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Next year, doctors and hospitals will no longer get paid according to the fee for services model. They will get a fixed salary according to how well patients do. We will see the equivalent of patient report cards. Personalized care is out, government one-size fits all healthcare is in. The more tests, scans, surgeries that hospitals and doctors do, the less they will make. What could possibly go wrong? It will have a devastating effect on patients’ access to care. Patients who come back for the same problem will be included in the one-time bulk rate. Beginning next year, Medicare,...

Lillian Palermo tried to prepare for the worst possibilities of aging. An insurance executive with a Ph.D. in psychology and a love of ballroom dancing, she arranged for her power of attorney and health care proxy to go to her husband, Dino, eight years her junior, if she became incapacitated. And in her 80s, she did... But one day last summer, after he disputed nursing home bills that had suddenly doubled Mrs. Palermo’s copays... Palermo was shocked to find a six-page legal document waiting on her bed. It was a guardianship petition filed by the nursing home, Mary Manning Walsh,...

Nationally, 724 hospitals have had their Medicare funding reduced after the Centers for Medicare and Medicaid Services found that each had high rates of potentially avoidable “hospital-acquired conditions,” including falls, bed sores, and certain infections, including ventilator acquired pneumonia and catheter-associated urinary tract infections. CMS scored hospitals on the prevalence of three risk factors to their Medicare population patients: central line bloodstream infections, catheter-associated urinary tract infections, and serious complications, a catch-all group made up of eight types of injuries, including blood clots, falls, and bed sores. Funding can be reinstated for hospitals whose scores improve in the targeted areas.

I received many interesting comments from readers on Single-Payer "Medicare for All" Proposal; Live and Let Die; Why Does Single-Payer "Work" in Europe? This email is from a US M.D. named Ken. Ken writes ... I agree with everything you wrote, but you omitted a discussion of the variation of demand in relation to the cost. It is approximately correct to state that when the perceived cost to the user approaches zero, the demand for services approaches infinity. This is the crucial flaw in all "government-funded" single-provider programs. The demand for "free" services is impossibly huge. I have read extensively...

HICAGO — Denee Mallon marveled at the view of Lake Michigan from her hospital bed in the Windy City, where she had just made history: the then 74-year-old transgender woman underwent a milestone sex reassignment surgery she'd sought for decades. "Here I am, finally, after all these years," she said. "It happened." Her operation will be one of the first paid for by Medicare after she won a challenge in May to end the government insurance program's ban on covering such procedures for transgender individuals. Mallon's victory opened the door for other seniors to access this care and may influence...

The Obama administration announced new rules under Obamacare on Monday that target nonprofit hospitals’ efforts to get paid by their patients.Nonprofit hospitals, which serve a charitable purpose and are often religiously affiliated, will now be subject to strict rules on when and how they can collect payments from customers, thanks to regulations included in the health-care law. As a condition of their tax-exempt status, these hospitals must “take an active role in improving the health of the communities they serve,” Treasury Department deputy assistant secretary for tax policy Emily McMahon wrote in a blog post Monday. Under the new IRS...

The bullying of the nation’s physicians continues apace, now turning to penalizing doctors who don’t meet the administration’s one-size-fits-all approach to medical records. Bruce Japsen of Forbes reports: More than 250,000 physicians and other health professionals are being notified as early as today that their payments from Medicare and Medicaid will be cut because they aren’t adequately using electronic health records in their practices, the Obama administration confirmed. The Centers for Medicare & Medicaid Services, known as CMS, is telling about 257,000 eligible medical care providers who are largely physicians that they will be paid 1 percent less in reimbursement...

I need to pick something by 12/31.ATT is dumping us retired types to a BS type Exchange.The reps are minimum wagers and don't know squat. Been looking at plans and need, if possible some input on Plan F's "Excess charges"? Its a $70 month dif for me for a plan with it or without which is plan "N" Any one up to speed on this stuff your input would be appreciated. Last year went to the DR one time and the ER 1 time(i am not a roofer) Thanks

KITCHENER — A Kitchener anesthetist specializing in pain management has been charged with two counts of fraud after he billed the Ontario government for services he didn't provide. The Ontario Provincial Police Anti-Rackets branch arrested and charged Dr. Kulbir Singh Billing, 63, on Monday night. He will appear in Ontario Court in January. He faces two counts of fraud over $5,000. OPP Sgt. Peter Leon said the charges stem from billings to the Ontario government from 2010 to 2013. Leon said billings were made to the Ontario Health Insurance Plan and the Workplace Safety and Insurance Board for services that...

LEXINGTON — Rural hospitals in Kentucky are facing some of the biggest challenges in their histories and some may be forced to close their doors state auditor Adam Edelen told the Kentucky Chamber on Monday. Edelen, who will be releasing an audit on the plight on the states rural hospitals in January, told members of the Kentucky Chamber of Commerce who were attending their annual legislative preview conference, that the difficult economy and managed care are the primary drivers of the difficulty in rural health care. Generally, Medicare reimburses hospitals around 90 percent of cost while Medicaid reimbursement is around...

