Posts Tagged “Physicians”
ShowHide 3rd Party PapersHealthLeaders Media: Physician Compensation- Shifting Incentives
Center for Studying Health System Change: Rising Hospital Employment of Physicians: Better Quality, Higher Costs?
The Physician’s Foundation: Health Reform and the Decline of Physician Private Practice
AHIP: The Value of Provider Networks and the Role of Out-of-Network Charges in Risking Health Care Costs
Urban Institute: How will physicians be affected by health care reform?
Sermo and Athena Health: 2010 Physician Sentiment Index℠: Taking the Pulse of the Physician Community
ShowHide Commentary
Deloitte Physician Survey
by Kevin Roche on Tuesday, May 21, 2013
The Deloitte Center for Health Solutions conducted a survey of about 613 physicians on health issues, finding many concerns.
Tags: Physicians
The World According to Physicians and Nurse Practitioners
by Kevin Roche on Friday, May 17, 2013
A survey published in the New England Journal of Medicine finds that physicians and nurse practitioners have different perspectives on their respective value to and place in the health system.
Tags: Health Care Costs, Physicians
Rand Research on the Benefits of Integrated Care.
by Kevin Roche on Tuesday, May 14, 2013
A new paper from Rand looks at the effect of integrated care on a variety of outcomes, including provider and patient satisfaction, quality and costs.
Tags: Care Management, Health Care Costs, Health Care Quality, Physicians
How Much Does Socioeconomic Status Affect Medical Costs?
by Kevin Roche on Friday, May 10, 2013
An analysis of claims and other data from three Massachusetts health plans reveals that socioeconomic status seems to have little to do with relative physician costs of care.
Tags: Health Care Costs, Physicians
MedScape Physician Compensation Report
by Kevin Roche on Thursday, May 2, 2013
Medscape has released the results of a survey of physician compensation, which shows it will increase in 2013 for most physicians, as it did in 2012.
Tags: Physicians
The Status of Oncology Care
by Kevin Roche on Tuesday, February 26, 2013
An unusually detailed look at one medical specialty is presented in an American Society of Clinical Oncology report which gives a good perspective on issues and trends in clinical oncology.
Tags: Medical Care, Physicians
Concierge Care Effects
by Kevin Roche on Friday, February 8, 2013
A study in the American Journal of Managed Care looks at the effect on hospital utilization for patients who were care for in one of the country’s leading concierge practices.
Tags: Care Management, Concierge Medicine, Health Care Costs, Hospital, Physicians
MedPAC and Medicare Physician Reimbursement
by Kevin Roche on Thursday, January 24, 2013
At its annual meeting in January, the Medicare Payment Advisory Commission explores issues regarding payment for various providers, beneficiary access to care and quality. This January’s presentation on physician issues has some interesting data.
Tags: Health Care Costs, Medicare, Physicians
Doctors’ Responses to Patient Drug Requests
by Kevin Roche on Wednesday, January 9, 2013
A study in the Archives of Internal Medicine looks at the association between various physician characteristics and acquiescence to patient drug requests, finding some interesting correlations.
Tags: Consumers, Drugs, Physicians
Review of Medical Home Evidence
by Kevin Roche on Thursday, December 27, 2012
Patient-centered medical homes, accountable care organizations, who can keep all the delivery innovations straight! Research summarized in an Annals of Internal Medicine article reviews the state of the evidence on the use of medical homes. So far, not great, small gains in quality and no showing of overall cost savings.
Tags: Care Management, Health Care Costs, Health Care Quality, Medical Homes, Physicians
2012 Potpourri XXXIX
by Kevin Roche on Friday, December 21, 2012
Our penultimate Potpourri for 2012 is a festive blend of health data, including avoidance of health care due to costs, rates of expected spending increases in 2013, costs for younger versus older physicians, internet versus print health interventions, medical home results and poor health behaviors and health spending.
Tags: Consumers, Health Care Costs, Health Insurance, HIT, Medical Homes, Physicians, Wellness and Prevention
Physician Compensation
by Kevin Roche on Monday, December 17, 2012
A new 2012 physicians compensation survey reveals interesting data about how much doctors work, what they are paid, what kinds of practices they are in and how they feel about their work. Many doctors feel overworked and undercompensated.
Tags: Health Care Costs, Physicians
2012 Potpourri XXXVIII
by Kevin Roche on Friday, December 14, 2012
In this holiday season, it is a time for giving presents and our latest Potpourri presents you with many gifts of health information, including some positive news about an ACO program, some cautions for the success of ACOs, an apparently successful disease management program, lung cancer screening, earnings growth for physicians and other health professionals and lessons in bundled payments.
Tags: ACO, Bundled Payments, Disease Management, Health Care Costs, Physicians, Providers, Wellness and Prevention
2012 Potpourri XXXVII
by Kevin Roche on Friday, December 7, 2012
Our latest Potpourri captures the excitement of the holidays with scintillating items on certificate of need program effects on utilization, the public’s views on health care costs and government’s role in health care, the cost of developing new drugs and a survey on physician compensation.
Tags: Drugs, Health Care Costs, Health Care Reform, Health Insurance, Physicians, Regulation
Medicare Payment Policies and Their Consequences
by Kevin Roche on Monday, December 3, 2012
The Centers for Medicare and Medicaid Services is forever tinkering with reimbursement for various providers, usually not getting exactly the results it seeks. An example of this is given in research published in the Archives of Internal Medicine regarding changes for primary care and specialty physician office visits.
Tags: Health Care Costs, Medicare, Physicians, Reimbursement
Medicare Part B Drug Spending
by Kevin Roche on Wednesday, November 21, 2012
The Government Accounting Office examines trends in drug spending in Medicare Part B, which covers drugs administered in a doctor’s office. Looking at the 55 most expensive Part B drugs, GAO found that Medicare accounts for much of the overall spending on these products.
Tags: Drugs, Medicare, Physicians
2012 Potpourri XXXV
by Kevin Roche on Friday, November 16, 2012
Thanks be given for our last Potpourri before Thanksgiving, a table spread with delectable bites of information on hospital readmissions and quality measure performance, health plan enrollment growth, health price rises, use of deductibles in employer-based health insurance and trends in employment of physicians.
Tags: Consumers, Health Care Costs, Health Care Quality, Health Insurance, Hospital Readmissions, Medicare, Pay For Performance, Physicians
Limits on Use of Nurse Practitioners
by Kevin Roche on Tuesday, November 13, 2012
Everyone is concerned about health spending growth, the primary cause of which is unit price increases. So why are obvious methods to reduce unit price of services, like substituting less-expensive providers, ignored? An article in Health Affairs looks at limitations of use of nurse practitioners.
Tags: Health Care Costs, Health Care Quality, Physicians, Regulation
2012 Potpourri XXXIII
by Kevin Roche on Friday, November 2, 2012
Another installment of our non-award winning (are there any potential awards?) Potpourri, this one examining drug costs for conditions of aging, self-referral in imaging, in home palliative care at the end-of-life, more on hospital readmissions and retail clinic utilization.
Tags: Care Management, Drugs, End-of-Life Care, Health Care Costs, Hospital Readmissions, Physicians, Retail Clinics
2012 Potpourri XXXII
by Kevin Roche on Friday, October 26, 2012
The light fades but not our evanescent Potpourri, this week featuring stories on computerized point of entry ordering, the presence of large treatment effects in research, characteristics of patients with readmissions, a survey on Medicare physician reimbursement and a study on family caregivers.
Tags: Care Management, Health Care Costs, Health Care Quality, Health Care Research, HIT, Hospital Readmissions, Medicare, Physicians
The Effect of Patients Reading Their Doctor’s Notes
by Kevin Roche on Tuesday, October 16, 2012
Research published in the Annals of Internal Medicine examines the effects of allowing patients to read the notes written by physicians about their health and care. Patients generally seem to regard the practice very positively and it appears to have little negative impact on physician work processes.
Tags: Consumers, Health Care Quality, HIT, Physicians
Physician Survey
by Kevin Roche on Thursday, October 4, 2012
Physicians still largely control the levers of the health care system. Their perceptions of the system and their role in it therefore carry outsized importance. A detail survey by The Physicians Foundation reveals deep dissatisfaction among many doctors.
Tags: Physicians
CMS’ Physician Group Practice Demo Results
by Kevin Roche on Wednesday, October 3, 2012
The Physician Group Practice Demonstration conducted by Medicare has largely wrapped up , to be supplanted by the accountable care organization programs. The PGP demo appears to have led to slightly improved quality and has led to slightly lower cost savings over traditional fee-for-service Medicare.
Tags: Care Management, Disease Management, Health Care Costs, Health Care Quality, Medicare, Physicians
Physicians and EHRs
by Kevin Roche on Tuesday, September 4, 2012
With all the federal incentive money sloshing around, the health information technology market, especially for electronic medical records, has understandably been hot and there are many competitors all seeking revenue from that market. A recent Medscape survey identifies which EHR vendors seem to be making the most progress.
Tags: EHRs, HIT, Physicians
Financial Incentives for Providers
by Kevin Roche on Wednesday, August 29, 2012
Are financial incentives for providers a good thing? A review in the British Medical Journal examines when financial incentives can be helpful in improving care and when they might actually lead to worse outcomes. The authors created a checklist designed to provide easy guidance on design and implementation of pay for performance type programs.
EHR Adoption
by Kevin Roche on Tuesday, August 28, 2012
A report from the Centers for Disease Control updates information on rates of electronic health record adoption. Given the incentives from the federal government, adoption seems surprisingly slow and meaningful use lags even further behind. Most doctors report being satisfied with their system.
Tags: EHRs, HIT, Physicians
2012 Potpourri XXVII
by Kevin Roche on Friday, August 24, 2012
Yet another brilliant collection of health care data points, including use of gene profiling tests to guide breast cancer care, 30-day mortality models for stroke performance, hospital medication administration errors, the costs of the Medicare physician payment fix and patient-sharing networks among physicians.
