Preventive medicine

Article Abstract:

Physicians will receive assistance in their efforts to practice preventive medicine by several recent developments. One is the 1989 publication of the Guide to Clinical Preventive Services, a collection of rigorously evaluated recommendations for screening and early disease detection, immunization and chemoprophylaxis for the prevention of 160 illnesses and conditions. Starting from the premise that most deaths in people under 65 years of age are preventable, the guide helps physicians identify high-risk patients. While preventive strategies may help to avert subsequent, more costly care, physician reimbursement for preventive medicine is almost nonexistent. The guide explains when such reimbursement is authorized. The only two preventive strategies covered by Medicare are vaccination against hepatitis B for high-risk patients and immunization against pneumococcal pneumonia. Papanicolaou tests (Pap test, a simple test for cervical cancer) are not currently covered by Medicare, but will probably be after July 1990. A report evaluating possible private and public payment mechanisms for preventive care was also issued in 1989. With the Guide, it will help to convince Congress, the Physician Payment Review Commission, and private insurers, among others, of the need to reimburse this kind of health care. With regard to specific diseases, measles seems to be increasing in the US, while the character of HIV (human immunodeficiency virus, the virus associated with AIDS) is changing from an acute illness to a chronic disease. Both situations raise issues about the practice of preventive medicine in disease containment. In the case of HIV infection, proposals for contact tracing and partner notification would involve both private practitioners and the public health community. (Consumer Summary produced by Reliance Medical Information, Inc.)

Laws, regulations and rules, Reports, Prevention, Communicable diseases, Medical care, Cost of, Health care costs, Preventive medicine, Medicare, Medicine, Preventive

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Uncompensated and discounted Medicaid care provided by physician group practices in Wisconsin

Article Abstract:

The cost of health care is rapidly increasing, as is the number of poor and uninsured adults and children. A survey was conducted of several physician group practices in Wisconsin regarding the amount of uncompensated care, in the form of charity, bad debt (those who can but will not pay their bills) and Medicaid care (which is discounted compared with normal fees). The survey evaluated care that was provided in 1988. The annual average amount of charity care was 1.6 percent of the total income of the physicians, bad debt was 3.0 percent and discounted Medicaid care was 3.0 percent, for a total average of 7.6 percent. In dollar amounts, this translated to an average of $4,300 not collected as charity care, $9,100 as bad debt, and $7,500 as Medicaid discounted services, for a total of $20,900 per year. Practices that had large volumes of discounted Medicaid cases also had large volumes of charity and bad debt cases. More charity care was being provided in 1988 than in 1983. Data describing the amount of uncompensated care that physicians provide is important when analyzing policies that would provide for the poor and uninsured. (Consumer Summary produced by Reliance Medical Information, Inc.)

Social aspects, Medical economics, Medicaid, Group medical practice, Wisconsin, Charities, Medical, Medical charities

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Economics

Article Abstract:

The medical profession needs to discuss the ethical aspects of physicians selling their practices to a health plan and then working as employees of the company. In one such case, a group of doctors sold their clinic to a for-profit HMO and continued to work in the clinic as employees of the HMO. They were paid handsomely for the business, but when the clinic continued to lose money, the HMO sold the clinic to another company. This company instituted cost-cutting measures, which led the doctors to consider unionizing. It is not known whether the physicians disclosed the details of the original deal to their patients.

Analysis, Mergers, acquisitions and divestments, Ambulatory care facilities, Clinics, Asset-backed securities, Asset backed securities

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