For 11 years, Congress has failed to reform the Medicare physician payment system, and appears prepared yet again (for the 17th time) to fall back on another one-year patch for the unpopular sustainable growth-rate (SGR) formula to avoid a 24% cut in payments to doctors.  As House minority leader Nancy Pelosi said recently, “Instead of reforming the Medicare physician payment system, Congress seems intent on imposing yet another round of arbitrary provider ...

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How much Medicare pays doctors requires context The Centers for Medicare and Medicaid Services released a massive amount of information regarding how much money it paid out to individual doctors. For the policy nerds out there, here is the original data.  For everyone else, here is a simple way to look up how much your own doctor made. I decided to search for myself in the database ...

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From MedPage Today:

  1. ACA Enrollees Sicker Than Average? Offering a first glimpse of the healthcare needs of Americans who bought coverage through federal and state marketplaces, an analysis of the first 2 months of claims data shows the new enrollees are more likely to use expensive specialty drugs to treat conditions like HIV/AIDS and hepatitis C than those with job-based insurance.
  2. Endocrinologists React to ...

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The government dropped a gigantic dataset: details on nearly every single procedure performed by a U.S. doctor on a Medicare patient. The release was greeted with some serious gnashing of teeth, at least as far as doctors were concerned. The American Medical Association, which has always been staunchly opposed to the release of this sort of data, made sure it's objection was -- again -- on the record. MedPage Today leads ...

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From MedPage Today:

  1. Docs' Medicare Pay Totals Now Public. or the first time, totals of what Medicare pays individual healthcare providers are now freely available to download and browse on a government website.
  2. Fewer Americans Struggling With Medical Debt. The percentage of people in families having problems paying their medical bills continues to tick downward.
  3. Naloxone 'Stigma' a Barrier to Prescribing? Although ...

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I am all for transparency when it comes to health care. So when Medicare announced that it would tell the public how much doctors are paid to treat Medicare patients, my first thought was "hooray." Another victory for consumer information. Then I began to think about this in more depth. The Centers for Medicare and Medicaid Services (CMS), in response to a ruling in a federal case in Florida ...

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If you live in the rural U.S., you probably face relatively limited access to the wonders of American health care.  There won’t be as many physicians per capita offering you their services.  This paucity of health care professionals will be especially stark for subspecialty care.  There are not many ENT specialists opening up shops in rural Texas when they can find jobs in Houston or San Antonio. This undersupply of physicians ...

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What would you think if I told you that Medicare will require laboratories to disclose to CMS payment rates from private insurers? Or that they will identify physicians who order a high volume of CT tests and require them to pre-authorize those tests in 2020?  How about that CMS will begin its own analysis of the time and cost of providing services in order to determine RVUs, a job currently ...

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My home hospital is small. In a town of just over 20,000 people, this hospital has 25 beds and is designated "critical access" by Medicare because it is felt to be necessary to the health care of the community. Critical access is a designation which was introduced in 1997 when modernization of Medicare payment systems threatened to close a large proportion of hospitals in small communities which were unable to ...

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AMA: Urge Congress to repeal the SGR nowA guest column by the American Medical Association, exclusive to KevinMD.com. It’s crunch time for our nation’s physicians. After an 11-year battle, we stand closer now than ever before to repealing Medicare’s fatally-flawed sustainable growth rate (SGR) formula. With the introduction of the SGR Repeal and Medicare Provider Payment Modernization Act of 2014 last month, Congress took a critical step toward reforming ...

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