The interaction of supply and demand is an initial economic lesson. The FDA approves new drug's safety and efficacy. But it's the payers – Medicare and the insurance companies – that determine the true supply. Before we begin to discuss cost, let's first learn about supply.
Medicare's Diabetes Prevention Program pays hospitals to teach patients, who are at risk for diabetes, more healthful eating habits. For at least one of the hospitals, it's not an easy goal to accomplish – and it costs more than it pays or perhaps saves.
Inclusivity for those with chronic disease or differing abilities is gaining momentum as a fashion trend. These targeted solutions to quality-of-life issues are a refreshing way to achieve the larger goal of a healthier society.
Accountable Care Organizations want to share in the profits, but not the risk of providing health care. In the end, will being forced to take on risk result in this "innovative payment" program?
How far will behavioral economics go to improve our health and decrease costs?
Just a quick note. I have written previously about the Independent Payment Advisory Board. The budget legislation signed today, permanently repeals its existence. To return to my original metaphor, the final stake has been driven into its heart.
United Healthcare, the largest provider of Medicare Advantage (MA plans) services, is being sued by the Department of Justice (DOJ) for fraud. I think they may be right. They are gaming a system designed to protect Medicare beneficiaries and taxpayers from excessive cost and they are very profitable. Did your revenue go up by 11.6% last year? Theirs did.
In the last week, the Center for Medicare and Medicaid Services (CMS) initiated a demonstration project involving the bundling of care for two new diagnostic categories. First, acute myocardial infarctions (AMI) – heart attacks including their medical and minimally invasive treatment (coronary artery angioplasty and stents) and second, coronary artery bypass grafting (CABG) – surgery to improve/restore circulation to the heart arteries. And I should care why? ... the presumptive new Health and Human Services Secretary is expected to cancel the demonstration, but it is more important to look at the underlying economics CMS envisions because they are the savings part of Obamacare.
Are you shocked by this news in the headline? Us here, not so much. But hats off to the Harvard research team for its new approach to tackling gender inequality in medicine. And the researchers did it by getting back to basics: Let the evidence speak for itself. And to a certain extent, it does.
Enjoy the first installment of a new series entitled The Shackling of the Physician, about inane and laborious diagnostic coding excesses. Bitten by orca? Opera house as place of occurrence of external cause? Pecked by chicken? You have to be kidding ... Can anyone say #physicianburnout?
A recent study claims Medicare is discriminating against female doctors in payments. Here is what's really going on.