Health Policy

Physicians writing on KevinMD about the rules they practice under: prior authorization and the algorithms now deciding it, gold card laws, scope of practice and who may practice without supervision, Medicare and Medicaid, the Affordable Care Act, drug pricing, rationing that is done and not named, and the policies that decide which patients get care. Four maintained records draw on this archive: Prior authorization: what physicians say, in their own words, Scope of practice: what physicians, nurse practitioners, and PAs say, in their own words, Race and medicine: what physicians say, in their own words, and Medical ethics: what physicians say, in their own words.

America’s health system is dangerously out of balance

Brian Klepper, PhD

Health Policy

April 13, 2013

For a large and growing number of us with meager or no coverage, health care is the ultimate “gotcha.” Events conspire, we receive care and then are on the hook for a car- or house-sized bill. There are few alternatives except going without or going broke.

Steven Brill’s recent cover story clearly detailed the predatory health care pricing that has been ruinous for many rank-and-file Americans. In Brill’s report, a key mechanism, …

The Physician Payment Sunshine Act is here: Are you ready?

Jeremy Lazarus, MD

Health Policy

April 12, 2013

A guest column by the American Medical Association, exclusive to KevinMD.com.

Information is a source of learning. But unless it is organized, processed and available to the right people in a format for decision making, it is a burden, not a benefit.

-Former ServiceMaster CEO C. William Pollard

The new Physician Payment Sunshine Act (Sunshine Act) was created by Congress to ensure transparency in physicians’ …

Health reform: China offers a cautionary tale

Leana Wen, MD

Health Policy

April 9, 2013

chinese healthcare

Wang Li is a 48-year old farmer from Dalian, China. After a two-day trip to the major provincial hospital, he’s heading home to his village to die. Wang has lung cancer, and even with insurance, his surgery will cost him 20,000RMB—$3,000, which is twice his annual salary. The surgery would be curative, but it doesn’t matter. “I cannot burden my family,” he said.

I am a Chinese-born, American …

Why physicians should sympathize with federal employees

Bob Doherty

Health Policy

April 5, 2013

“Physicians care more about their pocketbooks than taking care of patients. They are self-interested and overpaid. They want to control everything. They don’t know what life is like in the real world of patients.”

By now, I am sure that physician readers of this blog can feel their blood boiling, for good reason. Why would I, as the principal staff advocate for internal medicine physicians, put such pernicious, unfair, inaccurate quotes …

Lawmakers shouldn’t care about the personal hardships of doctors

Anonymous

Health Policy

April 4, 2013

A response to Dear lawmakers: This is what it’s like to be a doctor today.

With a family and financial background that eerily matches Dr. Moeller’s, please count me as one soon-to-be physician who does not share the notion that lawmakers should spend their time being overly concerned with the demands placed on physicians or physician compensation. In fact, I …

Doctors should stop being compared to the airline industry

Jordan Grumet, MD

Health Policy

April 3, 2013

We have to stop comparing ourselves to the airline industry.

Sitting on the lounge chair at the pool, I can’t believe that just hours ago I was sludging the wintry streets of Chicago, rushing to the airport. The kids clucked away happily in the back seat as the adults in front where more subdued. As grownups do, we kept running through our mental checklists even though the ship had already sailed, we …

The movement for medical price transparency is happening

G. Keith Smith, MD

Health Policy

April 1, 2013

Years ago, I hired a carpenter to build a deck in my backyard. He showed up with a pencil behind his ear, a spiral notebook, and a tape measure. I told him what I was looking for, and he made a few suggestions. After 15 minutes of measuring and taking notes, he handed me a piece of paper with how much it …

Make small bets during the era of health reform

Angelo Falcone, MD

Health Policy

March 29, 2013

A good hockey player plays where the puck is. A great hockey player plays where the puck is going to be.
–Wayne Gretzky

Recently, I attended an end-of-year review with one of our hospital partner’s executive team. We reviewed our performance for the past year, and discussed mutually strategic goals and how to improve upon our excellent service. As part of the conversation turned …

How a smart process helped Kaiser Permanente save lives

Chip Heath and Dan Health

Health Policy

March 27, 2013

The following is an exclusive excerpt adapted from #1 New York Times best selling authors Chip and Dan Heath’s new book Decisive: How to Make Better Choices in Life and Work, which was released on March 26, 2013. Click here to order.

