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Fitness Bands Don’t Work

December 3, 2016

This shouldn’t come as a surprise to most readers of American HealthScare, but 2 recent studies found that wearable fitness bands did not improve outcomes. One was a study comparing 4 incentives to increase physical activity: Fitbit Zap activity tracker, tracker plus charity incentives, tracker plus cash incentives, and a control...
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Primary Care Physicians are the Most Cost Conscious

November 18, 2016

A recent survey of physicians asked several questions about prescribing practices. The primary report was that only primary care physicians cited costs as one of the most important considerations in their prescribing habits. Out of 10 factors, all of the ologists ranked cost as the sixth or less most important consideration. Pulmonologists...
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More Clarity on the Cost of Obamacare

October 31, 2016

I have written before about predictions of the actual costs of Obamacare and the probable death spiral of increasing costs and decreasing participants. Several recent reports have brought more clarity to the cost realities. Recently regulators across the country approved rate hike requests by Obamacare insurance companies even greater than they...
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MedPAC Says ACO Savings ‘Incredibly Unsatisfying’

October 24, 2016

A key part of Obamacare is not going so well. But before I continue, I assume that some of my readers won’t know some of the acronyms, so I’ll define them. An ACO is an Accountable Care Organization, which was created in the PPACA (Obamacare). The spirit of an ACO was...
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Hostility Against Primary Care

October 16, 2016

Just about every U.S. medical student who’s ever said they want to go into family medicine, or even other primary care fields, has heard this (or something like it): “Why do you want to waste your brain?” A new study shows what we in family medicine have always known/suspected. The comments...
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The Cost of Opaque Costs to Deliver a Baby

September 25, 2016

How much does it cost to deliver a baby in the U.S.? Just don’t do it in Sacramento. Castlight Health released a report based on claims data looking at the actual cost of delivering  a baby across the country. In other words, it’s how much money actually changed hands, not the inflated...
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The Cost of Health Information Technology

September 11, 2016

From the mid- to late-2000s, lots of pundits got into the business of shoving electronic medial records (EMRs)down doctors’ throats. There were a few incentives from the Feds to help with the upfront costs, but it was a pittance of what it really costed hospitals and physician practices. And there was...
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The Obamacare Death Spiral

August 21, 2016

Several commentators have talked about a death spiral for the Obamacare health insurance exchanges. What do they mean? One of the keys for any insurance plan to work is that a lot of healthy people have to sign up to cover the costs of the sick. For car or homeowner’s insurance, losses...
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A Chance to Talk About Drug Prices is Slipping Away

July 9, 2016

The new hepatitis C drugs are expensive. Harvoni costs $1000 per pill for a total of $84000 for treatment. It works well, clearing the virus in over 90% of cases, though the evidence-based medicine purists would still argue there’s no evidence that this improves any patient-oriented outcomes such cirrhosis and death....
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Family Physician Payment – A Lesson from Switzerland

June 27, 2016

There was a nice opinion piece in JAMA Internal Medicine recently where the primary author talked about moving from the U.S. to Switzerland and his experience in both systems. Primary care physicians are allowed to bill based on time there. This includes travel time, phone work, and documentation time. What a concept!...
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