The word “historic” is often used by PR professionals to hype something that is, well, pretty run-of-the-mill. They figure that no one is going to read a news release that announces “ proposes small change that really won’t make much…
The word “historic” is often used by PR professionals to hype something that is, well, pretty run-of-the-mill. They figure that no one is going to read a news release that announces “[Name of organization] proposes small change that really won’t make much of a difference.” The problem is that when something is done that really measures up to being historic, the recipient is less likely to believe it, kind of …
Until genuine rights are extended to all patients, the ongoing health-care-reform saga perpetrated by Congress and executive leadership will continue to fail the American people. Many Americans have suffered and died because of a broken health-care-delivery system. One of us…
Until genuine rights are extended to all patients, the ongoing health-care-reform saga perpetrated by Congress and executive leadership will continue to fail the American people. Many Americans have suffered and died because of a broken health-care-delivery system. One of us lost a 19-year old son due to lack of certain patient rights – specifically the right to evidence-based medicine and the right to a complete discharge plan from his hospital. …
The tide is finally rising under the idea of health care for all in America. It is no longer possible to tar this simple and ubiquitously implemented idea as a bid to “take away our freedom” or “destroy the free…
The tide is finally rising under the idea of health care for all in America. It is no longer possible to tar this simple and ubiquitously implemented idea as a bid to “take away our freedom” or “destroy the free market.” Hearteningly, the debate is shifting towards the harder questions of when, and how.
One popular idea is to expand Medicare to cover all Americans — essentially turning the government into …
From the CMS website, October 30, 2017, “Today, Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma discussed the agency’s efforts to streamline quality measures, reduce regulatory burden, and promote innovation … We need to move from fee-for-service to…
From the CMS website, October 30, 2017, “Today, Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma discussed the agency’s efforts to streamline quality measures, reduce regulatory burden, and promote innovation … We need to move from fee-for-service to a system that pays for value and quality — but how we define value and quality today is a problem. We all know it: Clinicians and hospitals have to report …
Quality-based Medicare payment is far from a new concept. However, the Quality Payment Program (QPP), created by the Medicare Access and CHIP Reauthorization Act (MACRA), introduces a new vocabulary, complex requirements and fast-approaching deadlines. Physicians have little time left to…
Quality-based Medicare payment is far from a new concept. However, the Quality Payment Program (QPP), created by the Medicare Access and CHIP Reauthorization Act (MACRA), introduces a new vocabulary, complex requirements and fast-approaching deadlines. Physicians have little time left to successfully navigate the program and avoid penalties for 2017.
A recent survey by the American Medical Association (AMA) …
Reformers have expended considerable effort to change the way Medicare buys health care for millions of Americans, finding a wide range of support across the political spectrum. But Medicare’s current structure may doom these reforms. Some primary care doctors fear…
Reformers have expended considerable effort to change the way Medicare buys health care for millions of Americans, finding a wide range of support across the political spectrum. But Medicare’s current structure may doom these reforms. Some primary care doctors fear that the skewed incentives in Medicare’s pricing system will get built into any new system, whether it is “accountable,” “affordable,” or “value-based.” This fear is well-founded. If special interests buy …
I was browsing the latest issue of the Journal of the American Medical Association, as I often do, and an article by one Andy Slavitt, MBA, and Gail Wilensky, PhD, titled “Reforming Medicaid,” caught my eye. From 2015 to 2017,…
I was browsing the latest issue of the Journal of the American Medical Association, as I often do, and an article by one Andy Slavitt, MBA, and Gail Wilensky, PhD, titled “Reforming Medicaid,” caught my eye. From 2015 to 2017, Mr. Slavitt served as the Acting Administrator for the Centers for Medicare & Medicaid Services (CMS). In that role, he oversaw the government’s awful Meaningful Use EHR program, and helped …
In an era of increasing transparency in medicine, the Centers for Medicare & Medicaid Services (CMS) has been publishing data annually on payments to individual physicians since 2014. The database, officially called the Medicare Provider Utilization and Payment Data: Physician…
In an era of increasing transparency in medicine, the Centers for Medicare & Medicaid Services (CMS) has been publishing data annually on payments to individual physicians since 2014. The database, officially called the Medicare Provider Utilization and Payment Data: Physician and Other Supplier Public Use File, has been a window (albeit a cracked and opaque window) into the practice patterns and reimbursement of individual physicians.
Recently, the Republicans’ health insurance bill was withdrawn, partly because of some Senators’ fear of underfunding Medicaid. The media and Democrats have clearly identified Medicaid as a wedge issue that divides Republicans. Unfortunately, those Republicans that have chosen to support…
Recently, the Republicans’ health insurance bill was withdrawn, partly because of some Senators’ fear of underfunding Medicaid. The media and Democrats have clearly identified Medicaid as a wedge issue that divides Republicans. Unfortunately, those Republicans that have chosen to support conventional Medicaid, as opposed to supporting a much-needed revamp of this program, have succumbed to false advertisements. So let me review some facts, and suggest some common sense changes that …
At this time in history, it may serve us well to reflect on the tortuous past, the harrowing present and the unpredictable future of health care in America. First and foremost we must recognize we do not have “a health…
At this time in history, it may serve us well to reflect on the tortuous past, the harrowing present and the unpredictable future of health care in America.
