How the Oregon Medicaid experiment is a failure An important article was recently published in the New England Journal of Medicine, titled The Oregon Experiment — Effects  of Medicaid on Clinical Outcomes. This study provides a rare look at the effects of expanding Medicaid coverage (specifically, Oregon Health Plan, Oregon’s version of Medicaid) to a population of previously uninsured patients. Having practiced medicine in Portland, ...

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I attended a medical staff meeting recently. These are required meetings and attendance is taken, as was done when we were in kindergarten. While some folks are interested in these meetings’ content, many are not and simply sign the attendance sheet and then slither out in a stealth fashion. Sly doctors grab their pagers and then leave hurriedly pretending that they were summoned to an urgent medical situation, when they ...

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Arkansas is now the first state to use Medicaid expansion dollars to buy private coverage for many of its 250,000 newly eligible residents rather than enroll them in the existing Medicaid program. The Arkansas House of Representatives approved the plan, followed by the  Senate, to confirm that the state will be implementing this “market-based approach” to expanding Medicaid. The idea of buying private insurance for Medicaid recipients is ...

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Much has already been written about the Oregon Medicaid study that came out in the New England Journal of Medicine. Unfortunately, the vast majority is reflex, rather than reflection.  The study seems to serve as a Rorschach test of sorts, confirming people’s biases about whether Medicaid is “good” or “bad”.  The proponents of Medicaid point to all the ways in which Medicaid seems to help those who were enrolled ...

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The Oregon Medicaid study: What does it tell us? Recently, an article by Kate Baicker and colleagues came out in the New England Journal of Medicine. Almost immediately, the article received widespread attention in the media where headlines claimed that giving people Medicaid coverage doesn’t improve their health. This is not exactly what the article said, but most journalists aren’t scientists, so we should cut them a bit of ...

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Brought to you by MedPage Today. 1. Robotics No Help in Cystectomy. A randomized trial comparing robotic with open cystectomy ended early after an interim analysis showed the minimally invasive approach did not reduce complications. 2. Medicare Reveals Hospital Charge Information. The Obama administration made public on Wednesday previously unpublished hospital charges for the 100 most common inpatient treatments in 2011, saying a ...

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Brought to you by MedPage Today. 1. Uniform Quality Measures Sought for an SGR Repeal. Doctors need quality measures from a single source and more avenues to qualify for value-based payments under a post-Sustainable Growth Rate (SGR) reimbursement system. 2. Triptans Go-To Migraine Drugs Even in Pregnancy. Monday's FDA announcement that pregnant women should not take valproate sodium and related drugs to prevent ...

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Brought to you by MedPage Today. 1. Study Eases Some Azithromycin Fears. Danish patients taking azithromycin were at no greater risk of cardiovascular death, relative to those using penicillin, when pretreatment mortality risk was taken into account. 2. Study: Medicaid Expansion Won't Help All Aspects of Health. Expanding Medicaid coverage improves mental health but doesn't tackle some basic measures of physical health, like ...

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We are frequently reminded by the General Accounting Office and CMS that a great proportion of Medicare health costs are incurred in the last three months of a patient’s life. Health care policy experts have tried to reduce these costs by encouraging end of life planning.  Living wills, health care directives and the availability of hospice and palliative services will not put a dent in these costs because of human ...

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Brought to you by MedPage Today. 1. 5 Ways Obama's Budget Would Change Medicare. President Barack Obama's fiscal 2014 budget includes a variety of what he says are "manageable" changes for Medicare's 54 million beneficiaries as well as for the hospitals, nursing homes, and other healthcare providers that serve them. 2. Boston Bombing: Finding Evidence in the ER. In the aftermath of Monday's ...

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