Wednesday, April 2, 2014

Comparison Shopping?

WASHINGTON (AP) — Medicare says it's preparing to release billing data for more than 880,000 doctors, giving consumers an unprecedented look at how personal physicians stack up compared to others.
Medicare deputy administrator Jonathan Blum says in a blog that the data could be available as early as April 9.
The files contain data on every test and procedure billed for in 2012 by individual doctors in all 50 states, who together received $77 billion that year through Medicare's Part B coverage for outpatient services.
Although individual patient information will remain off limits, the files will identify physicians by name.
Consumer groups, insurers and employers have long sought access to the Medicare data to help track quality. The American Medical Association says it's an invasion of doctors' privacy.

10 comments:

  1. Good it should be out of the shadows. I am not on medicare but a couple years ago I had an ear problem. The first thing I was scheduled to do even before a hearing evaluation was to go get a 2800 dollar MRI. An MRI that has yet to come up in any discussions with the ENT. And my ear is no better then the day it faded. So 2800 for the MRI and 1600 for a hearing aid. I'd say he did alright on that deal.

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  2. I don't know the entire story on this, but I'm not sure what goal they want to accomplish. Are they trying to shame physicians into altering a behavior? My feelings toward medicare are definitely love/hate and as a person who is likely to be working in a primary care role and dealing with medicare, I have a vested interest in what medicare does.

    What is positive about medicare to me is that they are (in part) genuinely trying to lower cost through rational means such as conducting research for what works best to treat a given condition. They also put the screws to hospitals to run clean ships by refusing to pay for infections that occurred AFTER someone was admitted. There is a lot of good that medicare does. But the downside, as a provider of care, is that the reporting requirements are brutal. Also, there has been a switch and now part of the compensation will also focus on how the patient or family (AKA the customer) FEELS about the care they received. I'm not sure what this data will show, can you describe it a little better Rick? I genuinely interested.

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    1. Max, I went to work one day and got very dizzy. The boss called my wife to come and get me because I was in no condition to work. It was Valentine's Day in 2012. While I was waiting for her he had me call the liquor store to see if our order was ready. I could barely hear on the phone. I thought it was a bad connection but I switched to the other ear and I could hear just fine. I went home and within a couple of hours felt fine. But my ear was ringing. I went a couple days later to my doctor, who examined me and treated me for what he thought was a severe sinus infection. I got no better after a couple weeks so he set me up with the ENT. The MRI: the ENT ordered this first. He explained that sometimes my condition could be caused by a tumor on the auditory nerve and that in 1/1000 cases it is malignant. I did the MRI and still today do not know if anything showed. I am assuming that since he said nothing that the scan was clean. But it would be nice to hear him say it. Still today I don't know. The audiologist is a nice lady but I was told that at this office was the place to get all the supplies I need for the hearing aid. Of course their prices are exorbitant, I buy the stuff off Amazon to get about a years supply of batteries and wax guards for what they charge for 3 months. I went back in September and although my hearing was better the ringing is still there. I would just like to have some answers as to what happened and can this ringing(tinnitus) can ever be treated.

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    2. Wow, that's quite strange he didn't even tell you the results of the MRI. Like Mick said though, you can always get a copy of the records and take them to someone else to interpret. Going straight to MRI does seem a little quick, but probably helps rule out a lot of things quickly. I hope they went through drugs if you are on any, and looked for interactions. There are a lot of drugs that can cause the ringing. There is age related loss as well, but I wouldn't think that would be so sudden. I would definitely ask about the MRI if for no other reason than to know what it showed. Coming from ICU as my primary background, I still have an enormous amount to learn about primary care. ICU is so much about treatment and less about diagnosis and general health.

      I was curious though about the story and if you had read any other stuff about it. I think I am hitting the field just as there is about to be a lot of change and these regulations are probably going to affect me quite a bit. I hope they get to the bottom of it for you soon.

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    3. Rick, I developed tinnitus in my left ear several years ago... I was in my late 40's. Of course no one knows exactly what triggers it nor do they have a cure. I coped with it ok as it was only off-putting with I tried to listen carefully for something with that ear or it was very quiet.

      One day I developed it in the other ear as well.(early 50’s) For about the next week, I thought I was going to go insane when it was time for bed... but as the body and mind seem capable of adapting, I got use to it (for the most part). Sometimes it is fairly predominate in my hearing so the subtleties of music are spoiled and listening to quite passages in movies is annoying. Its a pain in the butt, but what are you gonna do.

      I have read a couple of articles about some hearing aid advances that do something in mitigating the sound but I haven't investigated.. I think that they do auditory studies for frequency and amplitude as it seems that everyone’s tinnitus is different and then they match a hearing aid to this noise pattern that would act in some fashion like noise cancelling headphones. Seems that hearing loss many times accompanies this condition so the problem is compounded because you perhaps can’t hear as well also. Just think it is something you have to live with.

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    4. Max about the story no I have not read too much on it. About my ear, No no no, I don't take drugs from doctors. Only temporary ones 2 weeks or less. I am of the belief that most long term drug therapies cause more harm then good. There are other ways such as life style changes etc to get your self right. Luckily except for a bum ear I don't suffer from any medical conditions.
      Scott I was 56 when this happened. The hearing aid has helped but the ringing is still there, sometimes worse then others. I do believe that it is helping a lot. Sometimes when I don't have it in, (most of the time when I am home, scared to death that I am going to forget it and jump into the shower or the pool and destroy the thing) I stick my finger into the good ear just to see what is up. Many times I hear garble but sometimes I can actually hear pretty good. Certain sounds, like the beeping of the alarm clock are just falling on a deaf ear if I happen to be sleeping on my side with the good one buried in the pillow. About twice a year Momma has to do an overnighter for inventory at her store. I try to schedule myself off the following day. Without her to nudge me I am scared to death that I will over sleep. Just can't hear that damn alarm clock sometimes. Heard a commercial for a pill that is supposed to take the tinnitus away. But as with prescription meds from the doctor I don't do quackery either.

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  3. What I don't understand is the "invasion of privacy". Maybe all stores should stop posting prices on their merchandise because it constitutes invasion of privacy by having to tell the shopper what the stuff costs? Yes, Incidently, I went to my doctor this morning for my annual checkup ( I passed ). Medicare pays for it now, although they haven't in the past, which makes no sense. Pay for medical procedures but don't pay for preventive measures was their position.

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  4. Rick, I recently had an MRI done on my back, requested by my doctor. Not only did I get a copy of the radiologist's report but also a disc of the images. I think if you call the place where the MRI was done that they are obligated to supply you with the results. That's the case here in Florida anyway.

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    1. I got the disc, and I put it in the computer for shits and giggles but it was all foreign to me. About the most I could tell when going through the images was that sometimes my eyes were open and sometimes they were shut.

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    2. I know what you mean. The radiologist's comments were pretty clear though, they tend to make you seem a lot worse off than you really are, got to cover themselves.

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