Posts Tagged “Physicians”
ShowHide 3rd Party PapersAHIP: 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
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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
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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