efficient prescription drug benefit compared to Medicare’s hospital insurance and doctor visit components.
Source: capoliticalreview.com

Saving Medicare Through Premium Support

Comments are subject to approval and moderation. We remind everyone that The Heritage Foundation promotes a civil society where ideas and debate flourish. Please be respectful of each other and the subjects of any criticism. While we may not always agree on policy, we should all agree that being appropriately informed is everyone’s intention visiting this site. Profanity, lewdness, personal attacks, and other forms of incivility will not be tolerated. Please keep your thoughts brief and avoid ALL CAPS. While we respect your first amendment rights, we are obligated to our readers to maintain these standards. Thanks for joining the conversation.
Source: heritage.org

Counteroffer: Medicare, Social Security on the table as GOP issues new ‘fiscal cliff’ offer

Here at Maclean’s, we appreciate the written word. And we appreciate you, the reader. We are always looking for ways to create a better user experience for you and wanted to try out a new functionality that provides you with a reading experience in which the words and fonts take centre stage. We believe you’ll appreciate the clean, white layout as you read our feature articles. But we don’t want to force it on you and it’s completely optional. Click "View in Clean Reading Mode" on any article if you want to try it out. Once there, you can click "Go back to regular view" at the top or bottom of the article to return to the regular layout.
Source: macleans.ca

SinglePayerCentral: From SPnow

Some might be surprised that the for-profit healthcare system Dr. Coates criticizes so sharply is mostly paid for with our tax dollars. Through tax subsidies for private health insurance and for public employee health benefits, through direct government Medicare and Medicaid subsidies and through numerous other ways, our taxes pay around 60 percent of our current health spending, or as PNHP leaders Drs. Steffie Woolhandler and David U. Himmelstein say, we are “paying for national health insurance and not getting it.”
Source: blogspot.com

Is it a Revolution to Talk About Medicare Means Testing When Medicare is Already Means Tested?

House Minority Leader Nancy Pelosi could also prove an obstacle to new means testing in a fiscal-cliff bill. On Thursday, the California Democrat argued that entitlement reform should not be a part of the lame-duck negotiations. She’s calling instead for Congress to tackle those issues next year as part of a broader tax-and-spending package. “That should be left to next year,” she said. “That’s a longer conversation about where we go [on entitlements].”
Source: reason.com

California Labor Federation : Report: Lame Duck Congressional Deal to Cut Social Security Could Harm Millions of Californians

Oakland, California – According to a new report released by the AFL-CIO, nearly 5 million Californians could be negatively impacted if Congress attempts cuts to Social Security, including 662,232 people with disabilities and 364,365 children. Of the 11 million Californians who get their health care coverage from Medicaid, 4.4 million children and nearly a million seniors could be affected if the lame duck Congress makes cuts to Medicaid benefits.  Social Security, Medicare and Medicaid combined deliver $156.7 billion per year into California’s economy. As the so-called “fiscal cliff” approaches, members of Congress have suggested cutting these vital programs, even while calling for extending the tax cuts for the richest 2%. If those tax cuts are renewed, the richest 2% in California would receive an average tax break of $30,820, while the rest of Californians would receive an average of $1,440. The 2012 House Republican budget plan would cut federal support to California’s Medicaid program by at least $85 billion (22%) over 10 years.  “We can’t afford to let lame duck legislators in Washington play politics with our social safety net,” said California Labor Federation Executive Secretary-Treasurer Art Pulaski. “We need to protect Medicare, Medicaid and Social Security benefits for those among us who need it the most. Retirees, people with disabilities and children shouldn’t have to suffer because some in Congress want to give more tax breaks to the richest 2%.  It’s time for the rich to pay their fair share, and it’s time for our elected officials to strengthen these and other vital programs that create jobs and support the middle class.”  California’s working families have been mobilizing around the lame duck session and will continue calling on Congress to end tax cuts for the richest 2% and to say no to cuts to Medicare, Medicaid and Social Security. For more information and highlights from the report, visit http://bit.ly/1119SsR. 
Source: calaborfed.org

How to Prepare for Medicare Decisions

Consider cost and coverage.  Some Medicare Advantage Plans (Medicare Part D) cover much of your overall health care costs and some even have exceptional medication programs to suit your needs.  If you are happy with your current Medicare coverage, make sure that the benefits for 2013 are what you need and can afford.  Ask your doctor what health plans they like and how satisfied are their enrollees.
Source: patch.com

Learn About Medicare Changes November 14

789with which a consensus emerged within hours t http://www.coachfactoryoutletonlinebc.org air force, Western governments have shown little appetite for http://www.coachoutletod.com new military ventures in such a complex Arab state.nd Russia and China, which have blocked http://www.coachfactoryoutletbo.net previous moves against Assad in the United Nations http://www.coachoutletpn.com swiftly to alter positions which call for dialogue with Assad and view opposition groups http://www.coachfactorystoredo.com as being in thrall to the West.egional power Iran, in whose Shi’ite brand of http://www.coachfactoryoutletsp.com Islam Assad’s Alawite minority has its religious roots, remains firmly behind the president http://www.coachoutletstorefb.com in a conflict which pits him against majority Sunni Muslims supported by Iran’s http://www.coachoutletstoreonlinert.com Sunni Arab adversaries.After long arguments over whether and how to form the new http://www.coachoutletonlinelc.net opposition assembly, the speed with whichttp://www.coachoutletonlinelon.com that Khatib stood unopposed for the post of president was notable and may encourage its http://www.coachoutletonlinelsa.com supportersHis deputies will be Riad Seif, a veteran dissident who had proposed the U.S.-backed initiative http://www.coachoutletrf.com to set up an umbrella group uniting groups inside and outside Syria, and Suhair al-Atassi, one http://www.coachfactoryonlinebp.com of the
Source: patch.com

