Second Look Advocacy

Geographic variation in healthcare spending
An interim report on geographic variation in healthcare spending released by the Institute of Medicine observes that, even after adjusting for variables such as wages, rents, and attributes of Medicare patient populations, including age and health status, a significant amount of regional variation in Medicare payments remains unexplained. Overall, differences in Medicare patients’ age, sex, and health contribute to, but do not fully explain all the variation.

Defensive medicine costs more than $250 million a year
Data from a survey published in the Journal of Orthopaedic Trauma suggest that defensive medicine among orthopaedic trauma surgeons is a significant factor in healthcare costs. The survey of 1,214 orthopaedic surgeons found that, among orthopaedic traumatologists, 22 percent of all ordered tests were for defensive reasons, and defensive hospital admissions averaged 9 percent each month. Based on 2011 Current Procedural Terminology code reimbursement data, the research team calculated defensive medicine costs per respondent to be approximately $7,800 monthly or $94,000 per year, or $256.3 million annually across approximately 2,274 U.S. orthopaedic trauma surgeons.

Physician employment by hospitals
An article in HealthLeader’s Media cites data showing that the medical staff model of working with independent physicians is in decline and notes that younger physicians are displaying a generational shift in their overall work philosophy to focus more intently on patient care but also to give their lives stability. According to the author, under some circumstances, employing physicians can actually decrease organizational alignment and ultimately affect the hospital’s profitability.

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