Uncategorized Category

About half of Americans would prefer a single government health plan for everyone, according to this poll. However, when offered several choices, more would prefer to build on the current system (36%) than would prefer to establish a single government plan (24%). Also, followup questions show that the opinions of a single government plan are quite malleable, depending whether the query has a positive or negative slant.

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Slavitt has put himself in a box. He has admitted that Obama’s and Congress’s decision to force doctors to use the clumsy electronic health records (EHRs) sold by the American computer industry was bad policy, but he has no idea how to fix that problem. All he can do is talk like Donald Trump – he’ll come up with “something better.”

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The Medicare Payment Advisory Commission (MedPAC) has become so confused about the “patient-centered medical home” (PCMH) it will soon meet itself coming around the corner.

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Research on “patient-centered medical homes” (PCMHs) consistently finds they have little or no effect on medical costs and mixed effects on quality. This paper by Rosenthal et al. confirms that research. The paper evaluated the Colorado Multi-Payer Patient-Centered Medical Home Pilot, one of the earliest tests of the PCMH concept administered by multiple insurers.

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It doesn’t have to be this way. Lack of health insurance, unaffordable out-of-pocket costs, network restrictions, preauthorization requirements, penalties for readmissions, all stem from our private-insurance-based system.

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In this comment I focus not on CMS’s costs, but the costs incurred by the FQHCs that “transformed” into “medical homes.” RAND reports that it is unable to determine what those costs are and what the “medical homes” do with the subsidies they receive from CMS.

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One of the hottest new fads in managed care is “patient engagement,” aka “patient activation.” How hot? So hot Health Affairs devoted its February 2013 issue to the subject. But this fad is being sabotaged by a slightly older fad – pay-for-performance (P4P).

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NCQA’s ‘medical home’ baffles RAND

In: Uncategorized

In July the RAND Corporation released a report on the second year of CMS’s three-year “medical home” experiment with federally qualified health centers (FQHCs). The report concluded the clinics in the “medical home” arm of the experiment were spending more money than clinics in the control arm, and that this was unlikely to change by the end of Year 3. Sad to say, we’re never going to know what it was the experimental clinics did that raised their costs

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In this op-ed, Ezekiel Emanuel and his co-author admit health care inflation is heating up and accountable care organizations (ACOs) are failing to cut costs. Those are significant admissions coming from Emanuel, one of the planet’s most aggressive proponents of ACOs.

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Managed care proponents suffer from the free-lunch illusion – the illusion that the managed care interventions they support are free or, at worst, cost so little those costs can be totally ignored in reporting the alleged savings achieved by the intervention. This illusion is rarely questioned by reporters or editors of professional journals.

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Physicians for a National Health Program's blog serves to facilitate communication among physicians and the public. The views presented on this blog are those of the individual authors and do not necessarily represent the views of PNHP.

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