Senior Care in Rio Linda, CA: Open Enrollment for Medicare –Now through Dec 7, 2012

Would a small increase in premiums result in a large reduction in health care costs you pay? Check, for example, what coverage is available for prescription drugs you take? Medicare representatives can create a report containing the costs and benefits of various insurance products if you supply them with a list of your drug prescriptions. Ask questions about participating doctors and clinics. Some Medicare Advantage plans limit which physicians a patient can visit.
Source: homecareplacersacramento.com

Obama Skeptical Of Raising Medicare Eligibility Age

“When you look at the evidence it’s not clear that it actually saves a lot of money,” he said in an interview with ABC News’ Barbara Walters aired Tuesday night. “But what I’ve said is let’s look at every avenue, because what is true is we need to strengthen Social Security, we need to strengthen Medicare for future generations, the current path is not sustainable because we’ve got an aging population and health care costs are shooting up so quickly.”
Source: talkingpointsmemo.com

Prices Rise As Hospitals Buy Medical Practices

Posted by:  :  Category: Medicare

'The election of Obama would, at a stroke, refresh our country's spirit' by Renegade98While compensation helps explain why many doctors have opted to join hospitals, other factors also play a role. By joining hospital systems, many overworked physicians have been able to shorten their work weeks and share on-call duties. Hospitals also take over complicated back office functions such as billing, negotiating with insurance companies and managing the expensive transition to electronic medical records.
Source: cbslocal.com

Video: Medicare Supplement Plan, Cary, Raleigh, Durham, Chapel Hill, Greensboro, Charlotte, NC

Medicare Part D Open Enrollment Clinics in Lenoir County

Lenoir County Seniors’ Health Insurance Information Program (SHIIP) operating under the NC Department of Insurance and in conjunction with Lenoir County Cooperative Extension will provide two counseling clinics during the week of December 3, 2012. This will be the last week of counseling clinics in Lenoir County for 2012. Medicare Part D Open Enrollment ends on December 7, 2012.
Source: ncsu.edu

MGMA releases analysis of final 2013 Medicare fee schedule for members

Diamond Level Platinum Level Gold Level rmsource, Inc. Wells Fargo Insurance Services Silver Level Ford Harrison Medical Protective SunTrust United HealthCare Group Bronze Level Allscripts Apex Technology Bactes Imaging Solution Biz Technology Solutions, Inc. Call-A-Nurse ChoiceHealth, Inc. CNP Technologies Computer Service Partners Coverys DataMax Eastman Kodak Company Fifth Third Bank Healthcare First Citizens Bank Gateway EDI GMK Associates, Inc. Gordon Asset Management, LLC Greenway Medical Technologies, Inc. Henry Schein Medical Humana, Inc. JBA Benefits (Allergy Services, LLC) LabCorp Management Services On-Call Marketing Works McNeary, Inc. Medicus Insurance Company MedLinks Transcription, Inc. MedWaste Solutions NCHA Strategic Partners One Source Document Solutions ONLINE Information Services Physician Discoveries Physicians’ Alliance of America Prince Parker & Associates Professional Recovery Consultants Solstas Lab Partners Stanley Benefits Stern & Associates The Doctors Company TriMed Technologies Corp Virtual OfficeWare, Inc./GE Healthcare
Source: wordpress.com

Page not found : Hoke County, North Carolina

The Hoke County Board of Social Services will hold an open meeting on Monday, December 17, 2012, at 4:00 PM in the Commissioner’s Room located in the Pratt Building, 227 N. Main Street, Raeford, NC. The public is invited to attend. For further information, please contact the Hoke County Department of Social Services at 910-875-8725.
Source: hokecounty.net

Medicare Nursing Home Ranking System Under Scrutiny in North Carolina

While not every injury case meets our criteria, we offer free initial confidential injury case consultation, so call us toll free at (800) 752-0042. If you cannot get through due to high call volume, please leave a voicemail so we can return your call.
Source: hsinjurylaw.com

CMS Reveals First 27 ACOs in Medicare Shared Savings Program

The ACOs span 18 states and will cover roughly 375,000 beneficiaries. Five of the 27 ACOs are participating in the Advance Payment ACO Model, under which each ACO will receive advance payments to help cover the costs of establishing an ACO infrastructure. The names of the Advance Payment ACOs were not disclosed in the news release. CMS is now reviewing more than 150 applications from ACOs seeking to participate in MSSP beginning July 1. Of those applicants, more than 50 are applying for the Advance Payment ACO Model. The first 27 ACOs to participate in the MSSP program are listed here, along with their respective locations: 1. Accountable Care Coalition of Caldwell County, LLC (N.C.) 2. Accountable Care Coalition of Coastal Georgia 3. Accountable Care Coalition of Eastern North Carolina, LLC 4. Accountable Care Coalition of Greater Athens Georgia 5. Accountable Care Coalition of Mount Kisco, LLC (N.Y.) 6. Accountable Care Coalition of the Mississippi Gulf Coast, LLC 7. Accountable Care Coalition of the North Country, LLC (N.Y.) 8. Accountable Care Coalition of Southeast Wisconsin, LLC 9. Accountable Care Coalition of Texas, Inc. 10. AHS ACO, LLC (N.J.) 11. AppleCare Medical ACO, LLC (California) 12. Arizona Connected Care, LLC (Arizona) 13. Chinese Community Accountable Care Organization (N.Y.) 14. CIPA Western New York IPA, doing business as Catholic Medical Partners (N.Y.) 15. Coastal Carolina Quality Care, Inc. (N.C.) 16. Crystal Run Healthcare ACO, LLC (N.Y. and Pa.) 17. Florida Physicians Trust, LLC 18. Hackensack Physician-Hospital Alliance ACO, LLC (N.J.) 19. Jackson Purchase Medical Associates, PSC (Ky.) 20. Jordan Community ACO (Mass.) 21. North Country ACO (N.H.) 22. Optimus Healthcare Partners, LLC (N.J.) 23. Physicians of Cape Cod ACO (Mass.) 24. Premier ACO Physician Network (Calif.) 25. Primary Partners, LLC (Fla.) 26. RGV ACO Health Providers, LLC (Texas) 27. West Florida ACO, LLC
Source: beckersspine.com

