This is great news for the advance of electronic health records. Kudos to Louisiana Governor Jindal for embracing this step forward and the state legislature for bringing this bill forward (The Electronic Health Records Loan Program Act – Senate Bill 246 by Senators Sherri Smith Cheek, Ben Nevers and Francis Thompson, and Representative Anthony Ligi). The key element in all of this will be the federal interpretation of meaningful use. That is a very generic term and can cover a lot of ground. If it is applied to streamlining record keeping, maintaining an orderly flow of information to prevent loss of info or duplication of testing etc, then that will be a good thing. If however, the federal overseers in DC decide that meaningful use must translate into cost savings, cuts in spending and the like, then we continue to worry about the temptation to penalize practitioners as well as limit choice and options for patients. We have time and again urge the adoption of useful electronic tools in medical practice and health care, but we must temper that, always, with a prudent distrust and skepticism of the motives of the federal agencies behind these programs . . obi jo
DHH Secretary Alan Levine said, “We are looking forward to working with physicians and hospitals on Governor Jindal’s continuing efforts to better manage the health and well-being of our citizens. This program will help advance the use of technology in a meaningful way to provide better patient care.”
Jindal signs electronic medical records bill
Louisiana is creating a new electronic health records loan program designed to help hospitals and doctors go digital with medical records. Gov. Bobby Jindal signed the bill creating the program, but the plan is tied to federal stimulus money the state has yet to receive. The bill allows the state health department to apply for the stimulus money to dole out loans to health care providers for the purchase and implementation of electronic health record systems. The state budget includes $5 million in matching money required for Louisiana to apply for the federal grant. State officials hope to draw down $25 million in federal money. The law also allows the loan program to draw on other sources of funding if available.
Jindal signs electronic medical records bill – http://www.neworleanscitybusiness.com/uptotheminute.cfm?recid=25688&userID=0&referer=dailyUpdate
Jindal signs electronic medical records bill – http://www.nola.com/newsflash/index.ssf?/base/national-34/1247221707217270.xml&storylist=louisiana
Jindal signs electronic medical records bill – http://www.chicagotribune.com/news/local/wgno-news-medrecs0710-story,0,667165.story
Louisiana Gov. Jindal Signs Electronic Health Records Bill – http://hitconsultant.blogspot.com/
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Insurance reform + medical provider reform = health care reform, right? Utah health insurance reform has been center focus for the state, UAHU and private insurance carriers over the past 24 months. Mike Oliphant (UAHU board webmaster) runs a small Utah based health insurance website http://www.BenefitsManager.net as well as http://www.AHealthInsuranceQuote.com. Mike’s viewpoint provides a unique analysis which comes from being a “fly on the wall” observer in countless state session and insurance meetings. “Utah has been thrust into a state insurance reform pressure cooker which isn’t necessarily negative where I am an insurer, insured and patient”. Several interesting changes took place with H.B. 188 passage earlier this year which seems all too familiar to the ongoing federal health care reform attempt under Obama’s administration. The spirit of the bill allows private Utah market place remedies. It essentially guarantees a Utah health insurance carrier a “no loss” or “no gain” premise over competing carriers that operate within the “Utah Insurance Exchange portal”. On the surface it would seem unattractive to a carrier’s consideration (voluntary at this point). But you have to understand the carriers’ goal is to cover their administration fees and maintain a 3% profit. The Utah health insurance reform model claims this can be accomplished now by legislation and the watchful eye of the state’s risk adjuster board. The medical claim risks are essentially shared equally among the participating carriers. Therefore, the carriers can focus on administration efficiencies more so than competition over a fluctuating market share. Insurance carriers such as SelectHealth have efficiencies and risk management experience polished by long tested actuarial tables with health statistics and claim trends. Is it a bad idea to share that experience with a national carrier such as Humana? Would it surprise anyone to know that maternity NICU and anti-depressants represent the highest utilization in health insurance costs for medical and pharmacy in Utah? Compare this to Texas which suffers from abnormally high levels of diabetes and liver disease per capita.
The other half of the “health care reform equation” is medical provider and billing practices. The state claims this is on the agenda. It is popular belief among Utah legislators that reform stops with the insurance carrier. However, how can the insurance carrier continue to bear the risk and re-distribution of health insurance premiums back out the door in claims without provider billing reform? Add to this obstacle a continuing shrinkage of the insured populace. Obama’s administration proposes mandatory participation in a health insurance policy by employers of all sizes, self employed and unemployed populace. The logic being to shore up the unhealthy with healthy premium. When analyzing the Massachusetts’s system, you actually pay a penalty if you have no proof of coverage. The benefit level and health insurance price is nowhere close when you compare Utah health insurance quotes through benefitsmanager.net or dental insurance quotes at http://www.dentalinsuranceutah.net. Utah premium is easily half. This insight comes from a Utah health insurance agent whom often interacts with employers and residents looking for affordable coverage, making sure claims are paid correctly, implementation and explanation of the many policy procedures and putting a complex SelectHealth insurance language in understandable terms. Yet legislators claim agents to be of no value all in the name to save 3-4 off of Utah health%
With the latest announcement of hospitals agreeing to contribute $155 billion, where are the costs going to be shifted for this donation? In Utah, studies conducted by BenefitsManager.net revealed that cost shifting already exists in the ER. There is apparent lack of legislators in Utah and on the federal level proposing TORT REFORM. It is factual that a majority of US senators and representatives are lawyers. To push liability insurance premiums down that absorb as much as 15% in expenses with most medical providers is significant. Take 15% off total medical expenditures in US and you will see savings in the trillions.
If we go down the path of nationalized health care reforms, will we at some point be forced to address usage and ration? Will we have to define when to refuse further care for patients receiving critical illness treatments, intensive care unit, disease management, neonatal intensive-care unit for? SelectHealth documents that the single most expensive bills are NICU for newborns and seniors in acute / intensive care / pre-hospice.
Without TORT REFORM, medical provider costs will never drop. Liability insurance costs are approaching nearly half of the operating expenses for specialty care physicians, units and facilities. Humana health plans state that their costs of medical liability and defensive medicine accounts for nearly 10 cents out of every premium dollar collected. Compare that to Humana’s reported pharmaceutical claims of 15 cents out of every premium dollar collected. Or better yet, 21 cents out of every premium dollar collected is paid back to physicians for physician treatments.
Thank you for a thoughtful and detailed post. Without question you raise many good points. Drug utilization, access to care when millions of uninsured become insured, health labor force needs and malpractice reform are all issues that will need to be addressed in parallel with reform. Thanks again and keep reading!