The verdict is in: All three of CMS ’s “medical home” demonstrations have failed
By KIP SULLIVAN
Between September of 2016 and last month, CMS released “final evaluations” of all three of its “medical home” demonstrations. All three demos failed.
This spells bad news not just for the “patient-centered medical home” (PCMH) project, but for MACRA. The PCMH, along with the ACO and the bundled payment (BP), is one of the three main “alternative payment models” (APMs) within which doctors are supposed to be able to find shelter from the financial penalties inflicted by the MIPS (Merit-based Incentive Payment System) program which was recently declared to be unworkable by the Medicare Payment...
Source: The Health Care Blog - June 7, 2018 Category: Consumer Health News Authors: matthew holt Tags: OP-ED Physicians Kip Sullivan PCMH Source Type: blogs
Another Type of Urgent Care Facility Flourishing for Orthopedic Problems
In a recent note, I discussed how primary care practices and hospital-based ambulatory care are now being forced to compete with both walk-in clinics in retail drug stores and urgent care centers (see:Physicians Are Disappearing from the Front Line of Healthcare). I have just learned about another type of first-line competition for physician and physical medicine practices: walk-in, orthopedic urgent care centers (see: Orthopedic urgent care centers to expand). Below is an excerpt from the relevant article:A new orthopedic urgent care center operator is expected to start opening centers in Michigan later this y...
Source: Lab Soft News - June 6, 2018 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Healthcare Business Healthcare Delivery Healthcare Insurance Hospital Financial Medical Consumerism Source Type: blogs
Will Vertical Integration Kill the Primary Care Practice?
We've Moved! Update your Reader Now. This feed has moved to: http://feeds.healthblawg.com/healthblawg Update your reader now with this changed subscription address to get your latest updates from us. http://feeds.healthblawg.com/healthblawg (Source: HealthBlawg :: David Harlow's Health Care Law Blog)
Source: HealthBlawg :: David Harlow's Health Care Law Blog - April 8, 2018 Category: Medical Law Authors: David Harlow David Harlow Tags: Accountable Care Organization Digital Health Direct Primary Care Health care policy Health Insurance Health Law Health Reform Healthcare Innovation Physicians Value Based Purchasing Source Type: blogs
M édecins sans Hôpitaux (Doctors without Hospitals)
This study and others seem to show that “small is beautiful” with independent physician led ACOs apparently out performing ACOs on average. (https://catalyst.nejm.org/do-independent-physician-led-acos-have-a-future/ )
Physician Outsourcers such as Team Health, MedNax, AMN are for profit health service companies. They are not traditional healthcare providers and yet they organize tens of thousands of physicians. Team Health has 20,000 affiliated physicians and provides physicians for hospitals and health systems in several specialties especially emergency medicine, anesthesiology and hospital medicine. MedNax is a physi...
Source: The Health Care Blog - April 5, 2018 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
Health Savings Accounts: Are Lawmakers Being Target-ed or Amazon-ed?
By NIRAN AL AGBA, MD
Health Savings Accounts (HSAs) allow individuals to use pre-tax dollars to pay for high deductibles and other uncovered medical expenses. Currently, individuals are ineligible for tax-advantaged HSA contributions if they have “other” coverage in addition to a High Deductible Health Plan (HDHP.) Expanding HSAs to fund out-of-pocket expenses for routine healthcare places control directly in the hands of patients, a move that could bring down health expenditures. Large corporations are wrestling for control to direct where patients spend their hard-earned money.
A group of lawmakers recently introduce...
Source: The Health Care Blog - March 26, 2018 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
Opioids in the household: “Sharing” pain pills is too common
This study alone identified almost six million people, and even this underestimates the problems because the study excluded patients with a cancer diagnosis or who were in hospice. Off the top of my head, I can think of multiple cases where I suspected or was told outright that others were using a hospice patient’s pain pills. I asked the study author, Marissa J. Seamans, PhD, about why they excluded these patients. “Because opioids are indicated for patients diagnosed with malignancy or in hospice care, we excluded them to more easily identify comparable NSAID patients,” she explained. While this made the comparison...
Source: Harvard Health Blog - March 22, 2018 Category: Consumer Health News Authors: Monique Tello, MD, MPH Tags: Addiction Drugs and Supplements Health Pain Management Source Type: blogs
Incorporate side hustles to your primary care practice
Hustles are hustles, and side hustles add a little on the side. But if you want to maximize your income. You have to innovate.
When I started as an employed medical physician at the beginning of my career, I was overjoyed to make X. After years of watching money go out the door in medical school, and then making 0.25X in residency, I couldn’t believe that I was earning so much. As the dollars piled up, I listened a little too closely to the naysayers. They kept whispering that no one ever got bonuses. That Big Fancy Medical System never paid more than the basic salary.
A year later, bonus in hand, I cleared 2X. This was ...
Source: Kevin, M.D. - Medical Weblog - March 15, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/docg" rel="tag" > DocG, MD < /a > Tags: Finance Practice Management Primary Care Source Type: blogs
New Study Suggests That HIEs Deliver Value by Aggregating Patient Data
Historically, I’ve been pretty skeptical about the benefits that HIEs offer, not because the concept was flawed, but that the execution was uncertain. Toss in the fact that few have figured out how to be self-supporting financially, and you have a very shaky business model on your hands. But maybe, at long last, we’re discovering better uses for the vast amount of data HIEs have been trading.
New research by one exchange suggests that some of the key value they offer is aggregating patient data from multiple providers into a longitudinal view of patients. The research, completed by the Kansas Health Information Network...
Source: EMR and HIPAA - March 5, 2018 Category: Information Technology Authors: Anne Zieger Tags: Connected Health EHR EHR Benefits Electronic Health Record Electronic Medical Record EMR Healthcare Healthcare Interoperability HIE Population Health Population Health Management Value Based Reimbursement Diameter Health Ed.D. Source Type: blogs
Integrating Behavioral Health and Primary Care
AHRQ Academy is a resource dedicated to the integration of behavioral health and primary care. The information provided on the AHRQ Academy website is organized by experts in this field and includes research, expert insight, and suggestions for how to integrate behavioral health and primary care. The Academy also supports medication assisted treatment in primary care through technical assistance and resources.
One resource available is called the Playbook, which offers guidance to primary care practices and health systems about integrating behavioral health. There is a brief video tutorial available about the Playbook.
In ...
Source: BHIC - February 26, 2018 Category: Databases & Libraries Authors: Erin Seger Tags: Mental Health Source Type: blogs
The Luxury to Choose
By TRAVIS BIAS, MD
The 80 year-old woman lay on her mat, her legs powerless, looking up at the small group that had come to visit her. There were no more treatment options left. The oral liquid morphine we had brought in the small plastic bottle had blunted her pain. But, she would be dead in the coming days. The cervical cancer that was slowly taking her life is a notoriously horrible disease if left undetected and untreated and that is exactly what had happened in this case.
We had traveled hours by van along dirt roads to this village with a team of health workers from Hospice Africa Uganda, the country’s authority o...
Source: The Health Care Blog - February 25, 2018 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Gardasil Hospice Africa Uganda vaccines Source Type: blogs
