Texas Solution to ED Balance Billing Comes Under Fire
avatar

Tug of War Between Plan and Provider

A recently published report, Surprise Medical Bills Take Advantage of Texans by the Center for Public Policy Priorities, a non-profit research organization in Texas, has condemned, as inadequate protection for consumers, the legislative ‘solution’ to balance billing for out-of-network physician services in hospitals that are contracted with health plans. The report says “Texas consumers may reasonably expect that if treated in an in-network hospital in an emergency, the physicians practicing within that hospital would also … Continue reading

EmailLinkedInTwitterStumbleUponFacebookGoogle+Share/Bookmark
Posted in Managed Care Contracting, Payment Reform, Rants, The ER Experience | Tagged , , , , , , , , , , | 2 Comments

Medicaid Expansion: Is This a ‘No-Brainer’?
avatar

Leaving Money on the Table

  Should the states that have thus far turned up their noses at federal subsidies to expand Medicaid coverage to their citizens under Obamacare be praised for upholding conservative principles and fiscal responsibility, or derided for ignoring the needs of their poorest citizens and being penny wise and dollar stupid? When this issue is discussed in the media, in state legislatures and governor’s mansions, and in public policy discourse: this question is as often framed … Continue reading

Posted in Health Care Reform, Medicaid | Tagged , , , , , , , , | 2 Comments

Ebola: Is ‘Don’t Panic’ the Right Message?
avatar

Ebola:  Is 'Don't Panic' the Right Message?

If you do a search on Ebola on the net, there are tons of articles, blogs, and editorials from outlets like CNN and the LA Times to Al Jazeera and even scientific publications like Microbeworld, encouraging us all not to panic about the Ebola epidemic – but is ‘Don’t Panic’ the right message? I am certainly no expert on Ebola, and I do get the need for the government and health organizations to counter the … Continue reading

Posted in Peering into the Future, The ER Experience, Uncategorized | Tagged , , , , , , , , , , , | Leave a comment

Safe Pain Med Prescribing in the Emergency Department
avatar

Pain Med Prescriptions in the ED

Recently, the California Chapter of the American College of Emergency Physicians has endorsed and is promoting the efforts of Dr. Roneet Lev and in San Diego and Dr. Maureen McCullough in Los Angeles and others to implement Safe Pain Medication Prescribing policies and tools throughout California’s EDs. The model for this effort came out of Washington State ACEP’s response to a challenge to reduce the cost of Medicaid ED visits, and prior work done by … Continue reading

Posted in Bending the Cost Curve, The ER Experience | Tagged , , , , , , , , , , | Leave a comment

Why Do Physicians Over-test and Over-treat?
avatar

Over-testing....why not?

What prompts physicians to over-test and over-treat patients?  This is a very big and important question, and I find it sometimes helps to make a list when I am trying to get my arms around this kind of multifactorial issue. This list isn’t an attempt to be complete or even statistically valid or evidence based, but it does reflect some of the thoughts and studies that have been published on this question. In no particular … Continue reading

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