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#costsofcare

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Bích-Mây Nguyễn :verified:<p>&quot;States increasingly struggling to cover the rising cost of popular GLP-1 drugs like Wegovy, Ozempic and Zepbound are searching for ways to get out from under the budgetary squeeze that took them by surprise. </p><p>One solution some policymakers may try is restricting the number of people on Medicaid who can use the pricey diabetes drugs for weight-loss purposes.&quot;<br /> <a href="https://apnews.com/article/ozempic-wegovy-medicaid-weight-loss-glp1-dd34e5d76b660550dad73dc3069083ce" target="_blank" rel="nofollow noopener noreferrer" translate="no"><span class="invisible">https://</span><span class="ellipsis">apnews.com/article/ozempic-weg</span><span class="invisible">ovy-medicaid-weight-loss-glp1-dd34e5d76b660550dad73dc3069083ce</span></a></p><p><a href="https://med-mastodon.com/tags/healthcare" class="mention hashtag" rel="tag">#<span>healthcare</span></a> <a href="https://med-mastodon.com/tags/PrescriptionDrugs" class="mention hashtag" rel="tag">#<span>PrescriptionDrugs</span></a> <a href="https://med-mastodon.com/tags/DrugPrices" class="mention hashtag" rel="tag">#<span>DrugPrices</span></a> <a href="https://med-mastodon.com/tags/CostsOfCare" class="mention hashtag" rel="tag">#<span>CostsOfCare</span></a> <a href="https://med-mastodon.com/tags/Medicaid" class="mention hashtag" rel="tag">#<span>Medicaid</span></a> <a href="https://med-mastodon.com/tags/obesity" class="mention hashtag" rel="tag">#<span>obesity</span></a></p>
Bích-Mây Nguyễn :verified:<p>&quot;During an interview on the Somebody’s Gotta Win With Tara Palmeri podcast, billionaire entrepreneur Mark Cuban warned that the drug company he cofounded, Cost Plus Drugs, would be forced to raise its prices in response to a tariff on goods imported from India.</p><p>&#39;We won’t have a choice,&#39; Cuban said.&quot;</p><p><a href="https://fortune.com/well/article/mark-cuban-trump-tariffs-cost-plus-drugs-price-increase/" target="_blank" rel="nofollow noopener noreferrer" translate="no"><span class="invisible">https://</span><span class="ellipsis">fortune.com/well/article/mark-</span><span class="invisible">cuban-trump-tariffs-cost-plus-drugs-price-increase/</span></a></p><p><a href="https://med-mastodon.com/tags/healthcare" class="mention hashtag" rel="tag">#<span>healthcare</span></a> <a href="https://med-mastodon.com/tags/PrescriptionDrugs" class="mention hashtag" rel="tag">#<span>PrescriptionDrugs</span></a> <a href="https://med-mastodon.com/tags/CostsOfCare" class="mention hashtag" rel="tag">#<span>CostsOfCare</span></a> <a href="https://med-mastodon.com/tags/DrugPrices" class="mention hashtag" rel="tag">#<span>DrugPrices</span></a> <a href="https://med-mastodon.com/tags/tariffs" class="mention hashtag" rel="tag">#<span>tariffs</span></a> <a href="https://med-mastodon.com/tags/USpol" class="mention hashtag" rel="tag">#<span>USpol</span></a></p>
Brian Pierce MD<p>New case study from the center left think tank <a href="https://med-mastodon.com/tags/thirdway" class="mention hashtag" rel="tag">#<span>thirdway</span></a> about <a href="https://med-mastodon.com/tags/maine" class="mention hashtag" rel="tag">#<span>maine</span></a> <a href="https://med-mastodon.com/tags/hospital" class="mention hashtag" rel="tag">#<span>hospital</span></a> consolidation and how it&#39;s &quot;ripping off patients&quot;</p><p>As a Maine doc, the only omission I see is that they fail to discuss Maine&#39;s <a href="https://med-mastodon.com/tags/certificateofneed" class="mention hashtag" rel="tag">#<span>certificateofneed</span></a> law which allows hospitals here to block lower cost competitors. That&#39;s part of why we send some patients out of state for lower cost tests and surgeries.</p><p><a href="https://www.thirdway.org/report/fixing-maines-broken-hospitals-a-case-study" target="_blank" rel="nofollow noopener noreferrer" translate="no"><span class="invisible">https://www.</span><span class="ellipsis">thirdway.org/report/fixing-mai</span><span class="invisible">nes-broken-hospitals-a-case-study</span></a></p><p><a href="https://med-mastodon.com/tags/costsofcare" class="mention hashtag" rel="tag">#<span>costsofcare</span></a> <a href="https://med-mastodon.com/tags/healthreform" class="mention hashtag" rel="tag">#<span>healthreform</span></a></p>
