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2Dec, 2015

Who Pays For Healthcare?

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As I reach another personal birthday, I look back at over half a century of personal experiences. Not so out of reach is my passion for healthcare, and that is prompting this discussion of what has happened to healthcare in the U.S. over that period. Recently the California Healthcare Foundation ( published an incredibly interesting dynamic and informative report on healthcare cost, and the changes in cost and payments from 1960 to 2013 with some projections in to our current year. Wow! I urge anyone interested this industry to check […]

21Sep, 2015

The future of patient engagement, and the end of EHR as we know it… by 2025.

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Recently we have read a multitude of papers on the failure of providers to connect with consumers, as they use their electronic healthcare records (EHR). There are reasons this is important. First, the quality of medical care, as we have discussed on these pages, doesn’t equate to more care is better care. Second, patients are demanding it. In an era when we have cars that drive themselves, the ability to open your car, turn on your engine and heat it with a remote, check if your front door is locked, […]

10Sep, 2015

CMS Rereleases Data on ACO…

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The Centers for Medicare & Medicaid Services released the 2014 quality and financial performance results last week showing that Medicare Accountable Care Organizations (ACOs) continue to improve the quality of care for Medicare beneficiaries, while generating financial savings. As the number of Medicare beneficiaries served by ACOs continues to grow, these results suggest that ACOs are delivering higher quality care to more and more Medicare beneficiaries each year. According to the results, the 20 ACOs in the Pioneer ACO Model, and 333 Medicare Shared Savings Program, ACOs generated more than […]

6Aug, 2015

U.S. Healthcare Cost Back on Up Swing… on way to $5.4 Trillion (USD)

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Since 2009 healthcare cost appeared to be changing their mid-range trend line. Some, including the President of the United States, have tried to connect that “drop” in the cost of healthcare to the passage of the Affordable Care Act of 2010 (ACA and sometime referred to as “ObamaCare”); however, most know that ACA did literally nothing to control cost, or did very little to reform how we pay for healthcare. In fact, some could say, and I have said that the ACA will actually add to long-term healthcare cost, and […]

20Jul, 2015

Major Announcement on ICD-10 from AMA and CMS

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On July 6, 2015 the American Medical Association and The Center for Medicare & Medicaid Services (CMS) announced a new initiative to “help physicians get ready ahead of the October 1 deadline for conversion from the ICD-9 to ICD-10 codes.” In response to requests from the provider community, CMS is releasing additional guidance that will allow for flexibility in the claims auditing and quality reporting process as the medical community gains experience using the new ICD- 10 code set.” The key part of the announcement is though is that the […]

15Jun, 2015

Final Rules for ACOs-Act 2

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Today the U.S. Department of Health and Human Services (HHS) released the Final Rule for The Centers for Medicare & Medicaid (CMS) on the Medicare Shared Savings Program (MSSP) in an effort to encourage more participation of accountable care organizations (ACOs) in risk-based models. The CMS press release noted: The final rule issued today improves the program over the proposed rule in a number of areas, including but not limited to: • Creates a new Track 3, based on some of the successful features of the Pioneer ACO Model, which […]

5Jun, 2015

Back to the Future on ICD-10?

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A year ago, we were all on ICD-10 watch at this time. Odd makers were all taking sides as to what would happen with the deadline of October 1, 2014 to submit on ICD-10 billing codes to Medicare and Medicaid (the largest single payer of medical care in the United States). Insurance companies and hospitals were all rushing to meet the deadline to have Congress intervene and push off a full year. Today the watch is the same, and maybe with the Medicare Sustainable Growth Rate (SGR) issue resolved, (see […]