One …

Measuring quality: What doctors and teachers have in common

Shirie Leng, MD

Health Policy

March 21, 2013

I was watching Jon Stewart recently, and he had Michelle Rhee on. For anyone who doesn’t know her, she’s the superintendent of schools in Washington D.C. who made a bunch of reforms that caused some controversy and resulted in her being one of the main spokespersons for education reform in this country. Her conversation with Jon made me realize the similarities between …

AMA: Helping physicians thrive in an evolving healthcare system

Jeremy Lazarus, MD

Health Policy

March 20, 2013

A guest column by the American Medical Association, exclusive to KevinMD.com.

As American health care continues to transform, physicians in every state and specialty are attempting to comply with new rules, expectations and costs, and must evolve to meet new health care demands. The American Medical Association (AMA) is committed to helping physicians not only navigate the changing environment, but thrive in …

I wish my hospital was a Dreamliner

Richard Corder

Health Policy

March 17, 2013

The stories have now been relegated to the back pages: “Smoldering batteries forced safety regulators to ground Boeing’s new 787 Dreamliner jets.” This is a glimpse into the challenges that this aircraft and company seem to have been besieged by. The recent grounding of the fleet comes on the heels of other safety related incidents that while “typical” with a new plane …

Read more…

I wish my hospital was a Dreamliner

Medicare Advantage works well when you are healthy

Brad Wright, PhD

Health Policy

March 16, 2013

We all know about Medicare, the federal government health insurance program for Americans who are over the age of 65 and/or disabled. We know that as we have begun to live longer, the Medicare population has ballooned and the costs of the program are, by most estimates, “unsustainable.”

We also know that Medicare, despite being a government program, is beloved by America’s seniors. If it was an unpopular program, Congress would …

Is this the year Congress repeals the SGR?

Bob Doherty

Health Policy

March 13, 2013

An elderly doctor passes away, and he find himself standing before the Pearly Gates. The Almighty greets him and says, “In recognition of your stellar life of service to your patients, family and community, I welcome you to paradise. And because I know that doctors have a great sense of curiosity about all things, you can now ask me any question—any—and I will answer it.” The doctor ponders for a …

Is a winning health reform strategy best for patients?

Joe Flower

Health Policy

March 12, 2013

Rapid change is engulfing health care across the United States, but the strategic responses of organizations to these changes are sharply divided. In the shift that has been broadly shorthanded “from volume to value,” many organizations across the country are deeply engaged in moving toward “value” by building new partnerships, affiliations, capacities and economic structures, striving to bring better health and health care to more people for less money.

At the …

Primary care trends in the health reform era

Matthew Mintz, MD

Health Policy

March 11, 2013

As a physician who is involved in educating medical students, I am often asked for career advice. Medical students are by nature smart and ask very good questions. “Will I be able to pay of my student loans if I choose primary care?” “Will I have a balanced lifestyle if I decide to go into primary care?”

I try to be both encouraging and realistic. However, far too often I have …

How Obamacare penalizes safety net hospitals

Jeffrey Parks, MD

Health Policy

March 11, 2013

The weakest aspect to Obamacare is in its cost control strategies, or lack thereof. The predicted savings from converting to electronic medical records (EMR) have failed to materialize. And the Rube Goldberg-esque plan to save money by penalizing hospitals and doctors for having poor HCAHPS scores has reaped its own set of unforeseen complications.

HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) is the Press-Ganey …

Reducing medical errors: What we can learn from the Dreamliner

David B. Nash, MD, MBA

Health Policy

March 9, 2013

If you think that medical errors are a thing of the past, you are mistaken.

It has been 14 years since the Institute of Medicine’s report “To Err Is Human” shattered the myth that most, if not all, physicians are all-knowing practitioners with flawless skills and infallible judgment.

The story of what happened in the report’s wake was predictable:

Where the healthcare industry failed to …
Read more…

Reducing medical errors: What we can learn from the Dreamliner

Disclosure and offer: Who protects the patient’s interests?

Steve S. Kraman, MD and Gabriel Teninbaum, JD

Health Policy

March 6, 2013

When the Lexington, Kentucky VA Medical Center pioneered the “disclosure and offer” risk management strategy in 1987, it sought to make patients whole without the need to litigate. As part of this process, before meeting with injured patients, VA risk managers contacted the patient and recommended they seek their own legal counsel who they were welcome to bring to the meeting. The VA viewed this as a necessary step for …

Medicare patients should care about the way we pay providers

Kavita Patel, MD

Health Policy

March 6, 2013

It can be difficult to keep up with the jargon, countless proposals and complicated policies that surround the debate over Medicare reform. Whether you are discussing premium support, changing the eligibility age or Medicare for All, there is one relatively simple concept that patients should make a point to pay attention to – one that directly impacts them – and is the …

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