Importance Of Understanding Medicare Benefits

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Source: nchopecoalition.org

Romney confronts Ryan's Medicare question in N.C. rally

 I personal do not beleive mr romney about what he is saying with regards to the issue of their passing medicare cuts to the current budget with the help of the democrats not a true democrat anyway maybe with the help of some right winged winged nut of a democrat that is already so closely alinged with the repbulcians that he /she had may as well be a republican in the first place .  just another republican elephant posing as a donkey/ democrat by surely not a true democrat the democratic party in this state is better off with members of this nature for sure. they need to truely change their real registration to  reflect the actuakl way they feel an vote an stop posing as our current governor did as a democrat whenin fact they are republcians in the first place thank you
Source: newsobserver.com

AFLAC Medicare Supplement Insurance Plans Now Available for Sale in 27 States

All states except NY and FL are now available for recruiting. The final states recently added are WI, MN and MA. If you plan to recruit in these states make sure you are appointed. If you are not currently set up for any of these states and would like to be, please forward the State License you would like to be set up in and we will get you set up as quickly as possible.
Source: ihealthbrokers.com

Keeping an eye on Social Security and Medicare

When elected officials talk about the future of Social Security and Medicare, it’s usually a lot of “Washington-speak.” AARP is working to change that by making sure everyone in North Carolina understands what’s being discussed in Congress and has opportunities to express personal points of view. We’ve enlisted a broad range of experts from all political views to share their ideas so you can understand the pros and cons of leading proposals on the table in Washington.
Source: bluenc.com

Insurer halts Medicare Advantage sales in Georgia

Posted by:  :  Category: Medicare

Joe the Plumber - To Flush The System ... More scams aim to ensnare Brevard seniors - Their ingenuity is boundless, Archer said. (Jul 2, 2012) ... by marsmet524Public HealthHealth InsuranceHealth CostsHospitalsHealth ReformMedicaidDelivery of CareChildren’s HealthPhysiciansMental HealthSafety NetDisabilitiesCaregivingMedicareUninsuredHealth DisparitiesPrescription DrugsLong-Term CareNursesHealth QualityQuality of CarenursingRural Healthhospital
Source: georgiahealthnews.com

Video: Florida Medicare Advantage Plans – Supplement Health Insuran

What is a good Medicare advantage plan in the Ft Myers, Florida area?

The AARP plan is one option and can work for some folks. However you really will want to make sure to use network providers or else you wil get nailed hard for out of network co-pays. You can go to http://www.todaysmedicare.com and specifically requestt a plan compare of 3 different companies or more. Blue cross and humana have good plans also but you should get a plan compare to find out which plan will fit your specific needs
Source: aroundlee.com

Medicare Advantage Insurance Explained

The American Healthcare Education Coalition is a national, non-profit, public interest organization that pushes for free Market solutions to our healthcare issues.  According to the AHEC the affect of The Affordable Care Act (commonly known as Obamacare) is detrimental to Medicare Advantage, and their study of its negative impact shows the following:  Cuts to Medicare Advantage started right away in 2010 after the passing of The Affordable Care Act, with payment rates in 2011 being frozen at the 2010 levels. Medicare Advantage payment rates for doctors are being slashed from 2012-2017 and hospitals and medical providers will be cut in the government-managed, fee-for-service Medicare program. A portion of these cuts automatically get passed to Medicare Advantage Plans in the form of lower maximum rates.
Source: capeinthesand.com

medicare advantage plans in florida

Are you currently knowledgeable about the present medicare ppo plans? If you want to collect some helpful information on the topic, then you must pay us a trip on our new website and read the articles that people place online. Read around create a rational decision for your future.
Source: dealsbookmarks.com

MEDICARE ADVANTAGE PLAN PROBLEMS

Giving up Medicare Part A and Medicare Part B is necessary, because it allows the person to sign up with the insurance company that is selling the Medicare Advantage plan. This is a potentially dangerous sacrifice, considering the insurance company is not obligated to renew their contract with Medicare each year. If the insurance company did drop out of their Medicare Advantage contract, you would be dis-enrolled from that Medicare Advantage Plan and would have to start over looking for another one that met your needs adequately.
Source: floridahealthinsurancebroker.com

2013 Medicare Advantage Plans — Best Rated Florida Plans from AARP UnitedHealth, Blue Cross Blue Shield, Humana and Coventry

Now that open enrollment for 2013 has begun, seniors are looking for the best rated 2013  Medicare Advantage plans from large insurers like Blue Cross Blue Shield, AARP, Humana, Cigna and many others. Rates for the plans are now available.  While the rates are now available on the Medic are.gov website, rate updates are still pending for the Florida State insurance website, so Florida seniors that are searching for low cost Medicare Advantage plans will need to be careful that the rates that they see quoted are for 2013.
Source: medicaremedigaprates.com

The Florida Medicare Advantage and FL Medicare plans

The Florida Medicare Advantage, FL Medicare plans allows every insurer to gain access to a wide network of health care services .In some cases where in the people are suffering from chronic illness or being hospitalized in institutions they qualify for “dual eligible” scheme that covers most of their expenses. Call up a reliable FL agent to know more about the Florida Medicare Advantage or FL Medicare plans /supplementary plans today!
Source: wordpress.com

medicare advantage plans in florida

Are you currently acquainted with the existing medicare ppo plans? If you want to gather some helpful tips on this issue, then you should pay us a visit on our new website and check out the articles that people place online. Read around produce a reasonable choice for the future.
Source: beritasehat.com

