By the end of the long-range projection period, payment rates for affected providers would be about 57 percent lower than their level in the absence of these reductions. Currently, the Medicare payment rates for inpatient hospital services have declined to about 61 percent of those paid by private health insurance.97 …
It is conceivable that health care providers could improve their productivity, reduce wasteful expenditures, and take other steps to keep their cost growth within the bounds imposed by the Medicare price limitations. For such efforts to be successful in the long range, however, providers would have to generate and sustain unprecedented levels of productivity gains—a very challenging and uncertain prospect.
Opting-out of Medicare seems like a better idea every day – for doctors and patients.
If you’re a cash-based third-party-free practice, I invite you to join CCHF’s new “Wedge of Health Freedom,” an identified free-trade zone in the U.S. and an online site for patients and doctors to join together to break free. See videos of Dr. Brenda Arnett and Dr. Alieta Eck talking at our launch in D.C. www.JointheWedge.com
I would like to take few moments of your time and share with you some ideas on MOC/OCC and board re-certification exams. As a fellow physician and a Son of Dr. A.T. Still, we all share similar concerns. Our burden is to be true and faithful to our profession and to serve the needs of our patients honestly.
As an Osteopathic Physician like many in my situation, I completed my Osteopathic Internship, and participated in an ACGME anesthesia residency program which makes us uniquely qualified to be board certified by the AOA AOBA, ABMS ABA and The Royal College of Physicians and Surgeons of Canada, FRCPC (Canada). All three are fully respected and recognized in the USA. As a matter of fact, in my training program at USC we had many doctors from Canada who were certified by the FRCPC and were fully incorporated with a full Professorship status. The FRCPC has always been a Life-Time board certification process. Now, recently, last year, ABA has also re-adopted the Life-Time board certification process and dropped the EVERY-10-YEARS re-certification exam. Continue reading →
On, July 13, 2016, The U.S. Senate Committee on Finance held a hearing on MACRA implementation, with Andrew Slavitt testifying.
Any individual or organization wanting to present their views for inclusion in the hearing record should submit a typewritten, single-spaced statement, not exceeding 10 pages in length. Title and date of the hearing, and the full name and address of the individual or organization must appear on the first page of the statement. Statements must be received no later than two weeks following the conclusion of the hearing.
Statements should be mailed (not faxed) to:
Senate Committee on Finance
Attn. Editorial and Document Section
Dirksen Senate Office Bldg.
Washington, DC 20510-6200
Parties and special interests within the US federal government have been trying to passively and actively control the health and welfare of its citizens for a century. With the War Labor Board’s wage and price controls instituted in 1943 during WWII, the US federal government first warped both the employer/employee workplace and healthcare by firmly establishing health insurance as a employee “benefit” in lieu of salary. The premiums were paid with pretax dollars by a combination of the employer and employee.
This gave the employer the power to choose the coverage based on the employer’s needs and wants, not the end user employees needs and wants. This was the first degree of separation.
The insurance premium was used as a bet against the employee getting sick. Today, the insurance companies and other third parties make money by denying the healthcare payment for services, studies, tests and medications. After the insurance company processes healthcare provider claims, they make restrictive and sometimes arbitrary decisions about whether to fund the care, tests and medications. This leaves the patient on the hook for associated costs, despite the insurance premium already paid. This is the second degree of separation. Continue reading →
One thing we all hate is the high prices we pay in the US today for our prescriptions. Sure we do get some discounts, but that too has become an effort in algorithmic shopping to click here and click there to get the best price. It shouldn’t have to be that way, but it is as that’s how the systems have been built. There are a ton of discount prescription cards floating around out there and they all vary in one way or another, but the big thing to remember about all of them is that they are a marketing firm that can and will sell your data to make money. In addition, the discount cards act just like a pharmacy benefit manager with getting all your information when you use them to fill a prescription. In addition, some of them offer referral fees so they can increase the size of their data base of patient information. Data means money today and it can be repackaged and resold over and over, and yes, that’s us. Continue reading →
Could the below HHS regulation be a potential tool to help patients do an end run around MACRA privacy intrusions and rationing guidelines? Medicare patients CAN refuse to authorize the filing of a Medicare claim and pay cash as outlined below.
In 2013 HHS updated HIPAA regulations giving cash-paying patients greater ability to restrict the disclosure of health information. Here’s what the final rule states about Medicarepatients’ ability to assert this right:
One aspect perhaps not getting enough attention is how MACRA doubles down on price fixing for Medicare services. It’s price fixing coupled with increasingly complicated hoops to jump through; hoops that determine if a physician will get a small percentage more or less than the fixed price. But the costs and risks of jumping through the hoops far outweighs any potential gain for a solo physician. (It’s not really about paying physicians more anyhow but controlling costs under the guise of paying for quality.)
The CMS self-styled “innovation center policy nerds” think they are smarter than the free market at determining prices. They think they can create algorithms that somehow replace free market mechanisms to tie payment to value. The problem is that decades of Medicare payment policy developed by Medicare policy experts has resulted in one failure after another; flopped Medicare policies are actually responsible for divorcing payment from value. Why should we expect they are getting it right this time?