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Have you ever had the experience of a company overcharging you, but not listening to your reasons for their incorrect charging? Kaiser Health News published a story about one doctor being overcharged and his wife's subsequent experience in getting the charge corrected.

Have you ever had the experience of a company overcharging you, but not listening to your reasons for their incorrect charging? Kaiser Health News published a story about one doctor being overcharged and his wife's subsequent experience in getting the charge corrected.

Although the outcome was positive (with the couple saving over $2,000), it's notable that the patient himself is a doctor and that his wife oversees billing at the patient's practice. Even still, the couple had challenges getting their charges rectified. Perhaps not surprisingly, the hospital stated that its charge for a specific procedure was reasonable, despite being nearly double the out-of-network price estimated for that hospital's ZIP code. What is surprising, though, is the insurer's unwillingness to engage with the dispute -- despite the possibility of saving thousands of dollars. The final resolution was that the hospital admitted to charging for a procedure that was not actually performed. Unfortunately, the discrepancy is not one that was easily determined by the patient or his wife, let alone the average patient. The entire account raises the larger question of how frequently this type of mistake happens, and whether the system could be set up differently to better protect against these mistakes.

Kaiser Health News reported on how the hospital landscape might be changing with the addition of a new department: obstetrics emergency departments (OBEDs). Apparently, visits to these new departments can cost over a thousand dollars, without patients even realizing that they incurred a new fee. The article strongly suggests that these fees are likely to be engineered for hospitals to extract more money while not providing better patient care. For example, the article points out that a selling point for hospitals to adopt these new departments is "'boosting hospital revenues' with 'little to no structural investment for the hospital.'" The medical personnel who are quoted in the article seem skeptical of how these new departments enhance patient care, although various marketing and communications personnel made positive statements about the practice.

Kaiser Health News reported on how the hospital landscape might be changing with the addition of a new department: obstetrics emergency departments (OBEDs). Apparently, visits to these new departments can cost over a thousand dollars, without patients even realizing that they incurred a new fee. The article strongly suggests that these fees are likely to be engineered for hospitals to extract more money while not providing better patient care. For example, the article points out that a selling point for hospitals to adopt these new departments is "'boosting hospital revenues' with 'little to no structural investment for the hospital.'" The medical personnel who are quoted in the article seem skeptical of how these new departments enhance patient care, although various marketing and communications personnel made positive statements about the practice.

For now, it seems that these visits are relatively rare, although they appear to be growing in frequency. However, given the large amounts of money that are in health care, it is not surprising that private equity firms are investing in companies that help hospitals grow their profits. Theoretically, insurance companies have an incentive to stem these practices, but it is possible that these particular charges are small enough for them to not worry about -- at least for now. There is already widespread dissatisfaction with how expensive health care is, and it is unclear how awareness of tactics like these might result in changes to the regulatory or competitive environment for the industry.

Kaiser Health News published an interesting article about a journalist's quest to find better sleep. After the diagnosis, doctors recommended expensive testing. The journalist had previously "spent years covering the business of health care" and wrote about some conflicts of interest by the American Academy of Sleep Medicine, which determines the criteria for sleep apnea.

Kaiser Health News published an interesting article about a journalist's quest to find better sleep. After the diagnosis, doctors recommended expensive testing. The journalist had previously "spent years covering the business of health care" and wrote about some conflicts of interest by the American Academy of Sleep Medicine, which determines the criteria for sleep apnea.

In some ways, the conflict of interest might seem unavoidable. As an analogy, the American Dental Association is perhaps in the best position to publish guidelines on how frequently patients should come in for regular cleanings; at the same time, the association's members benefit financially if the association promotes a more frequent cleaning schedule. This article indicates that the American Academy of Sleep Medicine claims that every adult who is affected by five relatively common conditions should be screened for sleep apnea every year. Interestingly, the U.S. Preventive Services Task Force, an organization that grades the effectiveness of preventive care, seems to think that the American Academy of Sleep Medicine's recommendation for screening is too broad. Additionally, the author noted that his cost-effective treatment was never broached by the specialists that he saw: sleeping on his side. It is perhaps understandable that doctors might want a more comprehensive solution, but it seems that doctors should offer various treatment options and allow patients to make an informed decision. With both of these issues (screening guidelines and the broaching of various treatment options), it seems that professional organizations have conflicts of interest.

This week, we released another feature that we have also started working on a while ago: comments. Now, users can leave comments on provider profiles, in addition to reviews.

This week, we released another feature that we have also started working on a while ago: comments. Now, users can leave comments on provider profiles, in addition to reviews.

Reviews are meant to be opportunities for users to share close-up experiences of providers' services. For more information, please see our review guidelines. We intend for information not related to a patient's experience of a provider's services (such as an office being closed on a certain day or a provider accused of some impropriety) to not be captured in a review, but in a comment. Part of the rationale behind this policy is that some users have written negative reviews for providers based on factors outside of clinical practice (e.g. hobbies or heritage), and we think those reviews might unfairly reflect on a provider's actual skill in practice. We hope comments will give people who have meaningful information to contribute (but not a personal experience with a specific provider) an opportunity to do so. Our guidelines for comments can be found here.

Following the consequences of the opioid epidemic, people have been looking for people and companies to blame. The pharmaceutical companies that manufactured and marketed the opioids have been involved in the highest profile cases. However, the Department of Justice (DOJ) has also been going after doctors who wrote many prescriptions. Kaiser Health News reported on how the Supreme Court reached a unanimous decision that doctors who wrote multitudes of prescriptions -- far beyond what other medical professionals would consider reasonable -- are not necessarily vulnerable to a criminal conviction. The threshold appears to be that the doctors must have "knowingly or intentionally" written improper prescriptions, a charge that doctors can likely easily deny, given that no one else knows what they were thinking at the time of prescriptions.

Following the consequences of the opioid epidemic, people have been looking for people and companies to blame. The pharmaceutical companies that manufactured and marketed the opioids have been involved in the highest profile cases. However, the Department of Justice (DOJ) has also been going after doctors who wrote many prescriptions. Kaiser Health News reported on how the Supreme Court reached a unanimous decision that doctors who wrote multitudes of prescriptions -- far beyond what other medical professionals would consider reasonable -- are not necessarily vulnerable to a criminal conviction. The threshold appears to be that the doctors must have "knowingly or intentionally" written improper prescriptions, a charge that doctors can likely easily deny, given that no one else knows what they were thinking at the time of prescriptions.

If a doctor's workload becomes dominated by patients asking for prescriptions for an addictive substance -- to the point that even most other medical professionals think is unreasonable -- what responsibility does the doctor bear in investigating further to determine if his or her patients are addicted? If the courts rule that there is no criminal liability, who else would enforce accountability? The most obvious other body would be the medical licensing board, but those boards tend to respond to patient complaints, which likely are not common in this case. The Supreme Court rationale appears to be the justices' reluctance to punish behavior that might be permissible, given that doctors are expected to write prescriptions. This decision seems to raise the bar for criminal conviction so high that perhaps too many professionals can get away with negligence.