Research Roundup: Medicare Advantage Plan Beneficiaries May Get More Appropriate Services; CHIP Participation Grows

Posted by:  :  Category: Medicare

THE LITTLE MAN KILLED MEDICARE FOR EVERYBONE by SS&SSUrban Institute/Robert Wood Johnson Foundation: Medicaid/CHIP Participation Among Children And Parents – “Despite the economic downturn, most states have maintained or expanded Medicaid and CHIP for children, by expanding eligibility to higher income and immigrant children, undertaking enrollment and retention simplifications, and implementing new policy options,” the authors wrote about coverage rates between 2008 and 2010. The rate of eligible children participating in Medicaid or CHIP grew to 86 percent nationwide and the number of eligible children who were not insured fell by 500,000 in that time, the study found. Participation rates for eligible parents were lower, however. The authors conclude that the 2009 law designed to improve participation of children in the program “may have contributed to increased take-up for Medicaid/CHIP among children, but that additional efforts will be needed, particularly among parents, to achieve high levels of Medicaid enrollment under the Affordable Care Act ACA” (Kenney et al., 12/3).
Source: kaiserhealthnews.org

Video: 2011- 4/19 MEDICARE PATIENTS HAVE SHORTER HOSPITAL STAY AFTER HIP REPLACEMENT BUT

Medicare Advantage Outperforms Medicare

We found that utilization rates in some major categories, including emergency departments and ambulatory surgery or procedures, generally were 20-30 percent lower in Medicare Advantage HMOs in all years. Medicare Advantage HMO enrollees initially had lower rates of ambulatory visits and hospitalizations, although these rates converged by 2008; they also received about 10 percent fewer hip or knee replacements. In contrast, HMO enrollees underwent more coronary bypass surgery than patients in traditional Medicare. These findings suggest that overall, Medicare Advantage HMO enrollees might use fewer services and be experiencing more appropriate use of services than enrollees in traditional Medicare.
Source: ncpa.org

Medicare Advantage HMO Enrolles Use Fewer Outpatient Surgery Benefits

Medicare Advantage HMO plans may be offering more efficient care than Medicare Part A and Part B plans, according to a study published in the journal Health Affairs. According to the study, MA HMO enrollees receive fewer hip and knee replacements and use fewer benefits for outpatient surgeries and procedures, inpatient stays and emergency department visits. Based on a national comparison of data from MA HMO and traditional Medicare plans from 2003 to 2009, the researchers found that utilization rates in some areas — like ER and ambulatory surgery — were around 20 percent lower in MA HMO plans. MA HMO enrollees also received about 10 percent fewer hip and knee replacements and initially had lower rates of ambulatory visits and hospitalizations. Related Articles on Coding, Billing and Collections: Billing Company Executive to Be Charged With $41M in Tax Evasion Fraud 5 ICD 10 Regulation Myths
Source: beckersasc.com

6 Recent Medicare, Medicaid Issues

1. Sen. Dick Durbin (D-Ill.) told other liberal policymakers that Medicare and Medicaid reforms are needed to ensure their long-term health, but those two programs should not be part of the immediate fiscal cliff talks. 2. HHS’ Office of Inspector General expected recoveries from audits and investigations to total roughly $6.9 billion for fiscal year 2012. Also, the OIG reported $8.5 billion in estimated savings resulting from legislative, regulatory or administrative actions to reduce fraud in Medicare, Medicaid and other HHS programs. 3. Hospitals with high rates of surgical site infections after hip arthroplasty can be identified with Medicare claims. 4. If all states implemented the Medicaid expansion within the Patient Protection and Affordable Care Act, the total cost would be only $8 billion more than what states would spend on Medicaid under the PPACA without the expansion from 2013 through 2022. That results in only a 0.3 percent increase in total Medicaid spending. 5. The U.S. District Court for the District of Columbia ruled that a 2004 HHS rule change in how Medicare disproportionate share hospital payments were calculated must be vacated due to the department’s “gravely flawed” rulemaking process. 6. Roughly 2.4 million Medicare patients are currently receiving care through an accountable care organization.
Source: beckershospitalreview.com

President Obama Releases Ad Blasting VP Hopeful Paul Ryan’s Stance On Medicare [VIDEO]

Now that Mitt Romney has announced  Congressman Paul Ryan as his running mate, President Obama has honed in on the aspiring vice president’s short comings. Ryan has been criticized for his stance on Medicare which he believes should no longer be offered by the government, but adjusted in the form of a stipend given to senior citizens to purchase their own health care.
Source: hiphopwired.com

Hip Fracture Surgery Experience In Phoenix, Arizona (My Medicare Father at Banner Thunderbird Hospital, 2012)

I have taken care of many patients with broken hips over the years.  Hip fracture carries an incredibly high morbidity and morality. Mobility is the absolute key to survival.  If hip fracture patients cannot ambulate again, they can expect a life filled with recurrent complications.  Add on the risks associated with Parkinson’s and I fear for my father’s life from any number of complications from  aspiration pneumonia and bowel impaction to ileus and pulmonary embolism.  The human body was built to move.  His key to survival will be acceptance of  any limitations, prevention of all  falls all the time  and continued aggressive physical therapy,  without dropping  him. Sometimes, it’s best for patients to swallow their pride and accept a walker as their best friend.
Source: blogspot.com

Obama’s Medicare Myopia Threatens Fiscal Future

By all accounts, the budget talks between President Obama and House Speaker Boehner have stalled, and one reason is a failure to come to some reasonable agreement on spending cuts. Richard Durbin, a left-wing senator from Illinois was told he had assurances from the White House that they would not agree to raising the Medicare age from 65 to 67. This intransience on the part of the Administration is a bad idea and ultimately threatens the long-term future of Medicare.
Source: catholicvote.org

