JAMA Internal Medicine has published a study highlighting the dangers associated with an understaffed inpatient department. Researchers surveyed nearly 1,000 hospitalists to determine if there is a relationship between hospitalist case load and patient safety. Physicians were asked to approximate the amount of patients they could care for per shift, and of those who responded, 40 percent of hospitalists reported unsafe workloads occurring on a monthly basis. Those same physicians reported ordering unnecessary tests or procedures, decreased patient satisfaction scores, and an increase in medical errors during the same time period. Dr. Mark Talavera wrote about the need to improve integration across hospital departments, which could be a way to avoid the pitfalls of understaffing.
In the face of lowered reimbursements from Centers for Medicare & Medicaid Services (CMS), more and more hospitals are exploring house calls in an effort to reduce admissions (The Wall Street Journal). The programs aim to “provide hospital-level care in the home, including portable lab tests, ultrasounds, X-rays and electrocardiograms.” Although the efforts might reduce admissions, hospitals and insurers – both private and public – are still figuring out how such visits can be reimbursed properly under the current payment structure.
The Internal Revenue Service (IRS) and the Department of Health and Human Services (HHS) have published proposed rules regarding the individual mandate instated under the Affordable Care Act (The Hill). Although the mandate requires most people to purchase health insurance or pay a fine, the proposed rules outlined a number of exemptions to the law – including undocumented immigrants and low-income individuals who have opted out of Medicaid. The Affordable Care Act, including the individual mandate clause, was upheld by the US Supreme Court in 2012. Editors at FierceHealthFinance are skeptical of the individual mandate’s effectiveness, especially in rural areas that utilize a significant portion of migrant workers.