America's Best Hospitals, an annual ranking of the country's elite medical
centers, is a tool for patients who need medical sophistication most facilities
cannot offer. Unlike other rankings and ratings that grade hospitals on how
well they execute routine procedures like outpatient hernia repair or manage
common conditions like low-grade heart failure, the U.S. News approach looks at
how well a hospital handles complex and demanding situations--replacing an
85-year-old man's heart valve, diagnosing and treating a spinal tumor, and
dealing with inflammatory bowel disease, to name three examples. High-stakes
medicine.
This year, the 20th for Best Hospitals, institutions are ranked in 16
specialties, from cancer and heart disease to respiratory disorders and
urology. A total of 4,861 hospitals were considered; 174, or less than 0.4
percent of the total, were ranked in even one of the 16 specialties.
In 12 of the 16 specialties, those in which quality of care can spell life or
death, hospitals were scored on reputation, death rate, patient safety, and
care-related factors such as nursing and patient services; the 50 highest
scorers were ranked. Scores and complete data for unranked hospitals are
available as well. In the other four specialties--ophthalmology, psychiatry,
rehabilitation, and rheumatology--hospitals were ranked on reputation alone,
because so few patients die that mortality data don't mean much.
Here are a few of the details: Reputation, which counted as 32.5 percent of the
score, was based on three years of specialist surveys--a total of almost 10,000
physicians were asked to name five hospitals they consider among the best in
their specialty for difficult cases, without taking into account cost or
location. A mortality index, also 32.5 percent of the score, indicates a
hospital's ability to keep patients with serious problems alive. Patient
safety, new this year, made up 5 percent of the score; it indicates how well a
hospital minimizes harm to patients. And a group of other care-related factors,
such as nurse staffing and available technology, accounted for the remaining 30
percent.
Of the 174 hospitals that are ranked in one or more specialties, 21 qualified
for the Honor Roll by earning high scores in at least six specialties. This
demonstrates unusual breadth of excellence. Johns Hopkins Hospital tops the
list, as it has every year from 1991 on. (The Mayo Clinic was No. 1 in 1990,
Best Hospitals' first year.)
Medicare Part D - What You Need to Know
The six-week enrollment period for the Medicare prescription drug plan (Part D) is coming up soon -
enrollment begins November 15 through December 31, 2007 for the 2008 plans. Medicare's drug plans are subsidized by the
US federal government and offered through private insurers.
Medicare Part D - What's It All About?
Medicare Part D is a government subsidized prescription drug coverage program. Medicare Part D
prescription drug plans are provided by private insurance companies. The costs of you plan will vary depending on what
medications you use, what plan you choose, and whether or not you receive help paying your Part D costs.
Medicare Part D - What is a Formulary?
The formulary is the list of medications that your Medicare Part D plan covers.
Each Medicare Part D formulary must be approved by the Center for Medicare Services (CMS) as a condition for approval of
participation in the program. Regulations specify that formularies must include a minimum of two drugs in each
therapeutic category and pharmacologic class of products covered by Part D.
Medicare Part D - Understanding the Dreaded Donut Hole and How to Avoid
It
The donut hole is a coverage gap in Medicare drug plans. What it means to you is that
after you and your plan have spent a certain amount of money for covered medications (no more than $2,400), you have to
pay out-of-pocket all costs for medications until you hit the cap of $3, 850. This does not include the monthly premium
which you must continue to pay.
Medicare Part D - Paula Duffy, Test Case
Millions of Americans have taken advantage of the Medicare Part D
prescription coverage program, thinking that if they pay their monthly premiums, their prescriptions will be covered. We
have come up with a fictional scenario to demonstrate how Medicare Part D might work for different people. Ms. Duffy is
73 years old with high blood pressure, high cholesterol, asthma, depression, anxiety and osteoporosis. Her doctors have
prescribed the following medications
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