DOJ joins lawsuits against Kaiser Permanente affiliates for submitting inaccurate diagnosis codes to the Medicare Advantage Program

Going after Kaiser Permanente, a company that many view as the gold standard for Medicare Advantage, indicates the problem may touch almost every corner of the industry. The lawsuit alleges Kaiser Permanente knowingly made its Medicare Advantage patients look sicker than they were, to obtain more money from the federal government. These allegations, which come…

Research demonstrates that healthcare industry consolidation drives up cost and does not improve the quality of care!

Insurers and employers are not able to negotiate lower prices with hospital systems or establish smaller networks they believe deliver greater value when 1 or 2 healthcare systems are the only ones that own nearly all clinics and medical practices. These mergers have raised cost by as much as 50%. A new executive order, that…

US Nursing Shortage (PART V)

What solutions are then available to improve the nursing shortage? (continued) Group 2 is a collection of operational and recruitment and retention practices that should be embedded in all healthcare organizations. Let us start with the operational methodologies, but first a side note: I am often told that none of these methodologies matters when “we…

US Nursing Shortage (PART III)

Some of the key impacts of the nursing the shortage: Nurses confront life-altering decisions on a constant basis. Pandemic or not, having fewer nurses available to spread the workload adds levels of stress and limits the time available for patient care. Among the implications: opportunities to bypass safety protocols and lapses in treatments less attention…

US Nursing Shortage (PART II)

Several other factors are compounding the shortage: Location: estimates of nursing shortages at the state level are all over the place, with some states projected to have large shortages (CA >200K by 2030) and some avoiding it all together (“if” the current ratios of RNs per 1,000 population hold!) Rural communities: absorb greater impacts of…