REIMBURSEMENT
Medicare reprieve for doctors—and patients
The Numbers
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Last-minute congressional action to avert this year's scheduled 5 percent Medicare physician payment cut will help to ensure
access to care for America's seniors, says AMA Board Chair Cecil Wilson. If the 2007 Medicare cut had occurred as planned,
nearly half of physicians told the AMA they would have been forced to limit the number of new Medicare patients accepted into
their practice.
Under legislation passed by both houses, physicians will continue to receive the 2006 payment rate, and $1.35 billion will
be set aside to fund future payment and quality improvement. The money could be used to adjust the conversion factor in 2008.
Also, physicians who report certain quality measures through CMS' Physician Voluntary Reporting Program will be eligible to
receive a 1.5 percent bonus for services provided from July 1 through Dec. 31 of 2007. CARS
Plan now to maximize your car's resale value
Top 2007 models
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Honda and Acura vehicles are tied for the best resale values after five years, says Kelley Blue Book, a vehicle information
company. Depreciation is often the largest expense to hit drivers during the first five years of ownership. The average vehicle
will be worth only about 35 percent of its original retail price after five years, so that $20,000 car you buy today will
probably be worth about $7,000 in 2012.
Aside from buying a car with a high resale value, you can protect your investment by choosing features that used car buyers
will want down the road, such as antilock brakes, alloy wheels, CD player/changer, leather seats , and navigation system.
You should also stick with a popular color, such as black, white, or silver.
HOME IMPROVEMENTS
Remodeling will cost you more, earn you less
The costs of home projects keep going up, but the value of the work is shrinking, says an annual survey conducted for Remodeling magazine. A major kitchen remodeling cost a national average of $54,241 in 2006, with an 80 percent return on resale. The
same project cost an average of $43,862 in 2005 but earned back 91 percent of the costs. Midrange bathroom remodelings set
homeowners back an average of $12,918 in 2006, with an 85 percent resale value, compared to $10,499, with a 102 percent return,
in 2005.
MEDICAL ERRORS
Criminal actions or merely mistakes?
The Wisconsin Department of Justice recently filed criminal charges against a nurse who mistakenly administered an epidural
intravenously, resulting in a patient's death. Now the Wisconsin Hospital Association warns that the DOJ's action could have
a negative impact on the quality of care statewide because it sends a chilling message to healthcare providers in the state
and those interested in practicing there. Moreover, the WHA contends that "mistakes will occur." It argues that because of
the nature of healthcare delivery, the risk of a mistake "can be minimized" but not eliminated.
In a statement, the Institute for Safe Medication Practices supported the WHA's position: "Patient safety is better served
by determining the system-based weaknesses that led to this error, sharing lessons learned with others, and taking action
to prevent similar errors, rather than engaging in egregious criminal prosecution of a single individual."
CREDIT CARDS
Plastic, to control teens' spending?
A new prepaid MasterCard lets you dole out an allowance and set limits on where your kids can spend their money. The Allow
Card ( http://www.allowcard.com), issued by South Dakota-based First Bank & Trust, includes 35 parental controls, including blocks on specific merchants.
You'll also soon be able to keep your children from using the cards to get extra cash from an automated teller machine. But
this peace of mind isn't cheap. You'll pay an activation fee of $19.95, $3.95 in shipping, and a monthly fee of $3.50 per
account.
INVESTING
Don't count on your broker to save you money
Buying a load index fund through a broker will probably cost you three times as much in fees over time than if you bought
a no-load version on your own, says a new study. Investors who buy equity index funds through a broker usually end up in load
funds that carry higher operating charges, says the study from Zero Alpha Group, a network of independent investment advisory
firms, and Fund Democracy, a mutual fund shareholder advocacy group. Assuming a 10 percent annual return, the average investor
making a $10,000 investment, held over 20 years, would pay about $2,582 in expenses for a no-load equity index fund that doesn't
charge 12b-1 fees, used to cover sales and marketing expenses. If the no-load does charge these fees, however, the investor's bill comes to $3,744. That amount more than doubles for load funds that carry
12b-1 fees, to a whopping $7,600.
HEALTH RECORDS
Patients are of two minds when it comes to access
Gaining access to their medical records across an electronic network makes most patients leery, according to a survey
commissioned by the Markle Foundation. While nearly two-thirds of respondents said they'd like to be able to retrieve their
medical records electronically—especially when changing doctors—four out of five people raised concerns about identity theft
or fraud and feared that marketers could use their data without permission. If safeguards to protect their identity were in
place, however, three out of four patients would be willing to share their personal information to help improve the quality
of care and identify disease outbreaks.
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