Grading a Physician’s Value — The Misapplication of Performance Measurement — NEJM
NEJM realized the PQRS Emperor has no clothes.
Perhaps the only health policy issue on which Republicans and Democrats agree is the need to move from volume-based to value-based payment for health care providers. Rather than paying for activity, the aspirational goal is to pay for outcomes that take into account quality and costs. In keeping with this notion of paying for value rather than volume, the Affordable Care Act ACA created the “value-based payment modifier,” or “value modifier,” a pay-for-performance approach for physicians who actively participate in Medicare. By 2017, physicians will be rewarded or pena...
Source: GruntDoc - November 7, 2013 Category: Emergency Medicine Doctors Authors: GruntDoc Tags: Policy Source Type: blogs
Spin in the cancelled-policy articles
All the articles about cancelled Individual Insurance plans have some variation of this spin in them:
For some who have received the letters, the new plans being offered are more expensive, but for others — especially those who qualify for a federal subsidy to bring down the cost of the premium — their insurance bill will go down.
via Canceled health insurance plans add to angst of change | Local News | The Seattle Times.
Emphasis added.
Here’s the thing: people (like me) in the Individual market don’t have IBM or Exxon sitting across the table from an insurance company, dealing from a position of some stre...
Source: GruntDoc - November 4, 2013 Category: Emergency Medicine Doctors Authors: GruntDoc Tags: Policy Source Type: blogs
AAPS Sues to Stop the Unlawful Revisions to ObamaCare
A constitutional argument. From docs:
The Association of American Physicians & Surgeons (AAPS) has filed a lawsuit today in federal court to halt the unlawful revisions to ObamaCare (the Patient Protection and Affordable Care Act).
The separation of powers required by the Constitution prohibits the executive branch—the Obama Administration—from rewriting laws passed by Congress. Yet that is what Obama has done by changing key parts of ObamaCare in order to implement it.
The AAPS lawsuit, which was filed today in the Eastern District of Wisconsin, asks the Court to enjoin the Obama Administration from imposing its ...
Source: GruntDoc - November 1, 2013 Category: Emergency Medicine Doctors Authors: GruntDoc Tags: Policy Source Type: blogs
Obamacare Is the Worst-Case Scenario | National Review Online
I’m not usually up this early. Ate a lot of carbs last evening, paying the price all night. And today. Probably tomorrow, from the course of events.
Enough about me. This is a nice summary of thoughts on Obamacare:
…What do we have to look forward to? Obamacare in effect outlaws traditional insurance and substitutes in its place a mandatory system of prepaid health care administered by the kind and gentle souls who run insurance companies, which is in fact in many ways similar to the mandatory health-savings accounts in Singapore — minus the property rights, wealth building, heritability, efficiency, a...
Source: GruntDoc - October 31, 2013 Category: Emergency Medicine Doctors Authors: GruntDoc Tags: Policy Source Type: blogs
Obama’s Broken Promise of Better Government Through Technology – Businessweek
The top part of the article is typical Klein (intent is all that mattered, not execution, which he only allows to one party), but his writing about government in general and government IT in particular is interesting:
The saga of healthcare.gov has been a symphony of government inefficiency. The effort, directly overseen by the IT department of the Centers for Medicare and Medicaid Services, involved no fewer than 55 contractors. The process was thick with lawyers and political interference. In violation of current best practices in the software world, the code was kept almost entirely secret; other engineers weren’t abl...
Source: GruntDoc - October 31, 2013 Category: Emergency Medicine Doctors Authors: GruntDoc Tags: Policy Source Type: blogs
Peter Schiff Blasts “The Website Is Fixable, Obamacare Isn’t!” | Zero Hedge
Wait, wait, this was supposed to bend the cost curve Down…
It is also ironic that high-deductible, catastrophic plans are precisely what young people should be buying in the first place. They are inexpensive because they provide coverage for unlikely, but expensive, events. Routine care is best paid for out-of-pocket by value conscious consumers. But Obamacare outlaws these plans, in favor of what amounts to prepaid medical treatment that shifts the cost of services to taxpayers. In such a system, patients have no incentive to contain costs. Since the biggest factor driving health care costs higher in the first place...
Source: GruntDoc - October 30, 2013 Category: Emergency Medicine Doctors Authors: GruntDoc Tags: Policy Source Type: blogs
The Onion to the Rescue
Remember this? (From this blog):
Heroic State Attorneys General band together to force lawful commerce to stop, because they don’t like it.
July 13, 2013 by GruntDoc
…
So, 22 State Attorneys General sent a letter to Urban Outfitters demanding they stop selling gag merchandise described as their ‘Prescription line’, which includes the terrifically dangerous items of
glasses, coasters, mugs, drink holders and related products that mimic prescription pill bottles and prescription pads.
via Heroic State Attorneys General band together to force lawful commerce to stop, because they don’t like it..
Want to guess wh...
Source: GruntDoc - October 24, 2013 Category: Emergency Medicine Doctors Authors: GruntDoc Tags: Amusements Source Type: blogs
Assessing the Exchanges | National Review Online
Read and weep. My comments in [brackets]:
…[interviews with medical insurance policy-type reps in Washington]
One key worry is based on the fact that what they’re facing is not a situation where it is impossible to buy coverage but one where it is possible but very difficult to buy coverage. That’s much worse from their point of view, because it means that only highly motivated consumers are getting coverage. People who are highly motivated to get coverage in a community-rated insurance system are very likely to be in bad health. The healthy young man who sees an ad for his state exchange during a baseball game a...