10 Biggest Concerns for Orthopedic Surgeons in 2012

1. Balancing declining reimbursements with raising practice costs. In 2011, orthopedic surgeons saw the cost of running their practice significantly increased while reimbursement steadily declined — and 2012 promises more of the same. Meaningful use requires groups to implement expensive electronic medical records, absorb more overhead costs and spend more time filling out forms than seeing patients. At the same time, Medicare and private payors have such low rates that seeing some patients becomes unprofitable. “There is a constant downward pressure on what we are paid to deliver care,” says Frank Kolisek, MD, orthopedic surgeon and president of OrthoIndy, an Indianapolis-based orthopedic practice. “Something has got to give because it’s becoming more and more difficult for us to keep our practices afloat.” In addition to his clinical work, Dr. Kolisek and his group’s leadership are politically active and often meet with Congressmen and advocates for medical professionals in Washington, DC, and in the state of Indiana. One of the anecdotes he uses to illustrate the financial hardship of physicians today harkens back to his first practice, opened in 1992. At that time, his Medicare reimbursement for a hip and knee replacement procedure was 55 percent more than it was in 2011. That is a 45 percent decrease in the surgeon fee over the past 19 years. Over the same time period, overhead costs have increased about 65 percent. Therefore, it costs much more now to run a medical practice than it did 20 years ago and we get paid less for the medical care we provide. This is what is driving physicians to retire and/or seek employment by a hospital system. “I have performed a total hip replacement for a [patient on Medicare] and received Medicare reimbursement rates,” says Dr. Kolisek. “[The same patient] took her Labrador retriever to the veterinarian for a hip replacement and had to pay cash  upfront for the procedure and it was more than twice what Medicare paid me. The vet made 56 percent more to replace the dog’s hip than I did to replace the owner’s hip. I do not mean to be critical towards the vet, but rather to point out that physicians can’t withstand anymore cuts in Medicare reimbursement for medical care we deliver to patients.” This new focus on keeping costs down and maximizing profitability in healthcare could have an impact on patient care as well. “It’s well known that one of the challenges all medical practitioners take is balancing the needs of the patients with the measures to try to keep medical costs down,” says Bradford Parsons, MD, an assistant professor of orthopedics at Mount Sinai Medical Center in New York City. “We try to make sure there is appropriate utilization of resources, so patients have the appropriate tests and are indicated for the right procedure. The challenge comes when physicians feel a patient would benefit from a test or intervention, but the insurance company won’t approve it.” 2. Restricted access for Medicare patients. Over the next four years, the United States is projected to add millions of people to the Medicare-eligible pool, which is a population that often seeks orthopedic care. However, the reimbursement for treating Medicare patients often doesn’t cover the cost of care. Orthopedic surgeons are now being faced with a decision about whether to restrict access to these patients or absorb a loss on services provided. “If you look at surveys from medical societies, physicians are already restricting access to Medicare patients because they lose less money by leaving the slot empty than taking the Medicare patient,” says Dr. Kolisek. “The Medicare reimbursement rates are dropping even lower and now we are going to have millions of more patients on Medicare. Therefore, access to care may be an issue for Medicare patients in the future.” Figuring out how to provide reimbursement for these procedures to keep physician practices running without bankrupting the healthcare system is going to be crucial over the next few years. “There is a tremendous disparity between the work endeavor to perform orthopedic surgery and the reimbursement given to the surgeon and hospital,” says Henry Finn, MD, FACS, medical director of the Chicago Center for Orthopedics at Weiss Memorial Hospital and professor of surgery at the University of Chicago. “If you look at it only through a financial lens, surgeons are incentivized not to be involved in providing this type of care; yet it is a growing need in our country.” Compared with other countries, the American population right now has a more access to healthcare because the government supports people who are unable to obtain other forms of insurance. However, with the amount of dollars available to spend on healthcare decreasing, our government faces many challenges to continue providing care for the uninsured. “There is a finite amount of resources and medical care dollars,” says Dr. Parsons. “How do we provide appropriate care for everyone while also maintaining quality? That will require some careful thought and consideration to figure out.” 3. What the poor economy of 2011 means for joint replacement in 2012. When people feel financially insecure, they are less likely to undergo costly and time-consuming endeavors like elective joint replacement. Some sources suggest that in 2011, 75 percent of Americans felt financially insecure, and these people are less likely to invest in a new joint while missing work to do so — even if they would benefit from the procedure. Instead, more people are using alternative methods for pain relief and waiting on surgery until they are out of other options. “I would estimate that joint replacement across the board in the United States is down about 25-30 percent,” says Dr. Finn. “Instead of undergoing elective procedures, people are managing pain in several ways, including the use of narcotics. We are seeing many more patients who are addicted to narcotics prescribed for arthritis pain. Generally, we don’t think of chronic pain, such as pain from osteoarthritis, as an indication for narcotic use.” While the decision to prolong surgery could mean your joint degenerates to a much more difficult state, chronic narcotic use presents its own set of challenges. Narcotics abusers become tolerant and it takes a much higher dose of anesthetic and postoperative pain medication to make them comfortable. “Studies have shown that the expected outcome is not as good for narcotics users,” says Dr. Finn. “They show as many as 20 percent of these patients needed further surgery because they couldn’t complete rehabilitation from their first procedure appropriately — they were in too much pain. When patients are on narcotics for back or knee pain, we ask them to stay off the medication for six months so we control their postoperative pain.” As a result of fewer people undergoing joint replacements in 2011 and more people managing pain with narcotics, orthopedic surgeons may see a higher volume of patients with severely degenerated joints in the OR in 2012 and beyond. 