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CMS Billing Rules & Family Medicine – Incentives to Over-Treat

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July 22, 2014

I’ll make this one very short. The same realities apply in the CMS documentation, coding, and billing rules that incentivize over-treating as they do for over-testing. If I see a patient with a cough, I don’t prescribe antibiotics, and I give the long speech explaining why they don’t need antibiotics, and I reassure the...
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CMS Billing Rules Subjugate Family Medicine – Incentives to Over-Test

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July 14, 2014

I’m continuing my series on the reasons there are so few family physicians in the U.S. and why the Center for Medicare and Medicaid Services (CMS) is a root cause of this deficit. My conclusions are based on recent research on the topic. This specific issue is a detail that actually wasn’t mentioned often...
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CMS Billing Rules Subjugate Family Medicine – Payment for Complexity and Time

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July 6, 2014

I’m continuing my series on the reasons there are so few family physicians in the U.S. and why the Center for Medicare and Medicaid Services (CMS) is a root cause of this deficit. My conclusions are based on recent research on the topic. If you hired an accountant to do your taxes and after...
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CMS Billing Rules Subjugate Family Medicine – No Payment for Convenient Care

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June 23, 2014

I’m continuing my series on the reasons there are so few family physicians in the U.S. and why the Center for Medicare and Medicaid Services (CMS) is a root cause of this deficit. My conclusions are based on recent research on the topic. Have you ever wondered why doctors tell you to come in...
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CMS Billing Rules Subjugate Family Medicine – Inadequate Payment for Complex Care

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June 16, 2014

I’m continuing my series on the reasons there are so few family physicians in the U.S. and why the Center for Medicare and Medicaid Services (CMS) is a root cause of this deficit. My conclusions are based on recent research on the topic. In my last post, I showed how the American Medical Association’s...
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CMS Billing Rules Subjugate Family Medicine – The AMA and Comprehensive Primary Care

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June 9, 2014

For the next several weeks, I’ll try to explain to non-physician readers why the Center for Medicare and Medicaid Services (CMS) billing rules create the horrid lack of primary care patients experience when they simply want to find a personal physician. My conclusions are based on recent research on the topic. This task is...
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Shall We Overcome? – Reversing Decades of Primary Care Payment Bigotry

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June 4, 2014

OK, I’m back. (I had several weeks of intense work and family obligations). And OK, I’m going to go for it with the payment reform stuff. I will spend the next several weeks trying to explain to a general audience why the payment system for physicians is extremely rigged in favor of the doctors...
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Defending the VA Administrators

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May 20, 2014

The Veterans Administration is once again in the news for several scandals. My disdain for the VA system is well documented. I devoted an entire chapter to the subject in my book, American HealthScare. However, I have some sympathy for the administrators of the VA system, so I thought I’d actually defend them here....
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Hospital-Physician Integration Drive Up Costs to Insured Patients

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May 13, 2014

One of the big reasons Accountable Care Organizations have been mostly disappointing is that the regulators caved to the hospitals in the writing of the Obamacare law. The regulators assumed that hospitals could wring efficiencies out of the healthcare system. Integration of hospitals and physicians was assumed to be good. A new study in...
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Declining Middle Class Incomes and the Role of Healthcare Costs

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April 27, 2014

It was reported a few days ago that U.S. middle class family incomes are now falling behind their counterparts in Canada, and Europe is gaining. Here is an example from a report by CBS News: “While the report confirms what many Americans feel every day when they check their bank accounts — that they’re...
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