Anthony DiGiorgio, DO, MHA

@RepHarshbarger All using 340B! Time for reform!

Democrats screamed we were "gutting healthcare" when we cracked down on fraud. THIS is who they were protecting: A Haitian fraudster set up a fake clinic, destroyed HIV drugs meant for sick patients, & pocketed $58 MILLION. Then he bought a Bentley and a $2.5M mansion! ⬇️

@RealJoeGrogan Make the money follow the patient!

It’s promising to see that Congress may finally take steps to address the runaway 340B program. 340B has been exploited by large hospitals that pocket extra profits and decline to pass on any drug-discount savings to patients, burdening taxpayers. Sweeping reforms are needed.

Congress may finally be ready to take another look at the 340B drug discount program… Some nuggets from my story: -A new bipartisan House group is crafting 340B proposals that should be released soon -Senate’s 340B group also releasing new paper soon news.bgov.com/bloomberg-gove…

@MattZirwas It's always been the hospitals offlabelideas.com/p/its-the-hosp…

Hospitals are swindling the public and providing the receipts themselves. They paid for a survey about the public blames for healthcare inflation to prove it. Insurerers/PBMs = 64% Pharma = 34% Hospitals = 20% The truth about who drove healthcare inflation from 2022-2024: Hospitals (inlcuding employed providers) = ~50% Pharma = 11% Payers/PBMs = impossible to calculate The group most reponsible got blamed the least. That's not an accident.

@USCSchaeffer @KFFHealthNews offlabelideas.com/p/californias-…

A proposed California ballot measure to cap medical executives' pay is unlikely to reduce patient costs, USC Schaeffer's Glenn Melnick tells @KFFHealthNews. kffhealthnews.org/medicaid/seiu-…

@JOSEPH45075332 And if the order needs to be changed, YOU will be the one that needs to log into their chart and change the order.

It completely speaks to your point about not thinking and just asking the doctor We have removed all roadblocks to speaking with the physician Even a moments thought for anyone in healthcare would realize that for a 2-mo follow up appt, the precise order of two unrelated scans does not matter (as long as both are done in time for the appt) And if the patients appt is next week they can do whatever order is technically feasible

Just this morning … Radiology tech sends me a “CHAT” which interrupts me in the middle of clinic 2 months ago I had ordered two MRIs on a patient A liver MRI with “Eovist” contrast and a routine brain MRI with contrast I honestly didn’t know this … but the Eovist contrast interferes with the brain contrast Reason they had to urgently interrupt me? To ask me which order I wanted the scans done because they can’t be done on the same day For scans I ordered 2 months ago! And don’t need for a week! (Note - I never specified “same day” but patients often schedule scans same day for convenience- which is perfectly reasonable) This is not a doctor question. This is a scheduling question with a technical twist And the reason she said she had to interrupt *me*? Because she didn’t want to bother the radiologist 😡

@Pm1oPm1o Agree. Although both Medicare & Medicaid have managed care options.

@DrDiGiorgio First of all, it would never ever ever be medicare for all. It would be Medicaid for all. A managed care plan is the only reasonable pathway for universal healthcare coverage

This is the main reason I’m against a “Medicare for All” or other single payer system. It puts 100% of healthcare spending under the authority of the HHS secretary. That’s $5T under the control of one department, headed by one person. Imagine the power that person could wield. Look what happened here, with the HHS secretary controlling just under $2T of government healthcare spending. They were able to defund healthcare in certain communities. Imagine what a malicious administration could do to its enemies with 100% control of healthcare spending. It could defund treatments for certain diseases. Target specific communities. Pick and choose successful companies. With more and more jobs being consumed by the healthcare sector, that HHS secretary could decimate the economies of entire regions. I don’t care what you think of the current HHS secretary. Nobody should want that kind of centralization of power. If anything, we should decentralize even more. The current healthcare spending under HHS is too much. Decentralize healthcare, return power and agency to the people.

@mattdorsey Appreciate your nuance and open mindedness!

All that being said, I refuse to call what these athletes did bigoted or hateful — and I would urge all those offended or hurt by this episode to show them grace. The LGBTQ+ equality movement succeeds when we commit to winning hearts and minds, rather than shaming them. (5/5) 🏳️‍🌈

Today, I was asked to comment on the @SFGiants Pride Night, where I attended for the opening ceremony. I gave it some thought, and knowing it’ll never be quoted in full, here’s my response: To me, it was disappointing in several respects. (1/5)

“For the first time, policymakers would have a clear view into how 340B is being used. That transparency could help curb abuse and better align the program with its original purpose.” – As conversations in Washington ramp up around #340B program abuse, commonsense reforms could increase program integrity. Read more from @PacificResearch @SallyPipes in @NEWSMAX: newsmax.com/sallypipes/abb…

@SavageOnTheSun Exactly. We can move the other direction.

It’s essentially what we have now, although we do it with more steps. And because of that system, with the lack of price signals and incentives for efficiency, we have our current mess. Reforming that system to have even less market signals will destroy whatever we have left (access).

I’m gay and I’m exhausted by the idea that everyone must affirm, celebrate, or participate in Pride. A free society means people can disagree. If players are expected to wear Pride-themed gear, they should be free to express their faith too. I’m not offended by God. Why is everyone else?

@PNW_Wanderer91 I have a few more names to add to that list, but basically agree.

@DrDiGiorgio We need you, Dr Umbehr, Sean Flynn, Michael Cannon, Mark Cuban and Eric Burlison in a room together. The right of center is so weak on healthcare. We have the ideas. But we got to act on them. The left will sell medicare for all before we get our act together

@PNW_Wanderer91 Totally agree. open.substack.com/pub/offlabelid…

@DrDiGiorgio I think a “American Singapore” system would work. Emphasis on direct contracts, universal HSAs, enhance Community Health Centers along direct contract models and 5X funding for them as the state component. Universal standard catastrophic with free market add ons.

@WentzelJordan Why even have the doctors?

@DrDiGiorgio I'm suprised the administration didn't keep a coder paired with a Doctor going forward.

This reminds me of one of my favorite studies in healthcare. A clinical team simply had the coders round with them in the hospital. The profit per admission increased 42%. This was without changing a single part of their clinical care. Outcomes didn’t improve. They simply coded a higher intensity of care, leading to higher reimbursement. Our system rewards coding more than it rewards care. The institutions that master the coding game are the ones that do the best.

@WentzelJordan They probably did

@DutchRojas Self driving will decrease neurotrauma. I’m gonna be out of a job.

I trust Full Self-Driving more than I trust the guy next to me holding a coffee, scrolling Instagram, and steering with one knee.