The feds are at it again. Medicare is in the cross hairs with an anticipated 0.9 percent cut to Medicare Advantage plan payments in 2016. The final decision is to be made on April 6 of this year. Medicare Advantage plans are an alternative to traditional Medicare. Traditional Medicare consists of Part A (hospital) and Part B (medical) coverage.  Medicare Advantage plans (Part C) can be chosen in place of the ...

Read more...

medpagetodayFrom MedPage Today:

  1. MedPage Today at 10: Where We Have Been. Sometimes things go so right, that you get nervous. Really nervous. That's pretty much what happened when MedPage Today launched 10 years ago.
  2. Sepsis Readmissions May Be Correctable. It might be possible to prevent many of the hospital readmissions that occur ...

    Read more...

When I speak with colleagues about ways to provide primary care to the poor, they generally fall into one of two camps. The first camp, generally supporters of the Affordable Care Act, contends that the ACA's originally mandatory (but later ruled optional) expansion of Medicaid insurance eligibility and a temporary federally-funded increase in Medicaid fee-for-service rates to Medicare levels provided enough incentives to attract family physicians to patient-centered medical homes that ...

Read more...

Medicaid expansion “is one of the biggest milestones in health care reform,” according to the Obamacare Facts website. The goal was to provide insurance coverage to low-income Americans, specifically the uninsured. The major problem with Medicaid is low reimbursement. “Due to low payouts, many doctors don’t take Medicaid, and the quality of care tends to be poor,” admits the website. The solution was to raise the amount doctors get paid under ...

Read more...

For years, policy experts have been predicting the end of fee-for-service.  Yet it can be said of fee-for-service that, like Mark Twain’s alleged demise, reports of its death have been greatly exaggerated. (Actually, this is an often-used misrepresentation of what Twain actually said. After the New York Herald incorrectly reported that he was “grievously ill and possibly dying,” an “amused” Mark Twain wrote that “the report of my death has been ...

Read more...

Medicaid A physician friend of mine posted a copy of her Medicaid reimbursement on Facebook. Take a look at the charges compared to the actual reimbursement. She is paid between $6.82 and $17.54 for an hour of her time (i.e., on average, she makes less than minimum wage when treating a patient on Medicaid). The enthusiasm for expanding Medicaid coverage to the previously uninsured ...

Read more...

Of all the radical changes affecting health care that have sent providers reeling, we are about to experience the knockout punch: the effort to change health care reimbursement from a quantity-based to a quality-based system. Of all the changes to health care, I can't think of any other that has been based on more false assumptions. Given the fact that there is always low hanging fruit, supporters of the quality-based ...

Read more...

As we enter year two of the Affordable Care Act, we have seen many issues arise during implementation.  Through both executive order and executive memorandum, President Obama has unilaterally changed the law more than 100 times in order to advance his political agenda. When it became important to publicize enrollment and increased coverage of the uninsured, the president, and the ACA provided for an increased payment scale for patients with Medicaid. ...

Read more...

Medicaid is a federal program for the very poor implemented by grants to states, which do the administration.  Medicaid typically pays doctors about 60 percent of what Medicare pays.  In Florida, a typical primary care visit might pay the doctor $32.  In Alabama, doctors who agree to be the primary care physicians of record for Medicaid patients get a whopping $2.60 per beneficiary per month, a fee with which the ...

Read more...

So there is this guy from MIT or Harvard, or some other place where they teach our leaders how to lead, and his name is Jonathan Gruber. Mr. Gruber, it seems, was hired to consult with the Obama administration during the time the Affordable Care Act (ACA) was created because of his extensive expertise in designing the Massachusetts health care system. In recent weeks, people who don’t particularly like our ...

Read more...

Most Popular