4. Will 2012 bring a technology boom or bust? With financial pressures on the forefront of everyone’s mind, orthopedic surgeons are careful to recommend and perform the most cost-effective treatments possible for their patients. At the same time, researchers and innovators are developing new technology that has the potential to improve outcomes and improve efficiency in the operating room such as computer assisted and robotic assisted surgery. However, this costs money and somebody has to pay for it or technological growth could slow down. Many insurance companies do not want to pay for advanced technology and often call it “experimental.” Therefore, a hospital buys technology and can’t get reimbursed for providing this technology to patients. “What often makes for a good outcome isn’t the greatest and newest technique, but a good surgeon and motivated, healthy patient who undergoes a procedure without any complications,” says Dr. Finn. “We can use computers to navigate for joint replacements, but for an experienced surgeon the technology may not add benefit; instead, it would only increase the cost and risks associated with the procedure. You must have empirical knowledge and intuition to be a good surgeon — there is no substitute for that in high technology.” Even technological advancement showing cost and quality benefit may be stymied over the next few years due to lack of funding. If payors decline to reimburse for technology in favor of the traditional procedure, companies will stop focusing on advancement in that product line. “If there isn’t a market for new devices, we will stop advancing technology,” says Dr. Kolisek. “This would be terrible for patients and the entire medical community.” However, there are some bright spots in technology development for orthopedic surgeons. Patient-specific cutting guides for joint replacements may increase the accuracy, speed and outcome predictability of the surgery without unnecessarily raising costs. “Patient-specific cutting guides for joint replacements are different from other advancements, such as computer navigation or robotic surgery, because it actually decreases surgical time,” says Dr. Mehta. “Custom-made cutting guides that are MRI or CT based are an exciting development that will really go mainstream this year.” When it comes to assessing new technology, one of the biggest challenges for orthopedics surgeons is differentiating marketing hype from qualities that are actually advantageous to the procedure. While device companies try to distinguish their products on a competitive market, surgeons must know whether the product will make a positive enough impact on their patients to warrant all costs involved. Sacheen Mehta, MD, an orthopedic surgeon with Comprehensive Orthopaedics & Rehabilitation in Richardson, Texas, and Methodist Hospital for Surgery in Dallas, uses a simple rule in making this distinction: When a surgery is made more complicated, there are more things that can go wrong; when the procedure is simplified, more things go right. Even if new devices aren’t being released every day, there will still be room for basic science and procedural research in the future. “One of the most exciting things about the field is seeing how the technology and procedures evolve through the years,” says Dr. Parsons. “The basic science research on tendon, cartilage and bone is allowing dramatic clinical improvement for our patients.” 5. Dealing with patients who have unrealistic expectations. Dr. Finn often sees patients who have unrealistic expectations for their joint replacements based on outcomes for famous athletes or provider marketing material. “In some cases, patients think they are getting a new joint that is going to be as good as their natural one,” says Dr. Finn. “That might be the case for some patients, but not everyone. People undergoing joint replacements from severe arthritis will experience pain relief, but they must be educated about their limitations.” Advertising campaigns for orthopedic implants sometimes add to the myth of a natural knee or hip. Device companies may show someone undergoing strenuous physical activity, such as downhill skiing, after a joint replacement with their implant, but in many cases perfectly good joint replacements may not allow the patient to participate in high impact athletic endeavors. “Patients might have a perfect operation and they come to me, as a revision specialist, because they think there is something wrong since they can’t do everything pain-free,” says Dr. Finn. “A very common scenario is that most patients with knee replacements don’t like to kneel. You may not be able to be a plumber or do Judo with a knee replacement. People think they are going to be able to do anything after a their procedure, which might not be the case. Patients shouldn’t be going into surgery with these unrealistic expectations.” As people are engaging in more competitive physical activity and wanting to remain active later in life, they are developing injuries and degenerative conditions at younger ages than in previous decades. However, these younger patients are more impatient with the recovery process and may experience worst outcomes as a result. “It has been my observation that younger patients who are more physically fit struggle more with recovery and are less satisfied with the procedure than elderly patients,” says Dr. Finn. “Yet we are seeing younger patients more often these days.” 6. More orthopedic surgeons are heading toward hospital employment. For the past few years, orthopedic surgeons have watched hospitals a hire large number of specialists to enhance their market share; almost all cardiologists and a significant number of other specialists are now employed. Orthopedic and spine surgeons are some of the last hold-outs in private practice, but the pressures on the business side of medicine have made this increasingly difficult. A growing number of orthopedic surgeons coming out of medical school are also choosing the security of hospital employment over the risk of private practice — a decision some orthopedic surgeons with more experience feel they will regret in the future. “Orthopedic surgeons are deciding to become employed by the hospital because it’s difficult to run a group practice in an environment of high costs and low reimbursement,” says Dr. Kolisek. “Often with the first contract, hospitals will pay the surgeon more than the surgeon would receive in private practice so this is very attractive. However, when they have to renew their contract, it may not be as attractive as these surgeons won’t be paid more than they are bringing in.” Orthopedic surgeons who are close to retirement are also choosing to sell their business in favor of hospital employment to secure a good contract for their last few years practicing medicine. This is an attractive option for surgeons who are close to retirement because overhead costs have grown significantly in the past two decades. “When I began my practice in 1992, my overhead was around 40 percent, so I got to keep 60 cents of every dollar collected for personal income,” says Dr. Kolisek. “My overhead now is 78 percent so I get to keep only 22 cents on every dollar I collect; at the same time, I’m collecting fewer dollars than I did 20 years ago as reimbursements have decreased. The increased government regulations make it difficult to practice medicine and the overhead costs make it hard to keep our lights on.” While it’s easy to see why hospital employment looks like the best option for surgeons now, they must also consider what they are giving up: their autonomy. “Surgeons who succumb to the downward pressure on their income and choose hospital employment have lost their autonomy instead of battling to find opportunities to keep practicing independently,” says Dr. Kolisek. 