Despite the political angst, the doomsday predictions and a very rocky launch, the Affordable Care Act has enabled more than 8 million Americans to acquire insurance coverage through the public exchanges. Health insurance increases the probability that patients will access the medical care they need. And my colleagues at Kaiser Permanente are already seeing some positive stories emerging as a result. They’ve shared dozens of stories with me about patients with undiagnosed ...

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Did you ever read a seemingly inconsequential sentence somewhere and it then just refused to leave your mind for days on end, triggering avalanches of thoughts way beyond the original intent, if there even was one? It just happened to me a few days ago when I read one more industry article about the recent Medicare data dump. The following remark was attributed to a primary care doctor: “The U.S. is ...

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I was working overnight in Tiny Memorial Hospital, located in scenic rural America.  My call room there was a converted patient room.  As such, my bed was a hospital bed.  Lying there one night, I rolled to the side and raised the head of the bed using the button on the rail.  The blanket was standard hospital fare: stiff and thin.  And the television remote, fully two pounds and connected ...

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What a shame: Reimbursement rates are going up for private Medicare Advantage plans. Contrary to its April 7 announcement that private Medicare reimbursement rates would be reduced, the Centers for Medicare & Medicaid Services has just reversed course and announced that it will increase overall Medicare Advantage rates. The change in policy came after pressure from the political parties and insurance companies. As Medicare spending per beneficiary grows at a ...

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Medicare released the most comprehensive ever look at how Medicare dollars are paid out to physicians across the United States.  In the name of transparency, this data drop will “provide consumers with an ability to compare doctors and treatments in a way they have never had until now.” Will it really? Let’s look a bit closer at the data release. According to the Centers for Medicare and Medicaid Services, the payment data release aims to “make our ...

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"Health insurance is not health care." That is not original. I borrowed it from Los Angeles County Department of Health Services Director Mitchell Katz's JAMA Internal Medicine editorial about problems with ensuring access to health care for Medicaid recipients whose cheap public insurance usually doesn't even pay doctors enough to recoup costs of care, let alone earn a living. But somehow, during the impassioned political debates that preceded Obamacare, the botched rollout of ...

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According to a study by Jackson Healthcare, the percentage rate of U.S. physician compensation is among the lowest of western nations.  In 2011, physicians' salaries compromised 8.6 percent of the nation's total health care costs.  This is in comparison to 15 percent in Germany, 11 percent in France, and 11.6 percent in Australia.  Detractors point to the fact that although the percentages speak for themselves, if you look at ...

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CMS has paid out over $21 billion dollars in incentive payments to providers and hospitals who have successfully attested under the EHR Incentive Program (i.e. meaningful use). With that much money out the door, you can bet that Congress is watching closely to ensure that those dollars are only going to people who really have met the requirements. One way that CMS is monitoring meaningful use is by conducting audits ...

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It’s here. For the first time in 35 years (or 33, depending on which click bait headline you clicked on), the much anticipated release of data on Medicare payments to physicians, has been released to the public, on the historic date of April 9th, 2014. “Data trove shows U.S. doctors reap millions from Medicare,” according to the distinguished Reuters news service. The Washington Post will tell you “everything you need ...

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"Do patients care about how much money their doctors make?" This is the headline of a recently published post by Trudy Lieberman, and was written in response to the recent New Your Times' coverage of Medicare disclosing payments to individual providers. Now, I found the Times story fascinating on many levels, but I'll admit it hadn't occurred to me that the main value of this data release is that patients can ...

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