Tags: Drugs, Genomics, Health Care Costs, Health Care Quality, Hospital, Medicare, Physicians
Physician Participation in Government Health Plans
by Kevin Roche on Thursday, August 16, 2012
Health Affairs contains a survey regarding physicians’ acceptance of new Medicaid patients, which reveals that a significant fraction won’t accept new ones, largely because of low fees. The reform act attempts to ameliorate the issue, but likely will exacerbate it in the longer term.
Tags: Health Care Costs, Health Care Quality, Medicaid, Physicians
2012 Potpourri XXV
by Kevin Roche on Friday, August 10, 2012
Another wonderful Potpourri, as lovely as a summer day, with information on small physician practices, medication adherence in Medicaid, access to care in Massachusetts, plan loyalty and PHRs, a survey regarding onsite health centers and hospital productivity in Massachusetts after reform.
Tags: Consumers, Drugs, Health Care Costs, Health Care Quality, Health Care Reform, Health Insurance, HIT, Medicaid, Physicians
Current Physician Issues and Attitudes
by Kevin Roche on Thursday, August 9, 2012
A new survey from Jackson Healthcare gives a snapshot of current views of many physicians. Physicians are perhaps the most important part of the health care system and they appear stressed, concerned and discouraged about the future and about many of the health care programs they work with.
Tags: Physicians
More Primary Care Doesn’t Necessarily Lower Hospital Use
by Kevin Roche on Monday, August 6, 2012
Research published by the National Bureau of Economic Research uses experience from an HRA plan to examine what happens when people presumably have better access to outpatient care. The primary finding is that as there is more outpatient spending, there is a higher likelihood of an inpatient admission and greater inpatient spending, largely for more discretionary treatments.
Tags: Health Care Costs, Health Care Reform, Hospital, Physicians
2012 Potpourri XXIV
by Kevin Roche on Friday, August 3, 2012
The length of the summer day begins to decline, but not the quality of our Potpourri, this week including patient decision-making, the effect of genetic tests on overall health care use, an employee survey on health benefits, the growing market power of hospital systems, making decision aids more user friendly and physician compensation.
Tags: Care Management, Health Care Costs, HIT, Hospital, Physicians
2012 Potpourri XXIII
by Kevin Roche on Friday, July 27, 2012
At the height of the summer, with dryness across the land, there is no drought of information in our Potpourri, this week including use of an interactive health record to increase preventive care, Medicare and Medicaid geographical variation, shared decision-making, readmissions for heart attacks and Japan’s all-payer rate setting system.
Tags: Consumers, Health Care Costs, Health Care Quality, HIT, Hospital, Hospital Readmissions, Medicaid, Medicare, Physicians, Wellness and Prevention
Federally Qualified Health Centers
by Kevin Roche on Wednesday, July 25, 2012
Federally qualified community health centers are a lynchpin to providing accessible health care for lower income Americans. Two recent reports discuss quality and cost issues at these centers and indicate that they are a very good option for care.
Tags: Access, Health Care Quality, Health Care Reform, Physicians
AMA’s Report Card on Insurer Performance
by Kevin Roche on Thursday, June 21, 2012
The American Medical Association regularly assesses the administrative performance of the large health plans on issues relevant to physicians. This year’s report finds significant improvement in claims payment procedures and results.
Tags: Health Insurance, HIT, Physicians
2012 Potpourri XX
by Kevin Roche on Friday, June 15, 2012
Our Potpourri resumes, with information on consumer trust of insurers and providers, consumer use of online health information, price transparency in health care, imaging rates in integrated health care systems and effectiveness of telephonic depression therapy.
Tags: Care Management, Consumers, Health Care Costs, Health Care Quality, HIT, Physicians, Telemedicine
E-Prescribing Status Report
by Kevin Roche on Tuesday, June 12, 2012
The latest annual report on e-prescribing from SureScripts reveals continued rapid growth. The report also details benefits which appear to flow from greater use of electronic prescribing and opportunities to use the network created by SureScripts to address information sharing in other health care sectors.
Tags: Drugs, HIT, Physicians
Medscape Survey on Physician Compensation
by Kevin Roche on Monday, June 4, 2012
A Medscape survey of physicians gives statistics on compensation and compensation trend and reveals doctors’ attitudes regarding their pay. While “healthy”, physician compensation is not generally lavish and growth in physician spending is not nearly the problem that growth in hospital costs are.
Tags: Health Care Costs, Physicians
2012 Potpourri XIX
by Kevin Roche on Friday, June 1, 2012
Summer is heating up and our Potpourri is smoking too, with nuggets on a silly provision in the final MLR rule; research on causes of readmissions, some within hospital control, some not; why are some hospitals more costly in treating heart failure than others and an unintended consequence of a change in dialysis drug reimbursement.
Tags: Care Management, Health Care Costs, Health Care Quality, Health Care Reform, Health Insurance, Hospital, Medicare, Physicians, Readmissions, Reimbursement
2012 Potpourri XVIII
by Kevin Roche on Friday, May 25, 2012
We are on the road, but our Potpourri remains, in this issue covering malpractice claims against doctors, wellness program outcomes, the effect of drinking coffee, do EHRs help improve care and a wellness survey of employers.
Tags: Consumers, EHRs, Health Care Costs, HIT, Malpractice, Physicians, Wellness and Prevention, Workplace
2012 Potpourri XV
by Kevin Roche on Friday, April 27, 2012
Another tremendous edition of our Potpourri, featuring accountable care organization results, waste in our health system, self-referral costs, calculating hospital readmission rates and the benefits, if any, of telemonitoring frail seniors.
Tags: ACO, Care Management, Disease Management, Health Care Costs, Hospital Readmissions, Medicare, Physicians, Regulation, Telemedicine
Prostate Cancer Imaging Rates
by Kevin Roche on Thursday, April 26, 2012
An article in Health Affairs examines imaging rates for prostate cancer patients, adding a new viewpoint to the geographic variation in care debate by finding that low imaging areas have low rates of both appropriate and inappropriate imaging and vice versa.
Tags: Health Care Costs, Physicians
A Primary Care Program That Reduced Spending
by Kevin Roche on Thursday, April 19, 2012
Improving primary care is viewed as a method to lower health spending while maintaining or even improving quality. A Health Affairs article reports on a Virginia program that appears to have successfully used primary care reforms to meet these objectives.
Chemotherapy Costs
by Kevin Roche on Monday, April 9, 2012
In general, lower drug costs have helped decrease health spending growth, but specialty drug prices and use, often for cancer, have increased rapidly. New reports show these cost increases are exacerbated by a sift in treatment from physician offices to hospital settings.
Tags: Drugs, Health Care Costs, Hospital, Physicians
Physicians on Inappropriate Medical Care
by Kevin Roche on Thursday, April 5, 2012
Physicians are as aware as anyone of the need to control health spending. Several physician specialty associations have released lists of procedures or treatments that consumers and doctors should question before using. This hopefully reflects a trend of physicians being more engaged in delivering only needed care.
Tags: Care Management, Consumers, Health Care Costs, Physicians
2012 Potpourri XI
by Kevin Roche on Friday, March 30, 2012
Welcome to another Potpourri of health information, focusing on workers’ comp medical prices, cost-sharing on asthma meds, the Medicare Advantage program, doctors’ experience of quality improvement programs, a review of the last 60 years in health economics and the value of teledermatology.
Tags: Care Management, Consumers, Drugs, Health Care Costs, Health Care Quality, Medicare, Physicians, Telemedicine, Workplace
2012 Potpourri X
by Kevin Roche on Sunday, March 25, 2012
Spring is in the air but take a few minutes to refresh with our latest Potpourri, which includes the Congressional Budget Office’s latest health reform projections, ER use by those with Medicaid or private insurance coverage, the effect of selective outcomes reporting in research, an AonHewitt survey of employers on exchange use, another CBO report on employer incentives for use of TriCare and physician costs to comply with quality mandates.
Tags: Care Management, Comparative Effectiveness, Consumers, Employers, Health Care Costs, Health Care Quality, Health Care Reform, Health Insurance Exchanges, Medicaid, Physicians
2012 Potpourri IX
by Kevin Roche on Friday, March 9, 2012
Another outstanding collection of summaries from the health research literature, including this week, physicians’ difficulty in understanding the benefits of screening tests, physicians’ feelings about health information technology, AARP’s latest report on prices paid by seniors for commonly used drugs, the real cost of health reform, variation in outcomes and costs of knee replacements and shared decision-making in two common clinical situations.
Tags: Consumers, Drugs, Elder Care, Health Care Costs, Health Care Reform, HIT, Physicians, Wellness and Prevention
2012 Potpourri VIII
by Kevin Roche on Friday, March 2, 2012
Its March and spring nears; our Potpourri blooms with nuggets of health care information, including comparative regulation of medical devices in the US and Europe, do physicians always truthful with patients, CMS’ oversight of home health care agencies, the validity of a CMS’ measure of ER scanning, and patient-centered care.
Tags: Consumers, Devices, FDA, Health Care Quality, HomeCare, Medicare, Pay For Performance, Physicians
Practice Characteristics and Outcomes
by Kevin Roche on Monday, February 27, 2012
One of the hot new concepts is use of “medical home” physician practices to improve quality and lower costs. A study from Health Affairs suggests that practices having medical home characteristics don’t necessarily do better in producing good outcomes for outpatients.
2012 Potpourri VII
by Kevin Roche on Friday, February 24, 2012
Our latest Potpourri, a week late and we apologize, covers virtual coaching, the integration of drug and medical benefit management, how doctors chose to handle their own end-of-life care, Medicaid and ER visits, and malpractice and orthopedics.