First and foremost we must recognize we do not have “a health care system” — rather our health care is delivered in an uncoordinated, misaligned and exorbitantly expensive fashion. For example, 1 in 5 Medicare patients are readmitted to the hospital within 30 days of discharge, …
I already know I sound like a broken record. Yet, I can’t fathom why I seem to be the only person talking about this. There have been numerous articles in both syndicated journals and the blogosphere about the many things…
I already know I sound like a broken record. Yet, I can’t fathom why I seem to be the only person talking about this. There have been numerous articles in both syndicated journals and the blogosphere about the many things wrong with the American health care system, including the overspecialization which we know leads to higher costs (but not necessarily better outcomes). Just as I feared, the New York …
The Trump administration has made clear its intentions to drastically reduce the size and intrusive nature of government. Let’s hope that extends to the Medicare Access and CHIP Reauthorization Act, otherwise known as MACRA, the heavy-handed new government “value-based payment”…
The Trump administration has made clear its intentions to drastically reduce the size and intrusive nature of government. Let’s hope that extends to the Medicare Access and CHIP Reauthorization Act, otherwise known as MACRA, the heavy-handed new government “value-based payment” program for medical care, enacted in 2015, and set to rear its ugly head beginning this year. MACRA must die. MACRA is administrative overkill in an industry already overburdened by …
Thankfully, the GOP did not pass Paul Ryan’s repeal and replace bill for Obamacare. Immediately after, I saw a headline hopefully concluding, “Medicare for all may be next.” In Medicare’s current form, this would be devastating for the health of…
Thankfully, the GOP did not pass Paul Ryan’s repeal and replace bill for Obamacare. Immediately after, I saw a headline hopefully concluding, “Medicare for all may be next.” In Medicare’s current form, this would be devastating for the health of America. I am a young geriatrician; I know a heck of a lot about Medicare. Most people don’t. They just see it as a great perk of turning 65 in …
If you are planning on complying with Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), make sure to allot the appropriate time and funding necessary to update/upgrade your practice. Realize that the measures will be arbitrary, the data implementation…
If you are planning on complying with Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), make sure to allot the appropriate time and funding necessary to update/upgrade your practice. Realize that the measures will be arbitrary, the data implementation arduous and the moments for live patient care fleeting. Expect that, no matter how Herculean the task may be, the finish line will move often and unexpectedly. Prepare to get …
Rationing of health care services according to an individual’s ability to pay — or, as the case may be, the inability to do so — is becoming more prevalent in the United States, both in the public and private insurance…
Rationing of health care services according to an individual’s ability to pay — or, as the case may be, the inability to do so — is becoming more prevalent in the United States, both in the public and private insurance spheres. Commercial payers, for example, increasingly require doctors to follow a complex and time-consuming authorization process. Recent surveys show that 75 percent of doctors complain about this often unnecessary step.
One of the popular critiques of the American health care system is that it is high-volume, low-quality, and that this is a direct result of the traditional fee-for-service approach to paying doctors for medical care. In the past, doctors and…
One of the popular critiques of the American health care system is that it is high-volume, low-quality, and that this is a direct result of the traditional fee-for-service approach to paying doctors for medical care. In the past, doctors and hospitals have been paid much the same way that we pay for other goods and services. When they provide a service, such as an appointment or a procedure, they are …
The market for medical tourism grows as Americans increasingly seek medical care outside of the United States and pay cash for services. Patients know they can obtain adequate quality care in Mexico for out of pocket costs far lower than…
The market for medical tourism grows as Americans increasingly seek medical care outside of the United States and pay cash for services. Patients know they can obtain adequate quality care in Mexico for out of pocket costs far lower than their insurance plans with high deductibles would cover. Posting basic outpatient visit and simple procedure prices could benefit our independent practices in the same way. The only thing worse than …
Three men walk into a deli for lunch, take a number, and sit quietly until called. There are no prices on display, nor is the food visible. The first man, Ron, is called to the counter and states that he…
Three men walk into a deli for lunch, take a number, and sit quietly until called. There are no prices on display, nor is the food visible. The first man, Ron, is called to the counter and states that he is hungry when asked what brings him in. He presents his food insurance credentials, and five minutes later, he walks out the door with a 12-inch gourmet sandwich, a side …
Dear Dr. Price, Congratulations on your upcoming appointment as the new Health and Human Services Secretary under President Trump. As a physician myself, it’s great to know that a fellow physician will head up the agency. I’m sure you understand…
Dear Dr. Price,
Congratulations on your upcoming appointment as the new Health and Human Services Secretary under President Trump. As a physician myself, it’s great to know that a fellow physician will head up the agency. I’m sure you understand too, having been a practicing orthopedic surgeon, how disheartening and frustrating it is to have non-clinical “experts” making key decisions about health care.
The concept of sickness insurance began in Germany in 1883. Chancellor Otto Von Bismarck initiated insurance for the poor. A decision about how these services were to be delivered is critical to understanding the contentious debates around health care. Could…
The concept of sickness insurance began in Germany in 1883. Chancellor Otto Von Bismarck initiated insurance for the poor. A decision about how these services were to be delivered is critical to understanding the contentious debates around health care. Could Bismarck have given vouchers for care as needed? Alternatively, should the government control the needed health care facilities?
Perhaps thinking the poor did not have the capability to manage their own health, he chose …
