We reviewed the 'best" Health Train Express posts of 2013 as measured by the number of comments and our analytics.
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Showing posts with label health train. Show all posts
Showing posts with label health train. Show all posts
Friday, January 3, 2014
Looking Back at 2013
This report is somewhat late due to last minute projects at the end of 2013 and the confusion about the individual mandate, the botched launching of health benefit exchanges and some other unexpected tasks
We reviewed the 'best" Health Train Express posts of 2013 as measured by the number of comments and our analytics.
We reviewed the 'best" Health Train Express posts of 2013 as measured by the number of comments and our analytics.
Sunday, December 15, 2013
Freedom of Information Act Request filed by Health Train Express
Doctors Complain They Will Be Paid Less by Exchange Plans. Many will opt out of private plans. News reports indicate that 70% of California MDs will not participate in the Health Exchange and the Private plans Some have complained to medical associations, including those in New York, California, Connecticut, Texas and Georgia, saying the discounted rates could lead to a two-tiered system in which fewer doctors participate, potentially making it harder for consumers to get the care they need.
Insurance officials acknowledge they have reduced rates in some plans, saying they are under enormous pressure to keep premiums affordable. They say physicians will make up for the lower pay by seeing more patients, since the plans tend to have smaller networks of doctors.
If you’re a physician and you’ve negotiated a rate from insurance, shouldn’t it be the same on or off the exchange?” said Matthew Katz, executive vice president of the Connecticut State Medical Society. “You’re providing the same service.”
Insurance officials acknowledge they have reduced rates in some plans, saying they are under enormous pressure to keep premiums affordable. They say physicians will make up for the lower pay by seeing more patients, since the plans tend to have smaller networks of doctors.
If you’re a physician and you’ve negotiated a rate from insurance, shouldn’t it be the same on or off the exchange?” said Matthew Katz, executive vice president of the Connecticut State Medical Society. “You’re providing the same service.”
The benchmark for physician fees is the rate the federal government sets for services provided to older Americans through Medicare. In many markets, commercial plans may pay slightly above the Medicare rates, while doctors say that many of the new exchange plans are offering rates below that.
Physicians are uncomfortable discussing their rates because of antitrust laws, and insurers say the information is proprietary. But information cobbled together from interviews suggests that if the Medicare pays $90 for an office visit of a complex nature, and a commercial plan pays $100 or more, some exchange plans are offering $60 to $70. Doctors say the insurers have not always clearly spelled out the proposed rate reductions.
Health Train Express has filed a FOIA request from CMS (Freedom of Information Act which will require full disclosure to the providers and public (ie, transparency that Obama claims to encourage) Watch for the published link in about one month
Health Train Express has filed a FOIA request from CMS (Freedom of Information Act which will require full disclosure to the providers and public (ie, transparency that Obama claims to encourage) Watch for the published link in about one month
Tuesday, December 10, 2013
CMS AND ONC ACT TO SLOW DOWN THE HEALTH TRAIN EXPRESS
The Center for Medicare Services and the Office of the National Coordinator are responding to the intense "push back' from providers, insurance companies, health consultants and others. Realizing the debacle of Healthcare.gov may be a tremor of impending catastrophic health reform failure they have chosen to 'back off' and delay several major milestones for HIT.
Numerous mandates for the Affordable Care Act have been delayed due to what seems to be a systemic overload of HHS and other regulatory agencies that go beyond the Affordable Care Act.
1. Individual Mandate
2. Last date of enrollment on Healthcare.gov pushed back to December 23rd for a January 1 2014 enrollment. (Is this another pipe dream? 7 days from enrollment to eligibility with authentication of finances?..Another example of fantasy planning by Obama and his administration..
These delays are only the tip of an iceberg upon which the Titanic Obamacare ship founders.
Early on in 2010 shortly after the Affordable Care Act became law, the DOJ warned about employer sponsored health plans. Rather than the Health Benefit Exchange impacting on only five percent of the population, the actual numbers willl be much greater perhaps as great as 80% excluding public programs.
