Obama ’s Lousy Suboxone Offer
I was reading more about Obama’s executive order over at Dr. Burson’s blog. I guess she is a ‘competitor’ in the blogging world, but I have to admit that her blog has a lot more detail about the issue than I do. If you haven’t been there yet, check it out. Keep coming back here too of course!
She wrote recently about the rules that would be required by the Feds, in order for them t o allow us the ‘right’ to treat people with buprenorphine. I wrote to Dr. Burson after reading her post that she is providing the facts, and I can’t help but provide the emotion. And af...
Source: Suboxone Talk Zone - May 15, 2016 Category: Addiction Authors: Jeffrey Junig MD PhD Tags: Addiction Buprenorphine Public policy Suboxone treatment heroin addiction obama suboxone treatment Suboxone treatment cap TREAT Act Source Type: blogs
Obama’s Lousy Suboxone Offer
I was reading more about Obama’s executive order over at Dr. Burson’s blog. I guess she is a ‘competitor’ in the blogging world, but I have to admit that her blog has a lot more detail about the issue than I do. If you haven’t been there yet, check it out. Keep coming back here too of course!
She wrote recently about the rules that would be required by the Feds, in order for them t o allow us the ‘right’ to treat people with buprenorphine. I wrote to Dr. Burson after reading her post that she is providing the facts, and I can’t help but provide the emotion. And af...
Source: Suboxone Talk Zone - May 15, 2016 Category: Addiction Authors: Jeffrey Junig MD PhD Tags: Addiction Buprenorphine Public policy Suboxone treatment heroin addiction obama suboxone treatment Suboxone treatment cap TREAT Act Source Type: blogs
Misunderestimating the AMA
By BRADLEY FLANSBAUM, MD
CMS just released their proposed MACRA regs (Cliff Notes version), and as you could expect, every specialty society and interested party dug in and critiqued. The rule runs a thousand pages and will have a substantial effect on the future of provider payment. In case, you have not heard.
Each organization will cut their sections of interest out, parse them, synthesize their analysis, and return a long letter to CMS. They will offer the correct paths on which the agency should proceed–lest they go forward uninformed taking down entire blocks of the healthcare system on account of willful negle...
Source: The Health Care Blog - May 6, 2016 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized AMA Bradley Flansbaum Source Type: blogs
A pediatrician writes to the politicians about the state of medicine
This is the first letter I’ve ever written to a political figure, and I pray that someone on your staff will bring this letter to your attention. I have been a physician for close to 30 years. I am a second-generation pediatrician struggling to keep an independent solo practice alive. Not one politician has addressed what I feel is the major threat to health care: the physician-patient relationship. Without this, there is no quality of care no matter what you do. Physician-patient relationships require time with the patient.
Most of my diagnosis is derived from my patient-parent interview and a hands-on exam of the child...
Source: Kevin, M.D. - Medical Weblog - May 3, 2016 Category: Journals (General) Authors: Sharon S. Jellinek, MD Tags: Physician Pediatrics Source Type: blogs
Medicare Access and Chip Reauthorization Act (MACRA) Proposed Rule, MIPS, APM’s and Advanced Care Information
Discussion
Welcome news is the elimination of the all or nothing criteria of the meaningful use program. The exclusion of most ACO's under Medicare shared shavings is probably the most controversial part of the proposed rule as health systems have invested millions in the current Medicare shared savings program. That CMS is estimating that 87% of solo practitioners will be paying a penalty will also not be well received. Under MIPS CMS is estimating that non MD providers with the exception of nurse practitioners and physician assistants fare the worst including Chiropractors, Podiatrists and Dentists. Overall the propose...
Source: Policy and Medicine - April 28, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
Medical School is NOT where You Learn to be a Doctor
There seems to be a great deal of misunderstanding about Medical School. There are valid questions about curriculum, defined as what should be taught, and when, and who should teach it. But recent calls for students to “gain fluency in [health] systems” are completely misplaced. Here’s why.
What do you need to know to be a doctor?”
IT DEPENDS.
What kind of doctor are you going to be, and what kind of setting are you going to practice in (if you’re going to practice at all)? Because what you need to know to be a self-employed general surgeon in a rural area is completely different from what you...
Source: Musings of a Dinosaur - April 27, 2016 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
When Health Policy Gets Personal
Like most Health Affairs readers, I spend large parts of my day reading about, thinking about, and advocating for changes to health care. The flaws with our system are beyond obvious by now: access can be limited or nonexistent; health care costs too much; quality and safety are not guaranteed; care is not well coordinated; and, disparities are stubbornly hard to erase.
We compare ourselves to other industrialized nations—usually unfavorably—and wonder why we can’t be more like them, spending less and getting better outcomes. We celebrate mind-boggling scientific and medical advances but lament that they are ...
Source: Health Affairs Blog - March 21, 2016 Category: Health Management Authors: David Sandman Tags: Costs and Spending Featured Health Professionals Quality electronic medical record fee-for-service patient experience patient-centered care Physicians Primary Care value based care Source Type: blogs
Leaps of faith
It's funny how sometimes our lives can be guided by a gentle whisper. When ignored that whisper is no longer a quiet background noise.When ignored it takes on more the sound of a clashing symbol - a resonant and clear sign of something completely unplanned, but heavily and remarkably magnetic...and perhaps destined.A gift from Karen, a fellow cancer survivorThree months ago Patrick had a job offer in New York...of all places. Funny thing. Three years ago Patrick took a leap for me by leaving New York. He left this same city so he and I could share a zip code and truly grow our relationship.Back then he took on the very 'co...