7. Merging into large orthopedic groups and finding hospital partners. Even though government regulations and low reimbursements have made it difficult for orthopedic groups to survive without hospital employment, many large groups around the country maintain profitability because of their size. The more surgeons in a group, the more negotiating power that group has in payor contract rates and hospital partnerships. In many communities around the country, small orthopedic groups are merging together and leveraging their power productively. “Smaller groups are merging into larger groups to stay in business,” says Dr. Kolisek. The size and strength of a large group also makes it a formidable partner for hospitals looking to enhance efficiencies and quality of care. A large orthopedic group and a hospital can form a co-management agreement for running the orthopedic service line, which is attractive for both parties. “With co-management agreements, the hospital improves value, efficiency and outcomes while decreasing costs and complications; the physician group now has another income source from the agreement by sharing in the cost savings assuming they do a good job,” says Dr. Kolisek. “The hospital systems that have eyes wide open will try to set up partnerships that are positive for both parties. Those partnerships can be longer lasting than a situation where hospitals hold a competitive advantage over the physician groups by employing them, which can blow up because of physician dissatisfaction.” Accountable care organizations are a new concept that the federal government wants to implement. “Physicians and hospitals are skeptical as these are very costly to set up and preliminary results from pilot sites are not promising,” says Dr. Kolisek. “It is really another attempt to withhold care from patients as I see it.” With the final rule release late in 2011, many organizations are deciding whether to create an ACO and what type of structure would benefit specialists. An issue Dr. Kolisek sees with ACOs is the payment structure; if payments go to the hospital in one lump sum, the hospital would decide what percentage orthopedic surgeons received and the less care you deliver, the more money you make. This may not be good for patients. “If surgeons participate in this type of ACO, physician groups are going to fight with hospitals for reimbursement,” Dr. Kolisek says. “How will the hospital get their arms around making sure the patient is directed to physicians with the most efficient, highest quality and highest value care?” 8. Maximizing revenue in orthopedic groups. Even if large orthopedic groups are the way of the future, these groups must be savvy about capturing as much of the revenue from an episode of care as possible. This means adding ancillary services to the practice. “There may be other opportunities as well to capture additional income,” says Dr. Kolisek. “Orthopedic groups can own a surgery center, MRI and physical therapy services to help keep their practice going. Relying just on reimbursement for professional services rendered no longer works. We must deliver a high quality product with great value at a low cost. High quality care must be reimbursed better than lower quality care in the future.” Adding physical therapy and other conservative treatment to your practice is especially important as we move toward an era of patient information and empowerment. People are now able to access information online about many types of traditional and non-traditional treatment methods. Often, patients decide which methods they want to try first before even stepping foot in a physician’s office, says Dr. Mehta. Additionally, treatment pathways often dictate a period of conservative treatment before opting for surgery. Having conservative treatment services available at the practice will attract more patients. “People are asking for conservative care upfront and you want to capture that revenue,” says Dr. Mehta. “If you have physical therapy, you can also provide those services to patients recovering from surgery and capture that revenue postoperatively as well. Onsite physical therapy also adds convenience for patients because all their services are in one location.” Physical therapy can be a beneficial ancillary service to incorporate into your practice, but providing DME services is the easiest to implement, says Dr. Mehta. “Sending patients out for DME is an inconvenience for the patient, a hassle for the physicians and the practice is giving revenue away,” he says. “It may require some upfront investment to stock the DME, but that easily pays for itself.” 9. Quality rating in orthopedic and spine care. “Cost-effective” is now a buzz word among healthcare providers; everyone wants to provide the highest quality of care to increase their share of available healthcare dollars. However, the definition of “quality” in healthcare is still murky, as many websites and rating systems rely on inappropriate factors for reflecting a surgeon’s ability to achieve good outcomes. “There are so many groups now putting ratings out for physicians on their website, and many of these groups haven’t been around for very long,” says Dr. Kolisek. “Every one defines quality differently.” Most would agree that, in the purest sense, “quality” refers to achieving the best possible outcome given the limitations of each patient’s situation. A surgeon who treats sicker patients may not achieve the same outcomes as a surgeon who treats otherwise healthy patients or athletic injuries. The disparity in functional outcome and complication rate is often more a factor of the patient’s lifestyle and comorbidities than a reflection of clinical ability. These nuances are often lost on websites comparing surgeons on the same plane. Another weakness of some rating systems is conflation of quality outcomes with patient experience. For example, the rating system might ask patients whether they had to spend time in the surgeon’s waiting room before the visit; longer wait times reflect negatively on quality scores, which may be misleading. “A physician who isn’t busy will have time to see their patients right away and spend more time with them during the visit,” says Dr. Kolisek. “The patient might be satisfied with the short wait time and the amount of time they spent with the physician, but that doesn’t define quality; it just means the physician wasn’t that busy. When physicians are very busy, they will often see several more patients per day and often this causes then to run behind.” Running behind schedule doesn’t mean that you are not as good as a physician who stays on time. It could be that you are a very good physician and, therefore, more busy than the other physician with more patients wanting to see you. 10. Increased patient responsibility in healthcare spending. Without a clear idea of how health information exchanges and other facets of healthcare reform will impact the patient/payor relationship, it’s difficult to predict where payment trends are heading. One principle remains clear, however, says Dr. Kolisek: patients with insurance coverage that covers most of their bills are more likely to spend higher amounts on their care than patients with an insurance plan where they have to spend more of their own money like a high deductible plan. It is tempting to want everything rather than just what you need if you don’t have to pay for it, he says. “In some cases, I’ll tell patients they don’t need an MRI after looking at their X-rays and I won’t order one, so they go to a different provider who will order the MRI,” says Dr. Kolisek. “Now the healthcare costs go up because we have two physician visits, two X-rays and an MRI. Our practice owns an MRI machine, but I won’t order an image if the patient doesn’t need it. In healthcare, our system is set up so that people are shopping around with everyone else’s credit card and they want everything done because they don’t have to pay the bill.” On the other hand, Dr. Kolisek also sees patients with high deductible plans who do need MRIs, but they are reluctant to undergo the studies because they’ll be paying for it. “They will ask me if it is really necessary,” says Dr. Kolisek. “We have to somehow change the medical system to one where you can’t just let people shop with someone else’s credit card and not be responsible for the bill. If we do, they will continue to increase unnecessary spending.” Related Articles on Orthopedic Surgery: 16 Benchmarks for Orthopedist Starting Salary & Signing Bonus 125 Outstanding Knee Surgeons 11 Points on Technology & Treatment Revolutionizing Sports Medicine
Source: beckersspine.com

