fee for service

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America’s Healthcare Secret Pricing Scandal Exposed

For everyone who is literally sick and tired of being held ransom by a corrupt healthcare system where insurance companies, their lobbyists, hospital networks, and pharmaceutical companies have had the upper hand by keeping us in the pricing dark, Pratter believes it is time for the unsustainability and unfairness of secret pricing and crippling “surprise” medical bills to stop. This article exposes America’s secret pricing scandal like never before and how it is carefully and purposefully crafted. A review of several self-insured companies’ medical bills has led to the following conclusions. They call their pricing proprietary. We call it secret and unethical. Take your secretly priced anti-nausea medicine and keep reading.

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CareKit as an Enabler for Patient Generated Healthcare Data

As we move from fee for service to alternative payment models/value-based purchasing we will increasingly measure our progress based on outcomes and total medical expense. HealthKit was an enabler that led Beth Israel Deaconess to create [email protected], an iPhone and iPad app that uploads internet of things (blood pressure cuff, glucometer, scale, activity, sleep data etc.) to our electronic health record. CareKit, announced by Apple this week, takes us one step further on our wellness-focused journey.

Halamka's Dispatch from HIMSS

Every year I walk the HIMSS floor and speak at HIMSS events with the hope that I can distill the conference sensory overload into a few key themes. In the recent past, big data, interoperability, personalized medicine, population health, and wearables were buzzwords in every booth. This year, the buzzwords were replaced by one overarching concept - providers and vendors must innovate or die. In the next 24 months we’ll see an accelerating evolution of fee for service into alternative payment models fueled by MACRA and MIPS

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The Rise of Telemedicine

As reimbursement evolves from fee for service to alternative payment models, incentives will shift from treating sickness to keeping the population healthy. New investments will be made in technologies that reach into the home and enhance care team communication. 2016 saw an acceleration of telemedicine/telehealth. 2017 will see exponential growth. Telemedicine is hard to define. It could be real time video teleconferencing between clinicians (a consult), between a patient and clincian (a visit), or group to group  (tumor board discussion). It could be the transmission of a static photograph, such as the poisonous mushroom/plant teleconsultation I do 900 times per year. It could be secure texting to coordinate patient care...