Tags: Drugs, End-of-Life Care, Health Care Costs, HIT, Hospital, Malpractice, Medicaid, Physicians, Telemedicine, Wellness and Prevention
End-of-Life Care Discussions
by Kevin Roche on Thursday, February 23, 2012
End-of-life care discussions got some unwarranted and unwanted attention during the reform law debates, being characterized as “death panels”. The discussions are important, however, to ensure consistency with patient preferences and a new study finds they don’t always happen in the best manner.
Tags: End-of-Life Care, Physicians
Physicians Leaving Medicare
by Kevin Roche on Wednesday, February 22, 2012
One of the concerns around the continued wrangling over the long-term setting of physician compensation for services to Medicare beneficiaries is whether payment, and other aspects of the program, have reached a level where beneficiary access may be impacted. A recent Office of Inspector General report found inadequate data to address the question.
Tags: Medicare, Physicians
2012 Potpourri VI
by Kevin Roche on Friday, February 10, 2012
This week’s Potpourri focuses on the cost of robotic surgery, the benefits of aspirin compared to more expensive drugs, the benefits of fitness club use, what states and specialties are responsible for the SGR overrun, and the performance of safety-net hospitals on ER quality measures.
Tags: Devices, Drugs, Health Care Costs, Health Care Quality, Hospital, Physicians
2012 Potpourri V
by Kevin Roche on Friday, February 3, 2012
Another Potpourri brimming with doses of useful information that you eagerly await each week, including Medicare special needs plans and patients with diabetes, health information technology venture capital funding and M & A, identifying overuse in health care, what makes a better medical group, does merging weak hospitals help them and interventions that appear to work to prevent development of diabetes.
Tags: Care Management, Chronic Disease, Financings, Health Care Costs, Hospital, M&A, Medicare, Physicians
Big Health Care Issues
by Kevin Roche on Monday, January 30, 2012
The Wall Street Journal published a special section devoted to big health care issues, with a pro and con format on questions ranging from should there be a health insurance mandate to the potential for accountable care organizations to increase quality and lower costs.
Tags: ACO, Drugs, Health Insurance, HIT, Physicians
2012 Potpourri IV
by Kevin Roche on Friday, January 27, 2012
Another zinger of a Potpourri, with nuggets on a GAO audit of NQF work, use of web tools for diabetes management, the Healthways well-being index, the problem with federal health spending, hospital job losses from reimbursement cuts, and reducing unnecessary testing.
Tags: Care Management, Health Care Costs, Health Care Quality, HIT, Hospital, Physicians, Wellness and Prevention
Specialty Drug Trend
by Kevin Roche on Tuesday, January 10, 2012
A new report from Magellan subsidiary iCore provides information on trends in specialty drugs covered under a plan’s medical benefit, indicating that these compounds’ use and cost continues to rise rapidly, providing strong challenges for payers, who often lack good data and tools to manage this pharmaceutical category.
Tags: Drugs, Health Care Costs, Physicians
Medical Homes
by Kevin Roche on Wednesday, December 28, 2011
Another one of the concepts being counted on to help improve health care quality and lower costs in the wake of reform is the “medical home.” An AHRQ draft review finds little evidence on quality effects or cost savings, but also suggests there is promise in the approach.
Tags: Health Care Costs, Health Care Quality, Medical Care, medical home, Physicians
2011 Potpourri XXXXIX
by Kevin Roche on Friday, December 23, 2011
Our penultimate Potpourri delivers the quality you are accustomed to (for good or bad), including presents of health information on the Medicare physician payment method, telemonitoring results in the UK, the effect of eprescribing on fill rates, issues relating to use of health information technology in the home, the effect of social network on health behavior and whether imaging results actually influence decision-making or outcomes. Merry Christmas and Happy Holidays!
Tags: Consumers, Drugs, HIT, HomeCare, Medicare, Physicians, Telemedicine, Wellness and Prevention
Physician Views of Health Care
by Kevin Roche on Wednesday, December 21, 2011
Physicians have felt under assault for decades, with managed care restrictions, low reimbursement and malpractice concerns leading the charge. A new survey from Deloitte’s Center for Health Solutions give doctors’ perspectives on health care reform and their profession.
Tags: Health Care Costs, Health Care Quality, Health Care Reform, Health Insurance, Physicians
2011 Potpourri XXXXVIII
by Kevin Roche on Friday, December 16, 2011
The holiday season is in full swing, as is the time for bad weather, but nothing can deter the delivery of our Potpourri of health stories, including this week the nocebo effect, use of imaging when a financial interest in the equipment is present, broker commissions and the MLR, present-on-admission indicators, selecting patients for use in performance measuring, and physicians views of health insurers.
Tags: Health Care Costs, Health Care Quality, Health Insurance, Hospital, Medical Care, Pay For Performance, Physicians
2011 Potpourri XXXXVII
by Kevin Roche on Friday, December 9, 2011
Another scintillating Potpourri, focused on the effect of copayments on prescription adherence, use of PHRs in the FEHBP plans, doctors use of cancer drugs after a Medicare reimbursement change, visiting physicians after a hospital discharge, consumers expectations regarding health insurance and early experience with bundled payments.
Tags: Consumers, Health Care Costs, Health Care Quality, Health Insurance, HIT, Hospital, Physicians, Readmissions
2011 Potpourri XXXXVI
by Kevin Roche on Friday, December 2, 2011
The holiday shopping season is in full swing but our Potpourri is free, filled with useful data on high-deductible health plans and utilization, Medicare Advantage plan Stars bonuses, drug complications and hospitalizations, physician office visit trends, premium increases, and patient expectations.
Tags: Consumer Directed Health, Drugs, Health Care Costs, Health Care Quality, Health Care Reform, Health Insurance, Medicare, Patient Satisfaction, Physicians
2011 Potpourri XXXXV
by Kevin Roche on Friday, November 18, 2011
No Potpourri next week due to the holiday, so enjoy this festive collection of health care nuggets, including pay-for-performance in large physician groups, employer views on the effect of the reform law, the effect of physician financial interest in cardiac testing, experience with high deductible plans, medical homes and quality improvement and for-profit and non-for-profit hospital treatment of the uninsured.
Tags: ACO, Care Management, Consumer Directed Health, Health Care Costs, Health Care Quality, Health Care Reform, Health Insurance, Hospital, medical home, Pay For Performance, Physicians
2011 Potpourri XXXXIV
by Kevin Roche on Friday, November 11, 2011
The cold is approaching so curl up on the sofa and enjoy the warmth of our Potpourri, this week featuring results from a pay-for-performance program, the effect of the health insurance tax on premiums and employment, the evidence for a stroke treatment, collaborative care for heart disease and physicians views on their practices and health information tools.
Tags: Care Management, Consumers, Evidence-based care, Health Care Reform, Health Insurance, Medical Care, Pay For Performance, Physicians
2011 Potpourri XXXXIII
by Kevin Roche on Friday, November 4, 2011
Winter nears but our Potpourri will distract you from the cold breezes, providing compelling nuggets on prostate screening recommendations, consumer use of technology for health, insurer medical cost trends, what to do about Medicare’s physician payments, heart failure hospitalization and mortality rates and rates of non-filling of new prescriptions.
Tags: Chronic Disease, Disease Management, Drugs, Health Care Costs, Health Insurance, HIT, Hospital, Medicare, Physicians, Telemedicine, Wellness and Prevention
AHRQ on Provider Performance Reporting
by Kevin Roche on Thursday, November 3, 2011
The world’s aflame with reporting on provider quality and cost performance. Making sure the information is complete, accurate and credible is no simple task, as a recent Agency for Healthcare Research and Quality report demonstrates.
Tags: Health Care Quality, Hospital, Pay For Performance, Physicians
2011 Potpourri XXXXII
by Kevin Roche on Friday, October 28, 2011
Another brilliant Potpourri, with scintillating health care gems, including revising the FDA’s 510(k) process, the essential benefits package for health exchanges, the future of Medicare Advantage, the lack of labor productivity in health care, variation in elective procedure rates and the OIG’s work plan.
Tags: Care Management, Devices, FDA, Government, Health Care Costs, Health Care Reform, Health Insurance, Medical Care, Medicare, Physicians
2011 Potpourri XXXXI
by Kevin Roche on Friday, October 21, 2011
Another Potpourri, with tidbits on the Medicare Star program results for 2012, pain management, blood pressure management, Massachusetts’ physicians’ views on work and health care, online error reporting and the FDA and CMS parallel medical device review process.
Tags: Care Management, Devices, FDA, Health Insurance, Malpractice, Medical Care, Medicare, Physicians, Telemedicine
Shared Decision Making
by Kevin Roche on Monday, October 10, 2011
A new paper discusses the state of shared decision-making, illuminating progress and barriers to use by patients and providers. This approach results in higher-quality care, because it is consistent with patient values and with truly informed patient consent and it may also help reduce spending.
Tags: Comparative Effectiveness, Consumers, Health Care Costs, Health Care Quality, Physicians, shared decision-making
2011 Potpourri XXXIX
by Kevin Roche on Friday, October 7, 2011
October already!! Our 39th Potpourri of the year has many autumnal pleasures including selections on CMS’ Comprehensive Primary Care Initiative, a proposed guidance for FDA to use for mHealth regulation, end-of-life care discussions, CMS’ multi-payer database award, expected 2012 medical trend, and delivery of unnecessary care by doctors.
Tags: Care Management, Comparative Effectiveness, End-of-Life Care, FDA, Health Insurance, HIT, medical home, Medicare, Physicians, Telemedicine
2011 Potpourri XXXVII
by Kevin Roche on Friday, September 23, 2011
Another wonderful collection of health care research summaries, including a GAO report on likely effects of the MLR rule, physician work intensity, reducing hospital-acquired infections, discharge followup and hospital readmissions, the effect of pay-for-performance on cardiac care and use of EHRs and health history recording.
