With the expected cutbacks in healthcare funding and the increasingly dismal outlook for "new" money in the healthcare pot, "value" has quickly become a key watchword. In the past decade, we've seen many public and private payers implement value-based, pay-for-performance (P4P) programs as a means of spurring healthcare providers to improve the quality of services they provide and, tangentially, reduce the ...

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Have you noticed the recent trend against specialty physicians? Policy experts have determined that primary care needs incentives to attract medical students away from those "highly lucrative" specialties such as plastic surgery, orthopedic surgery, interventional cardiology, and neurosurgery. Our federal government believes in equal opportunity -- if you wish to become a family doctor. There are incentives sponsored ...

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8,000 patients will no longer be able to receive care from UNC Hospitals and their affiliated physician practices because of a dispute between UNC and the insurance company Aetna. The bottom line is that Aetna does not want to pay as much for care provided by UNC as UNC wants to be paid for providing this care. No surprise there, as the interests of the two parties (health care ...

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My first exposure to KevinMD.com is reading Healthcare costs can be reduced with emerging business models by Joe Flower. While I am not informed about the medical business models to which he refers, I am experienced in business. I hail from a family of doctors and hospital owners. While I did lose touch with the industry for several years, I have noted several changes which do not make sense. ...

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The cost curve of American medicine continues to bend up. That is unsustainable. It must begin to bend downward. Two recent headlines focus the problem: New York Times, May 14, 2011: Health Insurers Making Record Profits as Many Postpone Care And, CNN Money, May 11, 2011 reports "Your family's healthcare costs $19,393." That is for a family of four, which has a median income of $75,700  -- before taxes. Opportunity ...

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Doctors who do not successfully e-prescribe 10 times for Medicare patients in the first six months of 2011 using claims-based reporting may be hit with a 1% penalty on their Medicare Part B payments for covered professional services in 2012. The penalty will increase to 1.5% in 2013 for those who don't e-prescribe for 25 Medicare patients during 2011. Not yet e-prescribing? Maybe your Read more...

A guest column by the American College of Physicians, exclusive to KevinMD.com. by John Tooker, MD, MBA, MACP ACP: How accountable care is a team sportOn March 31, 2011, CMS issued a proposed rule to implement a section of the Patient Protection and Affordable Care Act (ACA) that requires the HHS Secretary to establish a Medicare Shared Savings Program. Under the proposed rule, eligible providers and hospitals ...

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The insurance middleman has taken a toll on the family doctor. New practice models plan to change that. Physicians in Seattle, Silicon Valley and Boston are proving what the rest of the world already knows. When you have a high function primary care system, there's less money spent and better health outcomes. Before House, M.D., ...

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One of our purposes e-Patients.net is to help people develop e-patient skills, so they can be more effectively engaged in their care. One aspect is shared decision making. A related topic, is understanding the challenges of pathology and diagnosis. Both posts teach about being better informed partners for our healthcare professionals. I’ve recently learned of an another topic, which I’m sure many of you know: practice ...

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I hear it all the time: "All these illegals are coming over here and they don't pay taxes, but they get all these government handouts and they're clogging up our health care system ..." I often point out that many undocumented immigrants actually do obtain a taxpayer identification number for the express purpose of paying taxes in hopes that if a path to ...

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