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To those who did not see my op-ed in the Baltimore Sun on 1/30 about HHS's new edict that doctors will be graded on quality and value, hit the link to get it: Baltimore Sun Op-Ed 1/30 or Hit This LInk An outline of the article is below: Today HHS Secretary Sylvia Burwell announced that, through the Affordable Care Act (ACA), Medicare would be taking drastic steps to assure that doctors are paid not for visits and procedures, but rather for the value of their work. The CMS website states that “providers must make fundamental changes in their day-to-day operations that improve the quality and reduce the cost of health care.” I am a full-time practicing primary care physician. Although I have
"Today's announcement is about improving the quality of care we receive when we are sick, while at the same time spending our healthcare dollars more wisely," said HHS Secretary Sylvia Burwell this week. "We believe our goals can drive transformative change, help us manage and track progress, and create accountability for measurable improvement." Through the ACA, the Health and Humans Service Secretary announced this week that Medicare was going to dramatically alter its physician payment model. Starting in 2016 (next year!) it is projecting that 85% of payment will not be based on revenue from direct patient visits. Although they did not explicitly say so, this would have to mean that pay
The ACA in association with the Medicare Innovation Center has pledged $10 Billion to finance programs designed to improve health care outcome. Much of this money is being rewarded to hospitals and academic institutions, as well as to private organizations that work with hospitals and large medical organizations. A major thrust of Medicare/ACA reform is geared to curbing the hospital readmission rate. It is felt that too many people discharged from hospitals are quickly readmitted, typically within 30 days, and if the ACA can cut that number then it will have made a significant dent in unnecessary health care spending. Across the country, the ACA is pouring its public funding into projec
A recent Washington Post editorial (12/19/14, “Obama deserves some credit for the good news about health care.”) praised aspects of the Affordable Care Act (ACA, aka Obamacare). The editorial pointed to some promising trends in health care. There has been a slowing of growth in Medicare’s costs, although those costs do continue to increase. Deaths from hospital errors have decreased dramatically by one report (100,000 deaths down to 50,000 deaths), while there are fewer falls, ulcers, and catheter related infections in the hospital. 30 day hospital readmissions have doped by 1.5%. And, perhaps most saliently, the number of uninsured Americans continues to drop. Certainly there is much t
We live in a specialized society. The percentage of doctors training in and practicing specialized medicine has exploded, while the number of primary care doctors continues to dwindle. There are many causes of this process, as I discuss in my book, and nothing in the docket of the ACA and Medicare reformers will reverse the trend. And so we have a medical system glutted by specialists; only about a third of all doctors in this country now practice primary care, and only a fifth of medical students enter the field. Those numbers continue to drop, as the number of specialists increase. But what is wrong with highly specialized care? As my 90 year old grandmother said, why see a doctor who
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