- To do want he wants to do, RFK Jr will be head of the wrong agency.
- More than 50% of the AMA’s revenue in 2023, or $266 million, came from a budget category that includes medical billing codes. (Statnews)
- From 1997 to 2011, 85% of the increase in real per-capita Medicare spending was on newly created procedure codes.
- Final House Select Committee report: Covid likely came for the Wuhan lab.
- More than one-third of 100 hospitals reviewed did not properly post machine-readable pricing data, as required by law.
Category: Policy & Legislation
New Findings on Risk Adjustment
Study: About two-thirds of the 41 percent increase between 2011 and 2019 in the share of hospital discharges coded as the highest severity was associated with upcoding.
Among patients discharged to a skilled nursing facility (SNF) during 2018–19, MA enrollees had risk scores that averaged 4.1 percent higher, with about 60 percent of that increment associated with chart reviews.
About one-quarter of the risk-score gap between MA and traditional Medicare from 2017 to 19 is due to the failure to consistently capture chronic conditions in fee-for-service claims.
Source: Health Affairs
Why Electronic Medical Records are a Failure of Epic Proportions
Some of the benefits of electronic medical records were supposed to be better care, more efficient care and better care coordination. It didn’t happen that way. In a (now) 5-year old analysis Kaiser Family Foundation discussed what went wrong: The article, Death By 1,000 Clicks: Where Electronic Health Records Went Wrong outlines an all too familiar tale.
Monday Links
- What’s wrong with Thanksgiving. “Land acknowledgements”: There is no legal sense in which the land on which they are being performed belongs to a Native American tribe.
- Why Trump’s pick to head the Department of Labor is worrisome.
- Why identity politics no longer works: “Among people who married in 2022, 32 percent of Asian Americans married outside their ethnic group, as did 30 percent of Hispanics, 23 percent of Black people and 15 percent of white people. In one Pew survey 58 percent of Hispanics also identified as white.” (NYT)
- How much of chronic illness is due to the food we eat?
- Medicare drug payments vary widely:
In central Illinois, Centene priced the cancer drug Lapatinib at $3,622, while Humana’s price was double the amount. It costs $10,000 in certain parts of California and more than $12,000 in the center of Pennsylvania.