Source: GruntDoc - October 18, 2013 Category: Emergency Medicine Doctors Authors: GruntDoc Tags: Policy Source Type: blogs
Why we should be very wary of using clot busting drugs in CVA
.
A concise treatise on the problems with TPa. Well Done!
Related posts:
Delusions of Benefit in the International Stroke Trial | Closer to the Truth More TPa for stroke… Delusions of Benefit in the International...
Related posts brought to you by Yet Another Related Posts Plugin. (Source: GruntDoc)
Source: GruntDoc - October 7, 2013 Category: Emergency Medicine Doctors Authors: GruntDoc Tags: Emergency Source Type: blogs
Facebook Like Now Covered by the First Amendment – Applications for Healthcare | Hospital EMR and EHR
This is at the end of an article talking about something else, but it deserves it own highlight:
My favorite thing is when healthcare organizations try and control and restrict social media. As many institutions have learned, that’s impossible to do. Instead, it’s much more effective to educate and inform people on their use of social media. The best reason you should educate and inform as opposed to control and restrict is the message it sends to your employees. The former sends a message of trust and respect while the later does the opposite.
via Facebook Like Now Covered by the First Amendment – Applications for H...
Source: GruntDoc - September 24, 2013 Category: Emergency Medicine Doctors Authors: GruntDoc Tags: MedBloggers Source Type: blogs
U.S. pilot scares off Iranians with ‘Top Gun’-worthy stunt: ‘You really ought to go home’ – Washington Times
In what only can be described as a scene out of Tom Cruise’s “Top Gun,” Gen. Mark A. Welsh III, Air Force chief of staff, describes how F-22 stealth jets scared off Iranian jets from a U.S. drone flying in international airspace.
via U.S. pilot scares off Iranians with ‘Top Gun’-worthy stunt: ‘You really ought to go home’ – Washington Times.
Click through to see what happened. I’ll be the in-cockpit tape of that gets out someday…and it will be cool.
Two other thoughts: are we now riding shotgun on drones (aren’t the drones so we don’t have to endanger pilot...
Source: GruntDoc - September 20, 2013 Category: Emergency Medicine Doctors Authors: GruntDoc Tags: Amusements Aviation Source Type: blogs
Your Government at Work, Army Corps of Engineers Division
Our Government is out of money. That’s given. Related but unrelated, our Government=Things we do together.
The Army Corps of Engineers recently decided that plowing Govt. Park access fees back into the parks through non-profits is verboten, because, get this, the money isn’t going into the US Treasury.
No thought to what makes the parks work. No thought to what the NonProfits (that’s Washington for sucker-bait) put into the parks, or what the Federal version of park running and maintenance will cost (that’ll be way way more than non-profits did it for). Or the park non-profit employees who are now o...
Source: GruntDoc - September 20, 2013 Category: Emergency Medicine Doctors Authors: GruntDoc Tags: Rants Source Type: blogs
Best Police quip of the year:
Wait for it….
Owner isn’t blaming dog for accidental shooting, Police say
By Deanna Boyddboyd@star-telegram.com
FORT WORTH — Surprisingly, this canine isn’t in the doghouse.
A 78-year-old woman was shot in the foot late Saturday when her shotgun discharged after her dog accidentally knocked it over, police reported….
You have to click through to read the best Police quip of the year.
“The victim advised it was an accident, and the dog was not to blame,” Neal said.
Police did not release the name or breed of the dog. “He has the right to remain silent,” Neal said.
via Owner isn’t blaming dog for ...
Source: GruntDoc - September 17, 2013 Category: Emergency Medicine Doctors Authors: GruntDoc Tags: Amusements Source Type: blogs
Defikopter drone air-drops a defibrillator to EMTs on the ground
The Defikopter is a UAV that can be activated by a smartphone app to automatically take to the skies and drop a defibrillator to medical personnel on the ground, shaving precious seconds from the time it takes to receive treatment for cardiac arrest.
The idea for the drone comes from Definetz, a non-profit group dedicated to preventing deaths due to heart failure.
via Defikopter drone air-drops a defibrillator to EMTs on the ground.
Interesting idea. Won’t work here in the Land o’ the Lawsuit.
Related posts:
The Untold Story of the Battle of Camp Bastion One year ago this month, under cover of night, fifteen.....
Source: GruntDoc - September 14, 2013 Category: Emergency Medicine Doctors Authors: GruntDoc Tags: Aviation Emergency Source Type: blogs
The Untold Story of the Battle of Camp Bastion
One year ago this month, under cover of night, fifteen Taliban, dressed as American soldiers, snuck onto one of the largest air bases in Afghanistan. What followed was a bloody confrontation highlighting a startling security lapse, with hundreds of millions in matériel lost in a matter of hours—the worst day for American airpower since the Tet Offensive. Yet the attack faded from view before anyone could figure out what went wrong. For the first time, Matthieu Aikins relives those heart-pounding moments and offers an extraordinary account of the Battle of Bastion
via The Untold Story of the Battle of Bastion.
Amazingly ...
Source: GruntDoc - September 10, 2013 Category: Emergency Medicine Doctors Authors: GruntDoc Tags: Aviation Other Source Type: blogs
