Here are some other local, state or national stories we are reading that may impact you, your practice or your patients.

California: Leading the Way? | Using hospital discharge data for 2007–16, Allen Fremont of the RAND Corporation and coauthors compared rates of hospitalizations due to acute myocardial infarction (AMI) in San Diego County with rates in the rest of the state — finding that county rates decreased by 22% versus 8% statewide. The authors’ goal was to quantify the impact of Be There San Diego, a multi-stakeholder collaborative aimed at reducing cardiovascular events by spreading best practices for improving control of hypertension, lipid levels, and blood sugar and through patient and medical community activation. The 22% decrease in hospitalization rates resulted in an estimated 3,826 AMI hospitalizations avoided, resulting in an $86 million savings in San Diego County. The study findings show that a science-based collaborative can improve health outcomes while lowering costs.

Medicare Appeals Board Drops Under-the-Radar Rule Changes | Hospitals can appeal certain Medicare payment decisions to an independent board, but with all the landmines involved, it's kind of like playing the board game Operation. "You're walking this fine, thin line; one false move and the red light goes on," said Ken Marcus, a partner with the firm Honigman Miller Schwartz and Cohn in Detroit. That board, the Provider Reimbursement Review Board, issued 90 pages of updated rules that, if not followed to the letter, could scrap appeals worth millions of dollars. The new rules were issued without notice and took effect when they were issued last week.

How to Tame HealthCare Spending? Look for One Percent Solutions | The healthcare system in the United States costs nearly double that of its peer countries, without much better outcomes. Many scholars and policymakers have looked at this state of affairs and dreamed big. Maybe there’s some broad fix — high deductibles, improvements in end-of-life care, a single-payer system — that can make United States healthcare less expensive. But what if the most workable answer isn’t something big but a host of small tweaks? A group of about a dozen health economists has begun trying to identify policy adjustments, sometimes in tiny slices of the healthcare system, that could produce savings worth around 1% of the country’s $3.3 trillion annual health spending. If you put together enough such fixes, the group points out, they could add up to something more substantial.

What's Driving Physician Burnout in 2018? | When the microphone was opened for questions, a physician from the United States took the floor. "EPIC!" he said, with great emphasis, each word measured. "They have complete disregard and antagonism for physicians. Any concern is regarded as whining and belly aching by a bunch of people who they view as completely worthless. ... Most of us like me … we get angry. ... The angry physician is least likely to get support because they are angry," he bemoaned. That one-minute tirade at the European Society of Cardiology (ESC) 2018 Congress drew deafening applause from the jam-packed room of attendees. Indeed, administrative and electronic health record (EHR) duties were among the most common issues mentioned that have destroyed the practice of medicine. Ultimately both physicians and patients lose.

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