Tag: Medicare

The New-Economy has Created a Trade Deficit in Small Cities and Towns. Healthcare Spending is the Bulwark

I recently drove through Lewiston, Maine.  It’s no longer the flourishing city it once was, though until the early 20th century Lewiston (seen in the drawing above) was a booming American mill town.  Its factories, hydro-powered by the Androscoggin River, were linked by rail to Boston and other large cities.  Like many mill towns in New England, ...

On the “Bay State Boondoggle”

The Boston Globe recently ran an article discussing layoffs at Baystate Health, a large health system in Western Massachusetts.  The system is planing to lay off 300 employees to try to close a $75M deficit.  According to the Globe, the deficits are mainly driven by declining Medicaid reimbursement, but, more interestingly, by a $23M hit to Medicare revenue ...

Hospitals are Pigging Out on Commercial Reimbursement and Starving on Medicare. What’s Next?

The Spring 2016 Medpac report on Medicare payments is out.  This annual report to Congress (put together by the 17 members of the Medicare Payments Advisory Committee) provides an assessment of the way Medicare pays for care, and offers recommendations for how to modify payments going forward. It’s a fascinating snapshot:

Once A Sail, Now an Anchor: Medicare Incentive Programs are Making Safety-Net Hospitals Unaffordable

Here is an interesting exercise and an unfortunate lesson in the law of unexpected consequences: Pop Quiz: Your elderly Granny comes from overseas without insurance and suddenly needs her gallbladder taken out.  You call around the hospitals in town and they agree to extend to you the same rates as they would charge Medicare.  (This is hypothetical, of ...

Another Domino Starting to Fall- The Narrowing of Physician Networks

In previous posts, I’ve discussed the inevitable squeeze that high cost/ low quality physicians will feel from payers as the system becomes more discriminating about paying more “reasonable” rates and only for performance. There now seems to be evidence that we are seeing the largest health insurers get tough by trimming their networks of the physician value ...