Tags: EHRs, HAI, Health Care Reform, HIT, Hospital, MLR, Pay For Performance, Physicians, Readmissions
2011 Potpourri XXXVI
by Kevin Roche on Friday, September 16, 2011
The leaves begin to fall but not the quality of our Potpourri, this week including useful data on hospital readmissions in the VA system, what makes top hospitals successful, the accuracy of mortality ratings for children’s hospitals, the use of mortality rankings to identify the best hospitals, advertising by health care providers and the quality effects of the annual changeover of trainees in hospitals.
Tags: Health Care Costs, Health Care Quality, Hospital, Physicians, Readmissions
Review of Physician Financial Incentive Programs
by Kevin Roche on Wednesday, September 14, 2011
A new Cochrane Review finds very minimal evidence to suggest that efforts aimed at improving quality of care by creating financial rewards or penalties for primary care physicians are having the desired impact, suggesting caution in implementing the programs until there is further and better quality research.
Physician Fees and National Health Spending
by Kevin Roche on Tuesday, September 13, 2011
The evidence continues to pile up that higher provider unit costs in the United States are the primary driver of our much higher than average per capita national health spending. Research published in Health Affairs indicates that our physician costs are higher because physicians charge more than in other countries.
Tags: Health Care Costs, Physicians
2011 Potpourri XXXV
by Kevin Roche on Friday, September 9, 2011
Fall looms and brings the football season. Our Potpourri scores with nutritious bites of health information, including getting more genetic data into medical records, giving doctors price lists, the value of HIEs, reducing hospital costs, medication continuation after hospitalization and use of episode-based payments.
Tags: Genomics, Health Care Costs, HIT, Hospital, Personalized Medicine, Physicians, Reimbursement
Medical Homes
by Kevin Roche on Wednesday, September 7, 2011
The medical home concept lumbers on, sometimes mixed in with the accountable care organization notion. The current status of the concept and issues affecting its ultimate impact are assessed in a new report from the Urban Institute and the Robert Wood Johnson Foundation.
Tags: Care Management, Consumers, Medical Care, Physicians
2011 Potpourri XXXIV
by Kevin Roche on Friday, September 2, 2011
A dazzling review of recent research and other health related nuggets is presented in this latest Potpourri, including potential problems with evidence-based medicine, physician dilemmas in controlling cost, workers’ compensation medical costs, reducing hospital infections, improving heart attack care and the growth of CDHPs.
Tags: Comparative Effectiveness, Consumers, Health Insurance, Hospital, Medical Care, Physicians, Workplace
Physician Pay-for-Performance Programs
by Kevin Roche on Tuesday, August 30, 2011
A paper from the National Bureau of Economic Research examines the effect of a physician pay-for-performance program in Canada. The study found very limited effects of the incentives in spurring greater delivery of the care which was incented.
2011 Potpourri XXXIII
by Kevin Roche on Friday, August 26, 2011
Summer begins to wane but our Potpourri remains hot, with items on large employers benefit intentions for 2012, Australia’s project to create a unified patient medical record, hospital collections at the point-of-service, physician compensation, trends in per capita medical costs and how to avoid issues in accountable care organizations.
Tags: ACO, EHRs, Health Care Costs, HIT, Physicians, Workplace
Hospital Employment of Physicians
by Kevin Roche on Wednesday, August 24, 2011
An issue brief from the Center for Studying Health System Change reviews the potential effects of increasing employment of physicians by hospitals. While there may be benefits in terms of greater care integration, the trend also will likely drive up spending.
Tags: Health Care Costs, Hospital, Physicians
Physician Malpractice Risk
by Kevin Roche on Monday, August 22, 2011
Malpractice and tort reform are politically controversial and there is uncertainty about how much malpractice litigation there is and how it affects medical practice. An article in the New England Journal of Medicine attempts to shed further light on the subject.
Tags: Malpractice, Physicians
GAO on CMS’ Physician Feedback Reports
by Kevin Roche on Monday, August 15, 2011
In the last couple of years CMS has begun providing feedback reports to physicians treating Medicare beneficiaries. A Government Accounting Office Report underlines the challenges CMS has had implementing the program and making it likely to affect physician behavior.
Tags: Health Care Costs, Medicare, Physicians
2011 Potpourri XXXI
by Kevin Roche on Friday, August 12, 2011
Mercer issued a release on its survey of employers regarding issues relating to the reform law. Among the findings are that employers have already seen a 2% enrollment jump due to having to cover children up to age 26, and that over 40% of employers expect the full implementation of the law to raise their [...]
Tags: Health Care Costs, Health Insurance, Medicare, Physicians, Workplace
2011 Potpourri XXX
by Kevin Roche on Friday, August 5, 2011
This week’s Potpourri features dropped malpractice claims, the quality benefits of EHRs, improper Medicare payments, health insurer customer satisfaction, the utilization and cost effects of using hospitalists, and determining if a patient has decision-making capacity.
Tags: Consumers, EHRs, Health Care Costs, Health Care Quality, Health Insurance, HITECH, Hospital, Malpractice, Medicare, Physicians
Risk-Bearing by Providers
by Kevin Roche on Monday, August 1, 2011
A recent report from the Commonwealth Fund describes the status of plans to have accountable care organizations and other provider systems take on financial risk for their patients, finding that there is a gap between the plans and the providers capabilities to manage the risk.
Tags: ACO, Care Management, Health Care Costs, Health Insurance, Physicians
2012 Medicare Payment Rules
by Kevin Roche on Thursday, July 28, 2011
Each year CMS issues proposed, and ultimately final, rules relating to reimbursement for various categories of providers in the next year. The 2012 rules have a wealth of background and other information in them, including significant detail on the increasingly important quality measurement programs.
Tags: Hospital, Medicare, Physicians
Early Massachusetts Experience With Global Payment
by Kevin Roche on Tuesday, July 26, 2011
Research published in the New England Journal of Medicine examines early results from the Massachusetts Blue Cross plan’s global budgeting program, finding very modest health spending reductions and small changes in quality.
Tags: ACO, Health Care Costs, Health Care Quality, Health Insurance, Physicians
2011 Potpourri XXVIII
by Kevin Roche on Friday, July 22, 2011
The dog days of summer bring yet another scorching hot Potpourri with a smorgasbord of data, including metabias in randomized clinical trials, the practice of defensive medicine, the status of HIEs, retail pharmacy drug costs and pricing and spending on medical devices.
Tags: Comparative Effectiveness, Devices, Drugs, HIT, Malpractice, Meaningful Use, Medicaid, Medicare, Physicians
2011 Potpourri XXVII
by Kevin Roche on Friday, July 15, 2011
A mid-summer’s evening (or weekend) Potpourri, but no heated discussion here, just soothing nuggets of knowledge, including use and misuse of PCI, how to measure blood pressure, CMS and telemedicine, preventing falls, copying and pasting EHR notes, and physicians attitude to work and compensation.
Tags: EHRs, Health Care Costs, Health Care Quality, Medical Care, Medicare, Physicians, Telemedicine
2011 Potpourri XXVI
by Kevin Roche on Friday, July 8, 2011
Our current Potpourri features Google’s dropping of its PHR, the AMA’s report on insurer claims paying, the role of health advocacy groups, employer’s intentions in regard to offering health coverage, drug approval in the US versus Europe and the use of a checklist to improve quality in the ICU.
Tags: Drugs, FDA, Health Care Costs, Health Care Quality, Health Insurance, HIT, Physicians
2011 Potpourri XXVI
by Kevin Roche on Friday, July 1, 2011
Fireworks galore for the Fourth of July Potpourri, including dynamite excerpts on the effects of parent caregiving on caregivers’ financial status; health insurance exchanges; physician compensation; provider performance data gathering and use; hospital market concentration; use of HIT in nursing homes and teen use of health websites.
Tags: Consumers, Elder Care, Health Care Costs, Health Care Reform, Health Insurance, HIT, Hospital, Meaningful Use, Pay For Performance, Physicians, Telemedicine
2011 Potpourri XXV
by Kevin Roche on Friday, June 24, 2011
Summer waxes but no heat-induced torpor can stop us from producing our Potpourri of health snapshots, including the health care and health care coverage of young adults; malpractice incidence; Massachusetts health spending; online provider ratings; access to specialty care for children in public programs and options for dealing with the SGR mess.
Tags: Access, Consumers, Health Care Costs, Health Insurance, Malpractice, Medicaid, Medicare, Physicians
Fee Schedules and Physician Charges in Workers’ Compensation
by Kevin Roche on Tuesday, June 21, 2011
An NCCI brief examines the effects of changes in workers’ compensation fee schedules on actual reimbursements, finding a complex relationship that may have applicability to group health as well.
Tags: Physicians, Workplace
Accurate Provider Performance Reporting
by Kevin Roche on Monday, June 20, 2011
Provider performance reporting is spreading rapidly and increasingly has payment consequences attached to it. New research published in JAMA gives further reason to be cautious in designing and implementing these programs.
CMS’ Review of Physician Reimbursement Methodology
by Kevin Roche on Thursday, June 16, 2011
CMS issued a proposed notice regarding its regular review of relative value units for physician reimbursement under Medicare. The notice gives you a sense of the impossibility of understanding what is going on there and the outsized influence of physicians in the process.
Tags: Health Care Costs, Medicare, Physicians
Massachusetts Provider Price Variation
by Kevin Roche on Wednesday, June 8, 2011
A new report on prices paid by commercial insurers in Massachusetts shows great variation, which appears unrelated to providers’ costs or to the quality of care delivered. While the specific causes of the variation aren’t analyzed, a large opportunity to limit spending by reducing high-end payments is apparent.
Tags: Health Care Costs, Health Insurance, Hospital, Physicians
New Ideas to Control Spending
by Kevin Roche on Monday, June 6, 2011
Responding to a challenge for each medical specialty to find methods for reducing inappropriate care and spending in that specialty, two oncologists identify a number of steps that could easily be adopted and are supported by research findings.