Numerous mandates for the Affordable Care Act have been delayed due to what seems to be a systemic overload of HHS and other regulatory agencies that go beyond the Affordable Care Act.
1. Individual Mandate
2. Last date of enrollment on Healthcare.gov pushed back to December 23rd for a January 1 2014 enrollment. (Is this another pipe dream? 7 days from enrollment to eligibility with authentication of finances?..Another example of fantasy planning by Obama and his administration..
These delays are only the tip of an iceberg upon which the Titanic Obamacare ship founders.
Early on in 2010 shortly after the Affordable Care Act became law, the DOJ warned about employer sponsored health plans. Rather than the Health Benefit Exchange impacting on only five percent of the population, the actual numbers willl be much greater perhaps as great as 80% excluding public programs.
Sunday, October 6, 2013
Arriving Track 1 on the Affordable Care Act
Where you stand depends on where you sit
Please stand back to avoid being ‘sucked’ under the train. Wait until the train has come to a complete stop before boarding or exiting (that may take some time)
Take some time to read the entire blog post from Phil Levy, the author of “Not running a hospital”
Friday, January 12, 2007
Which Locomotive are you in Front of?
This article in Southern California Physician in early January seemed to juxtapose with the title of my blog. Lytton Smith M.D. categorizes five different locomotives in the "health train express" which threaten to either derail or provide synergy in converting our present health care non-system into an efficient one focused on optimal patient care and outcomes.
With his permission I have copied a few key remarks:
After 30 years in healthcare, I think of these payment conflicts as locomotives of varying size and power. Each train carries a different constituency.Locomotive No. 1 represents the health plans. Thinking they drive the healthcare train, they charge ahead. Focusing on profits to maintain their stock value causes them to ignore the economics of actually paying for the care they expect from physicians and hospitals.Locomotive No. 2 includes hospitals. They carry the EMTALA burden as best they can. Despite complaining about being underpaid, many thrive by billing high charges for basic services. Health plans ignore the hospital charges because they are contracted. The hospitals with poor payer mixes and poor contracts close their doors or sell to alleviate their burden.Shoveling coal in Locomotive No. 3, the physicians rattle down their track. Due to antitrust rules and their own sense of independence, physicians have trouble coordinating the function of their train. With so many internal conflicts--group practice vs. solo practice, primary care vs. specialties--who has time to watch where the train is headed?In flashy Locomotive No. 4, a scenic rail car, are the legislators. With their top-rated medical insurance and VIP status, they protect themselves from the vicissitudes of medical financial struggles by passing laws to assure themselves that all will be well. Locomotive No. 4, fueled often by the engineers of Locomotive No. 1, looks sleek and rumbles along, trying to avoid seeing Locomotive No. 5.Locomotive No. 5 is the longest train of all, containing patients. With many classes of service, it consumes enormous energy as it moves down the track. Like No. 3, No. 5 has no focused leadership. But because of its enormous size, this train has the most potential momentum. No. 5 occupies the most important track as all the other trains exist to serve it.If Locomotives No. 1, 2 and 3 cannot resolve "fair and reasonable" vs. "usual and customary" issues, I fear that Locomotive No. 5 will push Locomotive No. 4 into crushing the others. The resulting collision will create a force for a single-payer system. The drive for all parties to "get their fair share" may result in an oligarchy in which no one is well served. In this environment, mavericks like Dr. Reddy will surely need to look elsewhere for financial satisfaction.Lytton W. Smith, MD, editor for the OCMA, is a physician practicing family medicine with the St. Jude Heritage Medical Group in Yorba Linda. Dr. Smith welcomes feedback on his articles and can be reached at editor@socalphys.com.
