Health policy and public health

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Articles, page 156

An ACO must make the patient experience meaningful

April 26, 2011Apr 26, 20115

Accountable Care Organizations (ACOs) are supposed to be provider-led (physician groups +/- hospitals) and, they are supposed to inject a new accountability, at the provider level, for the value of services delivered. You know the old equation. Value=Quality/Cost. Those of…

You know the old equation. Value=Quality/Cost. Those of us inside the health policy “beltway” know this mantra well. We have been talking about it for years (decades, really).

I spent almost …

Medical education

A moral imperative to address the costs of training our doctors

Andrew M. Ibrahim, MD & John A. Brockman

April 25, 2011Apr 25, 201146

by Andrew M. Ibrahim and John A. Brockman Despite the landmark progress of recent healthcare reform, it missed the mark on long term cost control by failing to address medical education. Radical changes are needed in the way we finance…

by Andrew M. Ibrahim and John A. Brockman

Despite the landmark progress of recent healthcare reform, it missed the mark on long term cost control by failing to address medical education.

Radical changes are needed in the way we finance tuition and how we teach our students.

While last month a new graduating class of medical students celebrated their …

Health policy

The future of primary care in Accountable Care Organizations

Davis Liu, MD

April 23, 2011Apr 23, 20117

A recent blog post in Health Affairs proclaimed The End of Internal Medicine As We Know It. What the article is really asking is the future of primary care in the world of health care reform and the creation of…

A recent blog post in Health Affairs proclaimed The End of Internal Medicine As We Know It. What the article is really asking is the future of primary care in the world of health care reform and the creation of Accountable Care Organizations (ACOs).

While doctors should be naturally concerned about change, I don’t completely agree with this …

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Physician voices

Primary care providers are needed to support health reform

Vanessa Hurley

April 23, 2011Apr 23, 20115

Like many American patients, the American health care delivery system suffers not only from acute crises, but also from a chronic, poorly managed and debilitating disease. Primary care is in trouble. Not only are primary care physicians (PCPs) fleeing the…

Like many American patients, the American health care delivery system suffers not only from acute crises, but also from a chronic, poorly managed and debilitating disease.

Primary care is in trouble. Not only are primary care physicians (PCPs) fleeing the profession in droves, but fewer and fewer medical …

Physician voices

When quality of care becomes customer satisfaction demands

Doc B, MD

April 20, 2011Apr 20, 20118

The new healthcare reform law appears to be using the idea of improved quality to justify the enormous expense of changing the way care is delivered in the United States. As a justification for the need for change is the…

The new healthcare reform law appears to be using the idea of improved quality to justify the enormous expense of changing the way care is delivered in the United States.

As a justification for the need for change is the reporting currently being touted as a great measure of quality. This information is gathered in many different ways and …

Patient voices

Smart patients need to establish a relationship with a primary care doctor

Trisha Torrey

April 19, 2011Apr 19, 20117

Good primary care physicians are becoming harder and harder to find. You may not have noticed it yet, but I predict that a year from now we’ll find it almost impossible to find primary care doctors who are willing to…

Good primary care physicians are becoming harder and harder to find.

You may not have noticed it yet, but I predict that a year from now we’ll find it almost impossible to find primary care doctors who are willing to take on new patients – at least any primary care doctor worth seeing won’t be …

Health technology

Top IT implications of healthcare reform

John Halamka, MD

April 19, 2011Apr 19, 20114

I'm often asked how healthcare reform will impact IT planning and implementation over the next few years. First, some background. The Patient Protection and Affordable Care Act (HR 3590) and Health Care and Education Reconciliation Act (HR 4872) were passed…

I’m often asked how healthcare reform will impact IT planning and implementation over the next few years.

First, some background. The Patient Protection and Affordable Care Act (HR 3590) and Health Care and Education Reconciliation Act (HR 4872) were passed to address several problems with healthcare in the US. We’re spending 17% of our …

Health policy

Can the Relative Value Scale Update Committee (RUC) be defended?

