American consumers value the freedom to comparison shop. We like to survey a variety of options and select "the one" that what we really want. If we want triple-ply, select-a-size paper towels with a blue shepherdess imprinted on them, then we expect to be able to find them in aisle 9. Deny us options and we’ll take our business elsewhere. When it comes to health care, though, endless options may not ...

Read more...

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 provider ...

Read more...

How much Medicare pays doctors requires context 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 ...

Read more...

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 in Florida ...

Read more...

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. This undersupply of physicians ...

Read more...

The Cayman Islands are nestled in the Caribbean Sea some 430 miles south of Miami. The three-island cluster is known for its inviting coral-sand beaches, laid-back island culture and tax-free status. While it lures many tourists and big banks, it’s not the first place you’d expect to find the future of American health care. That may change soon. Last month, I flew to the Caymans to moderate an afternoon-long panel on delivering ...

Read more...

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 ...

Read more...

Back in 1986, the Health Care Financing Administration launched the brave new era of quality reporting in this country by releasing "report cards" that detailed hospital-specific, risk-adjusted mortality rates for coronary artery bypass graft (CABG) surgery. Since that time, the number and type of publicly reported quality outcomes has grown exponentially with the goal of helping patients make informed decisions when selecting doctors, thereby driving quality improvement by doctors and hospitals. Has ...

Read more...

There's been a lot of hype about the "Ban Bossy" campaign in the news lately, and the talk is all over the map. I was thinking about it in regards to health care, especially nursing, since nurses are notoriously "bossy," or at least referred to as such. I can remember being a nursing student and talking with a physician about a patient during my clinicals. He told me, "You ...

Read more...

I first heard about the ICD-10 when I was working at a small start-up, trying to develop an EMR for a string of dialysis clinics. It was always spoken of with a certain gravity, like the ominous visit from an aunt that nobody in the family likes, but feels obligated to see.  Practical (read: business) people hate ICD-10. It’s giant and unwieldy. Doctors think it’ll be an excuse to bilk ...

Read more...

Most Popular