Congress addresses surprise bills
by jerry on January 15, 2021
At DocSpot, our mission is to connect people with the right health care by helping them navigate publicly available information. We believe the first step of that mission is to help connect people with an appropriate medical provider, and we look forward to helping people navigate other aspects of their care as the opportunities arise. We are just at the start of that mission, so we hope you will come back often to see how things are developing.
An underlying philosophy of our work is that right care means different things to different people. We also recognize that doctors are multidimensional people. So, instead of trying to determine which doctors are "better" than others, we offer a variety of filter options that individuals can apply to more quickly discover providers that fit their needs.
by jerry on January 15, 2021
There has been a lot going on recently in the nation's political scene. One point of political drama was the most recent round of relief payments for the pandemic. Buried in the surrounding controversy is that Congress addressed surprise medical bills -- an issue so popular that it garnered bipartisan support. The legislation takes effect in 2022 and patients will be protected from what's known as balance billing in cases of emergency care and when they are unknowingly treated by an out-of-network physician. There are some caveats. For example, patients can waive their protection against surprise medical billing under certain circumstances (with enough lead time).
An interesting component of this legislation is how the bill is resolved between the provider and the insurance company. This legislation gives the problem to arbitrators, but excludes prices on either extreme from consideration: chargemaster prices (essentially "list prices"), which would favor providers, and Medicare and Medicaid rates, which would favor payers. Arbitrators can consider in-network prices, which might reduce the pressure for some payers to enroll more providers in their network.
by jerry on January 10, 2021
In 2020, we worked on user interface improvements to make it easier for providers who have claimed their profiles to add information. Happily, we released those changes earlier this week.
One of the changes is that we streamlined the process when providers add multiple values: it used to be that adding each value (even for the same attribute) would require communicating with the server, and now that can be done in fewer trips. Another change is to better incorporate autocomplete to help the provider know what our software understands. Providers can also now re-order values that they add.
We're not done improving the interface, and hope to roll out some additional tweaks in the next week or two. As always, if you have any suggestions, let us know.
by jerry on January 01, 2021
Happy New Year!
May this year be better than the last.
by jerry on December 26, 2020
We hope everyone had a merry Christmas this year, despite the challenging circumstances.
2020 has been such a strange year, with time feeling like it has passed both slowly in some regards and quickly in others.
by jerry on December 20, 2020
In November, Kaiser Health News reported that 83% of the 3,080 hospitals evaluated by CMS had readmissions that exceeded certain thresholds. CMS enacted a policy of penalizing hospitals that saw too many readmissions in an effort to increase quality (reduce unnecessary patient procedures) at the same time as lowering costs (avoiding paying for unnecessary patient procedures). Understandably, the hospital industry has objected to the readmission measure as imprecise and biased against certain hospitals. The patient readmission metric is undoubtedly imperfect; however, waiting for a perfect measure to be agreed upon by the medical community would likely mean no progress at all.
83% seems like a high number for the percentage of eligible hospitals that failed to demonstrate sufficient progress or had adequate performance. However, it is unclear whether the goals were too lofty, or the penalty was too small, or perhaps most likely, a combination of the two.
A spokesperson for the American Hospital Association pointed out that the timing of this penalty is terrible, given the financial strain that many hospitals experienced this year.