Despite the political angst, the doomsday predictions and a very rocky launch, the Affordable Care Act has enabled more than 8 million Americans to acquire insurance coverage through the public exchanges. Health insurance increases the probability that patients will access…
Despite the political angst, the doomsday predictions and a very rocky launch, the Affordable Care Act has enabled more than 8 million Americans to acquire insurance coverage through the public exchanges.
Health insurance increases the probability that patients will access the medical care they need. And my colleagues at Kaiser Permanente are already seeing some positive stories emerging as a result.
They’ve shared dozens of stories with me about patients with undiagnosed …
Did you ever read a seemingly inconsequential sentence somewhere and it then just refused to leave your mind for days on end, triggering avalanches of thoughts way beyond the original intent, if there even was one? It just happened to…
Did you ever read a seemingly inconsequential sentence somewhere and it then just refused to leave your mind for days on end, triggering avalanches of thoughts way beyond the original intent, if there even was one? It just happened to me a few days ago when I read one more industry article about the recent Medicare data dump.
The following remark was attributed to a primary care doctor: “The U.S. is …
What a shame: Reimbursement rates are going up for private Medicare Advantage plans. Contrary to its April 7 announcement that private Medicare reimbursement rates would be reduced, the Centers for Medicare & Medicaid Services has just reversed course and announced…
What a shame: Reimbursement rates are going up for private Medicare Advantage plans.
Contrary to its April 7 announcement that private Medicare reimbursement rates would be reduced, the Centers for Medicare & Medicaid Services has just reversed course and announced that it will increase overall Medicare Advantage rates. The change in policy came after pressure from the political parties and insurance companies. As Medicare spending per beneficiary grows at a …
Medicare released the most comprehensive ever look at how Medicare dollars are paid out to physicians across the United States. In the name of transparency, this data drop will “provide consumers with an ability to compare doctors and treatments in…
Medicare released the most comprehensive ever look at how Medicare dollars are paid out to physicians across the United States. In the name of transparency, this data drop will “provide consumers with an ability to compare doctors and treatments in a way they have never had until now.”
Will it really? Let’s look a bit closer at the data release.
According to the Centers for Medicare and Medicaid Services, the payment data release aims to “make our …
"Health insurance is not health care." That is not original. I borrowed it from Los Angeles County Department of Health Services Director Mitchell Katz's JAMA Internal Medicine editorial about problems with ensuring access to health care for Medicaid recipients whose…
“Health insurance is not health care.”
That is not original. I borrowed it from Los Angeles County Department of Health Services Director Mitchell Katz’s JAMA Internal Medicine editorial about problems with ensuring access to health care for Medicaid recipients whose cheap public insurance usually doesn’t even pay doctors enough to recoup costs of care, let alone earn a living.
But somehow, during the impassioned political debates that preceded Obamacare, the botched rollout of …
According to a study by Jackson Healthcare, the percentage rate of U.S. physician compensation is among the lowest of western nations. In 2011, physicians' salaries compromised 8.6 percent of the nation's total health care costs. This is in comparison to…
According to a study by Jackson Healthcare, the percentage rate of U.S. physician compensation is among the lowest of western nations. In 2011, physicians’ salaries compromised 8.6 percent of the nation’s total health care costs. This is in comparison to 15 percent in Germany, 11 percent in France, and 11.6 percent in Australia. Detractors point to the fact that although the percentages speak for themselves, if you look at …
CMS has paid out over $21 billion dollars in incentive payments to providers and hospitals who have successfully attested under the EHR Incentive Program (i.e. meaningful use). With that much money out the door, you can bet that Congress is…
CMS has paid out over $21 billion dollars in incentive payments to providers and hospitals who have successfully attested under the EHR Incentive Program (i.e. meaningful use). With that much money out the door, you can bet that Congress is watching closely to ensure that those dollars are only going to people who really have met the requirements. One way that CMS is monitoring meaningful use is by conducting audits …
It’s here. For the first time in 35 years (or 33, depending on which click bait headline you clicked on), the much anticipated release of data on Medicare payments to physicians, has been released to the public, on the historic…
It’s here. For the first time in 35 years (or 33, depending on which click bait headline you clicked on), the much anticipated release of data on Medicare payments to physicians, has been released to the public, on the historic date of April 9th, 2014.
“Data trove shows U.S. doctors reap millions from Medicare,” according to the distinguished Reuters news service. The Washington Post will tell you “everything you need …
"Do patients care about how much money their doctors make?" This is the headline of a recently published post by Trudy Lieberman, and was written in response to the recent New Your Times' coverage of Medicare disclosing payments to individual…
“Do patients care about how much money their doctors make?”
Now, I found the Times story fascinating on many levels, but I’ll admit it hadn’t occurred to me that the main value of this data release is that patients can …
You won’t read about the International Classification of Disease (ICD) on TMZ or hear it discussed on The View, but it has the potential to be an unpleasant October surprise in the healthcare world. It is a list of codes…
You won’t read about the International Classification of Disease (ICD) on TMZ or hear it discussed on The View, but it has the potential to be an unpleasant October surprise in the healthcare world. It is a list of codes that physicians and hospitals use when billing insurance companies. These codes cover all manner of medical diagnoses for diseases, conditions, and injuries.
