Should ACOs Be Revamped?
In an article authored by the American Enterprise Institute’s Resident Fellow and Milton Friedman Chair, James C. Capretta, he argues Medicare Accountable Care Organizations (ACOs) haven’t produced savings for the federal government. He believes ACOs would become more efficient and innovative if they were forced to compete with the other options beneficiaries have for getting their Medicare-covered benefits.
Creation of ACOs
Capretta describes the initial purpose of ACOs. They were created to address Medicare’s problematic fee-for-service program which has been found to foster waste and overuse of services. While M...
Source: Policy and Medicine - February 14, 2018 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
MedPAC ’s Repeal And Replace MIPs Campaign Will Not End Well
By KIP SULLIVAN
“[T]his is tough. I don’t know how to proceed…. Lord help the staff who must bring all this together.”
That was how Dr. Francis Crosson, chairman of the Medicare Payment Advisory Commission (MedPAC), reacted to the commission’s baffling discussion at its January 11 meeting moments before it voted 14-2 to replace the Merit-based Incentive Payment System (MIPS) with something called the “voluntary value program” (VVP) (pp. 167-169 of the transcript ). MedPAC’s staff must now summarize the January 11 discussion and prepare a report for inclusion in MedPAC’s March 2018 report to Congress.
MIPS...
Source: The Health Care Blog - January 28, 2018 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized CMS MACRA MedPAC MIPS P4P VVP Source Type: blogs
Health Wonk Review - upcoming hosts
2018 Schedule
February 15 - Steve Anderson, HealthInsurance.org blog
Mar 15 - David Williams, Health Business Blog
Apr 19 - Louise Norris, Colorado Health Insurance Insider
May 17 - Jason Shafrin, Healthcare Economist
June 14 - TBA
July 12 - TBA
August 16 - TBA
September 20 - TBA
October 18 - Joe Paduda, Managed Care Matters
November 15 - TBA
December 13 - Julie Ferguson, Workers Comp Insider (Source: Health Wonk Review)
Source: Health Wonk Review - January 18, 2018 Category: Health Management Source Type: blogs
New Health Wonk Review at Managed Care Matters
Joe Paduda has posted the Ring in the New year with the latest and greatest… edition of Health Wonkl Review at Managed Care Matters. (Source: Health Wonk Review)
Source: Health Wonk Review - January 18, 2018 Category: Health Management Source Type: blogs
Health Wonk Review Archives: 2006-2018
March 15, 2018 - David Williams - Health Business Blog
February 15, 2018 - Steve Anderson - HealthInsurance.org blog
January 18, 2018 - Joe Paduda, Managed Care Matters
December 14, 2017 - Julie Ferguson - Workers Comp Insider
November 30, 2017 - Andrew Sprung - xpostfactoid.
November 9, 2017 - Jason Shafrin at Healthcare Economist
October 26, 2017 - David Williams at Health Business Blog
October 12, 2017 - Hank Stern - InsureBlog
September 28, 2017 - Brad Wright - Wright on Health
September 14, 2017 - Louise Norris - Colorado Health Insurance Insider
August 17, 2017 - Peggy Salvatore - Health System Ed Blo...
Source: Health Wonk Review - January 10, 2018 Category: Health Management Source Type: blogs
Sutter Health ’s antitrust case matters. Here’s why.
In case you missed it: Sutter Health, the Northern California health system titan was recently sanctioned for intentionally destroying 192 boxes of material relating to its anticompetitive actions and alleged overcharges. The material, which amounted to 10 years’ worth of evidence, was initially slated to be destroyed in 2035. Sutter’s Vice President, Melissa Brendt, authorized her executive assistant, Sita Santagata, to destroy the material in 2015. Santagata testified that “in her 17 years at Sutter, she was not aware of any other time when the Managed Care Department authorized destruction of records in storage....
Source: Kevin, M.D. - Medical Weblog - December 21, 2017 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/justin-bullock" rel="tag" > Justin Bullock < /a > Tags: Policy Hospital-Based Medicine Public Health & Source Type: blogs
Practicing Medicine While Black (Part II)
By KIP SULLIVAN
Managed care advocates see quality problems everywhere and resource shortages nowhere. If the Leapfrog Group, the Medicare Payment Advisory Commission, or some other managed care advocate were in charge of explaining why a high school football team lost to the New England Patriots, their explanation would be “poor quality.”
If a man armed with a knife lost a fight to a man with a gun, ditto: “Poor quality.” And their solution would be more measurement of the “quality,” followed by punishment of the losers for getting low grades on the “quality” report card and rewards for the winners. The ob...
Source: The Health Care Blog - November 27, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized CMS Kip Sullivan value-based care Source Type: blogs
Practicing Medicine While Black
By KIP SULLIVAN, JD
The managed care movement thrives on misleading words and phrases. Perhaps the worst example is the incessant use of the word “quality” to characterize a problem that has multiple causes, only one of which might be inferior physician or hospital quality. [1] To illustrate with a non-medical analogy, no one would blame auto repair mechanics if 50 percent of their customers failed to bring their cars in for regular oil changes. We would attribute the underuse of mechanics’ services to forces far beyond the mechanic’s control and would not, therefore, refer to the problem as a “quality” problem...
