I live in New York. Last week my daughter in Chicago called to say that a five dollar charge had been refused at a local coffee shop. My credit card company had identified an unusual pattern of purchases, and had put a hold on the card. No similar process exists for the Medicare system, where cost savings could be realized by systems that identify unusual patterns of charges and outright abuse ...

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A revealing article in Bloomberg recently described the latest way in which elderly patients are getting screwed by the system. Medicare reviews all admissions and if the patients don’t meet indications for admission, the hospital doesn’t get paid by Medicare. Medicare has also recently implemented a mercenary system called Recovery Audit Contractors (or RAC for short) in which third parties audit hospital charts to see whether Medicare “overpaid” for a patient’s ...

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Like it or not, “garbage in, garbage out” is the rule rather than the exception for the vast majority of bureaucratically dictated “quality control” programs that we’re ever likely to launch.  There are three primary reasons for this. First and foremost, there’s Goodhart’s Law:

“Originally, an economic theory stating that if a particular definition of the money supply were to be used as the basis for monetary policy, the stability ...

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Over the past year, states across the country have begun to develop Regional Extension Centers (RECs) to help support the broad electronic health record (EHR) initiative passed as part of the economic stimulus package in 2009. Why should physicians care? With benefit of a little background information, the answer is pretty clear. The evidence suggests -- and it is generally believed -- that adoption of EHRs by physicians and other healthcare providers ...

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Peter Orszag wants doctors to work weekends. The former director of the White House Office of Management and Budget wrote as much in this past weekend's New York Times:

Doctors, like most people, don’t love to work weekends, and they probably don’t enjoy being evaluated against their peers. But their industry can no longer afford to protect them from the inevitable. Imagine a drugstore open only five days a week, or ...

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by Asa Lockhart, MD Doctors, that age-old business advice still applies: Take your time and read carefully, and evaluate what it might mean to your patients and your practice, before you sign a contract. Specifically, the Patient Protection and Affordable Care Act (PPACA) paves the way for Medicare shared savings accountable care organizations (ACOs). Conceptually, this type of ACO is a collaboration of physicians and health care providers ...

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Somewhere in the Obama Administration, there is an elitist central cabal that operates with the support of the highest organs of our central government. It conspires in windowless basement rooms to plot the gun control, mass vaccinations and the nationalization of key U.S. economic sectors like automobile and chardonnay manufacturing. Healthcare, however, is its maximum target. Much like pieces on a chess board, and with the support of renegade organizations like ...

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How do you judge how good a doctor is? By personal interaction? By what relatives and friends say? By whether he or she is on time when you go for your visit? By doctor rating websites on the Internet? By patient satisfaction surveys conducted by doctors themselves or rating agencies? Or do you do it by the numbers? The federal ...

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by James Baker, MD All over the country, more people are seeking out mental health and developmental disability services from public clinics because they have lost their insurance. Yet at the exact same time, those services have taken a big hit due to the poor economy, too. One survey says that 32 states have cut their public mental health services, and the average cut is about 5%. That 5% may not ...

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Today we mostly have prepaid medical care insurance with some co-pays and deductibles – both with commercial insurance and with Medicare. In other words, our insurance covers essentially everything from basic and routine care to the catastrophic. And the insurance pays out based on units of care – a visit, a test, a procedure, a hospitalization, a prescription. This creates a system in which providers (physicians, ...

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