2011 Potpourri XXII
by Kevin Roche on Friday, June 3, 2011
Another round of health tidbits, including the association between primary care workforce and Medicare outcomes, comparisons of Type 2 diabetes drugs, effects of limiting DTC drug advertising, health information exchange sustainability, the effect of the Irish workplace smoking ban and barriers to diffusion of cost-effective care.
Tags: Care Management, Drugs, Elder Care, Health Care Costs, Health Care Reform, HIT, Medicare, Physicians, Wellness and Prevention, Workplace
2011 Potpourri XXI
by Kevin Roche on Friday, May 27, 2011
Our Memorial Day Potpourri, celebrating health information such as the growth of high-deductible plans, physician starting salaries, benefit design for high-cost conditions, why emergency room physicians order tests, the use of telehealth for heart failure patients and sources of physician pay.
Tags: Care Management, Chronic Disease, Health Care Costs, Health Insurance, Malpractice, Physicians, Telemedicine
Do Doctors Always Act in Patients’ Best Interest?
by Kevin Roche on Thursday, May 19, 2011
Notwithstanding clear research demonstrating the percutaneous coronary intervention has no significant outcomes advantages over medical therapy, almost no change in practice patterns has been observed, suggesting that doctors are seeking to maintain their incomes.
Tags: Health Care Costs, Medical Care, Physicians
2011 Potpourri XX
by Kevin Roche on Friday, May 13, 2011
Another Potpourri, this week delivering factoids on drug companies’ use of technology to reach physicians, waiting times in Massachusetts, use of atypical antipsychotics in nursing homes, unnecessary colonoscopies, EMRs and productivity, and a stupid FDA ruling.
Tags: Drugs, EHRs, Health Care Costs, Health Care Reform, HIT, Medicare, Physicians, Wellness and Prevention
ePrescribing Status Report
by Kevin Roche on Tuesday, May 10, 2011
A new report surveyed physician practices on their experience with eprescribing systems, finding that while use was increasing some features were not often accessed because of system design and information adequacy and accuracy concerns.
Tags: Drugs, HIT, Physicians
2011 Potpourri XIX
by Kevin Roche on Friday, May 6, 2011
Another edition of the Potpourri focuses on CMS and telemedicine, informal caregiver stress, wellness program results, emergency room visits, happiness and suicide, and sources for consumer health information.
Tags: Consumers, Elder Care, Physicians, Telemedicine, Wellness and Prevention
Outpatient Services
by Kevin Roche on Wednesday, April 27, 2011
The Agency for Healthcare Research & Quality released a Statistical Brief looking at physician visits, finding variance in cost and out-of-pocket expense, depending on the setting.
Tags: Health Care Costs, Hospital, Physicians
Physicians’ Treatment Recommendations
by Kevin Roche on Monday, April 18, 2011
New research published in the Archives of Internal Medicine finds that doctors prescribe different treatments for patients than they would choose for themselves when one choice involves potentially harmful adverse effects but a possibility of a better outcome.
Tags: Consumers, Medical Care, Physicians
2011 Potpourri XV
by Kevin Roche on Friday, April 8, 2011
Our Masters week Potpourri masterfully covers such items as EHR satisfaction, ICU telemedicine, effects of concierge care on Medicare, failure to fill prescriptions, percent of household spending on health care by seniors, and drug rep visits to physicians.
Tags: Drugs, EHRs, Health Care Costs, Health Care Quality, HIT, Medicare, Physicians, Telemedicine
Hospital-Employed Physicians
by Kevin Roche on Thursday, April 7, 2011
A NEJM article notes the increasing employment of doctors by hospitals, even though the hospitals usually lose money on the practice in the short-term. The effects of this trend on the costs and quality of care are explored.
Tags: Health Care Costs, Hospital, Physicians
Can ACOs Work for Providers?
by Kevin Roche on Wednesday, April 6, 2011
A Perspective in the NEJM calls into question whether most accountable care organizations would be able to achieve a return on investment under the planned CMS demonstration beginning in 2012.
Tags: ACO, Physicians
Acceptance of New Care and Payment Methods
by Kevin Roche on Tuesday, April 5, 2011
While health care is agog with the possibility of new care and payment methods like medical homes or ACOs and global or episode-based reimbursement, according to a Health Affairs article, neither physicians nor consumers are that eager to embrace them.
Tags: Physicians, Reimbursement
A Fool’s Potpourri XIV
by Kevin Roche on Friday, April 1, 2011
Every few years April 1st falls on a Friday, allowing us to put out our Potpourri on that day. As you might anticipate, one of our items this week is bogus, and it shouldn’t be too hard to figure out which one.
Tags: Care Management, Drugs, Health Insurance, Physicians, Telemedicine
2011 Potpourri XIII
by Kevin Roche on Friday, March 25, 2011
Another edition of the Potpourri, featuring results on the Guided Care program, bundled payment experience, academic physician compensation, end-of-life care, hospital prices and costs, and geographic variation in Medicare spending.
Tags: Care Management, Chronic Disease, Disease Management, Elder Care, Health Care Costs, Hospital, Physicians
Costs for a Physician Practice to Implement EHR
by Kevin Roche on Tuesday, March 15, 2011
Research published in Health Affairs examines the real-life costs of implementing an EHR system in a primary care practice setting, finding that while costs are significant, they may be largely covered by potential incentive payments.
Tags: EHRs, HIT, HITECH, Physicians
2011 Potpourri XI
by Kevin Roche on Friday, March 11, 2011
Another in our weekly series of health care nuggets, with this week’s Potpourri featuring Medicare beneficiaries and physician supply, the FDA’s position on certain device software, a wellness survey, the AMA’s stance on genetic testing, marketing of drugs, and an integrated disability and health care program.
Tags: Consumers, Drugs, FDA, Genomics, Health Care Quality, Medicare, Mobile, Physicians, Wellness and Prevention
Latest Dartmouth Atlas Work
by Kevin Roche on Thursday, March 3, 2011
The latest Dartmouth Atlas work looks at variation in elective surgery rates in the context of patient involvement in decision-making. The report highlights differences in treatment for a number of common conditions and provides good advice for patients.
Tags: Consumers, Health Care Costs, Health Care Quality, Medicare, Physicians
2011 Potpourri IX
by Kevin Roche on Friday, February 25, 2011
A positively presidential set of health care data points for your edification in today’s Potpourri, including examining correlations between hospital volume, quality and costs, improving quality program adherence, creating good insurance markets, the physician gender pay gap, the effects of the health reform law, and potential inconsistencies in HHS’ HIT incentive programs.
Tags: EHRs, Government, Health Care Quality, Health Care Reform, Health Insurance, HIT, HITECH, Hospital, Physicians
Physician Views of PHRs
by Kevin Roche on Thursday, February 17, 2011
Personal health records are electronic medical records collected or maintained by patients. Health Affairs reports on a survey of physicians regarding their views on these records, finding interest in having access to the information but almost no current use.
Tags: Consumers, HIT, Physicians
CDC Report on Physician Usage
by Kevin Roche on Monday, February 14, 2011
One of the primary concerns regarding Medicare spending is the significant population bulge in the 45-64 bracket, a group that is beginning to become Medicare eligible. A CDC brief explores physician usage trends in this group and the over 65 set and looks at potential implications.
Tags: Health Care Costs, Physicians
2011 Potpourri VII
by Kevin Roche on Friday, February 11, 2011
Another rendition of selections from the health literature, including advance directive issues; guideline problems; physician religious beliefs and end-of-life care; health information exchanges; the results of use of modified global payments with physicians and hospitals; and physician payment reform.
Tags: Care Management, Elder Care, HIT, Medicare, Physicians
2011 Potpourri VI
by Kevin Roche on Friday, February 4, 2011
Our usual end-of-the-week collection of health care tidbits, featuring HIE vendor awards; the point-of-care testing market; what makes medical groups successful; family caregivers and technology; clinical decision software for imaging; health care employee compensation; and communication between primary care and specialist physicians.
Tags: Care Management, Elder Care, HIT, Medical Care, Physicians
AHRQ Review of Clinical Decision Support
by Kevin Roche on Tuesday, February 1, 2011
An AHRQ report focuses on the evidence for the value of clinical decision support systems, finding strong evidence that they improve care processes but limited evidence for health or cost outcome improvement. The report also identifies features correlated with CDS success.
Tags: Care Management, HIT, Physicians
2011 Potpourri V
by Kevin Roche on Friday, January 28, 2011
On we go, wading through piles of research to arm you with the most relevant snatches of data, this week featuring geographic variation in the quality of drug prescribing; use of Facebook communities for health purposes; physicians’ hourly wages; medication adherence programs; surgical safety improvement; and using survey data to assess patient satisfaction.
Tags: Consumers, Drugs, Malpractice, Medical Care, Pay For Performance, Physicians, Telemedicine
Spreading Medical Knowledge
by Kevin Roche on Thursday, January 27, 2011
An article in Health Affairs discusses the important topic of disseminating new medical and health care knowledge to physicians and other providers, in this case specifically in regard to comparative effectiveness. Many barriers exist to widespread use of new knowledge and additional techniques are needed to maximize such use.
Tags: Comparative Effectiveness, Health Care Quality, Medical Care, Physicians
AHRQ Quality Study
by Kevin Roche on Tuesday, January 25, 2011
An unfortunate contributor to medical costs, as well as an obvious source of quality problems, are patient care errors. AHRQ releases the first results from a survey of medical offices on patient safety culture, with the goal of helping those offices reduce those patient care errors.
Tags: Health Care Quality, Physicians
Reuters Physician Survey
by Kevin Roche on Monday, January 24, 2011
A survey of 3000 American physicians reveals frustration and a widespread and strong disbelief in the supposed positive effects of the reform law on either health care for patients or physicians.
Tags: Health Care Reform, Physicians
2011 Potpourri IV
by Kevin Roche on Friday, January 21, 2011
On we go into the New Year, already on our fourth Potpourri, this one rich with information on state Medicaid program issues; what makes for a successful wellness program; what makes for a well-run hospital; pushing back on too much medical care; the value of colonoscopy and walking faster to live longer.
