Medicare
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Take Long View On Health Reform
Americans, especially the press, seem to be obsessive regarding the Affordable Care Act — or the sobriquet "Obamacare," as it has been dubbed. At first I was slightly disheartened by this, but, given further thought, it is only natural. For far too many years, we had no cohesive "system" for our health care, and now everyone, so it seems, is looking at a real system. Read More »
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Technical Requirements For Coordinating Care In An Accountable Care Organization
The concept of an Accountable Care Organization (ACO) reflects modern hopes to improve medicine and cut costs in the health system. Tony McCormick, a pioneer in the integration of health care systems, describes what is needed on the ground to get doctors working together. Read More »
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Telemedicine Clinics Make Inroads Into Primary Care
The health IT expansion of the last five years seemed to have left behind videoconferencing for remote patient visits. While it would seem a no-brainer that can potentially save time for both patient and provider, telemedicine seems to have been reserved for high-demand specialists, such as emergency stroke physicians and dermatologists who use telemedicine implementations to bring their skills to patients in rural areas. Read More »
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Tension and Flaws Before Health Website Crash
On a sultry day in late August, a dozen staff members of the Centers for Medicare and Medicaid Services gathered at the agency’s Baltimore headquarters with managers from the major contractors building HealthCare.gov to review numerous problems with President’s Obama’s online health insurance initiative. The mood was grim.
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The $100,000-Per-Year Pill: How US Health Agencies Choose Pharma Over Patients
Don Reichmuth survived prostate cancer once before, back in 2007, so his physician was concerned when tests recently revealed the cancer had returned. Reichmuth's physician prescribed a drug called enzalutamide, marketed by the Japanese company Astellas Pharma, Inc. under the brand name Xtandi. But when the physician sent the prescription to the pharmacy, the managers of Reichmuth's insurance plan sent back an immediate refusal to approve it. Reichmuth, a retired teacher who lives in Washington State, was puzzled by the logic. Then he learned the price of the Xtandi prescription: over $9,700 each month...
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The $2.7 Trillion Medical Bill: Colonoscopies Explain Why U.S. Leads The World In Health Expenditures
Deirdre Yapalater’s recent colonoscopy at a surgical center near her home here on Long Island went smoothly [...]. The test, which found nothing worrisome, racked up what is likely her most expensive medical bill of the year: $6,385. Read More »
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The Cure
While the partisan gap in Washington is wider than it’s been at any time in living memory, the two parties do have one remarkable agenda in common. Both have proposed cuts in Medicare so drastic that they would have been politically suicidal a decade ago and may still be. Yet neither party is backing off... Read More »
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The EHR Has No Clothes
Medical students returning from rotations at Veterans’ Administration Hospitals often rave about how good VistA is – something I have never heard with any other EHR. While I have not used it in clinical care, I have examined the demonstration client available on the web and been impressed by the simple, clean interface – quite unlike most other EHRs I have used or seen. Read More »
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The Fiscal Consequences Of The Affordable Care Act
The view that comprehensive health care reform must make a substantial positive contribution to repairing the federal fiscal outlook was one of the motivating principles underlying the March, 2010 passage of the Affordable Care Act (ACA). The ACA as enacted falls well short of that standard and would significantly worsen the federal government’s fiscal position relative to previous law. Read More »
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The GAO Report on Health Care Price Transparency
This morning during my still-dark-at-5:15 am walk, my iPod was motivating me to “get up offa that thing,” as James Brown was motivating me to “release the pressure.” Two minutes into the song, he urges, “Get into the sunshine, church is out.” Read More »
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The IT VistA Gets Larger
The 24th meeting of the WorldVistA community wrapped up a three-day run Sunday at University of California Davis. WorldVistA is a not-for-profit organization founded in 2002 to promote the use of an open-source version of the VistA system outside the Veterans Affairs Department, where the VA has been developing the EHR for more than 30 years. Read More »
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The Little-Known Decision-Makers for Medicare Physicians Fees
Have you ever heard of the RUC? If not, you are not part of the small circle of cognoscenti who know what makes the world go ’round – at least in Medicare. To enter the circle, read on. Read More »
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The Medicare Data Dump: How The Government Gave Physicians The Finger
According to a study by Jackson Healthcare, the percentage rate of U.S. physician compensation is among the lowest of western nations...So it was with great pomp and circumstances, as well as consternation from various physician sources, that the government released data for all payments made by Medicare to physicians in the year 2012...
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The Medicare Machine: Patient Details of 'Any Australian' for Sale on Darknet
A darknet trader is illegally selling the Medicare patient details of any Australian on request by “exploiting a vulnerability” in a government system, raising concerns that a health agency may be seriously compromised. An investigation by Guardian Australia can reveal that a darknet vendor on a popular auction site for illegal products claims to have access to any Australian’s Medicare card details and can supply them on request...
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The Obamacare We Deserve
TODAY marks the beginning of health care coverage under the Affordable Care Act’s new insurance exchanges, for which two million Americans have signed up. Now that the individual mandate is officially here, let me begin with an admission: Obamacare is awful. Read More »
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