Matthew Hahn, MD May 8, 2017
The American health-care system is broken, but it is not really “health-care” that is the problem. The science of medicine, the tests, and the treatments available are better than ever. It is health-care bureaucracy that is the problem. But doctors, nurses, and patients bear the brunt of the dysfunction. Medical professionals are unable to practice, and patients are denied the care they need, even though it is readily available. Careers are being ruined, and lives lost along the way. It is time to fight back.
Instead of focusing on ways to improve patient care, medical professionals today have to wade all day through a jungle of red tape just to get paid, order tests, and deliver treatments. Cumbersome government rules control the details of how we write notes, use a computer, calculate a bill, how much we can charge, who we can admit to the hospital, how long we can treat them, and much, much more.
And for everything we do, there must now be data. The bureaucracy is obsessed with data, to the detriment of everything else. It is tyranny through data. We spend so much time collecting data and running after all of these things that it is a challenge to find the time to actually care for patients! On top of that, newer health insurance policies with high premiums, high deductibles, prior authorizations, and narrow, inscrutable coverage block us from delivering the care patients need. It is health care by government and insurance company fiat. Medical professionals and patients have few choices and little control.
And now, on top of everything else, we face Medicare’s complicated new MACRA “value-based payment” program, which collects data across four categories: Quality Measures, Advancing Care Information, Performance Improvement Activities, and Cost. A physician’s annual score will be compared to the scores of other physicians to determine future Medicare pay increases or penalties. There is a huge effort being made to explain the intricacies of the new program, the first sign that it is too
And for everything we do, there must now be data. The bureaucracy is obsessed with data, to the detriment of everything else. It is tyranny through data. We spend so much time collecting data and running after all of these things that it is a challenge to find the time to actually care for patients! On top of that, newer health insurance policies with high premiums, high deductibles, prior authorizations, and narrow, inscrutable coverage block us from delivering the care patients need. It is health care by government and insurance company fiat. Medical professionals and patients have few choices and little control.
And the sad fact is that none of this data and/or analytics has been shown to improve care or costs. Most studies have been poorly designed, and never been confirmed.
For those of you wish to dive more deeply into . Medicare, MACRA, and other regulatory issues click on these links:
And now, on top of everything else, we face Medicare’s complicated new MACRA “value-based payment” program, which collects data across four categories: Quality Measures, Advancing Care Information, Performance Improvement Activities, and Cost. A physician’s annual score will be compared to the scores of other physicians to determine future Medicare pay increases or penalties. There is a huge effort being made to explain the intricacies of the new program, the first sign that it is too complicated to be of benefit.
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