Rural Care

A Mountain of Evidence Against Hospital Consolidation

As an independent physician in private practice, I care a great deal about our people, our patients, and healthcare delivery in Kitsap County. The fact hospital consolidations do not economically benefit patients is backed by a mountain of scientific evidence. While those in charge may decide merging is ultimately the best course of action, it will be imperative we stand up as a unified community and hold CHI accountable for ensuring the cost savings they have promised materialize.

Costs of a Hospital Monopoly in Underserved Counties

There is a growing body of evidence that hospital mergers lead to higher prices for consumers, employers, insurance, and government overall. It is imperative to educate patients and lawmakers as to how the consolidation of hospitals and medical practices raise costs, decrease access, eliminate jobs, and ultimately reduce care quality as a result. Lawmakers should focus on this “first pillar” of cost control as they go back to the drawing board.

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.

2020-05-14T03:29:09+00:00February 28, 2017|Categories: Policy|Tags: , , , , , , , |

Building Better Metrics: Invest in “Good” Primary Care and Get What You Pay For

Estimates suggest that a primary care physician would spend 21.7 hours per day to provide all recommended acute, chronic, and preventive care for a panel of 2,500 patients. An average workday of 8 hours extrapolates to an ideal panel of 909 patients; let us make it an even 1000 to simplify. A primary care physician could easily meet acute, chronic, and preventative needs of 1000 patients, thereby improving access.

CMS + MIPS/APM = Death of the Private Practice Physician.

We should pay physicians for time spent engaging patients in conversation, instead of rewarding them for checking boxes on a computer screen. Physicians were trained to care and comfort people, not chase blood pressure numbers and pain scale scores. Changes masquerading as meaningful have only increased physician workload. We are widgets in the ever expanding assembly line. Do you think the MIPS will give us more time to practice medicine? If you believe it will, then I have a bridge to sell you.

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