Over half of Medicare spending is concentrated in 10 percent of patients. With Medicare expenditures rising at an unsustainable clip, reigning in the costs of those patients is key to controlling health care spending.

So who are those patients and what expenses are they racking up?

It’s not who or what I expected. When I think of high-cost patients, I envision people with drawn-out hospital stays, or imagine people ...

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Dean Ernest had been living in a nursing home about a year when his son, John, got a call last winter asking if his father was experiencing back pain and would like a free orthotic brace. The caller said he was with Medicare. John Ernest didn’t believe him, said “no” to the brace and hung up. He didn’t give out his father’s Medicare number. And yet, not just one, but 13 braces ...

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I am going to make a prediction here. No matter who we elect in 2020, Bernie or Trump or anything in between, Medicare for all is not going to happen in America. One can run an electrifying campaign on the promise of Medicare for all, or indignantly against it, but this is pure theater on both sides. I don’t know if God can make a rock so big and heavy ...

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The Democratic debates this summer demonstrated massive confusion around Medicare for all. Does it mean Medicare for all who want it? Medicare Advantage? A "public option" on an Affordable Care Act (ACA) exchange? Democrats need to get their story straight. The confusion is understandable. Medicare for all has been an aspiration since at least the New Deal, but since 1965, when Congress ...

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The monumental shift in health care from fee-for-service or a volume-based approach to value-based care will change health care delivery for the better in the United States.  When physicians do what is necessary and avoid over-testing and procedures of limited or no value, the outcomes are best for the patient, and for the entire health care system. The Centers for Medicare and Medicaid Services have tested and continue to test models ...

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Every day I receive all kinds of emails and other ads telling me about services offering me help to meet MIPS quality metrics. While they may be helpful, most doctors don’t see the need for such a program. It drives up costs in administering and time in needless metrics reporting. Yet, give us a new regulation and a whole industry is going to pop up to profit ...

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As calls for radical health reform grow louder, many on the right, in the center and in the health care industry are arguing that proposals like “Medicare for all” would cause economic ruin, decimating a sector that represents nearly 20% of our economy. While exploring a presidential run, former Starbucks chief Howard Schultz called Medicare for all “not American,” adding, “What industry are we going to abolish next — ...

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This is a brief explanation of Medicare from a physician's perspective, as well as my thoughts on how Congress could make adjustments that would bring us closer to universal care and provide the private market the freedom to improve health care outcomes. Medicare is a national health insurance program that provides health insurance for Americans ages 65 and older, and those who are disabled or have specific chronic conditions. Medicare covers ...

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Recent polls show a majority of Americans support Medicare for all, but few seem to realize that no other system in the world operates like the current single payer proposals in Congress. Recently, I addressed the concept of single-payer health care, with Cuba's system as an example. Today I'm writing more about the ideas being discussed now in our country and how those compare to other nations ...

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Kaiser Health News told the story of a 69-year-old woman who went to a new doctor for her annual check-up, assuming it was covered by Medicare and was happy with the visit until she got a $400 bill. Most Americans believe in “annual check-ups,” at which your doctor reviews your medical history, gives you a thorough physical and orders lab tests. The actual value of such visits has been questioned, but ...

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