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Started By
Message
re: Medicaid should not pay for opioid prescriptions---
Posted on 10/14/17 at 9:35 am to GurleyGirl
Posted on 10/14/17 at 9:35 am to GurleyGirl
quote:
The disease tends to respond best to oxycotton
I'm sure it does.
Lol.
If not that then it’s another medicine, “can’t remember but t starts with a ‘d’”?
0
Posted on 10/14/17 at 9:38 am to el Gaucho
quote:
chronic diseases like fibromyalgia
What are the clinical markers for fibromyalgia?
Posted on 10/14/17 at 9:42 am to I B Freeman
It's amazing we have this opioid epidemic and still can't get marijuana legal, which would be a cheaper and safer alternative to pain management.
Posted on 10/14/17 at 9:44 am to SUB
Marijuana is a shitty pain reliever.
Posted on 10/14/17 at 9:51 am to the808bass
I never get prescribed them, what are people going in for to even get these? I think maybe the only time anyone gave me any was when I had my wisdom teeth removed.
Posted on 10/14/17 at 10:01 am to the808bass
My cousin has fibromyalgia and if he doesn't take his medicine he's extremely painful, can't hardly get out of bed, has diarrhea, cold sweats, almost flu like symptoms. People always make fun of it on here but fibromyalgia is a real disease!
Posted on 10/14/17 at 10:01 am to I B Freeman
Actually the two biggest factors for the increase in opioid prescriptions are "Pain as the 5th Vital Sign" and Press Ganey/ HCAPS
Pain as the 5th Vital Sign
https://www.medpagetoday.com/publichealthpolicy/publichealth/57336
In 2001 there was the notion that physicians were not treating pain appropriately and that we should focus more on pain. The introduced idea was treating pain as a vital sign (in addition to pulse, blood pressure, temperature, and oxygen saturation) The problem is that pain is subjective. But we were told by new standards that we should be treating the number of the pain score. This is one of the first marks and when you start seeing an increase in drugs used to manage pain
Press Ganey/ HCAHPS
https://www.pressganey.com/solutions/service-a-to-z/hcahps-regulatory-survey
HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) is your basic patient satisfaction survey. Now what the problem with this is that Medicare decided to tie 25% of their reimbursements to patient satisfaction. This is a terrible idea. Studies show that higher patient satisfaction is tied to worse patient outcomes and increased cost. Now imagine that you're working in the ER and someone comes in saying that they are in pain. If you don't think they need narcotics they may get angry, and give you a poor rating. This will decrease your take home pay for acting responsibly. If that patient ends up in the ER multiple times, they will get more surveys and the more it can affect take home pay. Also hospitals will pressure their doctors to improve their scores because it affects the hospital's income.
I don't think that this is right, but there are many doctors who start to cater to patients as customers and try to increase satisfaction instead of doing what is right for a patient.
Pain as the 5th Vital Sign
https://www.medpagetoday.com/publichealthpolicy/publichealth/57336
In 2001 there was the notion that physicians were not treating pain appropriately and that we should focus more on pain. The introduced idea was treating pain as a vital sign (in addition to pulse, blood pressure, temperature, and oxygen saturation) The problem is that pain is subjective. But we were told by new standards that we should be treating the number of the pain score. This is one of the first marks and when you start seeing an increase in drugs used to manage pain
Press Ganey/ HCAHPS
https://www.pressganey.com/solutions/service-a-to-z/hcahps-regulatory-survey
HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) is your basic patient satisfaction survey. Now what the problem with this is that Medicare decided to tie 25% of their reimbursements to patient satisfaction. This is a terrible idea. Studies show that higher patient satisfaction is tied to worse patient outcomes and increased cost. Now imagine that you're working in the ER and someone comes in saying that they are in pain. If you don't think they need narcotics they may get angry, and give you a poor rating. This will decrease your take home pay for acting responsibly. If that patient ends up in the ER multiple times, they will get more surveys and the more it can affect take home pay. Also hospitals will pressure their doctors to improve their scores because it affects the hospital's income.
I don't think that this is right, but there are many doctors who start to cater to patients as customers and try to increase satisfaction instead of doing what is right for a patient.
Posted on 10/14/17 at 10:06 am to el Gaucho
quote:
Many people have chronic diseases like fibromyalgia where unfortunately science hasn't found a cure and the only treatment is pain pills.
You say this in every pain pill thread. Pain pills are absolutely NOT the treatment for fibromyalgia. Any doctor who manages a diagnosis of fibromyalgia with opioids is either lazy or stupid.
Posted on 10/14/17 at 10:10 am to GEAUXT
Every stripper I've ever known has claimed to have Lupus. Their symptoms are pretty much identical to opiate withdrawal.
Posted on 10/14/17 at 10:10 am to el Gaucho
I'm not sure if you're trolling, as you like to do, but...
are signs of opioid withdrawal and not fibromyalgia.
I'm thinking you're trolling
quote:
extremely painful, can't hardly get out of bed, has diarrhea, cold sweats, almost flu like symptoms
are signs of opioid withdrawal and not fibromyalgia.
I'm thinking you're trolling
Posted on 10/14/17 at 10:22 am to GEAUXT
quote:quote:
extremely painful, can't hardly get out of bed, has diarrhea, cold sweats, almost flu like symptoms
are signs of opioid withdrawal and not fibromyalgia.
