Tag: "doctors"

Headlines I Wish I Hadn’t Seen

When America’s joint surgeons were challenged to come up with a list of unnecessary procedures in their field, their selections shared one thing: none significantly impacted their incomes.

Kathleen Sebelius for U.S. Senate?

Income Inequality Institute creates more inequality by paying Paul Krugman $25,000 a month — no teaching required.

What Are We Getting for the $30 Billion We Are Spending On Electronic Health Records?

electronic-medical-recordIn 2009, the federal government budgeted $30 billion to incentivize doctors and hospitals to install electronic health records and use them “meaningfully”. Here are the results from Boston’s Brigham & Women’s Hospital — one of the leading academic medical centers in the country:

Of 858 physicians, 540 (63%) were “meaningful users”. Meaningful use was associated with marginally better quality for 2 measures, worse quality for 2 measures, and not associated with better or worse quality for 3 measures.

Meaningful use of electronic health records was correlated with better control of cholesterol in patients with diabetes and of blood pressure in hypertensive patients. The meaningful-use group provided worse treatment of asthma and depression than the non-MU group did.

HT: Ken Terry, Medscape.

Being Uninsured is Better than Being on Medicaid to Get a Doctor’s Appointment

doc-with-patientPosing as patients, researchers made almost 13,000 calls to doctors’ offices in ten states, seeking appointments for a variety of ailments. For those posing as privately insured patients, they got appointments 85 percent of the time. For those posing as patients on Medicaid, they only got appointments 58 percent of the time. Researchers also posed as uninsured patients who were willing to pay in full at the time of the appointment.

The result? 78 percent were successful (for appointments costing more than $75) — 36 percent better than those posing as Medicaid patients and quite close to those posing as privately insured.

Doctors Push Back on Release of Data

doctor-xray-2Doctors reacted swiftly and indignantly to Wednesday’s release of government records revealing unprecedented details about Medicare payments to physicians…The top 10 doctors alone received a combined $121.4 million for Medicare Part B payments in 2012…In interviews, many of the doctors said they were just passing through the payment to drug companies. Some said they were unfairly singled out even though they were billing for an entire practice. And still others disputed the accuracy of Medicare data. (Washington Post)

Where Are The Medicare Dollars Going?

A recent analysis of Medicare data provided to The New York Times shows that two percent of doctors earn twenty-four percent of Medicare payments.

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Hits and Misses

Pediatrician Examining ToddlerA medical student wants “to do the greatest good for the greatest number.” What kind of doctor should he/she become? Tyler Cowen answers. So does David Henderson.

The health co-ops are failing.

Can teledentistry actually work?

Eli Lilly’s answer to fake drugs: A $110 million bar code system with secret codes.

Hooray! The Medicare Doc Fix is Fixed Until Next April!

Confident DoctorsCongress has given up on repealing the Sustainable Growth Rate (SGR) as a way to pay physicians under Medicare. This blog has previously written about the futility of politicians’ efforts to “fix” the way they pay physicians (especially here, here and here).

The one they just passed last week runs for a year. And, just as always, these politicians who are elected for two-year to six-year terms voted to massively increase spending today, in exchange for draconian cuts a decade hence.

According to the Congressional Budget Office’s score of the bill, it increases Medicare’s physician payments by $15.8 billion over ten years. However, $11.2 billion (71 percent) is spent by 2015, and $13.3 billion (84 percent) is spent by 2016.

The savings to pay for this? Those come later, much later: Savings don’t become greater than spending until 2020, and not significant until 2024 — the last year of the mandated scoring “window“, when the law is supposed to claw back $9.3 billion from hospitals and re-impose the sequester on Medicare.

Good luck with that. Congress continues to make a mockery of Medicare-physician payment reform.

Hits and Misses

Is Paul Krugman a shameful floccinaucinihilipilificator?

PCPs are opting out: choosing less rigorous work for hospitals, concierge practice and retirement.

3D printing breakthrough: Surgeons replace entire skull.

At least three states with their own ObamaCare exchanges may let healthcare.gov take over.

Robert Wood Johnson Foundation ranks each county’s health using 13 factors – only two involve the health-care system.

Ontario, Canada’s largest province, moves to outlaw all gifts from drug-makers to doctors.

What Happens After Surgeons Take a Break?

We find that a surgeon’s additional day away from the operating room raised patients’ inpatient mortality risk by up to 0.067 percentage points (2.4% relative effect) but reduced total hospitalization costs by up to 0.59 percentage points…Our findings are consistent with the hypothesis that after returning from temporal breaks surgeons may be less likely to recognize and address life-threatening complications, in turn reducing resource use. (NBER Working Paper)

HHS to Force Insurers to Have Wider Networks

Health plans selling on the federal marketplaces in 2015 must include 30 percent of area “essential community providers,” which are usually health centers and other hospitals serving mostly low-income patients. That’s up from a 20 percent requirement in 2014, the first year of expanded overage under the health care law. (Washington Post)

Perverse incentives problem explained here.