Brian Pierce MD<p><span class="h-card" translate="no"><a href="https://mastodon.social/@FrankPasquale" class="u-url mention">@<span>FrankPasquale</span></a></span> <br /><a href="https://med-mastodon.com/tags/costsofcare" class="mention hashtag" rel="tag">#<span>costsofcare</span></a> <a href="https://med-mastodon.com/tags/healthreform" class="mention hashtag" rel="tag">#<span>healthreform</span></a> <a href="https://med-mastodon.com/tags/healthinsurance" class="mention hashtag" rel="tag">#<span>healthinsurance</span></a></p>
Brian Pierce MD<p><a href="https://med-mastodon.com/tags/Capitation" class="mention hashtag" rel="tag">#<span>Capitation</span></a> involves a lot more than paying <a href="https://med-mastodon.com/tags/primarycare" class="mention hashtag" rel="tag">#<span>primarycare</span></a> a monthly fee. It creates perverse incentives for <a href="https://med-mastodon.com/tags/familymedicine" class="mention hashtag" rel="tag">#<span>familymedicine</span></a> docs and other PCPs to ration care.</p><p><a href="https://med-mastodon.com/tags/directprimarycare" class="mention hashtag" rel="tag">#<span>directprimarycare</span></a> <a href="https://med-mastodon.com/tags/costsofcare" class="mention hashtag" rel="tag">#<span>costsofcare</span></a> <a href="https://med-mastodon.com/tags/healthreform" class="mention hashtag" rel="tag">#<span>healthreform</span></a> </p><p><a href="https://kffhealthnews.org/news/article/compensation-pay-primary-care-shortage-solution/" target="_blank" rel="nofollow noopener noreferrer" translate="no"><span class="invisible">https://</span><span class="ellipsis">kffhealthnews.org/news/article</span><span class="invisible">/compensation-pay-primary-care-shortage-solution/</span></a></p>
Brian Pierce MD<p><span class="h-card" translate="no"><a href="https://mamot.fr/@pluralistic" class="u-url mention">@<span>pluralistic</span></a></span> Pertinent to <a href="https://med-mastodon.com/tags/healthreform" class="mention hashtag" rel="tag">#<span>healthreform</span></a> <a href="https://med-mastodon.com/tags/costsofcare" class="mention hashtag" rel="tag">#<span>costsofcare</span></a> <a href="https://med-mastodon.com/tags/MedMastodon" class="mention hashtag" rel="tag">#<span>MedMastodon</span></a></p>
Brian Pierce MD<p><span class="h-card" translate="no"><a href="https://fediscience.org/@petersuber" class="u-url mention">@<span>petersuber</span></a></span><br /> <br />Much of this is due to <a href="https://med-mastodon.com/tags/feeforservice" class="mention hashtag" rel="tag">#<span>feeforservice</span></a> billing paradigm and prepaying for routine care via <a href="https://med-mastodon.com/tags/healthinsurance" class="mention hashtag" rel="tag">#<span>healthinsurance</span></a></p><p>For <a href="https://med-mastodon.com/tags/primarycare" class="mention hashtag" rel="tag">#<span>primarycare</span></a>, it&#39;s simpler to dump both. That makes primary care efficient enough that we can provide it (and free phone calls and messages) for $44 to $99/month when the hospital clinic down the street is charging $173 to $351 per visit.</p><p>Save the insurance for big , expensive problems.</p><p><a href="https://med-mastodon.com/tags/costsofcare" class="mention hashtag" rel="tag">#<span>costsofcare</span></a> <a href="https://med-mastodon.com/tags/directprimarycare" class="mention hashtag" rel="tag">#<span>directprimarycare</span></a> <a href="https://med-mastodon.com/tags/dpc" class="mention hashtag" rel="tag">#<span>dpc</span></a> <a href="https://med-mastodon.com/tags/healthreform" class="mention hashtag" rel="tag">#<span>healthreform</span></a></p>