For 11 years, Congress has failed to reform the Medicare physician payment system, and appears prepared yet again (for the 17th time) to fall back on another one-year patch for the unpopular sustainable growth-rate (SGR) formula to avoid a 24%…
For 11 years, Congress has failed to reform the Medicare physician payment system, and appears prepared yet again (for the 17th time) to fall back on another one-year patch for the unpopular sustainable growth-rate (SGR) formula to avoid a 24% cut in payments to doctors. As House minority leader Nancy Pelosi said recently, “Instead of reforming the Medicare physician payment system, Congress seems intent on imposing yet another round of arbitrary …
The Centers for Medicare and Medicaid Services released a massive amount of information regarding how much money it paid out to individual doctors. For the policy nerds out there, here is the original data. For everyone else, here is a…
The Centers for Medicare and Medicaid Services released a massive amount of information regarding how much money it paid out to individual doctors. For the policy nerds out there, here is the original data. For everyone else, here is a simple way to look up how much your own doctor made. I decided to search for myself in the database …
The government dropped a gigantic dataset: details on nearly every single procedure performed by a U.S. doctor on a Medicare patient. The release was greeted with some serious gnashing of teeth, at least as far as doctors were concerned. The…
The government dropped a gigantic dataset: details on nearly every single procedure performed by a U.S. doctor on a Medicare patient.
The release was greeted with some serious gnashing of teeth, at least as far as doctors were concerned. The American Medical Association, which has always been staunchly opposed to the release of this sort of data, made sure it’s objection was — again — on the record. MedPage Today leads …
I am all for transparency when it comes to health care. So when Medicare announced that it would tell the public how much doctors are paid to treat Medicare patients, my first thought was "hooray." Another victory for consumer information.…
I am all for transparency when it comes to health care. So when Medicare announced that it would tell the public how much doctors are paid to treat Medicare patients, my first thought was “hooray.” Another victory for consumer information.
Then I began to think about this in more depth. The Centers for Medicare and Medicaid Services (CMS), in response to a ruling in a federal case …
If you live in the rural U.S., you probably face relatively limited access to the wonders of American health care. There won’t be as many physicians per capita offering you their services. This paucity of health care professionals will be…
If you live in the rural U.S., you probably face relatively limited access to the wonders of American health care. There won’t be as many physicians per capita offering you their services. This paucity of health care professionals will be especially stark for subspecialty care. There are not many ENT specialists opening up shops in rural Texas when they can find jobs in Houston or San Antonio.
What would you think if I told you that Medicare will require laboratories to disclose to CMS payment rates from private insurers? Or that they will identify physicians who order a high volume of CT tests and require them to…
What would you think if I told you that Medicare will require laboratories to disclose to CMS payment rates from private insurers? Or that they will identify physicians who order a high volume of CT tests and require them to pre-authorize those tests in 2020? How about that CMS will begin its own analysis of the time and cost of providing services in order to determine RVUs, a job currently …
My home hospital is small. In a town of just over 20,000 people, this hospital has 25 beds and is designated "critical access" by Medicare because it is felt to be necessary to the health care of the community. Critical…
My home hospital is small. In a town of just over 20,000 people, this hospital has 25 beds and is designated “critical access” by Medicare because it is felt to be necessary to the health care of the community. Critical access is a designation which was introduced in 1997 when modernization of Medicare payment systems threatened to close a large proportion of hospitals in small communities which were unable to …
A guest column by the American Medical Association, exclusive to KevinMD.com. It’s crunch time for our nation’s physicians. After an 11-year battle, we stand closer now than ever before to repealing Medicare’s fatally-flawed sustainable growth rate (SGR) formula. With the…
It’s crunch time for our nation’s physicians. After an 11-year battle, we stand closer now than ever before to repealing Medicare’s fatally-flawed sustainable growth rate (SGR) formula.
With the introduction of the SGR Repeal and Medicare Provider Payment Modernization Act of 2014 last month, Congress took a critical step toward reforming the nation’s …
Medicare’s Sustainable Growth Rate (SGR) payment formula has hung like an annual albatross around the necks of physicians, Congress, and medical associations for more than a decade. Finally, we have a realistic opportunity to fling that albatross into the sea.…
Medicare’s Sustainable Growth Rate (SGR) payment formula has hung like an annual albatross around the necks of physicians, Congress, and medical associations for more than a decade. Finally, we have a realistic opportunity to fling that albatross into the sea.
Three congressional committees — from both the House and the Senate, with both Democratic and Republican support — have crafted the SGR Repeal and Medicare Provider Payment Modernization Act of 2014, …
In describing why Cooper Union, a unique college that offers absolutely free education to students, would effectively die if it starts charging tuition, Kevin Slavin wrote: For many of us, Cooper wasn't even the cheapest way to go to school...So…
In describing why Cooper Union, a unique college that offers absolutely free education to students, would effectively die if it starts charging tuition, Kevin Slavin wrote:
For many of us, Cooper wasn’t even the cheapest way to go to school…So the question is: why did we go? We went not because of the financial value of free–that is, zero tuition–but rather, because of the academic value of free. At Cooper Union
