March 2020, Volume XXXIIi, No 12
Surprise billing
Causes and potential remedies
The $25,000 surprise bill arrived after the patient, himself a physician, had a radical prostatectomy and was discharged from the hospital two days after surgery.
We will examine why surprises occur, the congressional fights over price-fixing panaceas, why price fixing never works, and other possible remedies that do not involve price fixing.
March 2020, Volume XXXIIi, No 12
interview
Advocating for patients and providers
Rahul Koranne, MD, MBA, FACP
Minnesota Hospital Association (MHA)
Surprise billing: Causes and potential remedies
By Robert W. Geist, MD
The $25,000 surprise bill arrived after the patient, himself a physician, had a radical prostatectomy and was discharged from the hospital two days after surgery.
We will examine why surprises occur, the congressional fights over price-fixing panaceas, why price fixing never works, and other possible remedies that do not involve price fixing.
cover story two
Improving access to care: Expediting the licensure process
By Jon Thomas, MD, and Ruth M. Martinez, MA
The Interstate Medical Licensure Compact went live in 2015 after the law was passed by seven states (Alabama, Idaho, Montana, South Dakota, Utah, West Virginia, and Wyoming). That same year, Minnesota became the eighth member state when the Minnesota Legislature unanimously passed the law, and 29 states, the District of Columbia, and the Territory of Guam have now joined the agreement. In October 2015, member states met for the first time as the Interstate Medical Licensure Compact Commission.
Value-Based Reimbursement
Integrated Health Partnerships: v2.0: A win-win for patients, systems
By Mathew Spaan, MPA, and Sara Bonneville, MS, MPP
How are more than two dozen innovative Minnesota health care delivery systems making this happen? They are participating in a state program designed to create incentives to provide high-quality, efficient care to people enrolled in Medical Assistance (Minnesota’s Medicaid program) and MinnesotaCare, whether through managed care organizations or fee for service.
Re-evaluating “performance” measurement: Minnesota’s teachable moment
By Kip Sullivan, JD
Measuring and reporting in health care has gone through three phases corresponding roughly to the 1990s, 2000s, and 2010s. During the 1990s, policymakers claimed “report cards” on the quality of clinics, hospitals, and insurance companies should be published so that “consumers” could avoid the bad actors and patronize the good ones.
Behavioral Health
Project 2025: Partnering with physicians to reduce suicide
By Christine Moutier, MD, and Alex Karydi, PhD
Up to 45% of people who die by suicide visit their primary care physician in the month prior to their death. Suicide challenges the entire medical system and the services they perform. The ability of physicians to assess, intervene, and monitor suicidal behavior presents both a responsibility, and a significant opportunity, to save lives.
Developing an Assisted Living Report Card: A mandate of the 2019 ElderCare Act
By Tetyana P. Shippee, PhD; Tricia Skarphol, MA; and Odichinma Akosionu, MPH
The number of assisted living (AL) settings is steadily increasing nationally and in Minnesota there are currently about 1,300 AL communities. AL is commonly defined as the senior living option that combines housing, support services (e.g. meals), and health care, as needed. AL is meant to provide more assistance than an independent retirement community but less medical and nursing care than a nursing facility.
Nephrology
Dialysis 2020: A look inside the black box
According to the National Kidney Foundation, over 500,000 Americans with end stage renal disease (ESRD) require dialysis for survival. Renal replacement treatment becomes necessary when patients have lost 85–90% of kidney function (resulting in a glomerular filtration rate of less than 15) and is typically performed three times a week at in-center clinics.
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