Key Takeaways Here’s why you’ve been hearing about a possible government shutdown next week: Keeping the U.S. government running requires Congress to authorize spending by September 30 of each year, since the federal government’s fiscal year begins on October 1. So far, though, Congress has not been able to agree on spending levels for federal agencies … Read more
Key Takeaways In an updated guidance, the Centers for Disease Control and Prevention (CDC) now encourages healthcare providers to have discussions with patients about potential exposure to PFAS and to determine if blood testing would be useful. This is the first time the CDC and the Agency for Toxic Substances and Disease Registry (ATSDR) have … Read more
Key Takeaways Rats in New York City are becoming more than a nuisance. The New York City Department of Health has released a health advisory after recording six cases of human leptospirosis, an infection with Leptospira bacteria that can be spread through rat urine. In 2023, the city recorded 24 cases, the highest number in a single year. Leptospirosis … Read more
Disease management is an approach to health care that teaches patients how to manage a chronic disease. Patients learn to take responsibility for understanding how to take care of themselves. They learn to avoid potential problems and exacerbation, or worsening, of their health problem. Example: One step in teaching disease management to a diabetes patient is … Read more
The standard of care is a benchmark used in medicine to determine whether the professional obligations to patients have been met by a healthcare provider. Failure to deliver the standard of care may be deemed medical negligence.1 Standard of care is a legal term—not a medical one—defined by law and regulated by state administrative agencies. … Read more
The word “ambulatory” refers to walking. It is used quite often in medical settings to refer to a variety of healthcare concerns. It’s also used often in medical research, as a factor that influences medical outcomes, quality of life, and how treatment decisions are made.1 If you’re having outpatient surgery, it’s ambulatory. Once you’re able … Read more
Determining Who Needs Emergency Attention First The term “triage” means sorting out. Medically, it’s a process used to prioritize who needs emergency medical attention first, whether injured or sick people or disaster survivors. Patients are triaged or prioritized according to their need for emergency care. Resource availability is also taken into account during this process. … Read more
Payment to Healthcare Providers, Hospitals, or Others Who Provide Medical Services Healthcare reimbursement is the payment that your hospital, healthcare provider, diagnostic lab, or other provider receives for providing you with a medical service. The most common method is fee-for-service (FFS) in which the reimbursement is made for each individual service performed.1 Reimbursement is often made by … Read more
Pharmacy Benefit Managers Help Fill Your Prescriptions A pharmacy benefit manager (PBM) is a company that administers, or handles, the drug benefit program for your employer or health plan. PBMs process and pay prescription drug claims and are responsible for creating and updating your health plan’s drug formulary. Because these companies can buy medications in large … Read more
Capitation is a type of healthcare payment system in which a physician or hospital is paid a fixed amount per patient for a prescribed period by an insurer or physician association. The cost is based on the expected healthcare utilization costs for a group of patients for that year. With capitation, the physician—otherwise known as … Read more