Ever Wonder How Much Medicare Pays for Hip and Knee Replacement

Between 1998 and 2007, the Medicare reimbursement rate decreased 21 percent for total hip arthroplasty and 20 percent for total knee arthroplasty, according to the report. The researchers surveyed 1,120 patients in an outpatient office setting, asking patients what they thought orthopedic surgeons should receive for total joint arthroplasty and how much they thought Medicare actually paid surgeons. Patients were also asked the same questions about cardiac surgeons who perform open heart coronary bypass surgery and surgeons who perform appendectomy.
Source: nicholascappello.com

Hip Suburban White Guy: I Just Got Off The Phone With My Mom

My mom is 78 years old. Her only income is Social Security. She lives in Section 8 housing. Her only health insurance is Medicare which pays 80% of her health care costs, and a Medicare Supplement plan that pays the difference and costs her $9.00 a month out of her Social Security check. She called tonight complaining about her health care and the fact that the Medicare Supplement only closes the gap on what Medicare already covers. She thought her $9.00 a month would pay for the stuff that Medicare doesn’t cover. She thinks she’s getting ripped off. She is going to shop around for insurance policies that she thinks she can get on the open market that will provide a 78 year old woman who has preexisting conditions that include losing a breast to cancer, high blood pressure, degenerative myopia and mild dementia with coverage better than Medicare for less money. She doesn’t realize that what she thinks she can do is impossible.  But there is no shortage of unscrupulous insurance sales reps who get paid on commission who will be only too happy to feed on her fear, sell her a policy she can’t afford, send her to a collection agency and leave her without any health care at all when she can’t pay.  Because that’s how the unregulated free market economy works. In the future, if Republicans like Paul Ryan have their way, my mom wouldn’t get jack shit other than a fixed amount voucher, a URL and a “Good luck! Go figure it out for yourself. Because we don’t give a fuck.” Throwing American senior citizens under the bus, letting them curl up and die if they get sick because they couldn’t figure out how to make enough money so that in their retirement they could afford to make rich young doctors richer isn’t my idea of America. Is it yours? If it is, vote for Romney and hope you will wind up like him with millions of dollars in ill-gotten gains stashed in offshore tax havens. But if you truly think that America at least aspires to be the greatest nation on Earth, then vote for Obama and the party who thinks EVERY AMERICAN deserves to grow old with dignity and good health without bankrupting their friends and family.
Source: blogspot.com

Cataract surgery may prevent efficiently hip fractures in elderly which is huge cost for Medicare 10bn$/yr @FLAHAULT @drsilenzi

Results  There were 1 113 640 US Medicare beneficiaries 65 years and older with a diagnosis of cataract between 2002 and 2009 in the 5% random sample; of these patients, 410 809 (36.9%) received cataract surgery during the study period. There were 13 976 patients (1.3%) who sustained a hip fracture during the study period. The most common fracture-related comorbidity was osteoporosis (n = 134 335; 12.1%). The most common ocular comorbidity was glaucoma (n = 212 382; 19.1%). Compared with 1-year hip fracture incidence in patients with cataract who did not have cataract surgery, adjusted OR of hip fracture within 1 year after cataract surgery was 0.84 (95% CI, 0.81-0.87) with an absolute risk difference of 0.20%. Compared with matched subgroups of patients who did not receive cataract surgery, patient subgroups that experienced lower odds of hip fracture after cataract surgery included patients with severe cataract, patients most likely to receive cataract surgery based on propensity score, patients 75 years and older, and patients with a CCI score of 3 or greater.
Source: wordpress.com

gop to base … let ‘em eat fake

an interesting piece has popped up at waliberals.org showing that not only was the romney/ryan campaign spending their days lying to the public about just about everything, but that the right wing media was also engaged in the deception … and still is … no news there folks, but still, it’s always nice to be able to show it in black and white … and important too, if we’re ever going to make the changes to the media/politico structure that are so desperately needed … as discussed in a piece last week called “life in the bubble”, the right wing media seems to thrive on the dumbing down and “spoon-fed” ignorance of it’s base, and in the piece “an open letter to conservatives” the results of those lies and the price the right paid for them in this year’s election was shown to be as obvious as an erection in a vagina parade … now, with president obama and his fellow democrats about to embark on their latest foray into the “gop bubble-land of magical thinking and arithmetic” to try to find fixes to the country’s economic woes, i believe that it is vitally important that the public have it’s voice heard and it’s views known … and it is doubly important that the president and his allies hear that voice and use it as their ammunition in what is sure to be an upcoming fight to the finish against recalcitrance and obstructionism … both john boehner and mitch mcconnell are already signalling that they are going to continue the “just say no to everything” campaign that they have used the last four years … that they will continue to hold the country hostage economically to further try to protect the 1% and their tax breaks … now we have this story showing up that gives the president all the ammunition he needs to put an end to this fight, once and for all, and if the president really means what he says about standing up for the middle class and those trying to break from poverty and break into the middle class … ad it comes from the most conservative of conservative sources, newsmax … wave it in their faces and take it to the people mr. president … and take the advice of newly re-elected alan grayson and “don’t back down an inch” …
Source: wordpress.com