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Category: CMS Medicare Medicaid

A proposal to make the Social History more robust and proactive

October 2, 2014 Interviewed by Steven E. Greer, MD

Joseph Rhatigan, MD of Harvard Medical School published a paper in the NEJM proposing was to enhance the current social history section of the H&P. He explains how factors currently ignored by doctors, such as income and living conditions, are important to the compliance of the patient. The new ACA law might also make it financially rewarding for doctors to pay more attention to these issues.

Senator Angus King discusses the slowdown in healthcare costs

July 9, 2014- Interviewed by Steven E. Greer, MD

Senator Angus King from Maine discusses the various forces that are working to keep healthcare cost growth the slowest in decades.

The clinical hurdles to prescribing CGM

October 31, 2014- Interviewed by Steven E. Greer, MD

The portion of total Type 1 diabetes patients who use continuous glucose monitors (CGM) are still far less than 50%. We interviewed  the CEO of Dexcom, Terry Gregg, with diabetes expert Jay Skyler, MD, from Miami, to discuss the clinical hurdles to prescribing CGM.

Disclaimer: Dr. Skyler has various relationships with Dexcom.

Has the ACA law begun to reduce the uninsured, and at what cost?

July 27, 2014- Interviewed by Steven E. Greer, MD

Ben Sommers, MD PhD, from the Harvard School of Public Health has a new article in the NEJM that attempts to quantify the total number of uninsured people in the country, and map it out temporally to show whether the newly implemented Obamacare law is working as intended.

The Medicaid Roundtable

Part 1: Medicaid primer

Part 2: State spending on Medicaid

Part 3: Impact of Medicaid expansion to hospitals, states, and mortality

Part 4: Efforts by individual states to reform Medicaid away from fee-for-service

Part 5: Will other states adopt bundled payment plans for Medicaid and stop fee-for-service?

Part 6: What does the ACA ObamaCare law mean for Medicaid?

Part 7: Will individual state reforms of Medicaid lead to a more global reform of American healthcare?

Part 8: Impact the healthcare companies

Part 9: The outcome of the election and Medicaid/ACA law

How many stent cases does it take to bill Medicare for $18 Million?

Melgen with Obama and MendezApril 9, 2014- By Steven E. Greer, MD

The release of data by Medicare showing what each doctor earns from billing CMS is making news for the outlier doctors who billed for millions. One Miami ophthalmologist, for example, billed for $21 Million in 2012 alone. Also catching our eye was another Florida interventional cardiologist who billed for $18.1 Million.

Just how many stent cases per day would he have had to have performed to bill for $18.1 Million? We asked Dr. William O’Neill of Henry Ford Hospital. Read more »

Occluding the left atrial appendage to prevent stroke in A-fib

Thromboembolic stroke caused by atrial fibrillation is the primary reason patients are placed on anticoagulation. However, those blood thinners also carry significant bleeding risks. As a result, various mechanical surgical approaches have been tried to prevent stroke, and obviate the blood thinners.

The newly approved Boston Scientific Watchman left atrial appendage occlusion device aims to prevent clots from forming and migrating to the brain. We interviewed Dr. William O’Neill of Henry Ford Hospital, a leading interventional cardiologist, about the Watchman, and whether it will truly allow patients with A-fib to stop warfarin or other blood thinners.

Don Berwick, MD: State health insurance exchanges

The finances of TAVI: do prices have to come down?

Interviewed by Steven E. Greer, MD

William O’Neill, MD of Henry Ford discusses the finances of transapical aortic valve implantation (TAVI) and why the $30,000 pricetag for the devices should be closer to $5,000. He also discusses the overall market size for TAVI.

Don Berwick, MD: Waste in the American Healthcare System

Dr. Berwick, former Director of CMS and former President and CEO of IHI, discusses the percentage of waste in the American Healthcare System. He also mentions the new proposals by nine specialties recommending that 45 procedures and tests be performed less often as they are almost always unnecessary.

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