A doctor’s view on payments: Cherry-picking and lemon-dropping

Guest post summary: “The dirty little secret of current medical payment changes is doctors and hospitals now have a financial incentive to not provide care for some patients, those who put the providers at higher risk of financial penalties. We call this phenomenon cherry-picking and lemon dropping,” writes Mary O’Connor, M.D., Yale School of Medicine and Yale-New Haven Hospital, […]

A Medicare practice wastes money and infuriates doctors: KevinMD

Summary: “In the last decade, the federal government has undertaken considerable steps to control the way doctors care for their patients,” Andrew Lam writes over at KevinMD, in a doctor’s eye view of quality measurements. “Its goal is to improve healthcare quality and lower costs, but the very regulation tasked with achieving this has created […]

The history of our health care system, and the road not taken

Summary: “It’s that time of year again. Insurance companies that participate in the Affordable Care Act’s state health exchanges are signaling that prices will rise dramatically this fall,” Christy Ford Chapin writes over at The Conversation, in a thorough, thoughtful examination of how our health care system came to be — including an explanation of […]

Big-name hospitals fail to get 5 stars in new Medicare ratings: Kaiser

Filed Under: Costs, Patients, Providers

Summary: “The federal government released its first overall hospital quality rating on Wednesday, slapping average or below average scores on many of the nation’s best-known hospitals while awarding top scores to dozens of unheralded ones,” Jordan Rau writes over at Kaiser Health News. “The Centers for Medicare and Medicaid Services rated 3,617 hospitals on a […]

At small rural hospitals, paying more for worse treatment: WSJ

Summary: “Small rural hospitals called critical-access hospitals have in recent years been performing more and more inpatient orthopedic surgeries, even as their overall stays decline, a Journal analysis of Medicare billing records shows,” Christopher Weaver, Anna Wilde Mathews and Tom McGinty write in The Wall Street Journal. “Inpatient joint-replacement surgeries covered by Medicare rose 42.6% […]

Medicare Advantage vs. Medicare: My mom’s story, by Wendell Potter

Filed Under: Costs

Summary: “The odds are pretty high … that Mom would not still be counted among the living had she not switched from an MA plan to traditional Medicare,” Wendell Potter writes in a piece titled “Why Mom went back to traditional Medicare” for MedicareResources.org. He describes his mother’s experience, and concludes: “Only in original Medicare […]

Hospital quality ratings: Here’s another view, with hospital-by-hospital search

Summary: Quality ratings are hard to come by in the health-care marketplace, and the ones that exist tend to come to very different conclusions. But there’s a new set of quality ratings, imposed by the government, in an attempt to tie performance to pay by penalizing hospitals for complications and conditions acquired in the hospital. Jordan […]

The new Medicare payment data release: 2 experts set the stage

Filed Under: Costs, Regulators

SUMMARY: A big release of data from Medicare, on what doctors got paid what for doing what, is coming in hours. There’s a lot of debate about it — the American Medical Association resisted, and then stopped resisting — and the mystery about what’s in the data has been building for months. For a sneak […]

How much do prescriptions cost? Here’s the Medicare price info for 2014

Filed Under: Costs, Patients, Regulators

SUMMARY: Curious about drug pricing? Here’s the link to Medicare drug pricing files for 2014. This is important because prescription prices can vary widely. The price Medicare reimburses is the closest thing in this marketplace to a fixed or benchmark price. Read more on the next page…