Source: The Health Care Blog - November 9, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
Give Us Those Old Time Conflcts of Interest: Stephen Parente, Key Opinion Leader for UnitedHealth and Redeemer of Former CEO William McGuire to Assistant Secretary of HHS
DiscussionSo here is just the latest embellishment in the march of people transiting the revolving door from health care corporations, and related firms, such as lobbying firms, the the executive branch during the Trump administration. Fortunately, good investigative journalists have looked more deeply into this cases, showcasing its more interesting aspects. First, Mr Parente was not simply a corporate executive moving to the executive branch where he would be able to influence the fortunes of his former corporation. Mr Parente was apparently a distinguished academic in a business school. However&nb...
Source: Health Care Renewal - November 5, 2017 Category: Health Management Tags: conflicts of interest Donald Trump impunity key opinion leaders legal settlements revolving doors stealth health policy advocacy UnitedHealth You heard it here first Source Type: blogs
Health Wonk Review Archives: 2006-2017
December 14, 2017 - Julie Ferguson - Workers Comp Insider
November 30, 2017 - Andrew Sprung - xpostfactoid.
November 9, 2017 - Jason Shafrin at Healthcare Economist
October 26, 2017 - David Williams at Health Business Blog
October 12, 2017 - Hank Stern - InsureBlog
September 28, 2017 - Brad Wright - Wright on Health
September 14, 2017 - Louise Norris - Colorado Health Insurance Insider
August 17, 2017 - Peggy Salvatore - Health System Ed Blog
July 21, 2017 - Steve Anderson - healthinsurance.org
June 23, 2017 - Joe Paduda - Managed Care Matters
June 1, 2017 - Andrew Sprung - xpostfactoid
May 18, 2017 - Jason...
Source: Health Wonk Review - October 28, 2017 Category: Health Management Source Type: blogs
Health Wonk Review Archives: 2006-2018
January 18, 2018 - Joe Paduda, Managed Care Matters
December 14, 2017 - Julie Ferguson - Workers Comp Insider
November 30, 2017 - Andrew Sprung - xpostfactoid.
November 9, 2017 - Jason Shafrin at Healthcare Economist
October 26, 2017 - David Williams at Health Business Blog
October 12, 2017 - Hank Stern - InsureBlog
September 28, 2017 - Brad Wright - Wright on Health
September 14, 2017 - Louise Norris - Colorado Health Insurance Insider
August 17, 2017 - Peggy Salvatore - Health System Ed Blog
July 21, 2017 - Steve Anderson - healthinsurance.org
June 23, 2017 - Joe Paduda - Managed Care Matters
June 1, 2017...
Source: Health Wonk Review - October 28, 2017 Category: Health Management Source Type: blogs
Super Macranomics
By KIP SULLIVAN
This is the second of a two-part series on MedPAC’s October 4 decision to recommend the repeal of the MIPS program. In Part One , I gave the MedPAC staff credit for urging the commission to support repeal of MIPS, and I criticized their irrational proposal to replace MIPS. I said MedPAC is stuck in a vicious cycle – they recommend “reforms” without evidence, and when the reforms don’t work, they recommend evidence-free tweaks that don’t work either. I referred to this vicious cycle as a “tar pit.”
In this essay I attempt to explain how MedPAC created this intellectual tar pit. I begin by des...
Source: The Health Care Blog - October 26, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized CMS MACRA Source Type: blogs
How 10 States Are Reforming Medicaid Payment and Delivery
Ever since Medicaid’s managed care transformation began in earnest in the mid-1990s, states have been leaders in the effort to improve the accessibility, quality, and efficiency of care for low-income populations facing elevated health risks.
(Source: The Commonwealth Fund: Blog)
Source: The Commonwealth Fund: Blog - October 25, 2017 Category: International Medicine & Public Health Source Type: blogs
Doctor Of Osteopathic Medicine: A Growing Share Of The Physician Workforce
Conclusion
The doctor of osteopathic medicine workforce is growing rapidly with no signs of decreases in the quality of students accepted or their success in matching into a residency training program, which has been steadily rising. Given the doctor of osteopathic medicine workforce’s higher likelihood of practicing in rural communities and of pursuing careers in primary care, doctors of osteopathic medicine are on track to play an increasingly important role in ensuring access to care nationwide, including for our most vulnerable populations.
Note 1
Since some residencies are jointly accredited by both the ACGME and th...
Source: Health Affairs Blog - October 23, 2017 Category: Health Management Authors: Edward Salsberg and Clese Erikson Tags: Health Professionals Population Health doctors of osteopathic medicine osteopaths physician supply Source Type: blogs
The President ’s Executive Order: Less Than Meets The Eye?
The executive order (EO) signed by President Donald Trump on October 12 directs the Departments of Health and Human Services (HHS), Labor, and Treasury to develop federal regulations that could allow new and less expensive health insurance options for employers and consumers.
The EO marks a shift in the administration’s strategy on health care. After failing to get legislation through Congress to repeal and replace the Affordable Care Act (ACA), the administration is now attempting to move away from the ACA’s heavily-regulated markets through changes that can be implemented without a change in the law.
The executive or...
Source: Health Affairs Blog - October 20, 2017 Category: Health Management Authors: Joseph Antos and James Capretta Tags: Following the ACA Insurance and Coverage association health plans health reimbursement arrangements short term limited duration insurance Source Type: blogs
