Now here's a novel idea. What if someone asked the American people, or a demographically representative group of it, what it wants from healthcare. That would be called "market research." Ask the public what it wants, listen carefully, and then give it to them. Turns out that the New York-based Commonwealth Fund has done just that. In brief they found:

  • 72% of American adults believe that our healthcare system needs to be fundamentally ...

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by Jeffrey L. Cohen The current fixation on Accountable Care Organizations (ACOs) is causing an enormous amount of two things:  1) talking, and 2) inactivity. Yes, the concept of delivering care in a manner that reduces or at least controls costs is important and interesting.  Yet, the marketplace is replete with people and businesses that have adopted ...

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by Justin Chang, MD I think we can all agree — physician, payer, provider, patient, etc. — that the ultimate goal of regulations and reform should be to improve the delivery of healthcare, lowering costs and ultimately, making patients healthier and more satisfied. Coupled with driving toward the results defined by CMS, this requires some fairly significant changes ...

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Everyone knows that the excess growth in health care costs is driving the fiscal crisis in our country. The problem is that while everybody wants to somehow cut the cost of Medicare/Medicaid, in theory, when it comes time to actually make cuts, the courage of our politicians fails in the face of unrelenting public opposition to cuts in Medicare. How the IPAB takes policy and puts it in the hands of health care experts
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Accountable Care Organizations (ACOs) are supposed to be provider-led (physician groups +/- hospitals) and, they are supposed to inject a new accountability, at the provider level, for the value of services delivered. You know the old equation.  Value=Quality/Cost.  Those of us inside the health policy “beltway” know this mantra well. We have been talking about it for years (decades, really). I spent almost ...

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A recent blog post in Health Affairs proclaimed The End of Internal Medicine As We Know It.  What the article is really asking is the future of primary care in the world of health care reform and the creation of Accountable Care Organizations (ACOs). While doctors should be naturally concerned about change, I don't completely agree with this ...

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Recently, 47 American medical specialty societies sent Rep. Jim McDermott (D-WA) a letter, with copies to all members of Congress, containing a detailed defense of the American Medical Association’s (AMA’s) Relative Value Scale Update Committee (RUC). For 20 years, the RUC has exclusively advised the Centers for Medicare and Medicaid Services (CMS) on physician procedure valuation ...

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I took my eye off the ball for just a little while, and guess what happened? When I looked again, I discovered that familiar solo practitioner or small group physician medical practices are on the verge of disappearing. Going the way of the dinosaur. At least, that's what the pundits are saying. In a recently published nifty newsletter, STAT Monthly, I read:

Primary care physicians and other specialists will continue to ...

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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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