I’ve been in healthcare for nearly 30 years. Started in IT during Y2K when we thought the world would end at midnight. Health Care is a super cluster fuck. I don’t see it being fixed until all...
I’ve been in healthcare for nearly 30 years. Started in IT during Y2K when we thought the world would end at midnight. Health Care is a super cluster fuck. I don’t see it being fixed until all these for profit insurers become non profits or at min not for profits as a first step.
Also in health IT. I worked for my local HIE up until a year or so ago when they went under. I legit thought my coworkers were messing with me when they said we still deliver hundreds of clinical...
Also in health IT. I worked for my local HIE up until a year or so ago when they went under. I legit thought my coworkers were messing with me when they said we still deliver hundreds of clinical messages via FAX.
They were not. Turns out we even used to snail mail results up until 6-7 years ago.
HL7 - still a cluster fuck. FIHR? Less of a cluster fuck I guess but we never got around to implementing it. EHR systems? Interoperability is still not 100%.
I don't think it's a coincidence either. 7-10% is a lot less than the other numbers mentioned in the article (20%, 30%, 50%, 66%). Which is going off of limited data, but still. If the insurance...
Vermont demands more details, requiring insurers that cover more than 2,000 Vermonters to publicly release prior authorization and prescription drug information that is similar to what the state insurance commissioners collect. Perhaps most usefully, insurers have to separate claims denied because of administrative problems — many of which will be resubmitted and paid — from denials that have “member impact.” These involve services rejected on medical grounds or because they are contractually excluded.
Mike Fisher, Vermont’s state health care advocate, said there’s little indication consumers or employers are using the state’s information, but he still thinks the prospect of public scrutiny may have affected insurers’ practices. The most recent data shows Vermont plans had denial rates between 7.7% and 10.26%, considerably lower than the average for plans on Healthcare.gov.
“I suspect that’s not a coincidence,” Fisher said. “Shining a light on things helps.”
I don't think it's a coincidence either. 7-10% is a lot less than the other numbers mentioned in the article (20%, 30%, 50%, 66%). Which is going off of limited data, but still. If the insurance companies are refusing to show their data, there's something to hide.
Not all insurers are created equal. MediCare, Blue Shield of CA and HealthNet are reasonable. Blue Cross of CA is an absolute horror show. As a general matter, patients never file a complaint with...
Not all insurers are created equal.
MediCare, Blue Shield of CA and HealthNet are reasonable. Blue Cross of CA is an absolute horror show.
As a general matter, patients never file a complaint with state regulators as they feel it's a fight they can't win, they don't generally trust the government and they fear a billing contest with their insurance above all else.
It's a pity, since the state's regulatory agencies want to hear from patients, not doctors.
I’ve been in healthcare for nearly 30 years. Started in IT during Y2K when we thought the world would end at midnight. Health Care is a super cluster fuck. I don’t see it being fixed until all these for profit insurers become non profits or at min not for profits as a first step.
Also in health IT. I worked for my local HIE up until a year or so ago when they went under. I legit thought my coworkers were messing with me when they said we still deliver hundreds of clinical messages via FAX.
They were not. Turns out we even used to snail mail results up until 6-7 years ago.
HL7 - still a cluster fuck. FIHR? Less of a cluster fuck I guess but we never got around to implementing it. EHR systems? Interoperability is still not 100%.
I don't think it's a coincidence either. 7-10% is a lot less than the other numbers mentioned in the article (20%, 30%, 50%, 66%). Which is going off of limited data, but still. If the insurance companies are refusing to show their data, there's something to hide.
Not all insurers are created equal.
MediCare, Blue Shield of CA and HealthNet are reasonable. Blue Cross of CA is an absolute horror show.
As a general matter, patients never file a complaint with state regulators as they feel it's a fight they can't win, they don't generally trust the government and they fear a billing contest with their insurance above all else.
It's a pity, since the state's regulatory agencies want to hear from patients, not doctors.