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Who pays for healthcare in U.S.? Print E-mail
Written by Jeffrey Herschler   
Friday, 21 October 2011 09:29

Every Picture Tells a Story

 Payors Share of U.S. Healthcare Bill

America's privately-financed private health insurance companies pay a small a share of the nation's healthcare bill.   See Related Story:  America's Health Insurance Myth

Presented by MF Healthcare Solutions
Compensation Committee from Hell? Print E-mail
Written by Jeffrey Herschler   
Thursday, 20 October 2011 07:12

The Joint Committee on Deficit Reduction plans to closely examine entitlement programs like Medicare and Medicaid as it attempts to resolve the nation's long term budget gap.  Reimbursements paid by these programs will be under the microscope.  Click on the link below to view pics of your favorite legislators:

 National Debt Super Committee -

Senate Dem's include ,  Patty Murray, Washington, Co-Chair, Max Baucus, Montana and  John Kerry, Massachusetts.  Senate Pub's are Jon Kyl, Arizona, Rob Portman, Ohio and Pat Toomey, Pennsylvania. House leaders serving on the committee are Dem's Xavier Becerra, California,  Jim Clyburn, South Carolina and Chris Van Hollen, Maryland and Pub's Jeb Hensarling, Texas, Co-Chair, Fred Upton, Michigan and Dave Camp, Michigan.

Don't expect the healthcare community to go down without a fight.  For example, see below for latest posting on the MGMA website:

Joint Committee announces first public hearing, contact lawmakers now to repeal SGR!
The new Joint Committee on Deficit Reduction held its first operational meeting Thursday, Sep. 8, followed by its first public hearing Tuesday, Sep. 13. The 12-member bipartisan committee is tasked with proposing at least $1.2 trillion in debt reduction by Nov. 23, which Congress must vote on by Dec. 23.  MGMA urges members to call on the Joint Committee and Congress to address the flawed sustainable growth rate (SGR) and avert the 29.5 percent Medicare physician payment cut scheduled for Jan. 1, 2012. The Joint Committee process may be the best upcoming opportunity to repeal the SGR, as budget offsets for SGR repeal will be in short supply after the Joint Committee completes its work. Visit the MGMA Advocacy Center to get involved and voice your concerns. 

Meanwhile, according to Modern Healthcare, the U.S. House of Representatives has recently reignited its SGR Repeal rally and is also promoting the concept of the Joint Committee as a conduit for change: 

"A 'dear colleagues' letter that was circulated in the U.S. House of Representatives urging repeal of the sustainable growth-rate formula for Medicare payments to physicians garnered 114 signatures before being sent on to the Joint Select Committee on Deficit Reduction." 

Learn More 

View Video:  Deb committee's job:  Fix everything

Last Updated on Wednesday, 26 October 2011 16:36
Pill Mill Busts Around the State Print E-mail
Written by Various Sources   
Saturday, 15 October 2011 14:32
Last Updated on Saturday, 15 October 2011 14:47
New Law Now Enforceable Print E-mail
Written by Jeffrey Herschler   
Thursday, 13 October 2011 09:36


As of Oct 1, physicians from outside Florida are required to get a state certificate before providing expert witness testimony in medical malpractice litigation.  They then could face sanctions if it is determined that they gave "deceptive or fraudulent testimony."  The new law also offers safe harbor from lawsuits for doctors who donate health services to high school and college sports teams.  

Presented by MF Healthcare Solutions

Last Updated on Thursday, 13 October 2011 09:56
Healthcare Leaders Discuss Medicaid Reform Print E-mail
Written by Jeffrey Herschler   
Thursday, 13 October 2011 09:31

The Greater Miami Chamber of Commerce recently hosted a Panel Discussion entitled :

The Epicenter:  How Medicaid Reform Will Shake Up Healthcare in Florida

Serving on the panel :
-Melanie Brown-Woofter, AHCA, Acting Assistant Deputy Secretary for Medicaid Operations
-Jorge D. Luna, DO, Continucare (Broward County), Chief Medical Officer
-Jorge Rico, MBF Healthcare Partners, L.P., Co-Founding Partner
-Joseph Rogers, Broward Health, COO 

Ms. Brown-Woofter opened the discussion with a review of the current state of affairs, a few references to the past and some sobering statistics.  She reminded us that the state has a $20B budget with 56% federal and 44% state via the matching program.  (see Studies: Medicaid).  She went on to describe an explosion in utilization of Medicaid services due to a bad economy.  "This is what is driving the interest in managed care," she stated.

Dr. Luna stated that "This is Medicaid managed care 2.0" since it's already been attempted in the past.  He was optimistic about the potential to be "ahead of the curve" in Florida.   He went to suggest that the Medicaid managed care model works better in densely populated areas as a more robust network can be created.
Mr. Rico was also upbeat.  He predicted that managed care would create disciplines that are financially sustainable.  He pointed out that there are 3 million Medicaid recipients currently.  That number is expected to swell to 4 million by 2014.

Providing proof that panel discussions should always include a fourth, Mr. Rogers weighed in with a few zingers.  For example, he stated "Medicaid recipients know how to work the system."  He suggested that a program created as temporary assistance to those in an episodic crisis has evolved into a permanent health plan for many citizens.  He was decidedly skeptical about the merits of Medicaid managed care stating "You are dealing with a population not receptive to managed care".  He went on to impersonate a typical Medicaid patient:  "I call the ambulance.  They take me to the hospital.  That's my health plan."

At the end there was a Q & A.  One advocate expressed concern with the potential bad behavior of contracted third parties.  Ms. Brown-Woofter assured her that "intense monitoring of managed care" is part of the plan going forward. 

Last Updated on Thursday, 20 October 2011 07:24
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