TODAY’ TOP STORY:
Canadian healthcare providers can now practice in Michigan: Michigan Gov. Gretchen Whitmer signed a bill this week to immediately permit reciprocity in licenses, registrations and certifications for Canadian healthcare professionals in Michigan.
Canadian healthcare professionals can apply for reciprocity as long as they meet the educational, examination and billing requirements of Michigan law. The allowance had been in effect for Canadian health professionals from 2002 until it was allowed to expire in 2012.”
This type of legislation is unique in the US. Reciprocity among states is easing. In the EU, movement of physician across borders is legislated. But a state recognizing another country’s professionals like this is refreshing.
About pharma
HHS Releases Advisory Opinion Clarifying that 340B Discounts Apply to Contract Pharmacies: “On Wednesday, the HHS Office of the General Counsel released an advisory opinion concluding that drug manufacturers are required to deliver discounts under the 340B Drug Pricing Program (340B Program) on covered outpatient drugs when contract pharmacies are acting as agents of 340B covered entities.
The 340B Program requires drug manufacturers (in exchange for coverage of drugs under Medicaid) to offer substantial discounts to "covered entities," which include safety net hospitals, community health centers, and other institutions that serve vulnerable populations. Estimates suggest that discounts in the 340B Program can range between 25 and 50 percent and that approximately $30 billion of drugs are sold to covered entities each year, representing almost 6 percent of prescription drugs sold in the United States.”
About the public’s health
What Can Be Learned From Differing Rates of Suicide Among Groups: “In data released in 2017, the rate for white Americans was around 19 per 100,000, and it was about 7.1 for both Hispanics and Asian-Americans/Pacific Islanders, and 6.6 for Black Americans, according to the Centers for Disease Control and Prevention.” The article discusses multiple reasons for this discrepancy, especially social support (including religious affiliation).
Discovery of Virus Variant in Colorado and California Alarms Scientists: The virus variant hits a second state.
About health insurance
Obamacare, in Its First Big Test as Safety Net, Is Holding Up So Far: “Final government estimates of the uninsured rate are months away, but at least one survey, from the research group the Commonwealth Fund, shows the share of Americans without coverage was holding steady through the spring. The Affordable Care Act is a crucial reason for that.”
‘Blown away’: Spokane Valley church raising money to help pay off millions in medical debt: “Valley Real Life in Spokane Valley is raising money to help buy off outstanding medical debt owed by those in need in the Pacific Northwest. The church has partnered with a New York-based nonprofit called RIP Medical Debt, which leverages donations to purchase – and then forgive – qualifying debt portfolios for pennies on the dollar.
With still a few weeks left in the church’s fundraising campaign, Valley Real Life Church has raised enough to erase upward of $21 million in debt for struggling individuals and families.”
Charitable purchases of healthcare debt at large discounts has been around for several years and is a great use of those funds.
About medical groups
In 2019, Medical Groups Generated a Profit; Health System-Affiliated Groups a Loss, According to New Survey: “The survey shows the overall median profit/investment (P/I) per provider in 2019 to be -$22,028, an improvement from -$57,426 in 2018. For health system-affiliated medical groups, the overall median loss per provider (also known as ‘investment per provider’) in 2019 was -$163,994 in 2019, slightly better than -$165,050 seen in 2018. For independent medical groups, the profit per provider increased to $12,434 in 2019 from $5,200 in 2018.
The survey also measures median profit/investment (P/I) per physician. This metric includes financial performance divided by number of physicians only, whereas the per provider metric includes advanced practice providers (APPs) in the count of ‘providers.’ In 2019, the overall median per physician was -$32,985, a significant improvement from -$98,840 in 2018. For health system-affiliated medical groups, the overall median loss/investment per physician in 2019 was -$278,505 in 2019, a decline from the -$225,261 seen in 2018. For independent medical groups, the profit per provider increased to $16,603 in 2019 from $6,296 in 2018….
The numbers alone are not necessarily indicative of system-affiliated groups performing worse than independent groups,” said Fred Horton, M.H.A., AMGA Consulting president. “One reason for these divergent trends is that revenue generated from ancillary services, such as scans and lab work, is reflected in the bottom line of independent medical groups, but generally does not accrue to the bottom line of groups affiliated with a system. Another reason is that certain expenses are exclusive to system-affiliated medical groups, for example, system office allocations and centralized service expense allocations. Because of these nuances, we analyze compensation and production alignment, staffing ratios, and general volume-adjusted metrics to make a more apples-to-apples comparison.”
The results and explanations are complex, but they make one wonder whether the system affiliation promises that enticed physicians to affiliate are worth it.
A couple other considerations:
Hospitals affiliated groups can bill more because they can charge facility fees.
The groups that affiliated may have ben distressed and the independent groups did not affiliate because they were profitable.