As many people are discussing methods to improve healthcare, the Centers for Medicare & Medicaid Services (CMS) is giving stakeholders an opportunity to send in their thoughts on this topic.  In CMS’s April 14, 2017 proposed rule, CMS issued a “Request for Information” (“RFI”), where they described their desire to have a “national conversation” about improving the health care delivery … Continue Reading

The Medicare incentive programs with which you and your medical practice are familiar will soon be no more.  As of January 1, 2017, these programs (including the Electronic Health Records (EHR) Meaningful Use Incentive Program, the Physician Quality Reporting System (PQRS), and the Physician Value-Based Modifier Program) will morph into the new Medicare Quality Payment Program (QPP).   The QPP will … Continue Reading

The long-anticipated implementation of ICD-10 coding finally began this past Thursday, October 1, 2015.  As of that date, government and commercial payors ceased to accept claims under the old coding system (ICD-9).  The transition has been five years in the making due to a government delay in 2012.

The new system has five times the codes of the prior system, … Continue Reading

Adding an interesting wrinkle to an already complex environment, the Federal Trade Commission filed a suit this month to block an Idaho hospital from acquiring a physician practice.  According to an article on thomsonreuters.com, the FTC and the IDAHO Attorney General have filed an antitrust complaint  seeking to block St. Luke’s Health System’s acquisition of Saltzer Medical Group, a … Continue Reading

I imagine that few physicians contemplated being part of organized labor when they enrolled in medical school but as more and more physicians make the leap from private practice to hospital employment, perhaps large-scale unionization of the physician workforce could become a reality.  According to an article by David J. Leffell today on WSJ.com, the notion is perhaps not as … Continue Reading

 The term "concierge medicine" conjures images of exclusivity, special treatment and high cost.  But can the concept be adapted to appeal to the masses?  With an impending shortages of doctors – particularly in primary care – and many more patients covered by insurance than ever before (under the Affordable Care Act), there is a reasonably good chance that patients will … Continue Reading

According to a recent study published in the Journal of the Association of American Medical Colleges, a primary care physician who graduates with education debt of $160,000 should be able to raise a family, live in an expensive urban area, and repay their debt in 10 years without incurring additional debt, as long as their household income and spending … Continue Reading

Federal antitrust enforcement authorities have historically not gotten too excited about hospitals acquiring physician practices.  However, it is apparent from recent enforcement activity that the Federal Trade Commission (FTC) is keeping a wary eye on physician/hospital integration. According to the American Medical News, the FTC recently ordered a Nevada health system to allow a number of its "acquired" cardiologists out … Continue Reading

As the debate regarding healthcare reform rages on, perhaps too often the blame for rising health care costs is pointed at physicians, and as a result, physician reimbursement has historically been an easy target for cost-cutting. Unfortunately, as a recent New York Times article illustrates, in only a few short years, the demand for healthcare services in the United States … Continue Reading

According to an article in the Arizona Republic posted on AZcentral.com, Health Net of Arizona has begun offering a new "narrow network" HMO product to employers in conjunction with Banner Health, a health system offering healthcare services in seven western states.  Under the new plan, employers will receive premium discounts for limiting their network of providers to the newly formed "Banner Health … Continue Reading