by Benjamin P. Geisler, MD, MPH Everybody is talking about Accountable Care Organizations or ACOs these days. The reason being that the Centers for Medicare and Medicaid Services or CMS has released the rules for shared savings between ACOs and CMS. The complete proposed rule is 429 pages long and they're seeking comments on it now until early June. What is an ACO? ACOs will take care of ...

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ACO regulations and related federal issuances hit the street, after several months of waiting -- from CMS, OIG, FTC, DOJ and IRS. They cover the waterfront, ranging from the central regulation defining the structure and workings of the ACO, to  limited Stark self-referral ban and anti-kickback statute waivers in the fraud and abuse arena, to new frameworks for antitrust analysis, to rules governing joint ventures involving taxable and tax-exempt ...

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Federal law generally prohibits physicians from referring their own patients to a diagnostic facility in which they have an ownership issue - a practice called "self-referral" - unless the facility is located in their own practice. This exemption exists to allow patients with access to a laboratory test, x-ray, or other imaging test at the same time and place as when patients are seeing their physician for an office visit. Less ...

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An excerpt from Overhauling America’s Healthcare Machine: Stop the Bleeding and Save Trillions, published by Financial Times Press (2011).  Reprinted with permission of FT Press, and imprint of Pearson. In recent years, more and more of the revenue collected by U.S. healthcare facilities ends up paying for costs that have nothing to do with providing actual healthcare goods and services: things such as administration, billing, documentation, and the cost ...

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The Michigan Medical Group Managers Association had a conference recently in Mt. Pleasant, MI.  The theme of the conference was "Medical Management: Coaching Your Team to a Winning Season." Two speakers—Lloyd Carr, former head football coach of the University of Michigan Wolverines, and Lou Rabaut, partner of law firm Warner Norcross & Judd—both delivered excellent lessons on leadership.  Several of the ...

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To understand how hard it is going to be to control health care costs, one merely has to consider the outrage surrounding TSA's recent roll-out of "enhanced security" measures - measures which include 'enhanced pat downs' and full body scans. Videos of boys getting patted down personified the problem. But the upset and outrage and anger visible today will be nothing if ...

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Healthcare is a limited commodity. It’s limitations are defined by the numbers of professionals supplying it and their physical limitations on the number of patients they’re able to treat, on availability of biomedical equipment and technology, on availability of physical space to safely provide medical care and, underlying all of these, on the funding for such. And so, not ...

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With my extensive health care background, many people have asked for my opinion during the health reform debate. My response has been that the only way to really "reform" the system is to blow it up and start over, which isn't politically feasible. After delving deeper into the current legislation, I believe that we are going to see something ...

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"Someone needs to take this writer out and kick his ass." The quote leaped out at me from a New York Times article. Now, maybe I’m a little sensitive about using physical threats to try to silence writers, since I am a writer. Maybe I am especially sensitive about threatening to kick someone’s ass for writing about healthcare. To my eyes, the quote stood out as emblematic of the tumor ...

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On Kaiser Health News, Barbara Levy MD, the Chair of the AMA’s Relative Value Scale Update Committee (or RUC), published a glowing defense of the RUC’s activities. Her article extols the work of the 29 physician volunteers who, "at no cost to taxpayers ... generously volunteer their time, supported by advisers and staff from more than 100 national medical specialty societies and health care professional organizations." She fails to mention that the ...

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