Author: P Hasselbacher

Deaths Linked to Cardiac Stents Rise as Overuse Seen

StentsReporters Peter Waldman, David Armstrong, and  Sydney P. Freedberg of Bloomsberg News published an extensive report on overuse of angioplasty today that I have known was coming for several months.  Our fair state of Kentucky figures large in their expose of angioplasty abuse nationwide.  The article illuminates the reasons why this fee-for-service industry is out of control.  You will not be happy when you read it.

The profound shame is that this same scenario plays out for many other medical services in many other settings and with many other providers. Until we have a system that can deal with the misplaced incentives built into our healthcare system, we will never get a handle on the run-away health costs for services of lesser quality than we all deserve.  The medical-industrial-governmental complex has not be able to deal with this issue by itself.  It needs the knowledgeable cooperation of the public who pays for the whole thing!

Read KHPI’s coverage of this matter over the last year by clicking the “Angioplasty Abuse” link below.  This scandal is far from over, in Kentucky or the nation.

Peter Hasselbacher, MD
President, KHPI
Emeritus Professor of Medicine, UofL
September 26, 2013

Norton Healthcare and University of Louisville Meet Over Kosair Children’s Hospital Dispute

This started out to be the shortest ever post in the history of this policy blog. All I had to report was the following press release from Norton Healthcare.

Earlier today, representatives from Norton Healthcare and U of L held a meeting to discuss a number of issues relating to Kosair Children’s Hospital. Norton officials characterized the discussion by saying:

“We had a constructive meeting and plan to meet again.”

I was going to add that in diplomatic-speak, this amounts to the equivalent of, “everyone walked away from the meeting alive.” Continue reading “Norton Healthcare and University of Louisville Meet Over Kosair Children’s Hospital Dispute”

New Medicaid Managed Care Providers for Kentucky.

But only for new beneficiaries and not in Region 3?

Significance to Norton-UofL dispute over pediatric care.

We have been waiting for these next shoes to drop. The Commonwealth of Kentucky has announced its award of new contracts to three Medicaid Managed Care Organizations (MCOs) to provide services to new Medicaid beneficiaries in the 104 Kentucky counties not in Region 3. The contracts went to: Anthem of Kentucky (a division of Wellpoint that is an entirely different company from WellCare), Humana, and Passport (University Health Care, Inc.). These additions come just ahead of the major expansion of Kentucky Medicaid resulting from the federal Patient Protection and Affordable Care Act, known affectionately to some as Obamacare. Some 300,000 new beneficiaries will be added to the current 715,000 beginning January 2014. Continue reading “New Medicaid Managed Care Providers for Kentucky.”

Newborn Nursery and Neonatal Care in Kentucky’s Hospitals, 2012

Focus on Louisville.

Although in a previous life as a clinician I always cared for a few children by default, I cannot claim to have insider or expert knowledge about the operations or politics of children’s hospitals. Nonetheless, when I was a hospital lobbyist, I always made a point of bringing visiting legislators through Norton Kosair Children’s Hospital to brag about the fruitful cooperation between the University and a private hospital in which no patient was ever turned away for inability to pay no matter how long they stayed. (I would have to think twice before doing that today.) I therefore take the opportunity provided by the current University of Louisville/Norton Healthcare dispute to familiarize myself with pediatric care in the state.

Going to the numbers.
It should be no surprise to my readers that as an old scientist, I like to look at the numbers. I can’t spell or remember names, but patterns emerge when I look at tables of data causing me to want to know more. So it was when I looked at the distribution of Neonatal Intensive Care Units throughout the state. The obvious next step was to take a closer look at how those beds were being filled with patients. I have already posted relevant pages from hospital utilization data collected by the Cabinet for Health and Family Services for 2012. Lets take a closer look. For simplification, and to get an initial handle on what the data might tell us and what it cannot, I extract here the numbers for births and special care bed admissions for children in Louisville, and for comparison, the University of Kentucky. (Download Table as PDF.) Continue reading “Newborn Nursery and Neonatal Care in Kentucky’s Hospitals, 2012”