The state of Oregon and the Obama administration just announced the approval of a federal waiver to allow innovation in the state’s Medicaid program. The feds agreed to chip in $1.9 billion over five years to get the program off the ground. The AP reporter covering this story wrote, “Gov. John...
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First, let me acknowledge that many billions of dollars are lost by Medicare each year for outright fraud. I have heard that drug kingpins in Florida have looked at this enterprise as being just as lucrative as selling drugs, but with less potential prison time. A RAC is a Recovery Audit...
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The PCMH pushers love to talk about care coordination. They believe the key to more cost-effective care is to have primary care practices hire care coordinators to keep track of patients. I asked the leader of a large integrated network what his care coordinators actually do. He said they mostly track...
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The American Board of Internal Medicine Foundation recently led an initiative to reduce unnecessary testing. It’s called the ChooseWisely campaign and can be reached at http://www.choosingwisely.org/ There were nine medical societies that participated. Some of you might have seen articles in NEJM and the Annals of Internal Medicine where people proposed...
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I was going to write a post about the spineless leadership of the AAFP and how they caved in to the RUC (relative value update committee — the ologist-dominated committee of the AMA that makes physician fee recommendations to CMS). Visualize the AAFP dog whimpering pathetically with its tail stuck firmly...
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The evidence continues to build on how little electronic medical records (EMRs) contribute to healthcare. A Cochrane review of on-screen computer reminders found that physicians’ practices (process measures, medication ordering, vaccinations, and test ordering) improved by 4% and patients’ surrogate health measures (blood pressure or cholesterol levels) improved by 3%. Another...
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Since I started the blog American Healthscare, I’ve written nearly 80 posts trying to raise awareness about how inefficient and expensive our healthcare system is, how this reality harms the rest of our economy, which ironically leads to worse health. This is on top of the four years I spent writing...
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A colleague of mine, Jennifer Devoe, MD, PhD from the Oregon Health Sciences University, and I had a paper published in the Annals of Family Medicine this week. We basically found that the recession and recent slowdown of health insurance premium inflation pushes out the point that the cost of a...
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I talked about patient satisfaction last week, but I thought I’d extend the theme one more week. A study in the Archives of Internal Medicine analyzed data from the National Medical Expenditure Panel Survey. This is where AHRQ (a federal agency) interviews a representative sample of Americans periodically to keep track...
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I’ve just come back from my semi-annual renewal in my belief that family medicine is the foundational solution to make healthcare more affordable in America: the interim session of the Texas Academy of Family Physicians. The most important activity at these meetings is the networking: the chance to bounce ideas and...
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