Michigan health systems could run out of vaccines by middle of next week

Shah said senior patients receiving care at Dedicated centers experience 50 percent fewer hospital admissions compared with a standard primary-care practice, 28 percent lower per-member costs and significantly higher use of evidence-based medications than the comparable averages for Medicare beneficiaries.

One of the keys to managing patient care, said Shah, is that Dedicated’s providers average 200 to 250 minutes per year seeing each member, including an evaluation for physical, behavioral and social service needs. The average Medicare Advantage member sees his or her doctor an average of 20 minutes per visit, he said.

Duane DiFranco, Blue Cross’ vice president of medical management and senior health services, said care will be coordinated with the members’ existing primary care doctors or federally qualified health centers, if they have them.

Statewide, Blue Cross has approximately 140,000 members in individual Medicare Advantage plans, said DiFranco, adding that the members serviced by ChenMed would be

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Posted on 1 month ago

Mich. health systems adjust for vaccine increase, ask state to give them more

Shah said senior patients receiving care at Dedicated centers experience 50 percent fewer hospital admissions compared with a standard primary-care practice, 28 percent lower per-member costs and significantly higher use of evidence-based medications than the comparable averages for Medicare beneficiaries.

One of the keys to managing patient care, said Shah, is that Dedicated’s providers average 200 to 250 minutes per year seeing each member, including an evaluation for physical, behavioral and social service needs. The average Medicare Advantage member sees his or her doctor an average of 20 minutes per visit, he said.

Duane DiFranco, Blue Cross’ vice president of medical management and senior health services, said care will be coordinated with the members’ existing primary care doctors or federally qualified health centers, if they have them.

Statewide, Blue Cross has approximately 140,000 members in individual Medicare Advantage plans, said DiFranco, adding that the members serviced by ChenMed would be

Read More

Posted on 1 month ago

Beaumont’s new anesthesia model in place at additional hospitals

Shah said senior patients receiving care at Dedicated centers experience 50 percent fewer hospital admissions compared with a standard primary-care practice, 28 percent lower per-member costs and significantly higher use of evidence-based medications than the comparable averages for Medicare beneficiaries.

One of the keys to managing patient care, said Shah, is that Dedicated’s providers average 200 to 250 minutes per year seeing each member, including an evaluation for physical, behavioral and social service needs. The average Medicare Advantage member sees his or her doctor an average of 20 minutes per visit, he said.

Duane DiFranco, Blue Cross’ vice president of medical management and senior health services, said care will be coordinated with the members’ existing primary care doctors or federally qualified health centers, if they have them.

Statewide, Blue Cross has approximately 140,000 members in individual Medicare Advantage plans, said DiFranco, adding that the members serviced by ChenMed would be

Read More

Posted on 1 month ago

Michigan Blues to change pharmacy benefit manager from Express Scripts to OptumRx

Shah said senior patients receiving care at Dedicated centers experience 50 percent fewer hospital admissions compared with a standard primary-care practice, 28 percent lower per-member costs and significantly higher use of evidence-based medications than the comparable averages for Medicare beneficiaries.

One of the keys to managing patient care, said Shah, is that Dedicated’s providers average 200 to 250 minutes per year seeing each member, including an evaluation for physical, behavioral and social service needs. The average Medicare Advantage member sees his or her doctor an average of 20 minutes per visit, he said.

Duane DiFranco, Blue Cross’ vice president of medical management and senior health services, said care will be coordinated with the members’ existing primary care doctors or federally qualified health centers, if they have them.

Statewide, Blue Cross has approximately 140,000 members in individual Medicare Advantage plans, said DiFranco, adding that the members serviced by ChenMed would be

Read More

Posted on 1 month ago

Michigan health systems could run out of vaccines by middle of next week

Health systems asking Michigan state officials to speed up COVID-19 vaccine deliveries have an ally now in U.S. health secretary Alex Azar, who announced Tuesday he has authorized release of all Pfizer and Moderna doses the federal government has warehoused for second doses.

But Azar also said the earliest states could receive the hundreds of thousands of extra doses is two weeks, after Joe Biden is inaugurated as the nation’s 46th president.