In my previous column, I explained that you become ineligible for Covered California’s tax credits when you turn 65 and enroll in Medicare. You will owe money to the government if you keep getting the credits after your Medicare begins. So I tried to offer a simple solution: Cancel your Covered California plan. Unfortunately, in the past two weeks, I have heard from Californians and insurance agents across the state who have tried mightily — and failed — to cancel their plans. Instead, the premium bills just keep coming. A Covered California phone rep told him that the cancellation challenges...

Under President Obama’s new program to protect millions of illegal immigrants from deportation, many of those affected will be eligible to receive Social Security, Medicare and a wide array of other federal benefits, a White House official said Tuesday. In his speech Thursday night, the president touted his plan as a means of bringing accountability to a broken immigration system, under which 11 million or more people are estimated to be living in this country illegally. “We’re going to offer the following deal: If you’ve with been in America more than five years. If you have children who are American citizens...

The state of North Carolina has given Jonathan Gruber the boot, firing the ObamaCare architect after he was caught on camera repeatedly calling American voters “stupid.” Rep. Mark Meadows (R-N.C.) went “On The Record” tonight, explaining that Gruber was hired one year ago to help with a health care plan that dealt with Medicaid recipients and the uninsured. Meadows said that Gruber was supposed to be an unbiased individual, but after these reports, the auditor decided that he’s not so unbiased after all. …

As Medicare rackets go, authorities say, this one had no borders. Eleven people associated with a South Florida managed care company were charged Wednesday with fleecing Medicare for services provided to U.S. citizens while they were living in Nicaragua and the Dominican Republic, according to an indictment. Coral Gables-based Florida Healthcare Plus filed false bills for retired Medicare beneficiaries who claimed to be living in the state but were being treated by foreign doctors while they resided in the two Latin American countries. That is illegal under the federal taxpayer-funded program for senior citizens and the disabled, authorities said. Eight...

House Speaker John Boehner became eligible for Medicare when he turned 65 years old Monday, but he’s not planning to sign up. Instead, Boehner is going to keep his “expensive” Obamacare insurance plan. The Affordable Care Act required members of Congress to get off the federal government’s insurance plan and, in most cases, enroll in an Obamacare policy. When members turn 65, they become eligible for Medicare as well. When asked at a press conference on Tuesday about his health care coverage plans, he paused and laughed. “I’ll continue to purchase my expensive health care coverage,” he said in an...

They'd be better off with "less scope for choosing the wrong plan."In a 2009 paper, “Choice Inconsistencies Among the Elderly: Evidence from Plan Choice in the Medicare Part D Program,” Obamacare advisor Jonathan Gruber argued that there were too many Medicare Part D plans for seniors to choose from, which led them to make bad decisions when enrolling in a plan. In the paper, written for the National Bureau of Economic Research, Gruber wrote with Jason T. Abaluck that the privatization of the public Medicare program had resulted in dozens of private insurers offering a wide variety of insurance products...

Healthcare, Fiscal, and Tax 10/22/2014 Jeanne Shaheen's Dishonest Claim That Obamacare Doesn't Cut Medicare Avik Roy In last night’s U.S. Senate debate in New Hampshire between incumbent Jeanne Shaheen (D.) and challenger Scott Brown (R.), Shaheen uttered a flat-out, bald-faced lie: that Obamacare doesn’t cut Medicare spending to pay for its expansion of coverage to the uninsured. It’s a talking point that a number of Democratic Senate candidates—and their enablers in the lefty blogosphere—have been clinging to. And it’s embarrassingly dishonest. “I want to go back to Scott Brown’s suggestion that we’ve taken three-quarters of a trillion dollars out of...

While Sen. Mark Udall, D-Colo., is on the ropes in his bid for re-election, his cousin, Sen. Tom Udall, D-N.M., is now trying to fend off the momentum of retired U.S. Marine Corps Col. Allen Weh, who is near or within the margin of error in the latest polls. Just a week ago, Udall led Weh by 16 points. Since then, an Albuquerque Journal survey shows a seven-point race (50-43) while a Vox Populi poll released Monday suggests a 47-43 Udall lead. Weh said another poll has the margin down to two percentage points, and there are good reasons for...

Medicare is asking for public comment on whether it should pay doctors for counseling patients about their options for end-of-life care. Friday's announcement came in a voluminous regulation on physician payment. Spokesman Aaron Albright says it will "give the public ample opportunity to weigh in on the topic." Five years after a similar proposal triggered a political backlash against President Barack Obama's health care legislation, the administration is dipping its toe in the water.

More than one in three low-income seniors, or 41 percent, has already gone without medical or dental care because of high energy bills, according to a survey included in a newly released report. And things will only get worse for seniors, says the 60 Plus Association, as states scramble to comply with the Environmental Protection Agency's carbon-reduction rules. […] For example, because of high energy prices, 41 percent of seniors went without medical or dental care, 30 percent of seniors went without food for at least a day, 33 percent did not fill a prescription or took less than their...