Tags: Elder Care, Hospital, Medicaid, Physicians, Wellness and Prevention
2011 Potpourri III
by Kevin Roche on Friday, January 14, 2011
Once more into the Potpourri breach, this week covering CBO’s scoring of a repeal of PPACA; a global wellness survey; Medicare’s failure to use its data to identify abusive providers; Canadians’ view of their health system; Walmart’s preventive care package; and use of electronic messages to improve cancer screening rates.
Tags: Health Care Reform, Health Insurance, HIT, Medicare, Physicians, Wellness and Prevention
2011 Potpourri II
by Kevin Roche on Friday, January 7, 2011
Off we go into 2011, with more snippets of health developments including the OIG’s 2011 work plan; an international survey of internet usage for health purposes, physicians’ understanding of patients’ belief systems, medical tourism and care management for persons with multiple chronic conditions.
Tags: Chronic Disease, Consumers, Government, HIT, Medical Tourism, Physicians
New Year Potpourri or 20ll Potpourri I
by Kevin Roche on Friday, December 31, 2010
Happy New Year and a prosperous 2011 to all of you, a prosperity which undoubtedly will be aided by the insights from our Potpourris, which this week include physicians’ use of patient satisfaction data, drugs for children, Medicaid quality measures, health reform provisions taking effect in 2011 and the FDA’s rate of drug approval in 2010.
Tags: Drugs, FDA, Health Care Quality, Health Care Reform, HIT, Medicaid, Medicare, Physicians
Physician Compensation Methods
by Kevin Roche on Monday, December 27, 2010
Researchers and policymakers keep searching for solutions to the problem of inappropriate utilization of services. Fee-for-service payment is often targeted as a key cause, but a recent survey suggests that productivity-based compensation may not be inconsistent with lower spending and better quality.
Tags: Health Care Costs, Physicians
Christmas Potpourri
by Kevin Roche on Friday, December 24, 2010
A very happy and relaxing Christmas Eve and Day to all our readers. To aid in the pursuit of that happiness and relaxation we offer up our scraps of enlightenment, this week covering EHR impact on productivity, e-prescribing systems, health insurance rate reviews, not-for-profit hospital executive compensation, Oregon’s state health plan and use of placebos to improve health.
Tags: Consumers, Drugs, Health Care Costs, Health Insurance, HIT, Hospital, Meaningful Use, Medicaid, Physicians
Use and Misuse of Imaging
by Kevin Roche on Tuesday, December 21, 2010
Health Affairs carries several articles analyzing imaging use, particularly in regard to physician interests in imaging equipment. The findings support the idea that physicians are often driven by their own economic advantage when making decisions about patient treatment.
Tags: Care Management, Health Care Costs, Health Care Quality, Physicians
MGMA Survey on Payer Performance
by Kevin Roche on Monday, December 20, 2010
The Medical Group Management Association does an annual survey of how its members view various payers. In general, Medicare is viewed most favorably but its payment system is viewed as the worst and physicians want that system fixed.
Tags: Health Insurance, Physicians
The Costs of EHRs
by Kevin Roche on Friday, December 17, 2010
EHRs are coming and great benefits are promised in the quality of patient care. A new brief looks at the possible costs and cost benefits of EHRs, particularly for smaller group practices. Some interesting findings are included in a survey of practices without EHRs.
Tags: HIT, Physicians
Medical Home Value Evidence
by Kevin Roche on Wednesday, December 15, 2010
Research continues to accumulate suggesting that the patient-centered medical home can save money while improving care and patient satisfaction. A new report summarizes this evidence, but the applicability of the model across the entire system has yet to be demonstrated.
Tags: Care Management, Medical Care, medical home, Physicians
MedPAC on Retainer Medicine
by Kevin Roche on Monday, November 29, 2010
Retainer-based medicine, in which patients pay physicians a flat periodic fee to cover a package of basic medical services, often referred to as a “concierge” practice, is reviewed in a MedPac report, to ascertain if has or might have a deleterious effect on access or costs for Medicare patients.
Tags: Consumers, Medicare, Physicians
Turkey of a Potpourri
by Kevin Roche on Thursday, November 25, 2010
There you are, relaxing on a holiday and holiday weekend and for some reason you feel compelled to browse the internet and come across our Thanksgiving potpourri, hopefully not a turkey, but stuffed with edible data, including HHS’ final rule on MLRs; the AMAs survey on prior authorization; principles for ACOs, how to use research studies, Humana’s acquisition of Concentra and an explanation of why health care costs keep going up. Happy Thanksgiving!
Tags: Accountable Care Organization, Care Management, Health Care Costs, Health Insurance, HIT, M&A, MLR, Physicians, Workplace
Cancer Care Variation
by Kevin Roche on Wednesday, November 24, 2010
The Dartmouth Atlas project has issued numerous reports on variation in health spending across the United States. The most recent report focuses on cancer care for terminal patients and once again finds substantial difference in resource use both across and within geographic regions.
Tags: Hospital, Medical Care, Physicians
GAO on Integrated Delivery Systems
by Kevin Roche on Tuesday, November 23, 2010
The Government Accounting Office interviewed representatives of a number of integrated provider systems to ascertain features, purported benefits in assisting underserved populations and challenges to the success of the organizations.
Tags: Care Management, Hospital, Physicians
2010 Potpourri XLII
by Kevin Roche on Saturday, November 20, 2010
Thanksgiving approaches and we are thankful for the continuing stream of news to fill our Potpourri, including the effect of malpractice liability on Illinois’ ability to retain physicians; the role of prices in health spending increases; comparative health and death rates in the US and England; employer health insurance costs; CBO review of a plan to reshape to Medicare; and end-of-life decision making.
Tags: Chronic Disease, Consumer Directed Health, Elder Care, Health Care Costs, Health Insurance, Malpractice, Medicare, Physicians
2010 Potpourri XLI
by Kevin Roche on Saturday, November 13, 2010
The holidays approach, the Potpourri rolls on, this week unveiling information on potential savings for Medicare and Medicaid dual eligibles; EHR use’s effect on physician revenue; likely physician reaction to the SGR cuts, if implemented; characteristics of California health plan enrollees; CBO’s view of the impact of the reform law on drug prices and a health plan allowing nurse practitioners to be primary care providers.
Tags: Consumer Directed Health, Drugs, HIT, Medicaid, Medicare, Physicians, Providers
Reimbursement’s Impact on Medical Practice
by Kevin Roche on Wednesday, November 10, 2010
A New England Journal of Medicine article further solidifies the susceptibility of physicians to financial incentives to overuse care when it assists them economically. Removing those incentives does not seem to prevent continued delivery of the same care when it is needed.
Tags: Health Care Costs, Medicare, Physicians
2010 Potpourri XL
by Kevin Roche on Saturday, October 30, 2010
Is there anything scary about health care? Yes if you have to pay for it! Nothing scary about our Potpourri, just soothing health care nuggets, covering alternative therapies for back pain, CBO’s view on the reform law, peer interaction to help manage diabetes, diabetes prevalence, Massachusetts physician information, accountable care organizations, bias in clinical trial results and the effects of the health law on employer provided insurance.
Tags: Accountable Care Organization, Care Management, Chronic Disease, Disease Management, Health Care Costs, Health Care Reform, Health Insurance, Medical Care, Physicians, Workplace
Nursing Home Resident Hospitalizations
by Kevin Roche on Tuesday, October 26, 2010
There is so much health spending in the United States that it is sometimes hard to isolate the big buckets. Nursing home residents have very high medical costs and many questionable hospitalizations. A KFF report examines reasons why.
Tags: Care Management, Elder Care, Health Care Costs, Physicians
IOM’s Report on Nursing
by Kevin Roche on Monday, October 18, 2010
The Institute of Medicine’s report on The Future of Nursing discusses many issues, but one that catches the eye relates to the role of restrictions on nurse scope of practice in impeding better access and lower costs.
Tags: Health Care Costs, Health Care Quality, Physicians, Providers
Physician Use of Email
by Kevin Roche on Friday, October 15, 2010
A recent survey and study examine physicians’ use of email to interact with their patients, finding very low rates of use, due to reimbursement and other concerns, as well as limited technical access. Expanded use could help reduce costs.
Tags: Physicians, Telemedicine
Grand Junction’s Low Health Spending
by Kevin Roche on Monday, October 11, 2010
There appears to be significant variation in per capita health spending around the United States. The low-cost areas could provide valuable lessons to the rest of the country and a NEJM perspective examines the experience of Grand Junction.
Tags: Health Care Costs, Physicians
2010 Potpourri XXXVII
by Kevin Roche on Saturday, October 9, 2010
The regular weekend lineup of health care news, including doctors trying to limit nurse anesthetists’ practices; text messaging for teenager dermatitis patients; Hewitt’s cost projections for 2011; physicians and the internet; how to calculate MLRs and use of incentive pay for physicians.
Tags: Health Care Quality, Health Insurance, Physicians, Regulation, Telemedicine
Can Online Care Reduce Other Visits
by Kevin Roche on Wednesday, October 6, 2010
Enthusiasm abounds regarding new forms of physician encounters, such as phone, email and video visits. A pilot study from the Mayo Clinic suggests that such visits may reduce in-person encounters and save money.
Tags: Consumers, Physicians, Telemedicine
2010 Potpourri XXXVI
by Kevin Roche on Saturday, October 2, 2010
The days shorten but the potpourri stays strong, this week including information on the safety of FDA-cleared devices; medication adherence; genetic tests; the FDA and CMS working together to review products; state all-payer databases and the increasing control of physician practices by hospital systems.
