Exchange Plans Could Undermine ER Safety Net
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Posted on June 16, 2013 by
Exchange Plans - Closed ER - Open

Most everyone assumes that the Patient Protection and Affordable Care Act (PPACA) facilitated Exchange Plans, by increasing the number of insured patients and reducing the rolls of the uninsured, will generate additional revenues for hospital Emergency Departments and emergency physicians.  However, the net effect of these Exchanges and other aspects of the ACA could spell disaster for many emergency care safety net providers.  On the surface, it appears the PPACA should have a positive impact … Continue reading →

Posted in Health Care Reform, Managed Care Contracting, Medicaid, Peering into the Future | Tagged , , , , , , , , , , | Leave a comment

New Recipes for Health Care Delivery
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Posted on May 26, 2013 by
New recipes for health care delivery

My wife is a trained chef, and by definition I guess this means she is always open to new ways to prepare food and new recipes to try.   She certainly creates her share of new recipes, at the rate of about two per week, for her blog, The Wimpy Vegetarian.  I was reminded of the propensity of chefs to forsake the old and adopt the new when Susan tried a new way to prepare corn … Continue reading →

Posted in Bending the Cost Curve, Health Care Reform, Payment Reform, Peering into the Future | Tagged , , , , , , | Leave a comment

How Much Is the Nation Spending on ER Care? Wrong Question
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Posted on May 7, 2013 by
Asking the Wrong Question About ER Care

Recently, Drs. Lee, Schuur, and Zink published an article in Annals of Emergency Medicine that detailed three different approaches to estimating the percentage of total national health care costs that were expended for emergency department care.  The statement in this article that most health care journalists have picked up on is related to the authors’ assertion that spending on ER care could amount to as much as 10% of national health care budget.  This clashes significantly with … Continue reading →

Posted in Bending the Cost Curve, Health Care Reform, Payment Reform | Tagged , , , , , , , , | Leave a comment

Finding the Right Role Model in Response to the Boston Bombings
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Posted on April 23, 2013 by
Grace under fire.

Acts of terrorism in the homeland tend to bring out the best and the worst in us; which makes it all that more important to try to find the right role model to emulate in responding to these major insults to our collective national consciousness.  You might think that we should first look to our political leaders, but you have to be selective.  Hardly anything politicians say gets me inspired or riled up anymore:  I … Continue reading →

Posted in Rants, Uncategorized | Tagged , , , , | 1 Comment

‘Choosing Wisely’ Laying the Groundwork for Denial of Coverage
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Posted on April 13, 2013 by
Coverage Denied: not indicated under Choosing Wisely rules

 When the American College of Emergency Physicians (ACEP) decided not to join the Choosing Wisely campaign, I was among those who expressed disappointment with this decision, in part because I have long been a proponent of efforts to encourage more cost-effective care in the ED.   In fact I had already independently done a significant amount of work in the development of such strategies.  I recognized that there were legitimate concerns about participation in this campaign, … Continue reading →

Posted in Bending the Cost Curve, Health Care Reform, Payment Reform | Tagged , , , , , , , , , , | Leave a comment