The Centers for Medicare and Medicaid recently released its compiled data on what over 3,000 hospitals across the country charge for 100 of the most common discharge diagnostic codes under the diagnosis related group (DRG) system, and boy did the DRG really hit the fan.  Liberals, economists, and band wagoners got all upset about the enormous pricing differentials between hospitals for the same services. For example, Twin Cities Community Hospital in ...

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Maligned over the last decade as places to avoid because of the price of the care they delivered, a study by the RAND Corporation goes a long way toward improving the image of hospital emergency rooms (ERs). The ER price tag was too high for the insurance companies that paid the bills, so many of them tried to discourage ER use by designing policies with high coinsurance and copayments ...

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Today I am going to write about how the US could save up to 10% on its healthcare bill. The US spends more on health care than any other nation, $8,500 per person per year. Multiply that by 300 million people and try to grasp the vast sum of $2,5 trillion. A lot of changes are taking place with the intent to save healthcare dollars. So far, many of those changes have ...

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Hospitals that are already struggling financially to stay afloat face significant challenges in the coming months and years under some of the provisions of Obamacare. Under the Affordable Care Act's Hospital Readmissions Reduction Program, hospitals that readmit certain patients within 30 days of discharge could face significant penalties. The question is whether hospitals really have that much control over factors leading to readmission and whether they are really at fault. Some readmissions are ...

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I sometimes explain to medical students that they are entering a profession being transformed, like coal to diamonds, under the pressure of a new mandate. “The world is going to push us, relentlessly and without mercy, to deliver the highest quality, safest, most satisfying care at the lowest cost,” I’ll say gravely, trying to get their attention. “What exactly were you trying to do before?” some have asked, in that wonderful way ...

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Doctors are trying to rationalize our current story line:  the loss of autonomy and pay cuts are a necessary evil for the greater good.   We're taking one for the excess-health care cost team.  We're willing to take this personal sacrifice for our fellow man and woman.   It is the noble thing to do.   It will be good for America's healthcare system if we do our part, work harder ...

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T.Santo - Oregon Medicaid (media) An important article was recently published in the New England Journal of Medicine, titled The Oregon Experiment — Effects  of Medicaid on Clinical Outcomes. This study provides a rare look at the effects of expanding Medicaid coverage (specifically, Oregon Health Plan, Oregon’s version of Medicaid) to a population of previously uninsured patients. Having practiced medicine in Portland, ...

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How much to treat this pneumonia? The Centers for Medicare and Medicaid took a step towards answering such questions by publicly releasing how much each of 3000+ U.S. hospitals charged Medicare for 100 common medical issues in 2011 and how much Medicare actually paid them. The charges were remarkably variable, even among hospitals that share a zip code. Massachusetts hospitals tended to charge below the national average (eg. ...

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An excerpt from The Upstream Doctors: Medical Innovators Track Sickness to Its Source. There’s a story widely known in public health circles about three friends and a river. I retell it this way:

Three friends approach a wide, beautiful river leading to a waterfall. The idyllic scene is shattered by the cries of a small child in the water, flailing his arms while struggling to stay afloat. He’s fast approaching the ...

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In an ad-hoc poll among classmates, I recently inquired about the most important date (in 2013) to a 2nd year medical student. The overwhelming majority cited their respective USMLE Step 1 exam dates as most important, followed closely by the season finales of ABC’s Scandal and Grey’s Anatomy. While the top three responses all are worth their respective weights, the one date that should bear the most gravity in the minds ...

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