Adam Ostergar

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Adam Ostergar

Adam Ostergar

@adamostergar

Washington University School of Medicine, PGY2 Urology at Mayo Clinic AZ, dad, cyclist

St. Louis, Missouri Katılım Ekim 2017
291 Takip Edilen249 Takipçiler
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Dutch Rojas
Dutch Rojas@DutchRojas·
Dear @CMSGov I was looking through some Medicare expenditure data, which I assume is not how most people spend their evenings, but I do… And something jumped out at me. Across five specialties, independent physicians had the lowest total Medicare expenditures: $26,377 per beneficiary per year. Okay. So that’s the baseline. Now let’s look at the other models. Private equity–affiliated practices: $26,824. Corporate practices: $27,769. Hospital-affiliated physicians: $30,416. So just to make sure I understand this correctly… The most expensive model in the system is the one where doctors are employed by hospitals. And the least expensive model is the one where doctors run independent practices. That’s a $4,039 difference per Medicare beneficiary every year. Which would seem like the sort of thing policymakers might want to pay attention to. But it gets better. When physicians transition from independent practice to private equity, Medicare spending decreases by about $963 per beneficiary per year. Okay. Interesting. But when physicians transition to hospital employment, spending increases by $1,327 per beneficiary per year. Corporate affiliation? Also increases costs, by about $1,140. So the pattern here seems… fairly consistent. The model everyone keeps saying is “unsustainable” actually produces the lowest costs in the system. Meanwhile, the model that keeps absorbing those practices is also the one that drives spending up. And every time an independent physician disappears into a health system… Costs go up. Every time. Which raises a small question: If the goal is controlling healthcare costs… why is the United States Government steadily replacing the least expensive model with the most expensive one? Just asking…. -Rojas out
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Karen Stern MD
Karen Stern MD@KSternAZ·
Awkward fellow photos meets elite training @MayoUrology AZ. Apply now via @Endo_Society for our 2-year combined MIS/Endo fellowship. ☀️ Sunny Arizona 🌵 🤖 Robotics 🪨 PCNLs 😁 HoLEPs (tons!) 🫜 Metabolic stone disease 🔬 Research
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Mayo Clinic Urology
Mayo Clinic Urology@MayoUrology·
We are proud to welcome our incoming urology residents from #UroMatch2026! 💙 Welcome to the Mayo Clinic Arizona Urology family: Christopher Guske, Jaxson Jeffery, William Jevnikar, and Matthew Loper We can’t wait to have you here and watch you grow into incredible urologists!
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Real Doc Speaks
Real Doc Speaks@realdocspeaks·
The PBMs don't lower costs; they just extract billions from the system as a middleman we don't need. We need to fire the PBMs.
SJ Corber@bluesc12

@realdocspeaks Firing your purchasing department doesn’t eliminate supplier costs. It just means suppliers charge whatever they want. If you want to save money and eliminate PBMs (that make a sliver of the $356b you cite), the option is regulating pricing directly.

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Adam Bruggeman, MD
Adam Bruggeman, MD@DrBruggeman·
Everyone understands…. Hospitals, surgery centers, physicians, and patients, that these continued actions by insurers are inappropriate. I am thankful to Congress, the @ahahospitals, the @FAHhospitals, the @ASCAssociation, and all of the medical societies who have spoken out against this poorly thought out policy that hurts all parties but insurers while disrupting access to care.
IndeMed@IndeMedAction

In a bipartisan show of support, physicians in Congress from both parties urge federal action on Anthem’s new policy, warning it distorts federal law and jeopardizes patients’ access to care. 🔍Read the letter: indemed.org/wp-content/upl…