Perhaps the advent of social health care blogs and the entry of consumer driven plans and opinons will become the "caboose"
www.socalphys.com
With his permission I have copied a few key remarks:
After 30 years in healthcare, I think of these payment conflicts as locomotives of varying size and power. Each train carries a different constituency.Locomotive No. 1 represents the health plans. Thinking they drive the healthcare train, they charge ahead. Focusing on profits to maintain their stock value causes them to ignore the economics of actually paying for the care they expect from physicians and hospitals.Locomotive No. 2 includes hospitals. They carry the EMTALA burden as best they can. Despite complaining about being underpaid, many thrive by billing high charges for basic services. Health plans ignore the hospital charges because they are contracted. The hospitals with poor payer mixes and poor contracts close their doors or sell to alleviate their burden.Shoveling coal in Locomotive No. 3, the physicians rattle down their track. Due to antitrust rules and their own sense of independence, physicians have trouble coordinating the function of their train. With so many internal conflicts--group practice vs. solo practice, primary care vs. specialties--who has time to watch where the train is headed?In flashy Locomotive No. 4, a scenic rail car, are the legislators. With their top-rated medical insurance and VIP status, they protect themselves from the vicissitudes of medical financial struggles by passing laws to assure themselves that all will be well. Locomotive No. 4, fueled often by the engineers of Locomotive No. 1, looks sleek and rumbles along, trying to avoid seeing Locomotive No. 5.Locomotive No. 5 is the longest train of all, containing patients. With many classes of service, it consumes enormous energy as it moves down the track. Like No. 3, No. 5 has no focused leadership. But because of its enormous size, this train has the most potential momentum. No. 5 occupies the most important track as all the other trains exist to serve it.If Locomotives No. 1, 2 and 3 cannot resolve "fair and reasonable" vs. "usual and customary" issues, I fear that Locomotive No. 5 will push Locomotive No. 4 into crushing the others. The resulting collision will create a force for a single-payer system. The drive for all parties to "get their fair share" may result in an oligarchy in which no one is well served. In this environment, mavericks like Dr. Reddy will surely need to look elsewhere for financial satisfaction.Lytton W. Smith, MD, editor for the OCMA, is a physician practicing family medicine with the St. Jude Heritage Medical Group in Yorba Linda. Dr. Smith welcomes feedback on his articles and can be reached at editor@socalphys.com.
Perhaps the advent of social health care blogs and the entry of consumer driven plans and opinons will become the "caboose"
www.socalphys.com
Saturday, December 30, 2006
The Cusp of 2006
As we end 2006 I want to thank Dimitriy for involving me with The Medical Blog Network.
For the past two years my involvement with a RHIO and Health Information Technology have given me the opportunity to meet and learn from other professionals about improving healthcare.
A fresh outlook is always a good thing. I am convinced that patients must have involvement and ownership of their healthcare "system"; it is in fact an essential element to move forward.
Government alone, nor payors nor employers can perform this great task alone.
So I wish all of you a happy and health 2007, and hope that we all do not "pay for performance".
I invite you to read my further comments at healthtrain express www.healthtrain.blogspot.com
Gary Levin
For the past two years my involvement with a RHIO and Health Information Technology have given me the opportunity to meet and learn from other professionals about improving healthcare.
A fresh outlook is always a good thing. I am convinced that patients must have involvement and ownership of their healthcare "system"; it is in fact an essential element to move forward.
Government alone, nor payors nor employers can perform this great task alone.
So I wish all of you a happy and health 2007, and hope that we all do not "pay for performance".
I invite you to read my further comments at healthtrain express www.healthtrain.blogspot.com
Gary Levin
Tuesday, December 5, 2006
Web Seminars from Microsoft
As I have traveled along the health highway several trains have either run over me or passed me by.
In some cases all is well, but in others I have been caught on the track and unable to “get out of the way”
In today’s world one has to be a visionary with an open mind to see all the possibilities that are on the horizon or already quietly developing without your knowledge. Knowledge is power and the limiting factor on gathering important knowledge for you as a physician is critical.
It is as important to know what not to read as it is to read the sources that are credible and reliable. One also has to have discernment to differentiate between them. Time is wasted reading the wrong material, time that would be better spent relaxing.
In your daily activities operating, seeing clinic patients, overseeing business affairs, and keeping up with CME, licensure, credentialing requirements, legal affairs and business plans it is no wonder you may be tired and/or fed up by the end of a day. Balance is key to medical practice success as is location is to real estate.