Source: Life is like a sandwich...enjoy the big bites. - March 14, 2016 Category: Cancer & Oncology Source Type: blogs
Symposium: The New Health Care Industry—Consolidation, Integration, Competition In The Wake Of The ACA
Editor’s note: This post by Abbe R. Gluck introduces a Health Affairs Blog symposium featuring many of the participants in “The New Health Care Industry” conference held recently at the Yale Law School’s Solomon Center for Health Law and Policy. Gluck, who directs the Center, introduces the symposium and discusses the main themes addressed at the conference.
Today we are also publishing posts by Leemore Dafny and Christopher Ody and by Thomas “Tim” Greaney to kick off the symposium. Additional posts will follow on Tuesdays and Thursdays beginning Tuesday, March 1. Links to all posts in the symposium will be add...
Source: Health Affairs Blog - February 24, 2016 Category: Health Management Authors: Abbe Gluck Tags: Costs and Spending Featured Health Professionals Hospitals Insurance and Coverage Organization and Delivery Population Health Quality Accountable Care Organizations health insurance mergers Health Law market consolidation Yale Heal Source Type: blogs
Understanding Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models (APM’s)
Discussion
MACRA enshrines the concept of value vs. volume and a seismic shift from fee for service to value based payments. There will be tremendous need for education for today's clinicians to further understand MACRA and all its ramifications. Big questions need to be answered such as what the rule will look like, what does it mean to bear more than nominal financial risk, what will be included in value, will MIPS Meaningful Use, PQRS and Value Based Modifiers be similar to the current system .
Fortunately, there will be opportunities to let your voice be heard on this very important program.
&#...
Source: Policy and Medicine - February 18, 2016 Category: American Health Authors: Thomas Sullivan - Policy & Medicine Writing Staff Source Type: blogs
What's Nurse Career Coaching, Anyway?
When I encounter nurses online, or at meetings and nursing conferences, they often want to know what career coaching for nurses is really about and if it can truly help them. I generally reply that, yes, career coaching can be a powerful resource for most nurses, and I describe what I actually do in my role as a coach. < br / > < br / > < div class= " separator " style= " clear: both; text-align: center; " > < a href= " https://4.bp.blogspot.com/-hp4TqQM-TZI/VrqKoPvZriI/AAAAAAAAO0k/mZTz6HJeyxY/s1600/Coaching%2Bis%2Ba%2Bmeeting%2Bof%2Bminds.png " imageanchor= " 1 " style= " margin-left: 1em; margin-right: 1em; " > < ...
Source: Digital Doorway - February 10, 2016 Category: Nursing Tags: career career development career management careers healthcare careers nurse nurse career nurse careers nurse self care nurses nursing nursing careers self-care Source Type: blogs
What's Nurse Career Coaching, Anyway?
When I encounter nurses online, or at meetings and nursing conferences, they often want to know what career coaching for nurses is really about and if it can truly help them. I generally reply that, yes, career coaching can be a powerful resource for most nurses, and I describe what I actually do in my role as a coach.This post is about pulling back the curtain on career coaching for nurses, and spelling out exactly what working with me is like and how nurses benefit from such services. Sometimes, describing how a career coach can help is enough for a nurse to spring into action, hit the books, do his or her own re...
Source: Digital Doorway - February 10, 2016 Category: Nursing Tags: career career development career management careers healthcare careers nurse nurse career nurse careers nurse self care nurses nursing nursing careers self-care Source Type: blogs
Not Going to Take it Anymore - Doctors in the Pacific Northwest Unionize, Begin Collective Bargaining with Hospital Systems
We have posted about the plight of the corporate physician. In the US, home of the most commercialized health care system among developed countries, physicians increasingly practice as employees of large organizations, usually hospitals and hospital systems, sometimes for-profit. The leaders of such systems meanwhile are now often generic managers, people trained as managers without specific training or experience in medicine or health care, and "managerialists" who apply generic management theory and dogma to medicine and health care just as it might be applied to building widgets or selling soap.We have also ...
Source: Health Care Renewal - January 18, 2016 Category: Health Management Tags: concentration of power corporate physician generic management generic managers labor unions managerialism PeaceHealth University of Washington Source Type: blogs
Are Provider-Led Health Care Networks Too Big To Fail?
Are provider-led health care networks equipped to function like insurance companies? Do they have the expertise and experience to assess population health risks and costs and to accurately price health insurance products? The answer is no, and the current effort to consolidate providers and make them into ersatz insurers is a prescription for disaster.
The Affordable Care Act (ACA) is driving health care providers to combine into large health systems and to take on risk — i.e., to provide care for a specific problem or comprehensive care for a period of time, with the proviso that if costs exceed predetermined paymen...
Source: Health Affairs Blog - January 12, 2016 Category: Health Management Authors: Joel Zinberg Tags: Costs and Spending Featured Hospitals Insurance and Coverage Payment Policy Population Health ACOs physician perspective Physicians Source Type: blogs
Why I Will Never Close to New Patients
Closing a medical practice to new patients is like cutting off the very top of a tree. It’s the beginning of the end.
The top of the tree, the crown, is where the newest leaves are. It’s also the part that continues growing ever upward, at least until it reaches it’s maximal genetic height, depending on environmental factors like the availability of water and sunlight (both of which also depend on how many other trees are competing for them nearby.)
When you cut the top off a tree, the tree will die. Not right away. Sometimes not for many years. But its death is now inevitable. (By the way, see here for a...
Source: Musings of a Dinosaur - December 27, 2015 Category: Primary Care Authors: notdeaddinosaur Tags: Medical Source Type: blogs
