With limited choice and no responsibility, patients tend to feel entitled and deprived at the same time. This creates a toxic environment for delivering health care. I have never met a patient who felt in partnership with his or her insurance company – ever.

How should we determine how much to pay doctors (and hospitals or other facilities for that matter)? Dr. Duvefelt writes a post comparing his experience practicing medicine in Sweden versus the fee-for-service structure here in the US.  

Dr. Duvefelt advocates for considering the individual needs of a patient compared with health plans or government who try to divvy up limited healthcare dollars on a population basis. He points out that with greater understanding of genetics, healthcare will continue to become even more personalized (one size does not fit all!).

His quote above about how consumers respond to limited choice and no responsibility rings true. Many of the consumers who seek out help at CoPatient arrive with similar sentiments. Consumers are definitely telling us that with so much of their own dollars at stake, much more ownership is felt over every healthcare-related decisions.

You can read Dr. Duvefelt’s entire post here: The Healthcare Blog

Keep your information secure on the internet!

Recently a major security flaw was detected in OpenSSL, the open-source encryption standard used by the majority of websites and services.  

Rest assured, here at CoPatient, we have taken steps to address any potential vulnerability to the Heartbleed bug with an industry-standard toolset. Our user’s information remains safe and secure with CoPatient.

Please note that CoPatient has not been targeted or attacked and we have no evidence of any malicious behavior since early notification of this issue were made public.  

As an added measure of safeguard, experts strongly encourage you to change your password on any site where you store personal information! While it’s never fun to try to come up with a new password (and remember it later on!), we couldn’t agree more that protecting your personal information is worth those extra steps as a precaution.

When other approaches didn’t work for the state Medicaid program to cut costs … such as limiting the number of reimbursements for emergency care per beneficiary or refusing to pay for 500 diagnosis codes deemed unworthy of treatment in an ER… providers and the government came up with plan to share data across ERs. Brilliant! 

As the Affordable Care Act expands Medicaid to a greater number of patients, the need for states to keep ER costs in check will become pressing. Washington is showing how far a little data can go

Why Share?

Protected Health Information. HIPAA. Patient Privacy.  The language of healthcare is becoming harder to understand and doesn’t fit into our daily vocabulary. That’s even true in family life sometimes. When it came to my family’s medical history (which included mental illness, heart disease, alcoholism and a host of related conditions) my grandmother never spoke openly about it.   

In other areas of our lives, we benefit from sharing every day, whether  using a Yelp review to find a restaurant or – finding a room on AirBnB. Why not use those same principles to make our healthcare system better? Let’s use  the power of our own real-world experiences  to help others  be more informed. Being secretive and private has not helped combat spiraling costs, limited information on quality and an increasing sense of alienation from the system as a whole. Sharing our own experiences can inform and influence change in healthcare.  It’s not just for restaurants.

At CoPatient, we believe that sharing medical billing information gets right to the heart of consumers’ frustration with healthcare costs. And now, we’ve got a partner that also believes sharing is the best way to changed healthcare for good. PatientsLikeMe is a free online resource where more than 220,000 patients are sharing their real-world experiences on more than 2,000 different conditions. Members are tracking their health with personalized profiles, learning from others just like them and contributing to real-time research that can accelerate treatment and care advancements.

Every experience matters, so the more you share, the better it is for everyone, including you. It’s a group effort, and we’re all in this together. Join the healthcare revolution on today.

The financial scars of medical care can be just as disabling to survivors of any disease, and as we grow and change as a profession, it is important that our providers of the future, today’s residents and medical students, have an understanding of the financial realities of their jobs.

An absolutely fantastic essay from a doctor who experience financial hardship when dealing with cancer. He lost his insurance during treatment yet found the Massachuesetts law helped him ride out the storm.

http://thehealthcareblog.com/blog/2013/12/22/n-1-my-experience-with-the-new-health-care-system/

Medicare Advantage Plan Declares Bankruptcy, Consumers Caught in the Middle

Recently my parents received the following notice in the mail informing them that their Medicare Advantage plan from Universal Health Care was being terminated.

They quickly selected a new Medicare plan and moved on. However, their providers didn’t. They continued to receive bill after bill for a lab service that had been delivered while they were still covered by Universal, but the lab hadn’t submitted the claim until after Universal declared bankruptcy. I called the lab to let them know that Universal Health Care had declared bankruptcy, and they still continued to send bills.  I called again to tell them that Universal Health Care had declared bankruptcy, and they sent another bill. After repeating this cycle five times, each time on hold for over 15 minutes, I got frustrated and began researching the situation in earnest. I had tried to explain the situation to them multiple times, and they weren’t listening.

After doing a little digging, I discovered that the lab was in violation of their own contract, which states:

Section 3.6. Member Held Harmless. Provider hereby agrees that in no event, including, but not limited to, nonpayment by Health Plan, insolvency of Health Plan, or breach of this Agreement, shall Provider bill, charge, collect a deposit from, seek compensation, remuneration, or reimbursement from, or have any recourse against Members or persons other than Health Plan, Provider or persons acting on Member’s behalf for Covered Services provided pursuant to this Agreement.

 This got me wondering how many Universal Health Care customers have received bills from this lab and paid them unwittingly. If you’re a former customer of Universal, do not pay any bills denied or rejected by Universal without carefully checking the dates of service. If those dates were within the time you were covered and were for covered services, you shouldn’t pay anything.  The Order of Liquidation clearly states:

Section 4.10To any and all physicians and other health service providers under contract with or providing services to Universal HMO of Texas, Inc.:

Each of you are hereby restrained and enjoined from:

(a) Charging, billing, demanding or collecting payment from members, enrollees or beneficiaries of Universal HMO of Texas, Inc. in violation of any applicable statutory or contractual provisions; and

(b) Interfering with these proceedings or the Receiver or her designees.

If any healthcare provider continues to send you bills for services they provided that should have been paid by Universal, do not pay them. Inform them of the bankruptcy and the Order of Liquidation. If they continue to bill you, send them a notice in writing mentioning both their contractual obligation not to bill you and the injunction against billing you quoted above.

If they still persist, get an advocate on your side. Remember, we’ve always got your back!

Wondering what CoPatient was up to with AARP in Atlanta earlier this month? Here’s a great video from Health Innovation @50+ that explains how AARP brought together healthcare innovators and enabled them to interact and learn from AARP members.