Upcoding Crackdown: Federal Efforts Fail to Benefit Private Insurers

For more than a decade, taxpayer-funded health care programs have seen a steady uptick in higher-paying billing codes. Office visits, outpatient services, and emergency room care have all been billed at progressively higher reimbursement codes, raising fees by billions of dollars. Many providers contend the shift is the result of sicker patients coupled with the

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The Road to Optimal Opioid Prescription Length

The Centers for Disease Control and Prevention (CDC) estimates that the total economic burden of prescription opioid misuse in the United States is $78.5 billion a year. Most of that burden is related to workplace costs, such as lost productivity, prolonged time on disability, and increased work disability claim costs. To help combat this crisis, organizations

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The Future is Now – Telemedicine in the Marketplace

For years, telemedicine has been touted as the next frontier in healthcare. Based on data from multiple health systems, the future has arrived. Some of the country’s largest and most prestigious health systems such as Kaiser Permanente, NewYork-Presbyterian, and Johns Hopkins now boast robust telemedicine programs. At Kaiser Permanente, virtual patient encounters now outnumber in-person

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An Observation – Deadly Healthcare Mistakes & Orlando’s Tragedy

I often find myself coming back to this issue because it is so troubling – the third leading cause of death in America is, in fact, our nation’s healthcare. Patients are dying from the medical treatment itself versus the actual health issue they sought care for in the first place. Whether it be inappropriate medications,

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Third Leading Cause of Death in the US? Hospitals.

I have long encouraged people to avoid going to hospitals if they can help it. Just last year, I wrote a column for Risk & Insurance on this very topic. But the message bears repeating, because the numbers are staggering. An estimated​ 440,000 people die each year in the hospital – and not from the

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ER Visits Rise Under the ACA

One of the main selling points of the Affordable Care Act (ACA) was the contention that it would reduce the number of people going to the emergency room (ER) for non-emergency services.  When a patient does not have health insurance, these costs are often subsidized by taxpayers.  And even when there is insurance coverage, an

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Traditional Hospitals Believed to Become Obsolete?

This study shows that many people believe traditional hospitals will be obsolete in the near future. I’ve thought this for a long time. Traditional hospitals have an obsolete method of performing healthcare. Centralized, bureaucratic, overpriced, non-competitive, and full of sick people with open surgical wounds. The list of issues is endless. Healthcare is downstreaming. Just

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