Brian Klepper, PhD

April 19, 2011Apr 19, 201117

Recently, 47 American medical specialty societies sent Rep. Jim McDermott (D-WA) a letter, with copies to all members of Congress, containing a detailed defense of the American Medical Association’s (AMA’s) Relative Value Scale Update Committee (RUC). For 20 years, the…

For 20 years, the RUC has exclusively advised the Centers for Medicare and Medicaid Services (CMS) on physician procedure valuation …

Physician voices

Patient centered care and the family physician’s brain

Richard Young, MD

April 18, 2011Apr 18, 201137

Paul Grundy is IBM’s Director of Healthcare, Technology and Strategic Initiatives for IBM’s Global Well Being Services and Health Benefits. He has led the development of the Patient-Centered Primary Care Collaborative, which is leading the way to create a more…

Paul Grundy is IBM’s Director of Healthcare, Technology and Strategic Initiatives for IBM’s Global Well Being Services and Health Benefits.

He has led the development of the Patient-Centered Primary Care Collaborative, which is leading the way to create a more efficient and responsive healthcare system. Before I go any further, let me be very clear by saying that his work is hugely important and I agree with 90% of what this …

Health policy

To sell your practice or not: The decision facing most physicians today

Philippa Kennealy, MD, MPH

April 17, 2011Apr 17, 201115

I took my eye off the ball for just a little while, and guess what happened? When I looked again, I discovered that familiar solo practitioner or small group physician medical practices are on the verge of disappearing. Going the…

At least, that’s what the pundits are saying.

In a recently published nifty newsletter, STAT Monthly, I read:

Primary care physicians and other specialists will continue to be the

…

Physician voices

AMA: Getting the best value for our health care dollars

American Medical Association & Cecil B. Wilson, MD

April 14, 2011Apr 14, 20117

A guest column by the American Medical Association, exclusive to KevinMD.com. As physicians, many of us realize on some level that our practices contribute to our state and national economies - we just lacked the empirical evidence to understand how…

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

As physicians, many of us realize on some level that our practices contribute to our state and national economies – we just lacked the empirical evidence to understand how much.

That changed last month, when the American Medical Association released a report that studied the economic impact of office-based physicians. While a handful of states have previously studied the economic impact …

Health policy

How an ACO will affect physicians and Medicare patients

Benjamin Geisler, MD, MPH

April 14, 2011Apr 14, 20119

by Benjamin P. Geisler, MD, MPH Everybody is talking about Accountable Care Organizations or ACOs these days. The reason being that the Centers for Medicare and Medicaid Services or CMS has released the rules for shared savings between ACOs and…

by Benjamin P. Geisler, MD, MPH

Everybody is talking about Accountable Care Organizations or ACOs these days.

The reason being that the Centers for Medicare and Medicaid Services or CMS has released the rules for shared savings between ACOs and CMS.

The complete proposed rule is 429 pages long and they’re seeking comments on it now until early June.

What is an ACO?

ACOs will take care of …

Health policy

How the ACO regulations set the stage for Accountable Care Organizations

David Harlow

April 13, 2011Apr 13, 20113

ACO regulations and related federal issuances hit the street, after several months of waiting -- from CMS, OIG, FTC, DOJ and IRS. They cover the waterfront, ranging from the central regulation defining the structure and workings of the ACO, to…

ACO regulations and related federal issuances hit the street, after several months of waiting — from CMS, OIG, FTC, DOJ and IRS.

They cover the waterfront, ranging from the central regulation defining the structure and workings of the ACO, to limited Stark self-referral ban and anti-kickback statute waivers in the fraud and abuse arena, to new frameworks for antitrust analysis, to rules governing joint ventures involving taxable and tax-exempt organizations.

I had …

Physician voices

Preventing disease saves the crippling costs of tertiary care

Kohar Jones, MD

April 12, 2011Apr 12, 20112

When I was a family medicine intern, I met a diabetic patient in the hospital who had stopped seeing his regular doctor after he lost his job and his health insurance. His untreated diabetes made his feet go numb. He…

When I was a family medicine intern, I met a diabetic patient in the hospital who had stopped seeing his regular doctor after he lost his job and his health insurance.

