Tag: Medicare

Average Wait Time to See a Doctor up 30 Percent in Three Years »

Merritt Hawkins, a physician-staffing firm, has published its periodic survey of waiting times for appointments with physicians in 30 metropolitan markets. The results: Average new patient physician appointment wait times have increased significantly. The average wait time for a physician appointment for the 15 large metro markets surveyed is 24.1 days, up 30% from...
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Health Spending and Prices to Rise, 2018 through 2025 »

Before the Affordable Care Act passed in March 2010, President Obama repeatedly promised that the typical family’s health premiums would go down by $2,500 after implementing the expansion of health insurance we label Obamacare. Nothing of the sort has happened, of course. For the past few years, prices and spending have appeared moderate by...
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Medicare, Medicaid and VA at High Risk for Waste, Fraud and Abuse, Says GAO »

The Government Accountability Office (GAO) has published its biennial update of federal programs “that it identifies as high risk due to their greater vulnerabilities to fraud, waste, abuse, and mismanagement...” Healthcare programs feature high on the list. Medicare, the entitlement program for seniors, and Medicaid, the joint state-federal welfare program for low-income households, are...
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Everybody Gets a Medal: Performance “Incentives” in Medicare Reform »

In April 2015, huge bipartisan majorities passed a milestone Medicare reform bill called MACRA (Medicare Access and CHIP Reauthorization Act), which imported all the worst elements of Obamacare into Medicare. At the time, I wrote a series of posts (culminating in this one), which anticipated that physicians would refuse to swallow the medicine MACRA...
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Doctors Leaving Private Practice for Hospitals »

A new survey by the Physicians Advocacy Institute and Avalere Health, a consulting firm, shows a significant increase in the number of physicians leaving independent practice and joining hospital-based health systems: From July 2012 to July 2015, the percentage of hospital-employed physicians increased by almost 50 percent, with increases in each six-month period measured...
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Medicare’s Accountable Care Organizations Still Underwhelm »

Medicare’s Accountable Care Organizations (ACOs), which launched in 2012, were supposed to introduce a significant shift away from paying for “volume” to paying for “value.” Critics of Fee-For-Service medicine claim this system causes physicians to do more to patients so they get paid more, notwithstanding benefits to patients. Those critics seldom identify the moral...
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Medicare Changes Have Reduced Hospital Readmissions, but More Reforms Are Needed »

In 2012, Medicare began to penalize hospitals that readmitted too many patients. For a small number of targeted conditions, the program compares actual readmissions within 30 days to what an acceptable readmission rate should be. This measure is an important part of the drive to “pay for value, not volume.” The problem it was...
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Chemotherapy Payment Reform: Medicare Is Missing the Elephant in the Room »

Last May I wrote about the uproar over Medicare’s proposed changes to how it will pay doctors who inject drugs at their offices. This largely concerns chemotherapy. Currently, physicians buy the drugs and Medicare reimburses them the Average Sales Price (ASP) plus 6 percent. The proposed reform would cut the mark-up to 2.5 percent...
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The Republican Platform on Health Care: Good, Bad, and So-So »

The Republican National Convention churned out a 58-page campaign platform that did not ignore health reform. The committee that drafted it was co-chaired by Governor Mary Fallin of Oklahoma, U.S. Senator John Barrasso of Wyoming, and U.S. Representative Virginia Foxx of North Carolina. Whatever the likelihood of its enacted, it represents some kind of...
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Don’t Be Fooled by Misleading Rhetoric on Medicare Payment Reform »

A few weeks ago, Medicare proposed a pilot program to test a new way to pay doctors who inject drugs. Cancer is the big kahuna, cost-wise, when it comes to injected drugs. Medicare payment policy leads to certain industry practices to profit from the status quo. When the status quo is threatened, the “preservatives”...
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