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Matthew Lee
Matthew Lee@MSLee_MD·
Dr Jackson Cabo presenting their retrospective comparison of CVAC 2.0 vs. FANS for > 1.5 cm stone burden. > 95% stone volume clearance but residual stone burden higher with FANS as pre op stone burden increased. Zero fragment rate 19% vs 28% @MayoUrology AZ #WCET25
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Focal One
Focal One@FocalOneHIFU·
Join Daniel Frendl, MD, PhD (@dfrendl) from @MayoClinic at the Focal One Masterclass in Robotic HIFU during #WCET25. His presentation will discuss the role of focal therapy in prostate cancer care, focusing on patient selection, the role of the most recent diagnostic tools and how to launch and grow a successful focal therapy program. September 10 at 10:00 AM | Phoenix, AZ Register now – limited space available: events.focalone.com/wcet25-hifu-ma… #HIFUmasterclass | #ProstateCancer | #RoboticSurgery | #Urology | #MedTech | @Endo_Society | @FocalSociety | @SocietySURS
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Karen Stern MD
Karen Stern MD@KSternAZ·
Come get hands-on teaching for your favorite endo procedures at #WCET2025. Fantastic faculty with high-fidelity simulation models. HoLEP, FANS, CVAC, Virtuoso bladder tumor enucleation, laparoscopic hemorrhage, PCNL access, & much more! @Endo_Society. Registration link below.
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Karen Stern MD
Karen Stern MD@KSternAZ·
First publication on volumetric data for FANS from North America! Stone volume reduction 89.8% using 0.625mm slices & semi automated software for volume analyses. Great work Mayo AZ team! @MayoUrology sciencedirect.com/science/articl…
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Joel Funk MD FACS
Joel Funk MD FACS@jfunkmd·
To all my US based BPH Fanatics. This is our opportunity to speak up. @SocietyofBPD @Endo_Society
Justin Dubin, MD@justindubinmd

TO ALL UROLOGISTS (sorry for long tweet but please give it a read) The @CMSGov has once again changed some of the RVU values for surgeries and now while I do not perform as many BPH surgeries as I have in the past, I as well as the MAJORITY of practicing urologists, especially generalists are dedicated to the daily care of patients with benign prostatic hyperplasia (BPH). For decades, Transurethral Resection of the Prostate (TURP) has been the gold standard of surgical management for BPH, and it remains the benchmark in the rapidly evolving treatment landscape. The typical operative time for TURP has not changed and the procedure demands continuous mental focus, physical effort, and advanced technical skill. The 2026 proposed rule recommends reducing the value of TURP (CPT 52601) to 10.00 wRVU—down from 13.16 in 2025. This constitutes a cut of nearly 25% in reimbursement and represents a serious miscalculation. The intensity and complexity of performing TURP have not diminished. The work required remains unchanged and should be recognized accordingly. I have seen on several urology forums and chat groups how upset most urologists rightfully are about this, but little has been offered for fixing it. Here is an idea - not by me, but by my friend and excellent Urologist Dr. Michael Tradewell (@doctorT_urology) . His idea which I endorse, is below: I urge CMS to maintain the 2025 TURP value of 13.16 wRVU and to re-scale the remaining 2026 Section II, E, 4(11) Transurethral Robotic-Assisted Resection of Prostate (CPT Codes 52500, 52601, 52630, 52648, 52649, and 52XX1) wRVU valuations using the proposed 2026 values relative to TURP. For example, for aquablation (code 52xx1): 10.25 x 13.16 / 10.00 = 13.49 And for HoLEP (code 52649): 13.00 x 13.16 / 10.00  = 17.108 Adopting these values will provide fair and equitable compensation for the broad range of BPH treatments that urologists deliver now and in the years ahead. Thank you for your consideration. The proposed cuts to TURP are terrible… I submitted a comment to the CMS 2026 Proposed Rule. It was easy. You can do it too. Go to this link and leave a comment. You can leave your own comment but if you agree with his recommended changes feel free to copy/paste that and/or share. federalregister.gov/documents/2025… The 2026 CMS proposal was released around 14 days ago and today there are only 300 comments… Urologists have numbers, if we all submit to CMS we can hopefully move the needle in the right direction. Instead of complaining to each other, we have the opportunity to work together and try to help our community by using our voices. #SaveTURP

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Karen Stern MD
Karen Stern MD@KSternAZ·
We are so excited we get to keep @NikkiPayneMD another 2 years as our @Endo_Society fellow!! Her profile may say “aspiring pediatric urologist” 🤣 but she fortunately moved to the dark, laser-lit side. 🪨 🎆 @MayoUrology
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