Contents tagged with health care costs

  • TAFP’s top 10 news stories of 2012

    Tags: news, 2012, texas medical board, affordable care act, quality, health care costs, accountable care organization, recovery audit contractor, administrative burden

    As another year draws to an end and we’re once again waiting to see what Congress will do to about the SGR and the fiscal cliff-tastrophy, your TAFP Communications staff put together a list of the top 10 news stories from Texas Family Physician and TAFP News Now based on unique page views recorded through our analytics system.

    Not surprisingly, it shows that family physicians are concerned about the practice environment and the future. These stories outline new regulations, administrative burden, experimental practice and payment models, and the future of the specialty.

    1. TMB rules you may not know but should

  • By choosing wisely, physicians can help address the unsustainable trajectory of health care costs

    Tags: perspective, young, choosing wisely, health care costs, aafp

    By Richard Young, M.D.

    “Every admitted patient should have a chest X-ray and a VDRL,” said one of my Type A personality internal medicine attending physicians during residency. The year was 1990 and this attitude was shared by a few other knowledgeable physicians at the time, though others questioned the practice and were more flexible in their medical decision-making. I would venture to guess that few family physicians or internists practice this way in 2012, but the practice is not completely dead.

    A lot has changed since 1990. The total cost of U.S. health care was $724 billion and consumed 12.5 percent of the gross domestic product.1 In 2012, the total cost of U.S. health care is estimated to be $2.8 trillion and will consume 17.6 percent of GDP.2 This health care inflationary trend has continued unabated for the last 50 years.

  • Clinical integration: The case for getting involved now

    Tags: clinical integration, health care costs, autonomy, hospital, physician

    By Daniel J. Marino

    What is your reaction to the concept of clinical integration? If you are like most physicians I talk to, you are interested in the idea but wary of the many uncertainties that surround it. You may also have some reservations about getting involved with the local hospital. If you become clinically integrated, will you be able to maintain control of your own practice?

    One thing is clear: Doing nothing is not an option. Unsustainable health care cost trends are creating pressure that is simply not going away. All payers are pushing to reduce costs, and there is broad and deep agreement that greater coordination of care is the solution. Physicians who stick to the clinical models developed under fee-for-service reimbursement are going to suffer from steady fee schedule reductions.

  • Wal-Mart: The future leader of low-cost care?

    Tags: fragmentation, health care costs, medical home, wal-mart, family physician, health care, debate

    Save money. Live better. It’s Wal-Mart’s corporate motto, but put it in the context of health care and add a third line targeted at improving care for individuals and you’ve got something awfully close to Don Berwick’s triple aim for health care reform. If cost is the real cancer in the U.S. health care delivery system—and we think it is—why not look to America’s low-cost leader for the cure?

    When reports started hitting the news this week about a request for information Wal-Mart sent out to its vendors in late October announcing the mega-retailer’s intent to “build a national, integrated, low-cost primary care health care platform that will provide preventative and chronic care services that are currently out of reach for millions of Americans,” alarms went off in health policy circles across the country.

    The company has since backpedaled on the statement of intent. John Agwunobi, M.D., M.P.H., M.B.A., head of Wal-Mart’s health and wellness division, released a statement on Nov. 9, 2011, saying, “We are not building a national, integrated, low-cost primary care health care platform.”

  • The super charge

    Tags: budget, family medicine residency program, health care costs, legislature, family physician, payment, graduate medical education

    Texas House Speaker Joe Straus, R-San Antonio, released the interim charges for the standing committees of the House of Representatives. As he said in the accompanying letter, these charges will set the stage for legislation considered during the 83rd Texas Legislature, which convenes in January 2013.

    Of those that may affect family medicine, one assigned to the House Committee on Public Health stands out for its sheer immensity. It directs the committee to:

    • Examine the adequacy of the primary care workforce in Texas, especially considering: the projected increase in need (from an aging population and expanded coverage through federal health care reform), and cuts to workforce-building programs such as graduate medical education and physician loan repayment programs.
    • Study the potential impact of medical school innovations, new practice models, alternative reimbursement strategies, expanded roles for physician extenders, and greater utilization of telemedicine.
    • Make recommendations to increase patient access to primary care and address geographic disparities.

  • The unintended, but not surprising, negative consequences of hospitalism

    Tags: health care costs, family physician, hospital

    By Richard Young, M.D.

    A recent study in Annals of Internal Medicine looked at what happened when patients were cared for in the hospital by private physicians (presumably often their personal physicians) compared to hospitalists.

    For a little background, hospitalists are doctors whose job is limited to taking care of patients in the hospital. They pick up new patients in shifts or cycles and almost always have no previous relationship with the patients. They rarely see patients in clinics and have no long-term outpatient relationships with patients.