This week, Michigan received one of the lowest number of doses since mid-December, 60,450, which resulted in fewer distributions by five-fold than what health systems, local health departments and federally qualified health centers requested, system executives said.

Spokesperson Lynn Sutfin of the Michigan Department of Health and Human Services told Crain’s Wednesday morning that the federal government has only promised 62,400 doses of the Pfizer vaccine for next week.

Until the end of the month, the state’s Moderna

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Mich. health systems adjust for vaccine increase, ask state to give them more

Dr. Adnan Munkarah, Henry Ford Health System’s chief clinical officer, said the six-hospital health system plans to ramp up the number of vaccine doses between 4,000 to 5,000, up from about 1,100 to 1,300 per day, but only if the Detroit-based system receives more Pfizer doses from the state.

“We received a very small allocation this week. We are identifying people in our medical records over age 65 who fit the criteria for vaccination,” Munkarah said. “We are working with the state on vaccine availability. The state’s doses are based on what they receive from the federal government and the numbers are not enough.”

Munkarah said Henry Ford would also run out of vaccines by Tuesday or Wednesday if it doesn’t receive another large shipment. He said the system asked the state for 20,000 doses last week and only got about 6,000.

“We need to have more consistency” and advance

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Beaumont’s new anesthesia model in place at additional hospitals

Irving, Texas-based NorthStar Anesthesia has taken over anesthesia services at Beaumont Health’s three northern hospitals in Royal Oak, Troy and Grosse Pointe and associated ambulatory surgery centers and pain clinics, a move that angered some anesthesia nurses, surgeons and physicians when the contract was announced last summer.

With the consolidated contract, which began Jan. 1, NorthStar now offers comprehensive anesthesia services to seven of Beaumont’s eight hospitals. Last August, NorthStar started managing anesthesia services at Beaumont’s Dearborn, Taylor, Trenton and Wayne hospitals and their associated ambulatory surgery centers and pain clinics.

NorthStar replaced Anesthesia Associates of Ann Arbor for Beaumont’s four southern hospitals and North American Partners in Anesthesia for its three northern hospitals. Both anesthesia groups worked at Beaumont for many years and a number of long-serving anesthesiologists left to practice elsewhere over objections to the contract switch.

“NorthStar is proud to serve Beaumont, a pillar of Michigan health

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Michigan Blues to change pharmacy benefit manager from Express Scripts to OptumRx

Blue Cross Blue Shield of Michigan and Blue Care Network have decided to change pharmacy benefit managers to help reduce prescription prices and more effectively deliver services to members.

The switch from St. Louis-based Express Scripts Inc. to Irvine, Calif-based OptumRx will take effect Jan. 1, 2022, for commercial individual and group members, and Jan. 1, 2023, for Medicare individual and group members, the Michigan Blues said in a statement.

“Preparations are already underway to manage the change, which will be a significant corporate project spanning more than two years,” said Blue Cross in a Jan. 6 internal memo that Crain’s obtained. “We’re working with a firm that specializes in pharmacy benefit manager changes to ensure a smooth transition with no disruption for our group customers and members.”

Express Scripts is owned by Cigna and OptumRx is owned by another rival insurer, Minnesota-based United Healthcare. Blue Cross extended its existing

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Former DMC doctors awarded $10.6 million in arbitration for alleged wrongful discharge

On Oct. 1, 2018, Kaki and Elder were fired by DMC and later lost their medical staff privileges. Since 2014, they had been outspoken internally about concerns over quality of care problems at DMC.

In March 2019, Kaki and Elder sued DMC and its parent, Tenet Healthcare Corp. of Dallas, and four executives for retaliation under state and federal false claims acts.

For years, Elder and Kaki were top patient admitters and popular doctors among patients, staff and resident physicians. They had reported multiple problems to top management about dirty medical and surgical instruments, unnecessary procedures on patients performed by other doctors, lack of nursing staff and cutbacks in critical lab and support services.

In a 41-page lawsuit filed in U.S. District Court in Detroit, the two doctors also claimed top DMC and Tenet executives failed to investigate alleged incidents of Medicare and Medicaid fraud.

The U.S. Department of Justice

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