Reform dentistry but don ’ t blindly copy the medical model
It’s always struck me as odd that the dental and medical systems are so separate. Oral health and overall health are closely interlinked, and the mouth is just as much a part of the body as anything else. A commentary in Health Affairs (The Dental-Medical Divide) by Elizabeth A. Mertz, a dental professor at UCSF does a good job of laying out the current state and what to expect going forward. While I learned from the article and agree with many of the conclusions, I do think it’s important that dentistry continue to deviate in some ways from the path followed by the medical profession.
Dentists started as barber/surgeo...
Source: Health Business Blog - January 11, 2017 Category: Health Management Authors: dewe67 Tags: Policy and politics innovation LANAP Source Type: blogs
Corporate health care is doomed. Here ’s why.
As health care increasingly propels itself into the world of corporations and big business, it may seem like the practice of medicine has entered an irreversible new era. Gone are the days of good old Dr. Wilson in his solo private practice around the corner, loved and respected by all his patients and the community. Nowadays, it’s all about mega multi-specialty groups, health care mergers and hostile corporate takeovers.
Being someone who’s quite middle-of-the-road when it comes to politics, I’m not anti-big business by any means. Capitalism and globalization have produced countless benefits to humankind. Who can ar...
Source: Kevin, M.D. - Medical Weblog - January 1, 2017 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/suneel-dhand" rel="tag" > Suneel Dhand, MD < /a > Tags: Physician Hospital Source Type: blogs
One year later: A physician ’s letter to Medicare patients
Dear patients,
One year ago, I wrote to you about my concerns for the future of my practice in light of upcoming changes to the Medicare system. I explained my anxiety about the Medicare Access and CHIPS Reauthorization Act (MACRA), a change in fee structure from fee-for-service (I treat you in the office, submit the bill to Medicare, and they pay the bill), to “value-based” payment (I treat you in the office, submit the bill to Medicare, and they decide if my care provided adequate value to warrant payment).
This payment change guarantees to financially penalize 50 percent of Medicare providers, mostly solo and smal...
Source: Kevin, M.D. - Medical Weblog - December 29, 2016 Category: Journals (General) Authors: < a href="http://www.kevinmd.com/blog/post-author/rebekah-bernard" rel="tag" > Rebekah Bernard, MD < /a > Tags: Physician Medicare Source Type: blogs
Turning Weaknesses Into Strengths
Some of my most rewarding personal growth explorations have involved turning weaknesses into strengths. Nothing proves to me the value of investing in personal growth more than reflecting upon a strength I can leverage with ease and remembering what my life used to be like when I was weak, timid, ignorant, incompetent, or powerless in that same area.
Some skills that I regularly apply today used to be personal weaknesses, especially writing and speaking. I wasn’t naturally good at those skills when I was younger – just the opposite. I committed to improvement over a period of years, and that made a world of differe...
Source: Steve Pavlina's Personal Development Blog - December 14, 2016 Category: Psychiatry & Psychology Authors: Steve Pavlina Tags: Productivity Source Type: blogs
Turning Weaknesses Into Strengths
Some of my most rewarding personal growth explorations have involved turning weaknesses into strengths. Nothing proves to me the value of investing in personal growth more than reflecting upon a strength I can leverage with ease and remembering what my life used to be like when I was weak, timid, ignorant, incompetent, or powerless in that same area.
Some skills that I regularly apply today used to be personal weaknesses, especially writing and speaking. I wasn’t naturally good at those skills when I was younger – just the opposite. I committed to improvement over a period of years, and that made a world of differe...
Source: Steve Pavlina's Personal Development Blog - December 14, 2016 Category: Psychiatry & Psychology Authors: Steve Pavlina Tags: Productivity Source Type: blogs
Part Two: MACRA More MIPS, and APMs
In part two of our MACRA analysis, we continue our look at MIPS and evaluate the APM pathway of MACRA’s new quality payment program.
Small Practice Considerations
Exemption
Key finalized policies include a small practice-friendly low volume threshold. In 2017, the threshold has been set at “less than or equal to $30,000 in Medicare Part B allowed charges or less than or equal to 100 Medicare patients.” CMS says this new threshold represents 32.5 percent of Medicare clinicians but only 5 percent Medicare Part B spending.
CMS says that the new flexibilities from the final rule lessen the impact on smal...
Source: Policy and Medicine - December 4, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
I am a Terrible Doctor; and I ’ m Proud of it
It’s that time again. As the year draws to a close, various insurance plans try to finish collecting data to calculate bonus payments as “incentives” for “Quality” care. The only problem is that, as I’ve written before, all of their “Quality” measures are in fact nothing but proxies for cost, most of which I have no control over.
Back in the 1990s at the beginning of the Managed Care era, the model of the primary physician was that of gatekeeper. Twenty years later, the last vestiges of this model is the wretched “Referral,” a word which used to mean something but...
Source: Musings of a Dinosaur - October 4, 2016 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
Twenty-Seven Years
Twenty-seven years. More than a quarter of a century. Maybe not much in terms of a tree, but rather a long time.
Time for a babe in arms to reach adulthood, complete with a condo, live-in girlfriend, three cats, and a PhD within spitting distance.
