CMS Quietly Launches an Offensive Against Direct Primary Care

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By NIRAN AL-AGBA, MD Our healthcare system is self-destructing, a fact made more obvious every single day.  A few years ago, a number of brave physicians who were fed up with administrative burden, burnout, and obstacles to providing care for patients started a movement –known as Direct Primary Care (DPC.)  This is an innovative practice model where the payment arrangement is directly between a patient and their physician, leaving third parties, such as insurance or government agencies, completely out of the equation.  The rapidly growing number of DPC physicians have organized into a group called the DPC Coalition (DPCC); suddenly, the Centers for Medicare and Medicaid (CMS) is paying attention.  As of February 2018, there are 770 DPC practices across the United States … Read More

Legislature should not get in the way of important educational opportunities for California medical professionals

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The California Assembly is currently considering a bill, Senate Bill 790, which would put in place severe restrictions around gifts or other financial benefits that pharmaceutical companies can give to medical professionals as part of marketing activities. Not only will the bill limit physician access to important information about new treatments, but it also insults the integrity of every physician practicing in California and is a threat to the patient-physician relationship, which is the heart of effective health care. My personal experiences with pharmaceutical companies, like those of many of my colleagues, have been positive and productive. Before I will even consider writing a prescription for a new drug, I ask the manufacturer to provide me much-needed education and research … Read More

agenda – march 2017 meeting – Washington DC

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National Physicians’ Council for Healthcare Policy March 2017 Meeting Office of Congressman Pete Sessions, 2233 Rayburn House Office Building Energy and Commerce Committee Hearing Room, 2123 Rayburn House Office Building Washington, D.C. 20515-0001 11:30 AM – 12:00 PM 12:00 – 12:15 PM 12:15 – 1:15 PM 1:15 – 1:45 PM 1:45 – 2:45 PM 3:45 – 5:30 PM Sunday, March 19, 2017 Check-in and introductions Office of Congressman Pete Sessions, 2233 Rayburn Opening Remarks – Our Mission Forward Energy and Commerce Committee Hearing Room, 2123 Rayburn Co-Chairwoman Marcy Zwelling, M.D. Preserving Private and Rural Practice – MACRA Reforms Low Barrier to Entry APMs Vice Chairman Asa Lockhart, M.D., M.B.A. MACRA Quality Reporting Ayal Kaynan, M.D. Loss of Physicians in Rural … Read More

Fake repeal-and-replace legislation fails to reform health care

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  Fake repeal-and-replace legislation fails to reform health care By MARCY L. ZWELLING-AAMOT 2017-03-16 16:00:05 The Republican Affordable Care Act repeal-and-replace bill is public and the Congressional Budget Office report is out. The likelihood that the number of uninsured could actually go up in spite of legislation meant to “cure” all that ails our health care delivery system has animated the media into a frenzy. But whatever the ultimate number of uninsured, this legislation has little chance of reforming the health care marketplace. That’s because it doesn’t address the problem; it exacerbates it. The nation is once again throwing money at the very heart of the dragon. The exorbitant cost of health care owes its excess to the insurance industry … Read More

More Transparency Needed for Little-Known Driver of Health Care Costs

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Just when you thought your doctor was in charge of your care; confident that this professional has your well being at the center of his/her decision-making, your world comes crashing down.  You walk into the pharmacy to pick up your medication, the answer to your medical condition, only to find that the drug is not on the formulary.   What does that mean? It means that your medication was not “chosen” by the pharmacy benefit manager (PBM) contracted with your health plan. That anticipated $10 co pay has turned into $600 per month. The pharmacy calls your doctor but there is no generic equivalent and none of the other medications in the class are appropriate for you.  How can this … Read More

America needs health care that works

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Print Article: America needs health care that works America needs health care that works By MARCY ZWELLING-AAMOT 2017-01-13 07:46:19 Repeal of Obamacare has become a mantra of the new administration; one of many decrees to clean the proverbial swamp. Not so fast we hear from some in the GOP and the political left. And they’re probably correct to be cautious rather than cavalier and concentrate on fixing health care. Repeal gets us nowhere. It’s campaign rhetoric. The GOP needs to focus on a replacement that works to bring an opportunity for every American to purchase the affordable medical and health care that they need and want. Passing the ACA settled the debate about a person’s right to health care insurance … Read More

Public Health & Policy: MACRA Implementation Key Issue for Next Congress= ‘We all own it and it needs to be a success,’ says GOP staffer

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by Joyce Frieden  News Editor, MedPage TodayDecember 15, 2016  WASHINGTON — Members of the next Congress — from both sides of the aisle — will be watching to see whether the Medicare Access and CHIP Reauthorization Act (MACRA) is being properly implemented over the next few years, congressional staff members said here Thursday. “Making sure MACRA is a success [is important]; we all held hands and jumped on that one,” a Republican congressional aide said at the event, which was sponsored by the Alliance for Health Reform and the Jayne Koskinas Ted Giovanis Foundation for Health and Policy. “We all own it, and it needs to be a success, because this was our effort to take ideas from both sides and say ‘This … Read More