A variety of Medical Professionals overstate their quality of care

I ran across this well spoken woman Alicia Caramenico who wrote this article about our medical professionals and I want to share her thoughts with you as she stated in Fierce Healthcare, here ya go…

Amid calls to improve care, a new study suggests physicians and nurses may give themselves higher marks than they deserve for care quality for hospital patients prior to a serious complication, Reuters Health reported.
After examining 47 patient records, Dutch researchers revealed a disconnect between the quality of care found by independent experts and the quality of care providers thought they delivered.
The nurses and doctors said they were good at identifying a patient’s deteriorating condition, giving themselves high marks in communication, cooperation and care coordination, according to the study published in the journal Critical Care Medicine.
However, researchers found a delay in spotting deterioration in 60 percent of the patients, and 38 patients providers should have considered “at risk” in the two days leading up to complications.
Physicians’ and nurses’ misperceptions might explain why providers sometimes hesitate to implement patient safety efforts, the researchers noted.
Meanwhile, healthcare leaders also are overestimating the care provided at their organizations, noted Becker’s Hospital Review.
According to a recent Studer Group survey, for hospitals where 75 percent to 100 percent of leaders said their organization “did well” at delivering quality care, HCAHPS survey scores didn’t match up.
Such disconnects are alarming. “If you overrate performance, you’re not going to improve it,” Quint Studer told Becker’s. “Or rather, if you don’t know something is broken, you won’t be empowered to fix it.”

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Insurance Department Releases Rebate Data for Calif. Health Insurers – That means ”Rebate $$ Money” – read on….

On Tuesday, the state Department of Insurance released information on rebates being sent out by California health insurers this week under a federal health reform law provision.

Background

Under the reform law’s medical-loss ratio rule, private insurers must spend at least 80% in the individual market or 85% in the group market of premium dollars on direct medical costs.

Insurers that do not comply with the ratio must issue rebates to consumers.

About 1.8 million Californians are expected to receive a total of $73.9 million in rebates.

The average rebate amount in California is about $65 per family.

Rebates Issued by California Insurers

According to DOI, California insurers sending MLR rebates include:

* Aetna Life Insurance, which is issuing $3.4 million in rebates to large-group employers covering 84,428 policyholders, with an average rebate of $40.50;

* Anthem Blue Cross, which is issuing $38.6 million to 182,214 small-group policyholders with an average rebate of $212.

* Anthem Blue Cross Life and Health Insurance, which is issuing $1.3 million to 407,429 individual policyholders with an average rebate of $3.16;

* Blue Shield of California Life & Health Insurance Co., which is issuing $10.8 million to 239,595 individual policyholders with an average rebate of $45.15;

* Connecticut General Life Insurance, which is issuing $3.4 million to large-group employers covering 89,575 policyholders with an average rebate of $37.70;

* Kaiser Permanente Insurance, which is issuing $277,034 to 21,823 individual policyholders with an average rebate of $12.69;

* PacifiCare Life and Health Insurance, which is issuing $789,615 to large-group employers covering 63,600 policyholders with an average rebate of $12.42; and

* United HealthCare, which is issuing $3.8 million to 22,260 small-group policyholders with an average rebate of $173.

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