Unbiased Analysis of Today's Healthcare Issues

Archive for the 'Physician Compensation' Category

Is balance billing a good thing?

Are health care prices set on an open market? Almost certainly not. In many cases, physician fees are set by insurers. Currently, for instance, Medicare sets fees for physicians administratively. At Medicare’s inception, however, Medicare did allow physicians to charge whatever fees they wanted; Medicare would pay a base rate and patients would be responsible […]

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The problem with bundled payments

Bundled payments sound like a great idea for improving efficiency and in the short-run they are. Bundled payments involve paying a fixed fee for the treatment of a specific patient over a specific time period.  For instance, CMS have considered using a singled bundled payment to reimburse providers for both acute and post-acute care providers.  This approach gives providers […]

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FFS vs. Capitation Reimbursement: Responses by Physicians and Medical Students

How do people respond to financial incentives?  In the medical world, physicians often are paid fee-for-service (FFS) or capitation.  Physicians receiving FFS reimbursement receive additional compensation for each additional service they do.  For instance, physicians under FFS receive twice as much compensation for 2 office visits as they would for 1 office visit.  On the other hand, […]

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HWR and Kaiser

Kaiser Permanente is opening a medical school in 2019.  How will the school be different from current medical schools?  The L.A. Times reports: …its approach will differ markedly from that of many established medical schools. It will hew closer to the company’s commitment of rapidly adopting new technology and adhering to the latest medical evidence […]

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International perceptions of ability to manage complex patients

In an international study using data from the Commonwealth Fund, Robin Osborn and co-authors survey primary care doctors in the United States and nine other industrialized countries on how well they are able to treat patients with complex needs. They found that the percentage of doctors that feel that their practice is well-prepared to manage […]

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How do patients choose their physician?

What matters to patients when choosing a physician?  Expertise?  Bedside manner?  Previous relationship with the physician? To answer this question, a paper by Groenewoud et al. (2015) conducts a discrete choice experiment (DCE) survey of Dutch patients with knee arthrosis, chronic depression, or Alzheimer’s disease.  They found that patient preferences for their physician depended on the disease. The […]

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Funding Physician Medical Education

Each year, more than $15 billion of taxpayers’ money is spent to support physicians in residency training. About one-third of this amount comes from Medicaid, the Department of Veterans Affairs, and the Health Resources and Services Administration. The remaining nearly $10 billion flows through the Medicare program, primarily to academic medical centers via a complex […]

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Are doctors and nurses to blame for high health care costs?

A study by Glied, Ma and Pearlstein (2015) says the answer is no. High worker wages are a reasonable place to start for explaining why US healthcare costs are so much higher than other countries as about half of healthcare spending is spent worker compensation. The study by Glied, Ma and Pearlstein does find that: […]

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What is MIPS?

Yesterday I posted about MIPS, the new Medicare physician reimbursement program set to begin in 2019.  The Health Affairs blog provides a nice summary of some of the changes. First and probably most importantly, the formulaic approach to setting base payment rates is gone, replaced with automatic increases for all doctors from 2015 through 2019. For […]

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‘Doc fix’ fixed?

This may be the case.  Fox News reports: The Senate overwhelmingly passed legislation permanently overhauling how Medicare pays physicians late Tuesday in a rare show of near-unanimity from Congress. The legislation headed off a 21 percent cut in doctors’ Medicare fees that would have taken effect Wednesday, when the government planned to begin processing physicians’ […]

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