I'm thinking you're trolling
Either that or he's extremely gullible about what's wrong with his brother
Posted on 10/14/17 at 10:26 am to I B Freeman
quote:My 92 year old mom passed away 17 days ago from an acute, painful infection.
Medicaid should not pay for opioid prescriptions
All of her savings - around $470,000 - were wiped out paying for her care the previous few years. Once those funds were gone Medicaid kicked in.
During the last few weeks of her life, opioids administered by hospital staff and paid by Medicaid helped mitigate some of her suffering.
So yes, Medicaid should pay for opioids.
Posted on 10/14/17 at 10:27 am to I B Freeman
quote:There are two issues at play here. I'm not certain the author understands either.
According to the Agency for Healthcare Research and Quality, the number of opioid-related inpatient hospital stays nationwide (among states submitting data) that were paid for by Medicaid increased by about 40% between the fourth quarters of 2012 and 2014—about four times the rate of growth in Medicaid enrollment.
(1) Heroin is an opioid. Medicaid pays for an expanding variety of heroin related admissions. Heroin is not really a prescription-related issue. Further fentanyl, morphine, dilaudid, demerol, oxycontin, etc. are all available on the street. So tying their use to over-zealous prescriptions is not presenting a wholly accurate account.
(2) However, to the extent prescribed opioids do play a role, so too does systematic disempowerment of physicians in medical decision-making. Increased insertion of regulation and interference by politicians and administrators into the patient-physician relationship yields exactly the result you're lamenting.
E.g., A drug seeking patient reports to the ED. MD refuses to dole out opioids. Patient engages various social levers -- compliant lines, lawyers, activists, politicians, the press -- with charges of racism, cruelty, callous abandonment. CMS, with its increased care complaint-related scrutiny, publicly pursues enough of these as to be perceived by facility managers as threatening. Hospital Administration views such CMS interactions as a PITA at best, and often as a threat to their own job security.
So Hosp admin makes it clear to medical employees they want the problem to "go away."
In the past that kind of Admin-to-EmergencyMD interaction rarely happened.
Now it is far more common.
The solution is not to further advance political interference into the medical provision of care.
The solution is to get those with no medical knowledge out of the equation, and hold those with medical knowledge more scientifically accountable.
Posted on 10/14/17 at 10:30 am to ctalati32
quote:
Pain as the 5th Vital Sign
LINK
In 2001 there was the notion that physicians were not treating pain appropriately and that we should focus more on pain.
quote:Bingo!
Press Ganey/ HCAHPS
LINK
HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) is your basic patient satisfaction survey. Now what the problem with this is that Medicare decided to tie 25% of their reimbursements to patient satisfaction.
Posted on 10/14/17 at 10:33 am to I B Freeman
With nearly everything, there is more to the story. I don't have time to break down my opinions on it all atm, it's game day.
But any joe off the block would have told you the people down and out and addicted to opiates or with legit issues aren't holding down jobs and in turn holding down normal insurance policies. So of course the ones going on Medicaid are going to have boucoup more issues. I don't think it's the Medicaid making these people into ones that 'need' opiates, they were more than likely to this point pre-expansion.
ETA: also with the 'opioid- related hospital admissions', if some cat is found on the side of the road in his car passed out they will call an ambulance, give narcan, and rush him to the hospital. That's opioid related. Before expansion that shite was probably just charged to the game, now it's found out he is part of the expansion and BOOM it's charged off on Medicaid and adds to these stats. At 'opioid-related'
But any joe off the block would have told you the people down and out and addicted to opiates or with legit issues aren't holding down jobs and in turn holding down normal insurance policies. So of course the ones going on Medicaid are going to have boucoup more issues. I don't think it's the Medicaid making these people into ones that 'need' opiates, they were more than likely to this point pre-expansion.
ETA: also with the 'opioid- related hospital admissions', if some cat is found on the side of the road in his car passed out they will call an ambulance, give narcan, and rush him to the hospital. That's opioid related. Before expansion that shite was probably just charged to the game, now it's found out he is part of the expansion and BOOM it's charged off on Medicaid and adds to these stats. At 'opioid-related'
This post was edited on 10/14/17 at 10:36 am
Posted on 10/14/17 at 10:36 am to el Gaucho
This is some quality stuff 
Posted on 10/14/17 at 10:40 am to el Gaucho
quote:Regardless, opioids are a terrible treatment choice for it.
but fibromyalgia is a real disease!
Posted on 10/14/17 at 11:06 am to ctalati32
It's my cousin actually
The scary thing is the "libertarians" on here want to make marijuana legal so fibromyalgia sufferers like him can self medicate
That's terrifying to me that people think that a dangerous illegal narcotic is better than safe effective pills prescribed by a doctor for pain
The scary thing is the "libertarians" on here want to make marijuana legal so fibromyalgia sufferers like him can self medicate
That's terrifying to me that people think that a dangerous illegal narcotic is better than safe effective pills prescribed by a doctor for pain
Posted on 10/14/17 at 11:57 am to el Gaucho
It still kills me how many people fall for El Gaucho's schtick.
He trolls 24/7 and I'm a big fan, but he hooks people every time.
Good work, friend.
He trolls 24/7 and I'm a big fan, but he hooks people every time.
Good work, friend.
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