Tags: Care Management, Devices, Drugs, Health Care Costs, HIT, Hospital, Medicare, Personalized Medicine, Physicians, Regulation
New Papers on the Medical Home
by Kevin Roche on Thursday, September 30, 2010
Two recent publications explore the potential of widespread use of the medical home concept to create better primary care and coordination of overall care for patients, and examine barriers and challenges for adoption.
Primary Care Cost and Quality
by Kevin Roche on Monday, September 27, 2010
The Dartmouth Atlas researches whether more primary care necessarily leads to better quality of care. The answer appears to be usually not, but the explanation for this result is complex and it may not be as simple as cause and effect.
Tags: Consumers, Health Care Quality, Medicare, Physicians
2010 Potpourri XXXV
by Kevin Roche on Saturday, September 25, 2010
The days are shortening and the light fades, but there is still enough to read our Potpourri, which this week includes two benefit consultants’ views on health care coverage costs for next year, hospice care at end-of-life, insurance premium hikes in Connecticut, Massachusetts health reform outcomes, and how patients’ characteristics affects doctors’ quality ratings.
Tags: Health Care Costs, Health Care Reform, HIT, Medical Care, Pay For Performance, Physicians, Workplace
At-risk Payments to Physicians
by Kevin Roche on Thursday, September 23, 2010
An article in Health Affairs looks at new proposals for paying physicians on an at-risk basis in light of the historical experience with capitation, which operated in a similar manner.
Tags: Health Care Costs, Physicians
2010 Potpourri XXXII
by Kevin Roche on Saturday, September 4, 2010
We have certainly labored over the Labor Day weekend version of the Potpourri, featuring relative performance of US and foreign medical school graduates, California health insurance hikes, non-for-profit hospital CEO pay, performance measures and outcome variation at hospitals related to cost, new reimbursement methods and physician cost profiling.
Tags: Health Care Costs, Health Care Quality, HIT, Hospital, Physicians
Medical Home Value
by Kevin Roche on Monday, August 30, 2010
A study of a medical home model indicates reductions in hospital admissions and readmissions and possibly a reduction in total spending. It is not clear, however, what the full economic impact was nor is it clear that most practices would see the results that this particular provider system did.
Tags: Care Management, medical home, Physicians
Reimbursement Changes and Physician Behavior
by Kevin Roche on Thursday, August 26, 2010
It is well-established that physicians respond to various economic incentives by changing their treatment behavior. A recent study explores this phenomenon in the context of Medicare’s cancer chemotherapy drug reimbursement policies.
Tags: Drugs, Medicare, Physicians
2010 Potpourri XXX
by Kevin Roche on Saturday, August 21, 2010
Another selection of medical delights, including a telemedicine study that didn’t show improved outcomes, a telemedicine study that demonstrated the value of teleaudiology, end-of-life care, physician quality measurement, hospital quality measurement, and telemedicine for CHF patients.
Tags: Health Care Quality, Hospital, Medical Care, Physicians, Telemedicine
Accountable Care Organizations
by Kevin Roche on Wednesday, August 11, 2010
A Health Affairs/Robert Wood Johnson Issue Brief examines the accountable care organization concept, particularly as embodied in the recent federal health legislation. While there may be potential, as ACOs are structured for Medicare there will be many challenges on the road to meeting expectations.
Tags: Accountable Care Organization, Health Care Reform, Medical Care, Physicians
AMA Malpractice Report
by Kevin Roche on Monday, August 9, 2010
The American Medical Association has issued a report on the malpractice experience of physicians. Most will be sued at some point during their careers, and the fear of malpractice exposure likely affects how they practice.
Tags: Malpractice, Physicians
2010 Potpourri XXVIII
by Kevin Roche on Saturday, August 7, 2010
Summer begins to wane, but not our Potpourris. Another one full of useful data, including health insurance costs for 2011, a new telehealth joint venture, use of kiosks in physician offices, prostate cancer screening, health care use cutbacks, teledermatology and sharing of physician notes with patients.
Tags: Consumers, Health Care Costs, Health Insurance, Monitoring, Physicians, Telemedicine, Wellness and Prevention
End-of-Life Care
by Kevin Roche on Wednesday, August 4, 2010
The New Yorker carries an exceptional article by Atul Gawande on end-of-life care, highlighting irrational reimbursement policies and the difficult decisions that both patients and providers must make.
Tags: Health Care Costs, Health Care Quality, Medical Care, Physicians
Massachusetts Reports
by Kevin Roche on Tuesday, August 3, 2010
Although its reform effort appears to have gone amok, largely for cost reasons, the state of Massachusetts is producing a lot of useful data and research on medical service delivery, including three recent ones on avoidable emergency room and hospital use and the state of primary care services.
Tags: Health Care Costs, Health Care Reform, Hospital, Physicians
More Geographic Variation Research
by Kevin Roche on Monday, August 2, 2010
A study of diagnostic practices for Medicare beneficiaries reveals geographic variations. These variations not only may suggest either under or overuse of diagnostic tests but they can bias other research results and payment methods. A second study suggests that caution should be applied in analyzing regional variation to ensure that all possible sources of the differences are taken into account.
Tags: Health Care Costs, Medical Care, Medicare, Physicians
Medicare’s Physician Reimbursement Problem
by Kevin Roche on Friday, July 30, 2010
There has been no more gnarly health care problem for Congress than how to deal with physician reimbursement. At some point, as a Health Affairs article points out, it will have to come up with a better solution than the temporary fixes it has used for years.
Tags: Government, Health Care Costs, Medicare, Physicians
Physicians and Defensive Medicine
by Kevin Roche on Wednesday, July 7, 2010
One approach to lowering health care spending is to lower the costs of doing business for providers. One big item in those costs is malpractice insurance. Cutting malpractice costs could also lead to a reduction in ordering of unnecessary tests and services.
Tags: Malpractice, Physicians
AMA Rates Health Plans
by Kevin Roche on Thursday, June 24, 2010
The American Medical Association does an annual survey of claims processing and payment practices by large health plans. The AMA’s interpretation of the results needs to be taken with a grain of salt, given the definitions they use for appropriate payment.
Tags: Health Insurance, Physicians
Early Medical Home Demo Evidence Not So Great
by Kevin Roche on Thursday, June 17, 2010
The medical home is one of the hot concepts which is supposed to improve quality and lower costs. Many demonstrations are under way. A special issue of the Annals of Family Medicine reports on one of the largest of these.
Tags: Medical Care, Physicians
Retainer Services for Uninsured Persons
by Kevin Roche on Tuesday, June 15, 2010
Physicians are experimenting with retainer-like payments for uninsured patients. It appears that this may be attractive to many uninsured persons and may allow physicians to accrue more revenue than they do for a Medicaid patient.
Tags: Health Insurance, Physicians
Physician Compensation
by Kevin Roche on Friday, June 11, 2010
An MGMA survey and an article based on the survey provide a look at where physician employment and compensation is headed. Hospitals look to be extending their power and leverage.
Tags: Hospital, Physicians
Group Medical Visits
by Kevin Roche on Wednesday, June 9, 2010
As long as cost pressures continue, people will search for new and better ways to control them. One area of focus has been the cost of a physician interaction and group visits are an emerging approach to reduce that cost.
Virtual Physician Visits
by Kevin Roche on Thursday, June 3, 2010
One emerging trend in health care is a patient’s ability to interact electronically with physicians, including by video-conference, from a variety of locations. A study suggests that both physicians and patients find these video visits to be acceptable.
Tags: HIT, Physicians, Telemedicine
Physician Cost Profiling
by Kevin Roche on Wednesday, June 2, 2010
Physicians control most of the spending in health care. Understanding their practice patterns can be useful. New research demonstrates the difficulty of accurately attributing care to specific physicians.
Tags: Health Care Costs, Physicians
Group Health’s Medical Home Experience To Date
by Kevin Roche on Thursday, May 13, 2010
The patient-centered medical home is yet another highly touted solutions to health system problems. Several pilot programs of the concept have been underway. Health Affairs reports on the Group Health experience.
Tags: Health Insurance, Medical Care, Physicians
Primary Care–Save Money and Improve Quality?
by Kevin Roche on Wednesday, May 12, 2010
Health Affairs’ theme for the current issue is primary care. An article looks at research on the extent to which primary care improves quality and lowers costs. Ambiguity reigns.
Tags: Medical Care, Physicians
Online Physician Visits
by Kevin Roche on Wednesday, May 5, 2010
Traditional telemedicine has expanded in recent years to include a variety of methods for patients to interact with physicians in real and delayed time, including email, secure messaging, and video over the computer. A study examines the effect of these interactions on health spending.
Tags: Health Care Costs, Physicians, Telemedicine
Specialists as Patient Care Coordinators
by Kevin Roche on Tuesday, May 4, 2010
Specialist physicians are often blamed for the fragmented and expensive nature of American medical care. A perspective in the NEJM explores whether they might appropriately serve as principal physicians in the patient centered medical home models.
Tags: Care Management, Physicians
2010 Potpourri XIV
by Kevin Roche on Saturday, April 24, 2010
Another thrilling collection of health care tidbits; including patient safety, malpractice claims, physician discipline, hospital costs and charges, venture financings, employer health costs and who makes good liars.
Tags: Financings, Health Insurance, Hospital, Malpractice, Physicians
Physician Ownership of SurgiCenters and Operation Rates
by Kevin Roche on Friday, April 23, 2010
Another item that falls in the “shocking, just shocking” category. Research reveals that physicians who have an ownership interest in ambulatory surgical centers tend to do more surgeries at that surgicenter and to send the easier cases there.
Tags: Health Care Costs, Physicians
EMRs and Physician/Patient Communication
by Kevin Roche on Tuesday, April 20, 2010
Electronic medical records are touted as the solution to many health system problems, including improving information sharing. A Center for Studying Health System Change Issue Brief discusses potential benefits and challenges of EMRs in regard to patient/physician communication.
