“Differences in payment rates have unnecessarily shifted services away from the physician’s office to the higher paying hospital outpatient department,” admits CMS in the proposed 2019 rule for Medicare outpatient payment. CMS further reveals that payments made through Medicare’s Hospital Outpatient Prospective Payment System (OPPS), “[have] been the fastest growing sector of Medicare payments out of […]
Proposed changes to rules governing how Medicare pays physicians in 2019 were released by the Centers for Medicare & Medicaid Services (CMS) last month in a 1,472-page proposed rule known as CMS-1693-P. CMS says the proposal puts “Patients Over Paperwork” by ending the notorious AMA-designed Evaluation & Management (E&M) documentation “guidelines” that meld physicians to computer screens […]
An iPhone app consult with a nurse practitioner at the MinuteClinic will be your first stop for primary care if the CVS vision for the future of American medicine continues unabated. And managed care continues its takeover of Medicare and Medicaid as the programs speed towards insolvency. Is this the type of care you want for your children […]
Earlier this week we heard the good news that H.R. 365 was finally going to be considered by the House Committee on Ways and Means, bringing the use of Health Savings Accounts (HSAs) for Direct Patient Care (DPC) one step closer to reality. Then we learned “a few small changes” had been made to the […]
“The Direct Primary Care (DPC) model is burgeoning as patients yearn for quality time with their doctor at an affordable price,” writes Marilyn Singleton, MD, JD in a recent oped. But can the success of DPC help the Medicare program improve patient access to care while lowering costs? The Center for Medicare and Medicaid Innovation (CMMI) has […]
Some of the worst features of ACA—the individual mandate penalty and Independent Payment Advisory Board (IPAB)—are being relegated to the trash heap of policy failures and states are working to open escape hatches to alternatives outside of DC’s reach. We celebrate these needed changes; however, additional reform is vitally needed to expand patients’ options for access […]
Now that the ACA individual mandate penalty is about to be relegated to the trash heap of policy failures, additional reform is vitally needed to expand patients’ options for access to high-quality, lower-cost medical care. Opportunity knocks for taking the next step: in the coming days and weeks Congress will be considering and passing year-end spending and extender […]
Medicine is at a “critical inflection point,” write Victor Dzau and J. Michael McGinnis of the National Academy of Medicine (NAM) and Mark McClellan of Duke University (JAMA 8/16/16). The NAM is launching a massive initiative on “Vital Directions for Health Care” at a Sep 26 meeting in Washington, D.C., (http://tinyurl.com/z4shr2b), bringing together more than 100 “trusted health and health care leaders” to “ensure nonpartisan, evidence-based analysis” in the context of the upcoming change in administration.
The latest fad, a “free” smartphone app called Pokémon GO, has reportedly exceeded even Twitter and pornography in popularity. One hospital has banned it for employees because they were glued to their screens instead of interacting with patients.
According to the dictionary or common usage, to discriminate means to make a distinction, say between right and wrong, or good quality and poor quality. Virtually every decision we make when faced with more than one option involves discrimination.