News

New study reinforces SDoH impact Focus on the social determinants of health (SDoH) continues to intensify nationwide, and that means potentially higher costs of care for healthcare organizations. The recent study by NPR, the Robert Wood Johnson Foundation, and the Harvard University T.H. Chan School of Public Health has the…
Hospital medical records are under scrutiny by the Centers for Medicare & Medicaid Services.  Via two unrelated changes, the Centers for Medicare & Medicaid Services (CMS) is targeting the hospital medical record for added scrutiny. It is clear that caring for patients during the COVID-19 pandemic costs more than during…
The Social Dilemma of Health (SDoH). In March 2018, the world was shocked when it became public knowledge that Cambridge Analytica, a company based in the United Kingdom, had used data from Facebook to impact the presidential election in the United States. It turned out that they had also provided…
The Centers for Medicare & Medicaid Services (CMS) recently announced updates to the 2021 Medicare Physician Fee Schedule (MPFS). Among them are unprecedented increases in relative value units (RVUs) associated with office-based evaluation and management (E&M) visits. Under these changes, CMS will reimburse a greater number of RVUs. Then, in…
This has been a humbling six months to be an American and an emergency physician. It seems like we have gone from one crisis to the next, with COVID-19 persistently in the background, ready to ignite when too many people ignore it or get sloppy about prevention because of fatigue.…
Recently, as I was speaking with one of my colleagues who specializes in reviewing and negotiating agreements with third-party payers, she lamented that no one reads their provider agreement anymore.  I fear that she may be right. Reading a provider contract is not exactly a hoot. If you combine that with the…
By now we’ve all heard the words “anyone who wants a COVID test can have one.” Occasionally, that claim is followed by the word “free,” or “no copay or deductible.” Such statements make great news and sound bites, but it leaves people like me wondering: where’s the catch? Accepting a…
Medicare spending on acute-care inpatient hospital services will increase by about $3.5 billion in FY 2021 As the healthcare industry continues to be buffeted by the unrelenting coronavirus pandemic, the Centers for Medicare & Medicaid Services (CMS) has released the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital…