Years ago, we had an MD/PhD student in our program who had Eilers-Danlos syndrome, a connective tissue disorder that causes joint laxity and frequent painful joint dislocations. After over a decade of being misdiagnosed, her correct diagnosis was made by a physical therapist, not a physician. I noted in a previous post that I’ve been […]
There are changes coming to the Medicare market place and Medicare Advantage. “Market exits by Humana, Aetna, and UnitedHealthcare will collectively affect nearly 70% of those 1.8 million individuals.” The remainder of the 1.8 million will be looking at new plans with the same insurance provider. The market consisting of people exiting their old Medicare […]
America is the only industrialized nation where you can go bankrupt because of medical care. The ACA helped mitigate that risk for tens of millions, but the Trump Administration is promising to abolish the ACA. For those with some form of health insurance (private insurance, the ACA, Medicare), there’s still the challenge of (a) finding […]
The commentary was initially written at EconoFact by Mark Shepard. I took liberties with this commentary to emphasize the many points the author presents and to make it an easier read. I also added an introduction and some history on the ACA. There is much here to absorb. I felt breaking the commentary out further […]
It has been a bit since I have said anything about the Opioid epidemic. Such was brought on by companies and distributors (more like PBMs) claiming it was harmless and non-addicting. I do want to catch up and see how the Sacklers made out. Whether the Gov finally put the screws to them or did […]
“Medicare Advantage: Questionable Use of Health Risk Assessments Continues to Drive Up Payments to Plans by Billions,” Office of Inspector General | Government Oversight | U.S. Department of Health and Human Services Why OIG Did This Review Medicare Advantage (MA) companies receive higher risk-adjusted payments from CMS for enrollees who are sicker, which helps to […]
The Government made it possible for people to choose between Traditional Medicare and Medicare Advantage for their care at 65. An alternative was provided under the guise of commercial healthcare providing better healthcare and other services to those who qualify for Medicare at a lesser cost. There are superficial and also meaningful pluses that are […]
Robert Devereaux, MD wrote a piece on upcoding at MedPage. “The Trouble With Upcoding Extends Far Beyond Ethics.” This is a topic I have touched upon a couple of times and have experienced myself. Fix the issue I am telling you about if you can or pass me along to someone who can. “The practice […]
Recent articles I have been reading suggest Medicare Advantage provides healthcare at a lesser cost than Traditional Medicare. Or maybe it would be better to qualify this as individuals claim MA plans do so? I do not know whether such takes into consideration the cost of a Supplemental Plan or not and also Part D […]
This week’s Covid coverage includes the most common variants … currently circulating – by r. j. Sigmund Briefly, since the CDC’s Covid demographic metrics continue to recede, albeit slowly. Among the “early indicators” “test positivity”, or the percentage of tests for Covid that were positive, fell to 4.8% during the week ending November 2nd, down […]