Are you an entrepreneur and own your practice, or does it own you? Almost all physicians see themselves as entrepreneurs, but they are not. We as physicians set up our own businesses but are truly just “technicians”, be it medical or business. Entrepeneurship is entirely different…..requiring visionary thinking, not replicating something already in existence.
Have you read “E-Myth” by Michael Gerber, or his new book “The Dreaming Room”? Mr Gerber gave an eloquent and exciting presentation via Microsoft Live Web Conference on Tuesday December 5 2006. This web presentation is now archived. Judging from this initial presentation sponsored by Microsoft, and Intel the remainder of the series will also be dynamite. The series can be found at:
· Michael Gerber, December 5. 'E-myth' author kicks off Office Live seminar series. Register now.
· Stephen Covey, December 12,=. Get free small business advice from Stephen Covey. Register now.
Microsoft Office Live Seminar: The Age of the Alpha Dog with Donna Fenn https://msevents.microsoft.com/cui/r.aspx?t=2&c=en-us&r=1287133118
Microsoft Office Live Seminar: Lessons of The Natural Entrepreneur with Andrè Taylor
https://msevents.microsoft.com/cui/r.aspx?t=2&c=en-us&r=1287133041
Microsoft Office Live Seminar: Effectively Influencing Up with Marshall Goldsmith
https://msevents.microsoft.com/cui/r.aspx?t=2&c=en-us&r=1287133099
Microsoft requires that you have a “Passport Account”. If you have a hotmail email or msn email you already have a “passport”. If not it is simple to acquire one.
I was surprised at the quality of these webinars, totally not technical in nature and of interest to all who are in business or the professions.
So, the health train is about to leave the station ..Will you be on it??
In some cases all is well, but in others I have been caught on the track and unable to “get out of the way”
In today’s world one has to be a visionary with an open mind to see all the possibilities that are on the horizon or already quietly developing without your knowledge. Knowledge is power and the limiting factor on gathering important knowledge for you as a physician is critical.
It is as important to know what not to read as it is to read the sources that are credible and reliable. One also has to have discernment to differentiate between them. Time is wasted reading the wrong material, time that would be better spent relaxing.
In your daily activities operating, seeing clinic patients, overseeing business affairs, and keeping up with CME, licensure, credentialing requirements, legal affairs and business plans it is no wonder you may be tired and/or fed up by the end of a day. Balance is key to medical practice success as is location is to real estate.
Are you an entrepreneur and own your practice, or does it own you? Almost all physicians see themselves as entrepreneurs, but they are not. We as physicians set up our own businesses but are truly just “technicians”, be it medical or business. Entrepeneurship is entirely different…..requiring visionary thinking, not replicating something already in existence.
Have you read “E-Myth” by Michael Gerber, or his new book “The Dreaming Room”? Mr Gerber gave an eloquent and exciting presentation via Microsoft Live Web Conference on Tuesday December 5 2006. This web presentation is now archived. Judging from this initial presentation sponsored by Microsoft, and Intel the remainder of the series will also be dynamite. The series can be found at:
· Michael Gerber, December 5. 'E-myth' author kicks off Office Live seminar series. Register now.
· Stephen Covey, December 12,=. Get free small business advice from Stephen Covey. Register now.
Microsoft Office Live Seminar: The Age of the Alpha Dog with Donna Fenn https://msevents.microsoft.com/cui/r.aspx?t=2&c=en-us&r=1287133118
Microsoft Office Live Seminar: Lessons of The Natural Entrepreneur with Andrè Taylor
https://msevents.microsoft.com/cui/r.aspx?t=2&c=en-us&r=1287133041
Microsoft Office Live Seminar: Effectively Influencing Up with Marshall Goldsmith
https://msevents.microsoft.com/cui/r.aspx?t=2&c=en-us&r=1287133099
Microsoft requires that you have a “Passport Account”. If you have a hotmail email or msn email you already have a “passport”. If not it is simple to acquire one.
I was surprised at the quality of these webinars, totally not technical in nature and of interest to all who are in business or the professions.
So, the health train is about to leave the station ..Will you be on it??
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