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The Insurance Companies That Are Most Likely To Refuse To Pay Doctors
Healthcare reimbursement in the U.S. is frighteningly complex. We have federal payers, like Medicare; state/federal payers, like Medicaid; private, for-profit insurance companies, like Aetna; private, not for profit insurers, like many local Blue Cross Blue Shield networks. Oh yes, and we have private insurance companies managing reimbursement for many Medicare and Medicaid recipients. This complexity…
Genetic Testing Can’t Do Our Behavioral Dirty Work
Here is the opening of a recent media story, reporting on a noble attempt researchers made to promote colon cancer screening by telling people when their genetic risk of such cancer was elevated: People at average-risk for colorectal cancer (CRC) who underwent genetic and environmental risk assessment (GERA) to evaluate their risk for CRC were…
Podcast on Healthcare.gov 3.0
The Managing Editor of the New England Journal of Medicine interviewed me about the piece I wrote, with David Comerford and Eric Johnson, on redesigning the health insurance exchanges. For those of you with long commutes, here is that podcast: Healthcare.gov 3.0
How To Tell Someone That She Is Dying
Elizabeth’s breast cancer had already spread to her bones and was now invading lymph nodes in her right armpit, causing painful swelling that kept her up at night. Today, however, as she walked into her oncologist’s office, Elizabeth felt like things were under control. “All right, so how is your arm?” the oncologist asked. “Actually,…
It's Physician Pay, Stupid!
In 2006, health-care expenditures in the U.S. rose 6%, a rate of growth significantly higher than inflation and one that, if sustained, would lead to a doubling in health-care spending in a mere dozen years. Some of that extra spending was a function of more doctors doing more things to more people—an increasing number of…
Nearing the End of the Solo Medical Practitioner
I teach an undergraduate health policy class at Duke, populated in part by ambitious premeds. (Sorry for that last bit of redundancy.) One of the things I like to emphasize in the class is the kind of medical practice milieu students can expect to encounter when they finally become physicians. That’s a good way to…