The anticipated and dreaded letter from my health insurance company arrived yesterday.

Dear Member: We are writing to let you know about some important changes to your individual health insurance coverage ... Your health insurance plan will no longer be available after December 31, 2013. We very much want to continue serving you and so have selected a new ACA-compliant Regence plan for you. Your new plan has more benefits and a different ...

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Healthcare markets are complex and confusing places.  But one fact is simple and straightforward:  all else equal, hospitals and emergency departments are a lot more expensive than outpatient clinics.  Which makes it all the more bewildering that so many low income patients prefer hospitals over primary care clinics. Bewildering until now.  Shreya Kangovi and colleagues at the University of Pennsylvania interviewed low income patients and discovered some fascinating reasons why they aren’t ...

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A recent post observed that the “highly charged scope-of-practice” fight between the medical and nursing professions has resulted in social media hate speech -- too often, from physicians directed at other physicians. “Like bees to nectar, a post on the topic is sure to draw dozens of anonymous, hate-filled comments” write the authors.  They propose the following “principles for civil discourse” which I believe should apply more broadly to all social media ...

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The Centers for Medicare and Medicaid (CMS) sets the rates all physicians get paid and insurance companies base their rates on the same formula. So who creates the formula? Well, it’s the doctors, silly! Or at least some of the doctors. Here’s how it works. A 31-member committee formed by the American Medical Association is made up of representatives from the various specialty societies. This Relative Value Update Committee (RUC) meets ...

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Medical science is making such remarkable progress that soon none of us will be well. -Aldous Huxley The recently completed conference, "Preventing Over Diagnosis," was easily the most important meeting I ever attended. Sponsored by the British Medical Journal, Consumer's Reports, and Dartmouth and Bond Universities, the goal was to identify the excesses in medical care and to figure out how to correct them. The evidence is compelling that we in the developed countries ...

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Soon, millions of uninsured Americans will be able to enroll in qualified private health insurance plans offered through their state marketplaces, with federal dollars to help them afford it.  The state marketplaces, created by the Affordable Care Act (Obamacare) will begin enrolling eligible people on October 1, and eligible persons will have until March 31 to sign up.   The coverage and subsidies for those who sign up will start on ...

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The main purpose of health reform, said the president at a recent press conference, was to provide health insurance to people at affordable rates. He meant the nub of Obamacare -- the state shopping exchanges with their smorgasbord of insurance policies -- would give coverage to millions of Americans who did not have insurance. Whether that coverage will be affordable or comprehensive for families remains to be seen. What is crystal ...

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The Affordable Care Act (ACA), aka Obamacare, is law.  And its implementation is moving along slowly, but steadily. You have to give credit to the folks who believed in it, whether grass-roots supporters or highly placed politicians.  They rammed it down the American gullet like a lead ball down the muzzle of a Hawken rifle.  The problem is, once it goes off, the whole thing is going to explode. The reasons are ...

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In 2008, a couple of years before the Affordable Care Act became the law of the land, Donald M. Berwick, MD, and his colleagues at the Institute for Healthcare Improvement (IHI) introduced the Triple Aim concept and set to work on ways to (1) improve population health, (2) increase patient satisfaction and (3) reduce per capita healthcare costs. In pursuit of these goals, IHI encouraged the exploration of a variety of ...

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ama_logo A guest column by the American Medical Association, exclusive to KevinMD.com. The administrative burden of being a physician continues to fuel discontent among doctors. The unfulfilling interface with the insurance bureaucracy is a major contributor to physician dissatisfaction. But not all health insurers are equal when it comes to hassle factors imposed on physicians. New data released by the American Medical Association (AMA) ...

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