Archive for April, 2011

Obesity Raises Complication Risks with General Anesthesia

20 Apr

Obesity comes with many health risks, but what makes matters worse is that if you end up in the hospital for one of those health problems, being heavy can lead to complications with the anesthesia used in surgical procedures.

Researchers in the United Kingdom have found that obese patients have double the risk of non-obese patients of developing serious airway complications while they are under a general anesthetic. People who are severely obese were actually four times more likely to develop the same complications.

The researchers analyzed all major airway complications that occurred among patients in the UK who received general anesthesia between 2008 and 2009. The study focused on situations that led to severe consequences, such as the need for a breathing tube to be inserted in the front of the neck, being admitted to the intensive care unit (ICU), brain damage or death.

The researchers also found that, while obese patients are more likely to die if they experienced airway complications in the ICU, when a breathing monitor called a capnograph is used, the chances of brain damage and death are greatly reduce

"The report is important for patients and anesthetists alike," said the study’s co-author Dr. Nick Woodall, a consultant anesthetist at the Norfolk and Norwich Hospital in the United Kingdom.

"The information will enable obese patients to be better informed about the risks of anesthesia and to give informed consent. We hope our findings will encourage anesthetists to recognize these risks and choose anesthetic techniques with a lower risk, such as regional anesthesia, where possible, and also prepare for airway difficulties when anesthetizing obese patients," said Woodall.

Most of the major health complications that come with being obese present major risks for complications while under anesthesia. Heart risks, blood clots, and blood pressure are among the issues associated with obesity and surgery.

But there are some overlooked problems that anesthesiologists and other healthcare professionals face with obese patients. For instance, it can be more difficult to locate veins in obese patients. Also, a medical professional has to be able to figure out that if an obese patient is experiencing chest pain, whether that is just tightness due to being obese or a risky cardiac problem.

Since obesity is one of the risk factors that can’t be hidden, forgotten, or accidentally not included in one’s medical records, there is no reason that the patient shouldn’t have the opportunity to discuss their anesthesia options with their doctor before a medical procedure is performed.


Senate Bill Looks to Make Medicare Billing Data Public

07 Apr

A Senate bill, introduced by Senator Charles Grassley (R, Iowa), is looking to trim Medicare fraud. In the process, physician billing data would be published online, irking doctor privacy advocates.

The bill would allow people to see how much doctors earn each year from the program. The data has been kept private by a court ruling for more than 30 years. Lawmakers are looking to lift the ban in order to bring Medicare billing data public in an effort to prevent fraud.

The measure was presented to a Senate Finance Committee hearing on Medicare and Medicaid fraud on March 2, 2011. Part of the bill’s requirements would be that the Deptartment of Health and Human Services starts to publish Medicare claims and payment data on the website by the end of 2012.

According to Senator Grassley, making the data public could save billions each year in taxpayer dollars.

"More transparency about billing and payments increases public understanding of where tax dollars go," Grassley said. "The bad actors might be dissuaded if they knew their actions were subject to the light of day."

Oregon Senator Ron Wyden (D) has said that he is drafting his own legislation that would make Medicare claims data available to the public.

On the other side of the argument you have the American Medical Association who says that only bad can come from publicizing the records and that those who monitor fraud already have access.

"Releasing Medicare claims data to the public does not further the goal of combating fraud, as those tasked with this responsibility already have access to the data," said Ardis Dee Hoven, MD, chair of the AMA Board of Trustees.

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Medicare Error Rate Falling

01 Apr

CMS, or the Centers for Medicare & Medicaid Services, set a goal to cut the Medicare fee-for-service error rate in half by 2012. According to a CMS official’s testimony in front of Congress, they are seeing progress towards that goal.

According to Deborah Taylor, CFO and director of the CMS’s Office of Financial Management, the error rate fell by nearly two percent from FY 2009 to FY 2010. Their goal is to cut the error rate from 12.4 percent to 6.2 percent by 2012.

Taylor testified alongside Health & Human Services Inspector General Daniel R. Levinson in front of the House Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies on March 17.

"We recommended that CMS take several actions to address these errors, including improving controls, educating providers and clarifying guidance," said Mr. Levinson in regards to the collaboration between CMS and HHS on developing methods of detecting and stopping payment on claims errors.

Ms. Taylor said the agency has installed automated safeguards for this year that could detect and reject payments for "medical services that are physically impossible, such as a hysterectomy billed for a male beneficiary."

She does caution that some errors can’t be corrected through automated means and that they need to be further reviewed and be susceptible to other means of correction.

The Centers for Medicare & Medicaid Services expects to process 1.2 billion Medicare claims in 2011.

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