Dr. Niran Al-Agba

Is the Marital Status of a 5 year old Child Important?

Doctors have spent decades honing their clinical skills and should be entitled to choose the documentation method they find most effective and efficient. Some physicians find electronic records helpful and should be encouraged to use them. My pediatric practice will keep surviving on a shoestring, a prayer, and good old-fashioned paper. It warms my heart to know each chart note contains helpful information and not one human being leaves with NONE as their diagnosis.

Niran Al-Agba2020-05-26T02:14:29+00:00January 16, 2018|Categories: Policy, Practice|Tags: Burnout, EHR, Electronic Records, EMR, Government Medicine, Health Policy, MACRA, Physician Autonomy|

Blood, Guts, and MACRA

DR-Exit: Sean MacStiofain said “most revolutions are caused… by the stupidity and brutality of governments.” Regulation without legitimacy, predictability and fairness always leads to backlash instead of compliance. If something is not done to stop MACRA implementation, more physicians will opt-out of Medicare and Medicaid than is fathomable. Once DRexit begins, there will be no turning back.

Niran Al-Agba2020-05-14T03:29:09+00:00February 28, 2017|Categories: Policy|Tags: Affordable Care, Consolidation, DRexit, Hospitals, MACRA, MIPS, Physician Autonomy, Rural Care|

Gaming the System: Pediatrics, Mammograms, and MACRA

Imagine what quality metrics the pediatric cardiac surgeon is going to track. He would do well to collect statistics on how often he images patients for appendicitis because it is likely a rare occurrence. Things are really looking up for the use of data and technology in healthcare. Costs are likely to keep rising with everyone scoring in the 99th% percentile once they figure out how to game the system. But we certainly cannot stand in the way of science or progress now can we?

Niran Al-Agba2020-05-14T03:27:54+00:00February 21, 2017|Categories: Policy, Practice|Tags: ACA, Affordable Care, MACRA, MIPS, Physician Autonomy, Transparency, Value-based Care|

Meaningful Use: A Bird’s Eye View from the Penalty Box

Welcome to the penalty box, with no term limit. Every single visit, procedure, counseling session, or medical intervention will have 2% shaved off the top. The average family physician receives about $100,000 a year in Medicare reimbursements, so a 2% penalty for 2017 will become 3% in 2018, and increase to 4% in 2019—a combined three-year total of $9,000.

Niran Al-Agba2020-05-04T01:54:53+00:00January 24, 2017|Categories: Policy, Practice|Tags: Burnout, EHR, EMR, MACRA, Meaningful Use, MIPS, Penalty|

MACRA Payment Regulations Should Be Evidence-Based

Whether applied to policymaking for individuals, large populations, or administration of health services nationwide, it is imperative regulatory decisions be anchored to empirical evidence. The official MACRA rule has now been released. (continue reading →)

Niran Al-Agba2020-05-03T23:15:25+00:00October 18, 2016|Categories: Policy, Practice|Tags: ACA, Burnout, EHR, EMR, Health Policy, MACRA, Medicare, MIPS, Physician Autonomy|

Don’t Surrender Doctors… Fight. My Call to Action.

Independent physicians are at the beginning of a challenging movement as we fight to stay relevant and solvent during the transition of health care from independence to “regulation without representation”. In 1773, (continue reading →)

Niran Al-Agba2020-05-03T23:12:11+00:00October 13, 2016|Categories: Physician, Policy|Tags: ACA, Burnout, EHR, EMR, Independent Practice, MACRA, MIPS, Physician Autonomy, Rural Medicine|

Building Better Metrics: Using Physician Outcomes

Government and insurance companies should stop wasting dollars and cents chasing visions of value, rather use common sense and give physician outcomes the attention they deserve. Healthcare will be on better footing now and into the future.

Niran Al-Agba2020-05-03T22:34:52+00:00August 12, 2016|Categories: Policy, Practice|Tags: Burnout, MACRA, Medicare, MIPS, Physician Autonomy, Physician Suicide, Value-based Care|

MACRA is to Medicine what No Child Left Behind was to Education

The No Child Left Behind (NCLB) Act is to the education system what MACRA is to healthcare. Why must we keep repeating history?

Niran Al-Agba2020-05-03T22:42:21+00:00August 2, 2016|Categories: Policy, Practice|Tags: Education, MACRA, No Child Left Behind, Physician Advocacy, Physician Autonomy|

Rural Care: A Primer For Washington Officials, Columnists and Economists.

I am not convinced time and money spent implementing new technology does anything to improve patient care; I am fairly certain, however, conversations with my patients provide considerable value.

Niran Al-Agba2020-05-03T22:59:10+00:00July 27, 2016|Categories: Policy, Practice|Tags: Corporatization, EHR, EMR, Government Medicine, MACRA, MIPS, Rural Care|

Going Rogue

As the reality of MACRA (Medicare Access and CHIP Reauthorization Act of 2015) looms, the pressure is on small practices to survive. CMS plans to penalize 87% of solo physicians and reward bonuses to 81% of practices with more than 100 physicians. It is time for passive resistance, defined as protesting against a law using peaceful methods such as refusing to obey or refusing to leave a building. I vehemently refuse to leave the building.

Niran Al-Agba2020-05-03T23:02:44+00:00July 20, 2016|Categories: Practice|Tags: Burnout, Independent Practice, MACRA, MIPS, Physician Advocacy|