30 day hospital re-admission rates. It's a statistic that keeps hospital administrators up at night. Whether you agree or disagree with the use of this statistic as a quality and reimbursement metric, if it creates change, reduces hospital re-admissions and…
30 day hospital re-admission rates.
It’s a statistic that keeps hospital administrators up at night. Whether you agree or disagree with the use of this statistic as a quality and reimbursement metric, if it creates change, reduces hospital re-admissions and improves patient care, then in theory I support it.
I’m reminded of Mrs G. She is emblematic of today’s chronic disease patient. She was admitted to our hospital for a congestive heart …
Most doctors will tell you that Medicare payments to doctors haven’t increased in a decade, and that doctors are turning away Medicare patients in droves. But they would be mistaken on both counts. An authoritative compilation of current data from…
Most doctors will tell you that Medicare payments to doctors haven’t increased in a decade, and that doctors are turning away Medicare patients in droves. But they would be mistaken on both counts.
An authoritative compilation of current data from the Medicare Payment Advisory Commission shows what is really happening with Medicare physician spending:
Medicare spending per beneficiary on physicians’ fee schedule services steadily increased from 2001 to 2011. In 2001, Medicare …
A guest column by the American Medical Association, exclusive to KevinMD.com. As the new president of the AMA, I’m excited to help lead the nation’s largest physician organization during this important time for our health care system. The year is…
As the new president of the AMA, I’m excited to help lead the nation’s largest physician organization during this important time for our health care system. The year is off to a positive start – only two weeks after I was inaugurated at the AMA’s Annual Meeting, the Supreme Court declared …
A guest column by the American College of Physicians, exclusive to KevinMD.com. In early June I participated in ACP Services 2012 Leadership Day on Capitol Hill in Washington, D.C. I sincerely believe that we have an obligation to share our…
In early June I participated in ACP Services 2012 Leadership Day on Capitol Hill in Washington, D.C. I sincerely believe that we have an obligation to share our experiences with elected representatives. Internists through ACP have been doing this for years and have raised awareness of the high …
If the government was a physician, it wouldn't be an ordinary doctor like you or I. It would be a sexy actor like the ones we see on those medical melodramas that have become so popular over the last few…
If the government was a physician, it wouldn’t be an ordinary doctor like you or I.
It would be a sexy actor like the ones we see on those medical melodramas that have become so popular over the last few years. His hair coiffed, his jacket pressed and free of stains, and his manor confident he would rush into the trauma bay. As the beeping monitor flat lines, he would sweep the nurses …
Nothing in life is free. In the midst of all the turmoil and excitement surrounding the newly passed Affordable Care Act, I believe we should not lose sight of the bigger picture: providing better healthcare at a lower cost for…
Nothing in life is free.
In the midst of all the turmoil and excitement surrounding the newly passed Affordable Care Act, I believe we should not lose sight of the bigger picture: providing better healthcare at a lower cost for more people. The idea of the Patient Centered Medical Home, although in its trial stages thus far, is what we should be focusing on as physicians and health care providers.
I was recently struck by two conversations that I had with acquaintances about recent experiences that they had had with their primary care physicians. The first occurred at my local pool. A fellow swimmer asked me if I took new…
I was recently struck by two conversations that I had with acquaintances about recent experiences that they had had with their primary care physicians. The first occurred at my local pool. A fellow swimmer asked me if I took new Medicare patients. She bemoaned that she was abandoned — her beloved physician of over 20 years had sent out a letter announcing that she would no longer accept Medicare patients. My …
The Supreme Court upheld the Affordable Care Act. I'll leave the detailed legal analysis to other commentators that you'll no doubt find elsewhere. Although some may not feel this way, this is an outcome everybody should be happy with. Most…
The following column was published on June 17th, 2012 in the New York Times’ Room for Debate blog. In this election year, the Supreme Court’s judgment on the Affordable Care Act will be interpreted through a political lens. But the…
The following column was published on June 17th, 2012 in the New York Times’ Room for Debate blog.
In this election year, the Supreme Court’s judgment on the Affordable Care Act will be interpreted through a political lens. But the decision will have real-life consequences on patients, whose voice won’t be heard through the ensuing partisan din.