His untreated diabetes made his feet go numb. He stepped on a nail and didn’t realize it until he noticed …

Physician voices

Could alternative medicine practitioners take the lead in health policy?

Emily Lu

April 12, 2011Apr 12, 201123

Recently, I attended a conference on integrative medicine. It was a lovely conference and I learned a lot: about Chinese therapies used for cancer, about osteopathic manipulation, and about the growing community of doctors that respect the value of complimentary…

I also left with a sense of dissatisfaction with what …

Patient voices

Ordering tests may take food out of the mouths of our patients

Tarcia Edmunds-Jehu

April 11, 2011Apr 11, 201116

Sitting in an exam room I am watching my patient struggling to ask a difficult question that she clearly does not want to ask. After several attempts at starting and a few half finished sentences she finally manages to mumble…

Sitting in an exam room I am watching my patient struggling to ask a difficult question that she clearly does not want to ask.

After several attempts at starting and a few half finished sentences she finally manages to mumble a request for help with obtaining food for herself and her two daughters. She is a 41-year-old woman, 32 weeks pregnant with her third child, and …

Health policy

Physicians referring patients to a diagnostic facility they own

Bob Doherty

April 10, 2011Apr 10, 201119

Federal law generally prohibits physicians from referring their own patients to a diagnostic facility in which they have an ownership issue - a practice called "self-referral" - unless the facility is located in their own practice. This exemption exists to…

Federal law generally prohibits physicians from referring their own patients to a diagnostic facility in which they have an ownership issue – a practice called “self-referral” – unless the facility is located in their own practice.

This exemption exists to allow patients with access to a laboratory test, x-ray, or other imaging test at the same time and place as when patients are seeing their physician for an office visit. Less …

Social media in medicine

Talking social media and health reform with medical students

Kevin Pho, MD

April 9, 2011Apr 9, 20115

I recently concluded a trip down to Nashville, TN where I gave my talk on the health care-social media intersection at Vanderbilt University School of Medicine. My audience normally consists of physicians and hospital staff, so talking to students was…

I recently concluded a trip down to Nashville, TN where I gave my talk on the health care-social media intersection at Vanderbilt University School of Medicine.

My audience normally consists of physicians and hospital staff, so talking to students was a refreshing change.

I had the opportunity to have dinner the night before, and breakfast and lunch the day …

Health policy

Overhauling America’s Healthcare Machine, an excerpt

Douglas Perednia, MD

April 8, 2011Apr 8, 20114

An excerpt from Overhauling America’s Healthcare Machine: Stop the Bleeding and Save Trillions, published by Financial Times Press (2011). Reprinted with permission of FT Press, and imprint of Pearson. In recent years, more and more of the revenue collected by…

An excerpt from Overhauling America’s Healthcare Machine: Stop the Bleeding and Save Trillions, published by Financial Times Press (2011). Reprinted with permission of FT Press, and imprint of Pearson.

In recent years, more and more of the revenue collected by U.S. healthcare facilities ends up paying for costs that have nothing to do with providing actual healthcare goods and services: things such as administration, billing, documentation, and the cost …

Health policy

What you need as a leader of your accountable care organization

Donald Tex Bryant

April 7, 2011Apr 7, 2011

The Michigan Medical Group Managers Association had a conference recently in Mt. Pleasant, MI. The theme of the conference was "Medical Management: Coaching Your Team to a Winning Season." Two speakers—Lloyd Carr, former head football coach of the University of…

The Michigan Medical Group Managers Association had a conference recently in Mt. Pleasant, MI. The theme of the conference was “Medical Management: Coaching Your Team to a Winning Season.”

Two speakers—Lloyd Carr, former head football coach of the University of Michigan Wolverines, and Lou Rabaut, partner of law firm Warner Norcross & Judd—both delivered excellent lessons on leadership. Several of the …

Health policy and public health

Articles, page 156

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