Concierge physician practices expanding to large hospitals
Editor's Note The practice of concierge physicians is expanding as thousands of doctors at large hospital systems shift to a model facilitating high fees and decreased patient load, according to an April 1 report in KFF Health News. The concierge physician model began decades ago in wealthy areas of Florida…
Private payers profit by delaying medical claims
Editor's Note Private payers initially deny reimbursement on 15% of claims, only to later approve more than half of those initial denials, according to a national survey of healthcare institutions published March 21 by Premiere, Inc. Additionally, the denied claims on average tend to be more prevalent for higher-cost treatments…
How data puts the ‘value’ in value-based care
What if a surgeon decided to perform a procedure on a patient that was not totally necessary? It happens more often that one might realize. As recently as August 2023, Forbes published an article that cited a Harvard Business Review report stating that over 50% of lumbar spine surgeries are…
Medicare offers advance payments for providers impacted by Change Healthcare cyberattack
Editor's Note In a March 9 Press release, CMS announced it will offer emergency funding for healthcare providers experiencing continued disruptions in the wake of a February 21 cyberattack on Change Healthcare, a subsidiary of UnitedHealthGroup and a major processor of medical claims. According to the release, CMS will extend…
Session: What to expect from healthcare policy, regulation in 2024
Editor's Note Since the pandemic, the view of the healthcare industry in congress has essentially gone from “hero to zero” – a shift with potentially big implications for the healthcare business leaders gathered at yesterday’s closing session from Soumi Saha, PharmD, JD, senior vice president of government affairs at Premier…
Session: What are the legal implications of AI in healthcare?
Editor's Note How will healthcare regulators deal with artificial intelligence? How will malpractice law change, and who will be liable for harm derived from AI diagnosis and treatment recommendations? What can be done about bias in AI? Even amid a surge in algorithms cleared by the FDA, all of these…
Bipartisan congressional letter calls for end to Medicare payment cuts
Editor's Note Nearly 200 members of Congress co-signed a letter urging House and Senate leaders to act quickly in order to prevent a 3.37% cut to Medicare reimbursement payments that was scheduled to take effect on January 1, 2024. The American Medical Association, which supports the effort, reported the news…
Gender pay gap identified for gastroenterologists
Editor's Note According to a report by researchers from the University of Virginia Healthcare System, there is a significant gender pay gap in Center for Medical Services (CMS) reimbursements for gastroenterologists, Gastroenterology & Endoscopy News October 19 reports. The findings were reported in this poster presentation as well as first…
Women neurosurgeons receive half the Medicare reimbursement of male counterparts
Editor's Note From 2013 to 2020, women neurosurgeons received half the reimbursement dollars from Medicare compared to their male counterparts, JAMA Network October 11 reports. This investigative study, titled "Gender differences in Medicare practice and payments to neurosurgeons," was published by JAMA Surgery. The researchers analyzed data for 6,052 neurosurgeons…
Cardiac interventional procedures are shifting from hospitals to ASCs
Editor's Note At ACC.23 (the American College of Cardiology 2023 conference), Sunil Rao, MD, director of interventional cardiology at NYU Langone and president of the Society of Cardiovascular Angiography and Interventions (SCAI), spoke about the shift in interventional procedures from hospitals to ambulatory surgical centers (ASCs), Cardiovascular Business April 10…
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