It strikes me that in developing payment reform related, compensation driven cost-containment strategies aimed at constraining the cost of emergency care, policy makers, emergency physicians, and health insurers should adhere to certain principles. The American College of Emergency Physicians should be at the forefront when it comes to establishing these principles, which I hope will be focused on protecting our patients first, and our specialty second. The concept and practice of ...

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Much is being written about the ever increasing cost of health care in the US, especially compared to the rest of the developed world. As a nation, we spend nearly 16% of our GDP on health care.  All estimates predict that this amount will continue increasing unless costs can be controlled now.  Hence the passage of the Affordable Care Act.  Not only was it designed to extend coverage to more ...

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by Benjamin P. Geisler, MD, MPH A recent New York Times article on how to value a life drew almost two-hundred heavy-handed comments. It discussed how different governmental agencies such as the Food and Drug Administration (FDA), the Environmental Protection Agency (EPA) or the Department of Transportation (DoT) place a monetary value on each life saved. In many public policy areas, cost-benefit Analysis (CBA) is being used to assess whether an investment ...

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by John Kaegi We all complain about the cost of health care and health insurance.  Ours is by far the most expensive health care system in the world.  And for the money, our health isn’t so hot either.  On the world stage, the U.S. ranks 37th in health care efficiency (a measure of health outcomes such as infant mortality, incidence of chronic disease, etc.) as reported by the World Health Organization.  America ...

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by Grayson Wheatley, MD It was supposed to be a routine office visit for my patient. Unexpectedly, it turned into a real-world health economics lesson for me, the treating physician. The old adage "listen to your patients; they will always give you the answer" became exceedingly true in this case, even when it dealt with an issue beyond a medical diagnosis, such as lack of transparency ...

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The New York Times reports on Washington state’s efforts to "to determine which medical devices and procedures Washington will cover for state employees, Medicaid patients and injured workers, about 750,000 people in all." An expert panel, appointed by the state, is getting national attention, writes the Times, "in part because its process is public and open. . . [and] provides a living laboratory of the complexities of applying evidence-based ...

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With the roll out of the Affordable Care Act and perhaps more significantly the approach of the 2012 elections, public discussions of healthcare reform has been drowning in an alphabet soup of ACOs (not to be confused with the above ACA), CMS, SCHIP, and RUVs, just to name a few. The challenge is twofold. Most of these plans/systems/agencies deal with how to better pay for a seriously flawed system.  ...

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A guest column by the American College of Physicians, exclusive to KevinMD.com. by John Tooker, MD, MBA, MACP ACP: ACOs – On to the final ruleRecently, I commented on cost saving, quality, and care coordination requirements in the proposed rule that physician practices will likely need to meet to be eligible for additional Medicare payments. The public comment period on the proposed rule for the ...

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If we're serious about cutting Federal health care expenditures over the long term, here are two changes that will do just that. 1. Requiring HHS to negotiate with pharma for Part D drug costs would reduce annual expenditures by over $20 billion. As I've noted repeatedly(but unfortunately few in the mass media have), Part D's perhaps the biggest deficit problem we have - the ultimate unfunded liability is now over $20 trillion. ...

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Recently, the Board of the American Academy of Family Physicians (AAFP) announced that, for now, it would continue participating in the Relative Value Scale Update Committee (RUC), the secretive American Medical Association committee that, through a longstanding relationship with the Centers for Medicare and Medicaid Services (CMS), has heavily influenced physician reimbursement. At nearly the same time, Medicare announced that it will go broke in 2024, a decade sooner ...

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