Brian Pierce MD<p><span class="h-card" translate="no"><a href="https://mastodon.social/@jeffjarvis" class="u-url mention">@<span>jeffjarvis</span></a></span> </p><p>All those false positives (&quot;indidentalomas&quot;) from full body <a href="https://med-mastodon.com/tags/MRI" class="mention hashtag" rel="tag">#<span>MRI</span></a> will get expensive workups and then follow up studies that will be paid by the rest of us via higher insurance premiums and taxes.</p><p>Get some data first please. Failing that, add a special tax on these to cover the extra workups upfront instead of socializing their false positive costs to everyone.</p><p><a href="https://med-mastodon.com/tags/medmastodon" class="mention hashtag" rel="tag">#<span>medmastodon</span></a> <a href="https://med-mastodon.com/tags/costsofcare" class="mention hashtag" rel="tag">#<span>costsofcare</span></a> <a href="https://med-mastodon.com/tags/radiology" class="mention hashtag" rel="tag">#<span>radiology</span></a> <a href="https://med-mastodon.com/tags/evidencebasedmedicine" class="mention hashtag" rel="tag">#<span>evidencebasedmedicine</span></a> <a href="https://med-mastodon.com/tags/ebm" class="mention hashtag" rel="tag">#<span>ebm</span></a> <a href="https://med-mastodon.com/tags/sbm" class="mention hashtag" rel="tag">#<span>sbm</span></a> <a href="https://med-mastodon.com/tags/sciencebasedmedicine" class="mention hashtag" rel="tag">#<span>sciencebasedmedicine</span></a></p>
Brian Pierce MD<p><span class="h-card" translate="no"><a href="https://newsie.social/@brittanytrang" class="u-url mention">@<span>brittanytrang</span></a></span> <span class="h-card" translate="no"><a href="https://newsie.social/@STAT" class="u-url mention">@<span>STAT</span></a></span> </p><p>4. <a href="https://med-mastodon.com/tags/maine" class="mention hashtag" rel="tag">#<span>maine</span></a> is one of many states that still have Certificate of Need laws that had the goal of reducing oversupply/use of services but now protect hospital networks (mostly regional monopolies) from lower priced competitors. <br /> It&#39;s not rare for me to send patients out of state for cheaper studies, procedures, etc. The price savings are often big enough to make the trips worthwhile for them. The shorter wait for consults are a bonus.</p><p><a href="https://med-mastodon.com/tags/costsofcare" class="mention hashtag" rel="tag">#<span>costsofcare</span></a></p><p><a href="https://www.pressherald.com/2021/04/07/board-wont-recommend-central-maine-healthcares-proposed-topsham-surgical-center/" target="_blank" rel="nofollow noopener noreferrer" translate="no"><span class="invisible">https://www.</span><span class="ellipsis">pressherald.com/2021/04/07/boa</span><span class="invisible">rd-wont-recommend-central-maine-healthcares-proposed-topsham-surgical-center/</span></a></p>
Brian Pierce MD<p><span class="h-card" translate="no"><a href="https://newsie.social/@brittanytrang" class="u-url mention">@<span>brittanytrang</span></a></span> <span class="h-card" translate="no"><a href="https://newsie.social/@STAT" class="u-url mention">@<span>STAT</span></a></span> </p><p>2. A large proportion, if not most, of medical care is routine, non-urgent and potentially &#39;shoppable&#39; but we prepay for it with the same mechanisms we use for ER visits and big inpatient stays causing great harm. It&#39;s like using auto insurance for oil changes or homeowner&#39;s to have the plumber fix the toilet. </p><p>Yes, I&#39;m biased as a <a href="https://med-mastodon.com/tags/directprimarycare" class="mention hashtag" rel="tag">#<span>directprimarycare</span></a> doc but this realization was a big part of why I left <a href="https://med-mastodon.com/tags/insurance" class="mention hashtag" rel="tag">#<span>insurance</span></a> paid practice eight years ago.<br /><a href="https://med-mastodon.com/tags/dpc" class="mention hashtag" rel="tag">#<span>dpc</span></a> <br /><a href="https://med-mastodon.com/tags/costsofcare" class="mention hashtag" rel="tag">#<span>costsofcare</span></a></p>