Tags: HIT, Physicians
2010 Potpourri XIII
by Kevin Roche on Saturday, April 17, 2010
More exotic gleamings from the world of health care, including self-directed care, telemedicine, point-of-care diagnostics, HCA, doctor-patient interactions and socio-economic factors in health outcomes.
Tags: Care Management, Consumers, Diagnostics, Health Care Quality, Physicians, Telemedicine
Geographic Variation, Physician Practice Patterns and Malpractice Fears
by Kevin Roche on Thursday, April 15, 2010
There is an ongoing line of research around regional differences in utilization of and spending on health care. A study published in Circulation surveyed physicians on their practice styles and finds that malpractice fears and peer pressure may account for a significant fraction of regional variation.
Tags: Malpractice, Physicians
2010 Potpourri XII
by Kevin Roche on Saturday, April 10, 2010
The latest collection of health care tidbits, including telemedicine, physician attitudes, medication adherence, retail clinics, physician value to hospitals and CDHPs.
Tags: Consumer Directed Health, Drugs, Health Insurance, Hospital, Physicians, Telemedicine
Patient Choice of Retail Clinic or Physician Office for Care
by Kevin Roche on Wednesday, April 7, 2010
A survey examines the bases for patients’ preferences for a site of care, in particular what factors would lead them to chose a retail clinic versus a regular physician office when they have a relatively minor health need.
Tags: Medical Care, Physicians
2010 Potpourri XI
by Kevin Roche on Saturday, April 3, 2010
This week’s collection includes obesity, clinical trials results, how hospitals make money from physicians, strategic implications of reform, what reform is likely to do to young people’s insurance premiums and patents on genes. Enjoy!
Tags: Consumers, Health Care Reform, Health Insurance, Hospital, Physicians
EHRs and Diagnostic Errors
by Kevin Roche on Friday, April 2, 2010
A variety of benefits from expanded use of electronic medical or health records have been advanced by advocates. An article in the New England Journal of Medicine explores whether such electronic records can help limit the number of diagnostic mistakes by physicians and other health professionals.
Tags: HIT, Malpractice, Physicians
The Massachusetts Debacle
by Kevin Roche on Tuesday, March 30, 2010
The Massachusetts Attorney General’s final report on what is driving health care cost increases in Massachusetts confirms the preliminary version’s finding that most of the spending rise is due to nothing more than application of raw provider market power to extract high prices from private payers. Another report also examines hospitals’ pricing practices.
Tags: Health Care Costs, Health Care Reform, Hospital, Physicians
Relative Pay of Primary Care and Specialist Physicians
by Kevin Roche on Friday, March 26, 2010
MedPAC had outside researchers look at the effects of paying all physician services in the United States under the Medicare fee schedule. Changes in that schedule were supposed to be creating more equal pay between primary care and specialist physicians, but that does not appear to have happened.
Tags: Health Care Costs, Physicians
Physician Profiling Reliability
by Kevin Roche on Wednesday, March 24, 2010
Because physicians ultimately control so much of health care spending, understanding variations in their patterns of practice is important. A NEJM article examines the reliability and accuracy of physician profiling methods.
Tags: HIT, Physicians
How Do Physicians Say “No” to Patients
by Kevin Roche on Thursday, March 11, 2010
Physicians control almost all the utilization and spending in health care. Patients often ask or even demand some health services, which they often don’t need or which are not appropriate for the patient. Research looks at how physicians can persuade patients they don’t need a service or product.
Tags: Consumers, Medical Care, Physicians
Physician Work Hours
by Kevin Roche on Tuesday, March 9, 2010
An JAMA article examines whether physicians are working less, and if so, whether the reduction is related to changes in fees. The results indicate physicians are putting in fewer hours, which appears correlated with fee reductions.
Tags: Physicians
Pay-for-Performance Program Evaluation
by Kevin Roche on Monday, March 8, 2010
Three recent articles provide some additional insight into pay-for-performance programs. Research has generally shown inconsistent results, so there is great benefit in understanding what features may make a program most successful in improving quality and outcomes.
Tags: Pay For Performance, Physicians
Refining Quality Measurement Programs
by Kevin Roche on Friday, March 5, 2010
Increasingly physicians and hospitals are measured on compliance with process of care and outcomes, in some cases being incented or penalized depending on their performance. A new study suggests how to ensure exceptions to these guidelines are properly taken into account.
Tags: Physicians, quality
Medicare Fee Change Effect on Utilization
by Kevin Roche on Thursday, March 4, 2010
A new research article examines the link between Medicare fee changes and the volume of utilization, confirming standard economic theory that the volume, or supply, of physician services does appear to be subject to normal supply and demand curves.
Tags: Medicare, Physicians
Consequences of Reimbursement Changes
by Kevin Roche on Wednesday, February 17, 2010
As part of health care reform, various reimbursement changes have proposed, such as episode bundling or time-based global payments. An article in Cancer points out that such revisions to payments don’t always have the intended effect.
Tags: Medicare, Physicians
Massachusetts Report on Provider Pricing Impact
by Kevin Roche on Monday, February 1, 2010
The Massachusetts Attorney General investigates and discovers that hospitals and some physicians have market power and consequently are able to demand high payments and those payments are the main cause of increases in the cost of health insurance, not utilization increases.
Tags: Health Care Costs, Hospital, Physicians
Quality Reporting Programs Impose Costs on Physician Practices
by Kevin Roche on Monday, January 25, 2010
Quality measurement and pay-for-performance programs continue to spread, in the belief that they will improve health care quality. A new study looks at the costs these programs impose on physician practices, finding that any financial incentives are usually lower than the costs.
Tags: Health Care Reform, HIT, Pay For Performance, Physicians
2010 Potpourri III
by Kevin Roche on Saturday, January 23, 2010
Healthy health care snacks–concierge medicine, personalized medicine, health care hiring, electronic medical records, Medicaid, disease management–all for your reading pleasure on the weekend.
Tags: Care Management, Chronic Disease, Disease Management, HIT, Medical Care, Personalized Medicine, Physician Practice Models, Physicians
Managing End-of-Life Care
by Kevin Roche on Monday, January 18, 2010
End-of-life care achieved some notoriety in the health reform debate, but it deserves thoughtful attention since it accounts for a great deal of cost and research indicates that patients’ wishes for less intensive care are often not honored. A new study looks at how physicians approach the issue.
Tags: Care Management, Medicare, Physicians
2010 Potpourri 2
by Kevin Roche on Saturday, January 16, 2010
Another collection of health care tidbits, a little telemedicine, a little reform, a little on medical care, a little personalized medicine and a smidgen of physician happiness.
Tags: Health Care Reform, Personalized Medicine, Physicians, Telemedicine
A Few Physicians Account for a Lot of Workers’ Comp Spending
by Kevin Roche on Friday, January 15, 2010
Health care costs account for over half of workers’ compensation spending. More attention is being given to drivers of this spending and a new study identifies a small group of physicians as responsible for a huge amount of the cost.
Tags: Physicians, Workers Compensation
How Does Capitation Affect Care
by Kevin Roche on Thursday, December 17, 2009
A new study suggests that physicians who are paid by capitation for some patients spend less time with those patients. Is that appropriate or inappropriate?
Tags: Medical Care, Physicians
International Survey of Primary Care Doctors
by Kevin Roche on Tuesday, November 10, 2009
The Commonwealth Fund supported a survey of primary care physicians in several countries to compare their use of health IT, the availability of incentives, patient payment issues and other matters. The United States lags other developed nations in many areas.
Tags: HIT, International, Physicians
GAO Report on Medicare Use of Physician Profiling
by Kevin Roche on Thursday, November 5, 2009
The General Accounting Office gives its perspective on the viability of the per capita method of physician resource use profiling by Medicare and provides useful insight into the topic of variable physician practice patterns.
Tags: Health Care Costs, Physicians, Providers
CMS Physician Payment Changes
by Kevin Roche on Tuesday, November 3, 2009
CMS released its rule changes for physician payments in Medicare. Significant cuts are set forth in the rule’s 1669 pages, sure to spark a strong response from the physician community and Congress.
Tags: Medicare, Physicians
Physician Group’s Health Reform Ideas
by Kevin Roche on Friday, October 9, 2009
The American College of Physicians presents its reform ideas.
Tags: Government, Health Care Reform, Physicians, Providers
House Calls Returning?
by Kevin Roche on Tuesday, September 15, 2009
The Los Angeles Times reports on a possible return of house calls.
Tags: Care Management, Medical Care, Physicians, Providers
Interesting Data About American Physicians
by Kevin Roche on Thursday, September 10, 2009
A survey of physicians reveals useful observations.
Tags: Physicians, Providers
Getting Physicians to Participate in Research
by Kevin Roche on Monday, August 17, 2009
An article examines barriers to physician participation in medical research.
Tags: Medical Care, Medical Research, Pharmaceutical, Physicians, Providers
AHIP Survey Illustrates Physician Fee Issues
by Kevin Roche on Wednesday, August 12, 2009
Insurers have been under sharp attack for causing many of the problems reform is designed to address. One response has been to shift the responsibility for these problems to other components of the health system; in this case physicians’ fees.
Tags: Health Care Costs, Health Insurance, Physicians, Providers
An Interesting Pay-for-Performance Evaluation
by Kevin Roche on Friday, July 24, 2009
An analysis of England’s pay-for-performance system finds improvement but some interesting trends and concerns as well.
Tags: Health Care Reform, Medical Care, Pay For Performance, Physicians
Who Is the “Voice” of Physicians?
by Kevin Roche on Wednesday, July 15, 2009
A physician website challenges the AMA’s representation of physicians.
Tags: AMA, Medical Care, Physicians
ShowHide Headlines
If you read the tea leaves, they aren’t falling in favor of small primary care physician practices.
Medical schools in the U.S. plan to add 3,000 first- year students by 2018 – it won’t be enough
U.S. Census Data Indicate Physician Workforce May Be Smaller, Younger Then Expected, Study Says