Tag: Medicare
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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Medicare Pays for Prevention – For the First Time
The Centers for Medicare & Medicare Services has announced that Medicare (that is, taxpayers) will pay for lifestyle-intervention program that prevents type 2 diabetes: In 2011, through funding provided by the Affordable Care Act, CMS awarded the National Council of Young Men’s Christian Associations of the United States of America (Y-USA) more than $11.8...
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Obamacare’s Death Panel: Deferred, but Not Dismissed
Soon after Associate Justice Antonin Scalia passed away on February 13, Senate Republicans felt the need to declare that they would not even entertain the thought of holding confirmation hearings for any candidate President Obama might nominate to the Supreme Court in the last eleven months of his second term. Given the high drama...
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Traditional Medicare Is Disappearing Faster than Expected: Does It Matter?
Republican and Democratic politicians accuse each other of plotting to destroy “Medicare as we know it” when campaigning against each other, but they collaborate enthusiastically to do exactly that when they get to work on Capitol Hill. For better or worse, Exhibit A is last week’s announcement by the Centers for Medicare & Medicaid...
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Ten Percent of Cancer Drug Spending Is Wasted
A remarkable study published in the BMJ concludes that $1.8 billion of the $18 billion spent on the 20 most expensive cancer drugs in the United States is wasted due to cunning marketing by drug-makers. Chemotherapeutic doses are often adjusted by body weight. However, the drugs are shipped in vials containing doses appropriate to...
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