Obamacare: 2018 Enrollment is Lower than 2017

Obamacare Open Enrollment came to a close on December 15th, 2018. The start of the 2018 season was slow. The sign-up numbers were much lower than previous years. The enrollment period for this season is half of what is was last year, only lasting six weeks. Medscape reported an increase in numbers during week five. Even so, enrollment is much …

Public Programs Provide Stability for Commercial Insurers

The top five commercial insurers in the United States are UnitedHealthcare, Anthem, Aetna, Cigna, and Humana. Medscape reports these insurers make up 43% of the nation’s population with health insurance coverage. New research has shown that these providers are becoming more reliant on public programs to provide stability. Their profit and growth are becoming more dependent on programs like Medicaid …

The January Patient vs. the June Patient

The Emerging Third Revenue Source If someone were to have questioned a medical provider 10 years ago regarding sources of revenue, the answer would invariably have listed two sources – the government and insurers. As small to medium practice medical providers have become acutely and painfully aware, in the intervening time, patient co-pays, and more significantly, patient deductibles render the …

Physician Payments: Is the Sunshine Act Filling its Purpose?

Created in 2010, the Physician Payments Sunshine Act still intends to create transparency within the healthcare industry. The Centers for Medicare and Medicaid Services (CMS) reports a public database of physician payments. Drug companies must report payments they make to physicians or hospitals. This allows the public to see physicians who earn money from drug companies. CMS feels this will …

Medicaid Participation: Does Parental Coverage Help Children?

Medicaid Participation: Does Parental Coverage Help Children? In the early years of life, the body grows and develops key traits at a rapid rate. The progression and development of a child’s mind and body are crucial for their overall maturation over the course of their life. It is important that children in development stages hit key standards and milestone to …

Physician Freedom: From Being the Man to Working for the Man

Physician Freedom: From Being the Man to Working for the Man

Year after year, regulations and laws continue to pile up on physicians and decrease physician freedom. Although they are meant to create concrete guidelines and progress within the field, these rules are consuming clinicians all over the country. There was a time where physician freedom was elevated, and providers could practice how they saw fit. But this isn’t true anymore, …

Open Payments

Open Payments: Increased Transparency in Healthcare Gains Momentum

When a doctor or hospital has a financial relationship with a manufacturing company, they trade money for things like research, gifts, public speaking, food, and travel. The Affordable Care Act (ACA) requires that when companies and providers make this exchange, they disclose the spending. CMS has created a program called Open Payments that the federal government maintains. CMS works to …

CMS Reveals How Much Physicians Earn

CMS Reveals How Much Physicians Earn

Earlier this year CMS announced that they now have information outlining Medicare data and its relation to how much physicians earn. This type of clarity has not always been available to the public. In the past, CMS could only release information including a physician’s name, address, and phone number. This was because of rules and regulations put in place by …

CMS Makes Medicare Card More Secure

CMS Makes Medicare Card More Secure

Unfortunately, scammers target vulnerable populations including people over the age of 65. It has been this way for centuries and most likely not changed. They aim for older individuals over the phone, claiming to be a representative of Medicare. To inhibit this, CMS has announced they will be issuing more secure Medicare cards to all Medicare recipients starting in 2018. …

Healthcare Plus One Party Turns into a -3 Party

When the Healthcare Plus One Party Turns into a -3 Party

At this juncture, it is abundantly clear that the repeal and replace of Obamacare is not happening in 2017. Even a cursory review of the current trajectory of Obamacare shows that absent real and meaningful corrective action, Obamacare will continue having increasing negative consequences on the general population. This is something upon which both sides of the aisle have readily …

Anthem cuts

Anthem Cuts 17 More Counties from Obamacare

Last week Anthem made yet another announcement about cutting access to Obamacare while insurers across the board continue to withdraw their participation.  As uncertainty continues to rise about the future of the Affordable Care Act, the resulting shakeout could be catastrophic. To date, major payers such as UnitedHealth Group Inc., Humana Inc., and Aetna Inc. have all exited most of …

ACA Healthcare vs. State’s Deathcare

We generally grant the last wish of a person condemned to die if it is reasonable – what happens when the last wish is to be put to death? While America grapples with myriad issues regarding the healthcare of its citizens, the states that allow capital punishment and seem to have ample funding are similarly grappling with which drugs/medications are …

Texas Healthcare in Light of Harvey

Our hearts and prayers are with the many people who are currently suffering in Texas. In addition, we recognize and thank the many people who live in Texas as well as many others who have traveled to Texas along with the many organizations that have pitched in to try to alleviate this unfathomable catastrophe. Ultimately, and unfortunately, the healthcare needs …

Getting Reimbursed for Telehealth

In 2016, telehealth became the No. 1 regulatory concern for health boards across the nation.  Most of their attention was focused on practicing across state lines.  In other words, is the patient located in the state where the provider is licensed during the telehealth visit?  If not, that’s an issue.  While lawmakers and physicians are fighting it out, they are …

Can America Afford Healthcare Reform?

There seems to be a general consensus that American healthcare needs a reset. The basic debate revolves around the extent to which Obamacare, or the ACA, will be modified, augmented or replaced. I do not recall seeing any reasonable solution, however, that will not cost the United States government any money. Accordingly, it might be interesting to look at how …