By  | December 5, 2016 |  0
Given the signs Paul Ryan, Speaker of the House, has flashed during his tenure, expect phase one of the health care financing overhaul to be heavily focused on Medicaid. The incoming administration aligns with this change (#6), as does the president-elect’s choice of Tom Price for HHS Secretary.    This turn will have an impact on […]
By  | January 11, 2016 |  5
  If you have given any thought to corporatized medicine and its impact on medical practice, I advise you to read this extended New York Times piece:           The story concerns the contentious relationship between a hospitalist group and their employer, PeaceHealth Sacred Heart Medical Center in Springfield, Oregon.  The group alleges the hospital […]
By  | November 1, 2015 |  1
Because hospitalists lack a specialty code for billing (probably forthcoming), and we do not have formal board certification (I would bet it’s in our future), anyone interested in identifying hospitalists beyond their hospital walls has a tough slog.  You can call several thousand hospitals and speak with the appropriate department and question; you can call […]
By  | August 17, 2015 |  0
  A few weeks ago, I wrote about small numbers of patients consuming large and disproportionate shares of health care goods.  The thinking being, if we focus efforts on outliers, hospitals will save money and FTEs by economizing in the right places.  Why waste resources on interventions applied to fifty percent of the hospital population […]
By  | August 10, 2015 |  1
  I am pleased to cross-post a terrific piece from The Incidental Economist on the sometimes rival effects of LOS shortening and readmissions.  (I can’t recommend TIE enough by the way–and do not let the title fool you, it is a health care site). We feel the yin and yang tensions daily on this subject: discharge […]
By  | July 17, 2015 |  0
by Howard Epstein, MD, FHM Last week, the Center for Medicare and Medicaid Services (CMS) – the nation’s largest payer of healthcare services and the 800 pound gorilla in setting medical necessity and coverage policies – announced a proposal to begin paying for goals of care and advance care planning (ACP) discussions between medical providers […]