The market for medical tourism grows as Americans increasingly seek medical care outside of the United States and pay cash for services.  Patients know they can obtain adequate quality care in Mexico for out of pocket costs far lower than their insurance plans with high deductibles would cover.  Posting basic outpatient visit and simple procedure prices could benefit our independent practices in the same way.  The only thing worse than ...

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Three men walk into a deli for lunch, take a number, and sit quietly until called. There are no prices on display, nor is the food visible. The first man, Ron, is called to the counter and states that he is hungry when asked what brings him in. He presents his food insurance credentials, and five minutes later, he walks out the door with a 12-inch gourmet sandwich, a side ...

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Dear Dr. Price, Congratulations on your upcoming appointment as the new Health and Human Services Secretary under President Trump. As a physician myself, it’s great to know that a fellow physician will head up the agency. I’m sure you understand too, having been a practicing orthopedic surgeon, how disheartening and frustrating it is to have non-clinical “experts” making key decisions about health care. I’m sure you’ve also seen the news about how ...

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The concept of sickness insurance began in Germany in 1883. Chancellor Otto Von Bismarck initiated insurance for the poor. A decision about how these services were to be delivered is critical to understanding the contentious debates around health care. Could Bismarck have given vouchers for care as needed? Alternatively, should the government control the needed health care facilities? Perhaps thinking the poor did not have the capability to manage their own health, he chose ...

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Dear patients, One year ago, I wrote to you about my concerns for the future of my practice in light of upcoming changes to the Medicare system.  I explained my anxiety about the Medicare Access and CHIPS Reauthorization Act (MACRA), a change in fee structure from fee-for-service (I treat you in the office, submit the bill to Medicare, and they pay the bill), to “value-based” payment (I treat you ...

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President-elect Donald Trump has repeatedly vowed to “repeal and replace Obamacare.” A logical question is: With what? The announcement of Rep. Tom Price (R-Ga) as Trump’s nominee for secretary of health and human services provides some answers. Unlike other Republican critics of the Affordable Care Act (ACA), Price, an orthopedic surgeon, has offered many replacement plans of unmatched detail. His Empowering Patients First Act was 242 pages ...

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It used to be that hospitals billed Medicare for the services they provided, and Medicare -- I know this is crazy! - simply paid the bills. Those days are rapidly receding into history. Soon, a significant chunk of hospital revenue will be at risk, under a series of Medicare pay-for-performance programs. The idea behind P4P (as the cool kids call it) is simple. Third-party payers, like insurance companies or the Medicare ...

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american medical associationThe AMA supports the nomination of Dr. Tom Price based on decades of interactions with him as a member of the AMA House of Delegates, Georgia state senator and as a member of the House of Representatives since 2005.  Over these years, there have been important policy issues on which we agreed (medical liability reform) and others on which we ...

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On Tuesday, November 29, President-elect Donald Trump named Dr. Tom Price, a former orthopedic surgeon, current Republican congressman, and chair of the House Budget Committee, as his pick for Secretary of Health and Human Services. The same day, the American Medical Association issued a press release enthusiastically endorsing Price for the position. The next day, Dr. Andrew Gurman, the president of the AMA, came to my hospital to ...

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MACRA -- the Medicare Access and Chip Reauthorization Act of 2015 -- is a disaster. It will take the joy out of practicing medicine without significantly improving patient outcomes (except in a circular way) or reducing cost, by moving medical decisions from the bedside to the C-suite. It benefits primarily the health policy community -- consultants, academics, executives -- who designed it. Ironically, MACRA was one of the few major pieces ...

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