MedPAC: Lack of site-neutral payments driving physician-hospital mergers Print E-mail
Written by Jeffrey Herschler   
Tuesday, 12 November 2019 17:46

Robert King reports for Fierce Healthcare on Nov. 7:
Medicare's payment policy is a major driver of physicians linking up with hospitals, a trend that is raising costs for beneficiaries, new data show. The data from the Medicare Payment Advisory Commission examined the rate of consolidation and the reasons behind it. The findings released during MedPAC's meeting Thursday will be part of a report that was requested by Congress in 2018 on physician and hospital consolidation. Since 2012, billing under Medicare has shifted from physician offices to hospital outpatient clinics. For instance, physician offices saw a 16% decline in service volume of chemotherapy administration from 2012 to 2018. But hospital outpatient departments saw an increase of 52%, according to MedPAC's analysis of Medicare claims. 
A big incentive for a hospital to acquire a physician practice is that "the physician's office becomes a 'hospital outpatient facility' and the billing rates for all visits and procedures double or triple," states David Fater, CEO at ALDA and Associates Internationalin Boca Raton. A hospital typically loses $100,000 per physician, per year after an acquisition, according to Mr. Fater. But collecting the hospital outpatient facility fees more than makes up for the losses. This is bad news for a healthcare system struggling to contain costs. Physicians can end up on the short end as well. "The physician's income does not necessarily increase as a result of this," states Mr. Fater. "In fact, in many cases it goes down since the physician is now an employee of the hospital. In many instances after five years, the physician has had enough and terminates the relationship out of frustration and has to start over building his/her practice from scratch."
If the Centers for Medicare & Medicaid Services (CMS) adopted site-neutral payments between hospital and physician offices, then it could reduce the incentive for such mergers. Hospitals will argue that consolidation will provide greater efficiencies and lower costs. Furthermore, the hospitals maintain that the extra fees are meant to cover hospitals for overhead that a freestanding physician's office does not carry.

Last Updated on Tuesday, 12 November 2019 17:57
Letting go when people let go of their lives Print E-mail
Written by John Dodson, MD | KevinMD   
Tuesday, 05 November 2019 18:46

My 83-year-old patient had outlived peoples' expectations on several occasions. Faced with a critical illness three years ago, she underwent emergency surgery and spent several months in the hospital with a series of complications, including septic shock, renal failure, and hospital-acquired pneumonia. I'd seen her in the office for a new visit soon after she was discharged. It took nearly 20 minutes to go through her history before walking into the exam room. Notes from several doctors during that hospitalization said that she might never become well enough to be discharged home. When I finally walked into the room, I expected to see someone frail, debilitated, with a caregiver answering most of my inquiries. Instead, she appeared robust, completely alert, and cheerfully answered my questions herself. "You look better than your chart," I told her, truthfully. Given the extent of her recent workup, we agreed to keep further testing and medication changes to a minimum. I established that we'd touch base in the office every three to four months - a typical interval at her age.

Re-imagining Elder Care: Creating a More Financially Sustainable, Community-Focused Model Print E-mail
Written by David Friend, MD, MBA & Chris Cooper, RN, MHA, MIM | BDO   
Friday, 25 October 2019 17:12

Elder care is in a race against time. In 2016, there were approximately 45 million Americans over 65. This cohort represents 16 percent of the population, but an astounding 36 percent of overall healthcare spending. At nearly $18,000 per person, we spend five times more on older Americans than we do on children. Further, the senior population continues to grow rapidly, forecast to reach more than 80 million individuals, or nearly double, by 2050. The math is simple: today's way of caring for the elderly is unsustainable. Healthcare organizations, especially those in parts of the Midwest with larger proportions of seniors, must re-imagine the way they care for The industry needs to place greater emphasis on investment in empathy- and community-based care focused on preserving and improving quality of life. Seniors are already demanding such care, fueled by five industry forces that will shape the future of elder care.

Last Updated on Friday, 25 October 2019 17:26
Vaping Related Illness Now Has a Name: EVALI Print E-mail
Written by FHI's Week in Review   
Monday, 14 October 2019 16:42

Megan Thielking reports for STAT on Oct. 11, 2019:

The vaping-related condition that has sickened hundreds of people has a new name: EVALI, or e-cigarette or vaping product use-associated lung injury. The new name, noted Friday in newly issued guidance for clinicians from the Centers for Disease Control and Prevention, is a sign of the rapidly evolving investigation into the illness, which has sickened 1,299 people across 49 states, Washington, D.C., and the U.S. Virgin Islands. The case count has continued to climb week after week. 

Read more in the current issue of Week in Review>>

Last Updated on Monday, 14 October 2019 16:59
Sponsor Showcase Print E-mail
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Wednesday, 24 July 2019 00:00
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Last Updated on Tuesday, 23 July 2019 10:29

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