Tag: Medicare

4Feb, 2016

Healthcare and Economics; Pt. 1

By: Charity Darby | Tags: demographics, economics, healthcare, Medicaid, Medicare, technology

Today we are going to recognize something that has been apparent to anyone who reads this modest blog. In the last 3 blogs I admitted that my favorite subjects are healthcare, technology and demographics, with a not so small dose of economics. To me, they are hugely influential, and in my world, they are interconnected. An industry that is as large as healthcare has its own economic dynamics, and like a Red Giant star, it seemingly affects everything around it. Previously mentioned, I once read that in the mid-2000s General […]
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9Dec, 2015

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U.S. Spending on RX 2014

By: Charity Darby | Tags: : FDA, Average Wholesale Price, Big Pharma, Congress, cost, insurance companies, Medicaid, Medicare, PMPM, prescription drugs, price

The United States Spends $297 Billion (USD) on Prescription Drugs, is that fair? As the headline read, in 2014 the United States spent $297,700,000,000 on prescription drugs. This is not only a staggering amount, but what is even more disturbing is we in the U.S. pay the greatest for the most advance drugs in the world. I come to this subject from many angles. One angle is my decade’s long use of prescriptions for chronic problems, the consumer whose life has been saved by those same innovative and revolutionary drugs. […]
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2Dec, 2015

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Who Pays For Healthcare?

By: Charity Darby | Tags: California Healthcare Foundation, CMS, GDP, Government, health spending, hospital care, investment, Medicaid, Medicare, pharamceuticals, public health activity, spending trends

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 (www.chcf.org) 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 […]
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23Nov, 2015

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Free Trade in Healthcare?

By: Charity Darby | Tags: Certificate of Need, competition, Diagnostic Related Group, facilities, Florida, Florida legislature, Medicaid, Medicare, pharmaceutical provision, U.S. Anti-Trust policies

For the last few months, we in the US, have been witnessing the discussion on the national stage of The Trans-Pacific Partnership (TTP) . The TTP is a 12 nation agreement lead by the US Government, and potentially a landmark deal for President Obama and his administration. This agreement, subject to Congressional approval, was negotiated between the US and 11 other Pacific Rim nations – Australia, Brunei Darussalam, Canada, Chile, Malaysia, Mexico, New Zealand, Peru, Singapore, Vietnam and Japan – and have been negotiating the TTP Free Trade Agreement since […]
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10Sep, 2015

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CMS Rereleases Data on ACO…

By: Charity Darby | Tags: ACOs, CMS, Financials, Medicaid, Medicare, Medicare Shared Savings Program Performance, Performance, Pioneer ACO Model, Quality Meausures

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 […]
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6Aug, 2015

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

By: Charity Darby | Tags: ACA, CMS, EHR, EMR, GDP, Inflation, insurance, Mandates, Medicaid, Medicare, Regulations, Spending, U.S. Healthcare, Wellness

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 […]
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31Jul, 2015

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Healthcare in the age of Uber, eBay and Facebook.

By: Charity Darby | Tags: Ebay, EMR, Facebook, healthcare, Integration, Medicare, Social Media, technology, Uber

Today is an amazing time to be involved in most industries. This week I read articles in the Wall Street Journal (WSJ) that separately discussed the taxi and transportation revolution brought on by Uber, Inc., and the transformation traditional media companies are making to quickly adapt to on-line advertising. It has been fascinating to watch Uber’s “application” of driven on-demand, morph the transportation business. Many cities, counties, states and even governments have challenged Uber because their “technology” is disruptive to the status quo; yet the outcomes have nearly always favored […]
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5Jun, 2015

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Back to the Future on ICD-10?

By: Charity Darby | Tags: CMS, HHS, ICD-10, ICD-11, ICD-9, Medicaid, Medicare, WHO

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 […]
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17Apr, 2015

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The SGR Is Dead!

By: Charity Darby | Tags: fee-for-service, Medicaid, Medicare, medigap, operating costs

We are now at the beginning of real healthcare payment reform in the United States. The President of the United States signed in to law the “Medicare Access and CHIP Reauthorization Act of 2015.” The new law represents 2 years of bipartisan hard work at the Capitol, and resolves a dilemma created by the Balanced Budget Act of 1997. Prior to today, legislative action has been required 17 times since 2003 to prevent catastrophic reimbursement cuts to Medicare service providers; this always creates huge political maneuvering not to mention, a […]
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