2017/12 - Confused by the Medicare Access and CHIP Reauthorization Act’s (MACRA) Merit-
Based Incentive Payment System (MIPS) and the Medicare Payment Advisory Commission
(MedPAC)? It seems all is not well and now "
Fixing MACRA Should Mean Fixing the APM Pathway"  
The Medicare Payment Advisory Commission (MedPAC) has been discussing for well over a year
how to reinvent the Medicare Access and CHIP Reauthorization Act’s (MACRA) Merit-Based
Incentive Payment System (MIPS).   As a result the commission intends to finalize substantial MIPS
program reform recommendations in January.  Reading between the lines, it's clear that the
Government's plan is back to square one.

2017/12 - In the article, "Dr. Nuance versus the Crusaders of the Lost Art," Saurabh Jha, MD asks
"Can we please bring back the art of medicine?"

2017/11 - Premium Support: Coming Soon to a Medicare Plan Near You?   - Unnoticed by most of
the media, the Congressional Budget Office recently released a report that could profoundly
change American seniors’ healthcare coverage.

2017/10 - The Rising Cost of Health Care by Year and Its Causes - In 2015, U.S. health care costs
were $3.2 trillion. That makes health care one of the country's largest industries, equaling to 17.8
percent of gross domestic product. In comparison, health care cost $27.2 billion in 1960, just 5
percent of GDP.

2017/08 - Eventually, the share of the American economy absorbed by healthcare will stop rising.
The question is when.  Jonathan Halvorsont proposes there is a solution under our noses that is
nearly ubiquitous in business, personal finance, and government programs worldwide. It can be
used to bring manageable, relatively predictable transformation, rather than sudden wrenching
change. It is a called a “budget.”  
Click here to read more      

2017/07 - The movement in healthcare toward payment for value is in trouble.  Kip Sullivan raises
a few worthy questions in the following articles.

The verdict is in: All three of CMS’s ‘medical home’ demonstrations have failed

Practicing Medicine While Black  

MedPAC Sinks Deeper Into the MACRA Tar Pit    (Part 2: Super Macranomics)    

On the Ethics of Accountable Care Research   

How CMS Undermines ACOs and What to do About It   

ACO Turnover is High. Doctors Have Few Patients, and Those Patients are Unusually Healthy

The ACO Information Vacuum

Would ACOs Work if They Were Turned into HMOs?

Value-Based Purchasing and “Free Lunch Syndrome”

Why We Have so Little Useful Research on ACOs

Simulated ACOs vs Real-World ACOs

More about ACOs

2017/06 - Sugar and Saturated Fat: Feeding the Parasites of Science -  "Saturated fat is neither
satan, nor saint. It is not the scapegoat some were seeking or perhaps believed it to be, nor any
kind of silver bullet - in coffee, or elsewhere. It is not the one thing wrong with our diets, any more
than it is the one thing to fix them. In fact, it isn’t one thing at all - it is a diverse class of compounds
with very different metabolic effects.

2017/05 - When the  Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was
enacted it replaced the broken Sustainable Growth Rate (SGR) formula MEDICARE had previously
operated under.  Now we learn MACRA is also broken.  Perhaps it’s time for Congress to recognize
that poorly thought out regulations will always be a problem.  It’s that bothersome issue called
unintended consequences.  Because something sounds good doesn’t mean it will work.  Really,
who could be against payment for value?  Apparently, it’s  anyone that’s actually tried to measure
value in healthcare.  So far, no one knows an actuarially valid way to make it work.  Read more at
MACRA is broken.

2017/04 - Imagine how the economist Friedrich Hayek might have characterized the healthcare
debate in 2017 - The health care policy you should support is the simple kind – the one that gives
maximum flexibility to the two most important players in the health care tangle - the patient and
their doctor.

2017/03 - Is DRexit Next? - Will the heavy hand of the Government create a backlash?  Some
predict that unless something is done to stop MACRA implementation physicians will opt-out of
Medicare and Medicaid.  Perhaps once DRexit begins, there will be no turning back.

2017/02  - The Last Heart Attack - In this documentary, Dr. Sanjay Gupta investigates whether diet
and the latest diagnostic tests are enough to prevent every heart attack. During the medical
journey of discovery, Dr. Gupta talks to former President Clinton, cutting edge doctors and puts his
own heart under the microscope as he offers practical advice and hard science to shows how we
could have...The Last Heart Attack.

2017/02 - More Than an Apple a Day: Preventing Our Most Common Diseases - In this rousing
and motivational video, Dr. Michael Greger explores the role diet can play in preventing,
arresting and even reversing many of our most common ailments. A founding member of the
American College of Lifestyle Medicine, Dr. Greger is a physician, author and internationally
recognized speaker on nutrition, food safety and public health issues. Dr. Greger’s offers a free
nutrition newsletter at http://www.nutritionfacts.org/subscribe and an excerpt from his
best selling book, "How Not To Die".

2017/01 - Medicare: A Study in Chaos – Our evolving health care system is leading to runaway
costs along with growing patient and physician malcontent.  There is a yearning for a more
personal patient-doctors relationship.  Is there a way out of the impending chaos?  Part of the
answer is in Dr. Kenneth Fisher’s brief history of how we got here.

2017/01 - Ten Questions Walter Cronkite Would Have Asked About Health Care Reform -
Congress enacted a health care plan that won't work and will cost taxpayers a fortune for
generations to come.  And yet, rarely do we hear an informative discussion of the most important

2017/01 - The Nation is Divided about the Affordable Care Act.  Some parts of the law are popular,
like protections against denial of coverage due to pre-existing condition.  However, the individual
mandate became a rallying cry for opponents who saw it as becoming government run health
Click here for an interesting opinion about what may change in 2017.

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