Brian Pierce MD<p><span class="h-card" translate="no"><a href="https://newsie.social/@ProPublica" class="u-url mention">@<span>ProPublica</span></a></span> <br />Another reason I&#39;m glad we left the insurance racket eight years ago.<br /><a href="https://med-mastodon.com/tags/healthinsurance" class="mention hashtag" rel="tag">#<span>healthinsurance</span></a> <br /><a href="https://med-mastodon.com/tags/MedMastodon" class="mention hashtag" rel="tag">#<span>MedMastodon</span></a> <br /><a href="https://med-mastodon.com/tags/costsofcare" class="mention hashtag" rel="tag">#<span>costsofcare</span></a> <br /><a href="https://med-mastodon.com/tags/dpc" class="mention hashtag" rel="tag">#<span>dpc</span></a> <br /><a href="https://med-mastodon.com/tags/directprimarycare" class="mention hashtag" rel="tag">#<span>directprimarycare</span></a></p>
Brian Pierce MD<p><span class="h-card" translate="no"><a href="https://mamot.fr/@pluralistic" class="u-url mention">@<span>pluralistic</span></a></span> <br />Thrilled to see you mention <a href="https://med-mastodon.com/tags/healthcare" class="mention hashtag" rel="tag">#<span>healthcare</span></a> in your newest article on monopolies.<br /><a href="https://med-mastodon.com/tags/MedMastodon" class="mention hashtag" rel="tag">#<span>MedMastodon</span></a> <br /><a href="https://med-mastodon.com/tags/costsofcare" class="mention hashtag" rel="tag">#<span>costsofcare</span></a> <br /><a href="https://med-mastodon.com/tags/healthcarereform" class="mention hashtag" rel="tag">#<span>healthcarereform</span></a></p>
Brian Pierce MD<p>&#39;And I would put my babies to bed, and they&#39;d say, &quot;How many charts do you have left tonight, mommy?&quot;&#39;</p><p><a href="https://med-mastodon.com/tags/PBS" class="mention hashtag" rel="tag">#<span>PBS</span></a> with a story about <a href="https://med-mastodon.com/tags/directprimarycare" class="mention hashtag" rel="tag">#<span>directprimarycare</span></a> ( <a href="https://med-mastodon.com/tags/DPC" class="mention hashtag" rel="tag">#<span>DPC</span></a> ): <br /><a href="https://www.pbs.org/newshour/show/innovative-clinic-helps-doctors-avoid-burnout-and-makes-healthcare-more-affordable" target="_blank" rel="nofollow noopener noreferrer" translate="no"><span class="invisible">https://www.</span><span class="ellipsis">pbs.org/newshour/show/innovati</span><span class="invisible">ve-clinic-helps-doctors-avoid-burnout-and-makes-healthcare-more-affordable</span></a><br /><a href="https://med-mastodon.com/tags/MedMastodon" class="mention hashtag" rel="tag">#<span>MedMastodon</span></a> <br /><a href="https://med-mastodon.com/tags/costsofcare" class="mention hashtag" rel="tag">#<span>costsofcare</span></a> <br /><a href="https://med-mastodon.com/tags/familymedicine" class="mention hashtag" rel="tag">#<span>familymedicine</span></a></p>
Brian Pierce MD<p><a href="https://www.nytimes.com/2023/06/15/magazine/doctors-moral-crises.html" target="_blank" rel="nofollow noopener noreferrer" translate="no"><span class="invisible">https://www.</span><span class="ellipsis">nytimes.com/2023/06/15/magazin</span><span class="invisible">e/doctors-moral-crises.html</span></a></p><p>&#39;...Until the system changes, some doctors are finding ways to opt out. I spoke to several physicians who have started direct-care practices, in which patients pay a modest monthly fee to see doctors who can offer them more personalized out-of-network care, without having to answer to administrators or insurers...&quot;</p><p><a href="https://med-mastodon.com/tags/familymedicine" class="mention hashtag" rel="tag">#<span>familymedicine</span></a> <a href="https://med-mastodon.com/tags/directprimarycare" class="mention hashtag" rel="tag">#<span>directprimarycare</span></a> <br /><a href="https://med-mastodon.com/tags/MedMastodon" class="mention hashtag" rel="tag">#<span>MedMastodon</span></a> <br /><a href="https://med-mastodon.com/tags/costsofcare" class="mention hashtag" rel="tag">#<span>costsofcare</span></a></p>
