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28Dec, 2015

America’s Unique Drug Problem

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We in the U.S. spend more on prescription drugs than any other country on earth. Put another way, we spend per capita more on pharmaceuticals alone than the following countries spend in TOTAL on healthcare (normalized in U.S. dollars) – Ukraine, Peru, Iran, Columbia, South Africa, Mexico, Poland and Russia. This brings an interesting perspective. In 2014, U.S. drug spending was up 12.2%; however, actual out-of-pocket spending for prescription drugs is actually down 14% since 2007. Where is this difference being spent? Government and private insurance programs. The argument is […]

26Oct, 2015

Consumerism in Healthcare 2016 and Beyond

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Part 1 There are many trends emerging today in healthcare that seem to be gathering momentum. Some may credit changes to the Affordable Care Act of 2010 (ACA), some may credit changes in demographics, some the advancement in technology, while others the success of increasing consumer engagement. Regarding changes due to the ACA; yes, the ACA has disrupted some elements in healthcare, but in the totality of its context, the ACA seems to have brought about more challenges than solutions. It is self-evident that a lot of work remains and […]

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, […]

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 […]