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"The details of health policy resemble brain surgery." - The Economist, October 2018
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Jay Nathan
161 posts
@joshuarosenowMD @DrDiGiorgio They're a great deal for payers, who find MA to be their most profitable plan type and so are motivated to expand it! That begs the question of what we are paying for, exactly...
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@DrDiGiorgio It's been shown many times that MA plans are a worse deal for taxpayers
Also, MA plans often disregard the rule that they need to cover everything that Medicare covers
MA plans impose onerous PA requirements that vastly exceed those imposed by Medicare
They're a bad deal
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There's plenty to criticize about Medicare Advantage plans.
We can't just assume they are cherry picking and upcoding, though.
There's little data that they do. There's also little data to say if fee-for-service Medicare patients aren't under-coded.
The studies are massively flawed because the data is massively flawed. Anyone who puts in ICD codes for a living (the data-entry clerks formerly known as physicians) will attest to how unreliable the codes are.
Until we have better data, I would avoid assuming that MA is ripping off the taxpayers. The same as I would avoid assuming someone with a better marathon time used performance enhancers.
Avik Roy@Avik
@mfcannon @medicarepayment @Forbes Imaging that Michael Cannon runs a marathon in 2022 at 4h21m. He runs the same marathon in 2023 at 4h5m. He asserts that his time improved because of hard work and training. MedPAC assumes he took performance-enhancing drugs. Who is right?
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@DrDiGiorgio There's also an odd distortion created with Medigap only being guaranteed-issue on initial eligibility but not on MA-FFS switching, except in 4 states. I have spent a fair amount of time researching MA and only learned this recently. Doubt patients know.
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@DrDiGiorgio And as you know, I want docs owning the utilization review/quality metrics and not insurers, including CMS :). Needs to be more patient-centered. I think current structure of MA favors plans, driving their profits and growth.
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@DrDiGiorgio Comp in name only because plans can easily game star rating system and coding, and there is minimal transparency. I think onus should be on MAOs to show how they are achieving better health value than FFS, if that is the goal.
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@jnathanMD I'm always skeptical, too.
Why do you say it's competition in name only? The average beneficiary has 9 plans from which to choose, in addition to traditional Medicare.
Whatever the incentives are, the public seems to prefer MA, as growth is outpacing traditional.
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Appreciated the chance to reflect on the learning journey, which never ends but just changes form. Great training and mentorship is the bedrock of high-quality care.
Neurosurgery@neurosurgery
NEW on #NeurosurgeryBlog by @JNathanMD: The Pros and Cons of Pursuing a Fellowship. After years of completing highly technical neurosurgical training as a resident, the decision to pursue an additional one to two years of fellowship training is ultimately highly personal: bit.ly/4ahXrkJ
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@umichneuro Thanks! Great foundation of training thanks to excellent faculty and inspiring co-residents. Excited to congratulate the next Michigan graduates soon and see where their careers take them! @SKoduriMD @MikeStrongMDPhD
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We know a little bit about what @jnathanMD experienced during his residency :) - Read this excellent piece at the link below:
Neurosurgery@neurosurgery
NEW on #NeurosurgeryBlog by @JNathanMD: The Pros and Cons of Pursuing a Fellowship. After years of completing highly technical neurosurgical training as a resident, the decision to pursue an additional one to two years of fellowship training is ultimately highly personal: bit.ly/4ahXrkJ
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Jay Nathan รีทวีตแล้ว
We have a lot of new exciting activities planned for #2023CNS, including a #5K along the historic streets of #WashingtonDC! CNS President @EladLevyMD can't wait to see your times! Learn more and sign up now: cns.org/annualmeeting/…
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Jay Nathan รีทวีตแล้ว
Registration for the #2023CNS Annual Meeting is now open! Start planning your trip to Washington D.C. today and get ready to be inspired, innovate, and imagine, September 9-13! See you there: cns.org/2023
@EladLevyMD
#washingtondc #inspire #innovate #imagine #nsgy
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@neurosurgery @RepDelBene @WaysMeansCmte @AANSNeuro @CNS_Update @councilsns @spinesection @MayaBabuMD @kt_kimmell_md What an impressive leader. Thankful that @RepDelBene is working hard for patients.
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.@Neurosurgery applauds @RepDelBene’s leadership in championing #PriorAuthorization reform! Patients may experience significant barriers to medically necessary care due to #PriorAuth requirements in #Medicare. TY for joining us for the #ASMFLYIN. #FixPriorAuth #HR3173
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@JMDaviesMDPhD @NINDSfunding @ionita_n @MokinMax @_AdnanSiddiqui @UB_Neurosurgery Congrats Jason! Fascinating question and glad you and your team are tackling it
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Can AI help to better predict who will develop vasospasm after subarachnoid hemorrhage, or perhaps equally importantly, who will NOT? We think so, and thanks to @NINDSfunding for believing we can, as well. @ionita_n @MokinMax @_AdnanSiddiqui @UB_Neurosurgery
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Kudos to the rocket stars at @NASAJPL for landing #PerseveranceRover on Jezero Crater. 10g deceleration in 7 min after 128 million miles of space flight, with an AI pilot that avoided treacherous terrain. Incredible.
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@UMichSurgery @UMichACS A role model clinician and investigator. Congrats!
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Congratulations to Dr. Lena Napolitano for this award! @UMichACS is as strong as it is in large part due to her contributions at all levels. 👏👏👏
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@SurgeonsVoice @RASACS @AmCollSurgeons @hari_keshava @JuliaColemanMD @YewandeAlimiMD @raphaelcsun @Jad_Sattar A vital investment in our health, and a great statement of Congressional support for residents. