Getting serious about health reform, part two – Medicare

As the GOP goes about repealing and replacing ACA, they’ll have to carefully consider how  Medicare will be affected, because it absolutely will be. Briefly, reimbursement, senior drug benefits, hospital funding, and private Medicare Advantage programs were all altered by passage of ACA. Outright repeal … Continue reading Getting serious about health reform, part two – Medicare

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What Medicare’s reimbursement changes mean for work comp

It isn’t possible to exaggerate the implications of the changes to Medicare’s provider fee schedule. When Medicare shifts its weight, the foundations of workers comp move – a lot.  Here’s why. First, around a third of provider reimbursement is governmental – … Continue reading What Medicare’s reimbursement changes mean for work comp

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Which better controls spending – Private insurance or Medicare/Medicaid?

Before you read further, cast your vote… Okay, a couple initial thoughts. First, when comparing health care systems’ ability to control cost over multiple years, the best metric is the cost trend per member; this accounts for differences in demographics and … Continue reading Which better controls spending – Private insurance or Medicare/Medicaid?

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Poor quality of care in work comp and the impact on SSDI and medicare

The estimable Gary Franklin MD, Medical Director of Washington Labor and Industry, weighed in with passion and precision at CWCI; Gary’s message was simple and straightforward: Workers injured on the job get worse and worse and worse, unlike people with … Continue reading Poor quality of care in work comp and the impact on SSDI and medicare

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Medicare doc fix – here we (don’t) go again…

The annual caterwauling about Medicare physician reimbursement has begun. For those who just want the takeaway – there very likely won’t be any substantive, long-term “fix”, but rather another temporary – and very slight – increase in reimbursement. The latest … Continue reading Medicare doc fix – here we (don’t) go again…

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Medicare Set-Asides and Workers’ Comp

I’m gingerly stepping into a topic I’ve mostly avoided to date – MSAs.  I avoid it because it is mind-numbingly complex, seemingly illogical in application, and served by often-contentious vendors. NCCI’s Barry Lipton et al just released an excellent synopsis … Continue reading Medicare Set-Asides and Workers’ Comp

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