The revelations about the huge golden parachute given the outgoing CEO of ostensibly non-profit Massachusetts Blue Cross Blue Shield induced some public discussion about the disconnect between executive compensation and the mission of health care organizations. First, new proxy statements revealed the compensation of executives of two large for-profit health care insurers/managed care companies. Cigna As reported by the AP, via ABC News, the CEO got a big raise:

Cigna Corp. ...

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Sometimes you just don't want to be right.  Over the past 5 years, I have seen an alarming pattern arise in my profession.  Many of my patients have heard me talk about Soylent Green, an old Charleton Heston movie.  The premise of the movie seems absurd.  Can you imagine the government of the United States providing for all the needs of its people including healthcare, food, clothing, and even death? David ...

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Medical malpractice reform is one of the few health care policy issues where there is a real possibility of agreement between the White House and Congress. A common refrain is that the fear of lawsuits leads physicians to practice defensive medicine, ordering too many tests just to cover their behinds in case of a lawsuit. It drives up costs without creating benefits. There’s some truth to this argument, ...

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Washington has been touting Accountable Care Organizations (ACOs) as the end-all solution to health care’s woes. Designed to reduce Medicare spending and increase care coordination across a large number of patients, members of an ACO – hospitals, primary care physicians, specialists – would be paid if and when their patient population received outstanding quality of care. However, as the Centers for Medicare and Medicaid Services (CMS) finalize their ACO ...

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At UC Berkeley in the 70s, the secretary in the Department of Psychology pasted a bumper sticker on her desk positing the question: "… yes, but are we asking the right questions?" For some reason, this subtle invitation remains with me today, echoing amidst the ACO fervor of "… better care at lower costs."

… the good news is we’re making great time, the bad news is we don’t know where ...

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AMA: Health insurers denial rates are down, but error rates are upA guest column by the American Medical Association, exclusive to KevinMD.com. Billions of dollars in administrative waste would be eliminated each year if health insurers sent a timely, accurate and specific response to each physician claim, and while this year’s AMA National Health Insurer Report Card shows promising improvements in denial rates, more work needs to be done. The AMA’s fourth annual ...

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We all know, broadly speaking, the mission of comparative effectiveness research (CER), now sometimes called patient-centered outcomes research. Such studies should inform clinical and health policy decisions made by physicians, payers, and regulators to help determine treatment guidelines, coverage policies, and the therapeutic value of new therapies relative to standard-of-care in real-world settings.

But dive deeper, and it’s clear there remains an uncomfortable level of confusion as to what CER ...

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In the Chicago Tribune recently, Bruce Japsen has an excellent article addressing Accountable Care Organizations, quality of care issues, and the change in how physicians will be paid in the future. Clearly, the government and insurers have decided that physicians will not be paid for services rendered.  Physicians will be paid based on patient outcomes and will share in any losses insurers sustain due to poor patient outcomes.  There ...

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There have been scores of recent articles about Congresswoman-elect Kathy Hochul's upset win in New York's 26th Congressional District special election.  They all seem to share a thread of incredulity, followed either by chortling or spin depending on the source.  These stories also share the sense that her victory was truly an underdog performance destined to become legend. According to The New York Times, "Two months ago, the Democrat ... was ...

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Does it really matter how many ribs Michelle Obama ate on her vacation? For too many conservatives, the answer seems to be yes, with pundits poking fun at the anti-obesity guru's dinner choice. But conservatives need to give it a rest: many seem to prefer scoring easy points against the First Lady to arguing about the best way to attack the obesity epidemic -- and some even claim that ...

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