Time for a medical practice to begin, grow, expand, and contract again until it is just the right size for a solo dinosaur.
Twenty-seven years ago today I hung out my shingle in front of a tiny basement office. I saw three patients that first day but only three more the rest of the week. I’ve had my ups and downs; overall, more of the former than the latter. Paper charts ha...
Source: Musings of a Dinosaur - October 2, 2016 Category: Primary Care Authors: notdeaddinosaur Tags: Family/Personal Medical Source Type: blogs
Fail to Scale: Why Great Ideas In Healthcare Don ’ t Thrive Everywhere
By JEFF GOLDSMITH and LAWTON BURNS
In the world of fine wine, it is well known that some types of wine grapes grow only in very specific climates and ecologies. The concept borrowed from the French is “terroir” (ter-WAHR). Terroir explains why the finest champagne grapes grow only in a small district in northeastern France, characterized by rolling hills and a chalky limestone subsoil that provides a steady level of moisture and imparts a mineral note to the wine’s flavor.
Health policy advocates have sought for generations to propagate promising forms of health care organization across the country. Yet one finds rep...
Source: The Health Care Blog - September 29, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs
Fail To Scale: Why Great Ideas In Health Care Don ’t Thrive Everywhere
In the world of fine wine, it is well known that some types of wine grapes grow only in very specific climates and ecologies. The concept borrowed from the French is “terroir” (ter-WAHR). Terroir explains why the finest champagne grapes grow only in a small district in northeastern France, characterized by rolling hills and a chalky limestone subsoil that provides a steady level of moisture and imparts a mineral note to the wine’s flavor.
Health policy advocates have sought for generations to propagate promising forms of health care organization across the country. Yet one finds repeatedly that some forms of organiza...
Source: Health Affairs Blog - September 29, 2016 Category: Health Management Authors: Jeff Goldsmith and Lawton Burns Tags: Costs and Spending Featured Insurance and Coverage Medicare Payment Policy Independent Practice Association Medicare fraud States Source Type: blogs
CMS Delay ’s Full MACRA Implementation to the Next Administration
In a blog post, CMS announced changes to the Medicare Access & CHIP Reauthorization Act of 2015 (MACRA) that will allow physician practices to choose the level and pace at which they comply with the new payment reform model aimed at emphasizing quality patient care over volume. The announcement comes after pressure from industry stakeholders and policymakers to ease implementation of MACRA, which is set to start January 1, 2017. We previously reported that CMS was considering a potential MACRA delay, and this appears to be what the agency will finalize in its November rule.
The Announcement
Acting CMS Administrator...
Source: Policy and Medicine - September 11, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
Music from Your Brain
The journalBrain has a new review on the history of converting theelectroencephalogram (EEG) into sound (Lutters& Koehler, 2016). The translation of data into sound, known assonification, has been applied to brain waves since the 1930s. In addition to early scientific and medical applications, sonification of the EEG has been used in the field of experimental music.In 1965, physicist Edmond Dewan and composer Alvin Lucier collaborated onMusic for the Solo Performer:Sitting on a chair, eyes closed, Lucier ’s brainwaves were recorded from his scalp, amplified andchannelled to numerous loudspeakers scattered around...
Source: The Neurocritic - August 30, 2016 Category: Neuroscience Authors: The Neurocritic Source Type: blogs
The Roadmap To Physician Payment Reform: What It Will Take for All Clinicians to Succeed under MACRA
As the largest change in Medicare physician payment since the Sustainable Growth Rate formula, the Medicare Access and CHIP Reauthorization Act (MACRA) will affect up to 836,000 clinicians and allocate more than $1.2 billion in payment bonuses and penalties in its first year alone. Reflecting the importance of this policy, the 962 page proposed rule for its implementation generated thousands more pages of comments, with nearly 4,000 organizations and individuals submitting formal comment letters to the Centers for Medicare and Medicaid Services (CMS).
The proposed rule has been summarized by CMS, and there have been severa...
Source: Health Affairs Blog - August 30, 2016 Category: Health Management Authors: Mark McClellan, Frank McStay and Robert Saunders Tags: Costs and Spending Insurance and Coverage Medicare Payment Policy ACOs Alternative Payment Models Comprehensive Primary Care Plus MACRA Merit-Based Incentive Payment System Source Type: blogs
Building Better Metrics: Invest in “Good” Primary Care and Get What You Pay For
By NIRAN Al-AGBA, MD
In 1978, the Institute of Medicine published A Manpower Policy for Primary Health Care: Report of a Study (IOM, 1978) where they defined primary care as “integrated, accessible services by clinicians accountable for addressing a majority of heath care needs, developing a sustained partnership with patients, and practicing in the context of family and community.” The four main features of “good” primary care based on this definition are: 1. First-contact access for new medical issues, 2. Long-term and patient (not disease)-focused care, 3. Comprehensive in scope for most medical issues, and 4. C...
Source: The Health Care Blog - August 16, 2016 Category: Consumer Health News Authors: John Irvine Tags: 2016 Town Hall Physicians Building Better Quality Metrics Niran Al-Agba primary care Source Type: blogs