The Medicare physician payment formula is a case-study in failed policy. Physicians have long known that it is not working. Polls show that an overwhelming 94 percent of Americans believe the massive cuts it schedules are a serious problem for…
The Medicare physician payment formula is a case-study in failed policy. Physicians have long known that it is not working. Polls show that an overwhelming 94 percent of Americans believe the massive cuts it schedules are a serious problem for seniors. Even members of Congress from both parties agree – and that is no small accomplishment – that it is …
While there is an extensive literature on how tired, overworked physicians provide lower quality medical care, one thing that has been ignored by advocates of quality improvement is that overwork financially harms hospitals as well. Just as tired physicians sometimes…
While there is an extensive literature on how tired, overworked physicians provide lower quality medical care, one thing that has been ignored by advocates of quality improvement is that overwork financially harms hospitals as well. Just as tired physicians sometimes fail to attend to certain clinical details, they are also more likely to commit errors when writing the notes which ultimately are used during the coding process. If hospitals consider …
I love it when I see Medicaid patients on my schedule for the day. Working at a community health center, our doors are open to all people, regardless of their ability to pay. It’s hard to run a medical office…
I love it when I see Medicaid patients on my schedule for the day. Working at a community health center, our doors are open to all people, regardless of their ability to pay. It’s hard to run a medical office when you get $20 for a visit, which is what our uninsured patients pay. So when a patient has Medicaid we know we’ll get paid a decent reimbursement for that …
Slightly over a year ago, the Department of Justice (DOJ) launched an investigation of a large number of institutions regarding concerns that implantable cardiac defibrillator (ICD) procedures were performed for reasons outside of the criteria set forth in Medicare’s National…
Slightly over a year ago, the Department of Justice (DOJ) launched an investigation of a large number of institutions regarding concerns that implantable cardiac defibrillator (ICD) procedures were performed for reasons outside of the criteria set forth in Medicare’s National Coverage Decision (NCD). This investigation occurred just after Al-Khatib and others published a report January 4, 2011 in JAMA that suggested as many as 22.5% of implantable defibrillators implanted …
Medicare needs to cut costs. It has chosen methods to cut costs that will damage the basic health care services needed by most Medicare patients. And instead of calling this cost cutting, it uses terms such as "shared savings." Even…
Medicare needs to cut costs. It has chosen methods to cut costs that will damage the basic health care services needed by most Medicare patients. And instead of calling this cost cutting, it uses terms such as “shared savings.” Even worse, the “shared savings” will result in even less health spending in United States locations that already have lowest health spending. Innovative designs are not the problem. The problem is …
Recently I have become interested in the obesity epidemic plaguing our country. I’ve actually been interested in obesity and co-morbid psychiatric illness since residency, but recently my interest has been revived. I read that Medicare is going to be reimbursing…
Recently I have become interested in the obesity epidemic plaguing our country. I’ve actually been interested in obesity and co-morbid psychiatric illness since residency, but recently my interest has been revived. I read that Medicare is going to be reimbursing health care practitioners for obesity counseling and screening. My initial thought was that this is a positive step in the right direction. But the cynic in …
She knew she was supposed to be careful about getting pregnant, although truthfully she didn’t think it could happen because of her blood pressure and kidney problems. The nurses at the county clinic started her on the pill, but her…
She knew she was supposed to be careful about getting pregnant, although truthfully she didn’t think it could happen because of her blood pressure and kidney problems. The nurses at the county clinic started her on the pill, but her blood pressure went all crazy. They asked her to come back on a Wednesday night when the doctor was there. The doctor asked lots of questions and spent a lot …
Hypertension was the trigger that forced medical cost awareness to the forefront. My doctor decided that with my rise in blood pressure it would be prudent to prescribe a blood pressure medication and order a nuclear stress test. With only…
Hypertension was the trigger that forced medical cost awareness to the forefront. My doctor decided that with my rise in blood pressure it would be prudent to prescribe a blood pressure medication and order a nuclear stress test. With only a catastrophic insurance policy and a $5000 deductible it was imperative for my financial health to know the cost of both the drugs and the procedure up front.
Patient satisfaction is all the rage. Medicare is beginning to tie patient satisfaction scores with hospital reimbursement, and doctors across the country are under pressure from administrative executives to raise patient satisfaction scores. High scores are even used by hospitals…
Medicare is beginning to tie patient satisfaction scores with hospital reimbursement, and doctors across the country are under pressure from administrative executives to raise patient satisfaction scores.
High scores are even used by hospitals as a powerful marketing tool.
But, in the end, are patient satisfaction scores hurting patients?
I wrote about the issue previously, saying that patient …
A guest column by the American Medical Association, exclusive to KevinMD.com. This week, I’m joining hundreds of physicians and medical students in Washington, DC during the American Medical Association’s National Advocacy Conference to talk to our federal lawmakers about an…
This week, I’m joining hundreds of physicians and medical students in Washington, DC during the American Medical Association’s National Advocacy Conference to talk to our federal lawmakers about an end to what has become an annual chore of stopping drastic scheduled Medicare physician payment cuts to preserve access to health care …
One of the things I love about family medicine is that I get to care for people of all ages. I almost went into pediatrics, but the time I spend with older adults was too valuable to give up. Our…
One of the things I love about family medicine is that I get to care for people of all ages. I almost went into pediatrics, but the time I spend with older adults was too valuable to give up. Our elders have such great stories and knowledge to impart – it’s an honor to participate in their lives and share their experience.
Since I first realized in residency training that Medicare …
The 
