Medicare Disadvantage?
Some Medicare Advantage health plans have wrongfully denied or delayed prior authorizations and payment requests, according to a new report from the Office of the Inspector General. Are these MA plans genuinely “great” if they only burden patients and providers? Some Background The $412 billion MA market is booming. MA plans saw an 8.8% increase in enrollment this year,…
Read MoreHospitology and Healthcare Huddle – 05/01/2022
BUSINESS Strike. Around 5K Stanford nurses went on strike last week. The ask? Better pay and better staffing. The strike highlights a trend of unionized nurses fighting for better working conditions. The Deets Unionized Stanford nurses have three asks: Provide real solutions for staffing. Offer competitive wages and benefits. Work to address the exodus of nurses from the injury. Stanford nurses and…
Read MoreMedicare Disadvantage?
INSURANCE Medicare Disadvantage? Some Medicare Advantage health plans have wrongfully denied or delayed prior authorizations and payment requests, according to a new report from the Office of the Inspector General. Are these MA plans genuinely “great” if they only burden patients and providers? Some BackgroundThe $412 billion MA market is booming. MA plans saw an 8.8% increase in enrollment…
Read MoreThe Next Frontier of Weight Loss
Eli Lilly’s diabetes drug, tirzepatide, led to a max 22.5% weight loss—or 52 pounds—in adults with obesity or overweight. Some have described tirzepatide’s effects as the “equivalent of inventing nuclear fusion.” Bold statement. But I agree nonetheless that these clinical trial results are a BFD for public health. The Deets Tirzepatide is a GLP-1 receptor agonist mixed with a…
Read MoreThe End.
Covid is still spreading through communities and is by no means “over.” However, this week, the government is likely to decide whether to extend the public health emergency (PHE). If the PHE isn’t renewed, what will the implications be? Implications for Hospitals, Clinicians and Providers Reimbursement ➡️ Medicare has increased reimbursement to hospitals by 20% for treating…
Read MoreThe Death and Life of the “Private Practice Physician”
BUSINESS The Death and Life of the “Private Practice Physician” Is the “private-practice physician” life dead? Around three out of four physicians are now employed by a hospital, health system or corporate entity (PE firm or health insurer). I’d answer, “dead.” For now… The DeetsThe percentage of hospital- or corporate-employed physicians increased 19% over the last three…
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