Medicare Physician Payments

Last week, with little fanfare, the federal government made public all of the “Part B” Medicare expenditures from 2012. For the first time, it became possible to view – by physician – the types of services being billed, the number of each type, the charges, and the actual payment from Medicare. Continue reading

Now What?

I really do not understand how Congress “works.” While it busied itself with passing a law that fails to fix the clearly broken “sustainable growth rate” formula for Medicare physician payments, it added in a surprise for the entire healthcare industry: a provision that mandates a delay in the adoption of ICD-10 by CMS. Continue reading

Sham good!

The results of a really interesting clinical trial were just reported at the annual meeting of the American College of Cardiology and simultaneously published online before print by the New England Journal of Medicine . Continue reading

Improving Ambulatory Care

I recently attended the IHI conference entitled “Improving Patient Care in the Office Practice and the Community” in Washington, D.C. It attracted about 1000 people from around the country to share their stories about how to make care better, and I want to share two of them with you. Continue reading

The Bending Cost Curve

I attended a really interesting conference last week on “Innovation in Health Care” that was cosponsored by The Advisory Board and the Aspen Institute.  It was a one-day affair in Washington, attended by about 1000 people from around the country who were treated to talks by a star studded cast that included HHS Secretary Kathleen Sebelius, Peter Orszag , Jeffrey Brenner, former US Senators Tom Daschle and Bill Frist, and a guy with more titles than I can count, Patrick Conway. Continue reading

Why does ICD-10 feel so bad?

It has been freezing cold in much of the country for the last two months, but things have been heating up in the controversy over the implementation of ICD-10. First, a quick primer for those of you who have not been following this. Continue reading

Just Listen

I just got back from a brief trip to Florida. I went down there to celebrate my mother’s 85th birthday. As you might expect, her social circle has shrunk in recent years, but she did get a number of cards and calls from friends and family members. The cards were on display in her kitchen, and a few calls came in while I was there. One in particular pointed out some of the many things wrong with medicine these days. Continue reading

Cancer Screening

I have been thinking a lot about cancer screening tests. It seems that there has been a constant stream of articles about screening in both the lay press and professional journals – as well as the inevitable stories in the lay press about the reports in professional journals — but this is more personal. I have had two recent experiences that I can’t get out of my mind. Continue reading