Brian Pierce MD<p><span class="h-card" translate="no"><a href="https://newsie.social/@STAT" class="u-url mention">@<span>STAT</span></a></span> <a href="https://med-mastodon.com/tags/flu" class="mention hashtag" rel="tag">#<span>flu</span></a> <br />The local branch of <a href="https://med-mastodon.com/tags/maine" class="mention hashtag" rel="tag">#<span>maine</span></a> &#39;s big hospital network won&#39;t run flu tests locally. &quot;Rapid&quot; test results come back the next day so we added point of care flu testing this week to reduce antibiotic use for pneumonias that might be due to flu.</p><p>Since the tests only cost us $10, we don&#39;t charge for them. We try not to nickle and dime our patients.</p><p><a href="https://med-mastodon.com/tags/costsofcare" class="mention hashtag" rel="tag">#<span>costsofcare</span></a> <br /><a href="https://med-mastodon.com/tags/familymedicine" class="mention hashtag" rel="tag">#<span>familymedicine</span></a> <br /><a href="https://med-mastodon.com/tags/directprimarycare" class="mention hashtag" rel="tag">#<span>directprimarycare</span></a> <br /><a href="https://med-mastodon.com/tags/dpc" class="mention hashtag" rel="tag">#<span>dpc</span></a></p>
Brian Pierce MD<p><span class="h-card" translate="no"><a href="https://med-mastodon.com/@rvaughnmd" class="u-url mention">@<span>rvaughnmd</span></a></span> <span class="h-card" translate="no"><a href="https://med-mastodon.com/@SolNataMD" class="u-url mention">@<span>SolNataMD</span></a></span> <br />No, we don&#39;t work for free but we only charge $35-$80/month so we get a nice socioeconomic mix of patients. </p><p>We also donate memberships to a free clinic to help the local safety net.</p><p>The alternative here is working for the local hospital monopoly with obscenely high prices and horrible access.</p><p><a href="https://med-mastodon.com/tags/costsofcare" class="mention hashtag" rel="tag">#<span>costsofcare</span></a><br /><a href="https://med-mastodon.com/tags/DPC" class="mention hashtag" rel="tag">#<span>DPC</span></a> <br /><a href="https://med-mastodon.com/tags/directprimarycare" class="mention hashtag" rel="tag">#<span>directprimarycare</span></a> <br /><a href="https://med-mastodon.com/tags/familymedicine" class="mention hashtag" rel="tag">#<span>familymedicine</span></a> <br /><a href="https://med-mastodon.com/tags/primarycare" class="mention hashtag" rel="tag">#<span>primarycare</span></a></p>
Brian Pierce MD<p>I&#39;ve been explaining to patients for years that they don&#39;t need annual lipids. Nice to have it confirmed again in this episode of my favorite podcast.</p><p>We even have some third party administrators (TPAs) that here require them of insured patients. </p><p>These are only about $20 at our office but the big hospital network here in <a href="https://med-mastodon.com/tags/Maine" class="mention hashtag" rel="tag">#<span>Maine</span></a> charges over $100 for a lipid panel test. That comes out of pocket for many patients.</p><p><a href="https://med-mastodon.com/tags/medmastadon" class="mention hashtag" rel="tag">#<span>medmastadon</span></a> <br /><a href="https://med-mastodon.com/tags/foamed" class="mention hashtag" rel="tag">#<span>foamed</span></a> <br /><a href="https://med-mastodon.com/tags/costsofcare" class="mention hashtag" rel="tag">#<span>costsofcare</span></a> </p><p>BS Medicine-<br /><a href="https://therapeuticseducation.org/episode-528-proving-you-dont-need-to-repeat-cholesterol-measurements/" target="_blank" rel="nofollow noopener noreferrer" translate="no"><span class="invisible">https://</span><span class="ellipsis">therapeuticseducation.org/epis</span><span class="invisible">ode-528-proving-you-dont-need-to-repeat-cholesterol-measurements/</span></a></p>
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