Jun 9, 2023 | Managed Care Friday
71/100: The portion of cardiologists from our national poll who are in the process of or contemplating whether to enter an affiliation with the local hospital to tap into EMR upgrades, reimbursement increases, and referral volume. 19 are contemplating merging with other groups, staying independent, and finding a way to partner with health plans, and 10 will retire. Of those looking to align with hospitals, the insurer isn’t surprised but wonders about cost – that Duplex ultrasound to test for a leg clot in a 79-year-old 2 weeks after quadruple bypass may be necessary, but at a 3x higher cost...
Jun 2, 2023 | Managed Care Friday
99: No not red balloons or that Prince classic but the amount in dollars that it costs people to get a cardiac CT calcium score, a scan that takes less than 10 minutes typically to see the amount of hardened plaque in your heart vessels and likely build-up in arteries. Insurers rarely cover this, but they may start to. “I could see it for healthy and active 50–60-year-olds with significant family history of heart attacks who would easily pass a stress test,” says Marla Calcaveccia, a medical director. Depending on the “score,” primary care doctors may recommend a statin or some other...
May 26, 2023 | Managed Care Friday
35: Percent of Americans who said their financial situation was worse in 2022 compared to 2021, which led to a higher number of people skipping medical treatment due to the cost, according to a Federal Reserve study. Only 75% of families with income under $25,000 reported being in good health, compared with 91% for those with income of $100,000 or more. People most often skipped the dentist, followed by seeing medical providers and filling prescriptions. Oh, The Worried Well: As Archie once said, ‘why do they always give me a shot where the pain ain’t…?’ It was classic Bunker, worried,...
