DermHelpCentral

Use and Cost of Actinic Keratosis Treatment for Medicare 2007 - 2015

See article in JAMA Dermatology

CONCLUSIONS AND RELEVANCE This study’s findings suggest that actinic keratosis imposes continuously increasing levels of treatment burden in the Medicare fee-for-service population. Reimbursement decreases have been used to control rising costs of actinic keratosis treatment. Critical research may be warranted to optimize access to actinic keratosis treatment and value for prevention of keratinocyte carcinoma.

Download Yeung JAMA AKs

When Hospitals Buy Doctors’ Offices, Patients' Fees Soar

Physicians who work for hospitals bill more for their services than do privately owned medical practices.  Thus, insurers and patients pay more money when they see a doctor who is employed by a hospital.  This is a dirty little practice that enriches hospitals and employed practitioners.

See:
When Hospitals Buy Doctors’ Offices, and Patient Fees Soar

Excerpts:
In the U.S.,  Medicare, the government health insurance program for those 65 and over or the disabled, pays one price to independent doctors and another to doctors who work for large health systems — even if they are performing the exact same service in the exact same place.

The Obama administration is recommending a change to eliminate much of that gap. Despite expected protests from hospitals and doctors, the idea has a chance of being adopted because it would yield huge savings for Medicare and patients.

The administration’s proposal would essentially end that system of different prices for similar services. Medicare would pay the same for any visit, test or procedure offered by doctors who work in private practice and by those who work in off-campus practices that are owned by hospitals. Doctors who work in the hospital building could still be paid the higher hospital rate. But the free-standing practice that suddenly changes hands would not continue to be paid more.

In the U.S.,  Medicare, the government health insurance program for those 65 and over or the disabled, pays one price to independent doctors and another to doctors who work for large health systems — even if they are performing the exact same service in the exact same place.

The Obama administration is recommending a change to eliminate much of that gap. Despite expected protests from hospitals and doctors, the idea has a chance of being adopted because it would yield huge savings for Medicare and patients.

The administration’s proposal would essentially end that system of different prices for similar services. Medicare would pay the same for any visit, test or procedure offered by doctors who work in private practice and by those who work in off-campus practices that are owned by hospitals. Doctors who work in the hospital building could still be paid the higher hospital rate. But the free-standing practice that suddenly changes hands would not continue to be paid more.

Cost of Medication

In a November 4, 2013 Op-Ed piece in the NY TImes, Dr. Peter Ubel tells us:
"If an antibiotic would cure your infection, your doctor would probably still warn you about the chance of sun sensitivity before prescribing the pill.
"But even when the costs of a medical intervention might force patients to choose between paying the bill or keeping up with their mortgages, American physicians rarely discuss that serious side effect with them. One physician recently explained to me that he felt money talk would “violate the doctor-patient relationship.”

For Full Op-Ed Piece:  Download Ubel Costs

This Op-Ed piece is based on the New England Journal of Medicine article, Full Disclosure — Out-of-Pocket Costs as Side Effects by Peter A. Ubel, M.D., Amy P. Abernethy, M.D., Ph.D., and S. Yousuf Zafar, M.D., M.H.S.:   Download Ubel Costs NEJM

Negotiating Fees for Health Care

For some patients, co-pays, office visits, procedures and medications may be unaffordable and/or a hardship.  Insurance companies pay lesser fees for all services than a private patient will. There is almost always room for negotiation -- one just need a stragegy.  "With patients paying more out of pocket for their health care than ever before — in the form of higher co-payments and co-insurance, high deductibles and uncovered and out-of-network treatments — negotiating with doctors and other providers has become commonplace.  But how exactly should you approach these nerve-racking discussions?  See this NY Times article for starters:   A Talk With the Doctor May Help Patients Afford Care.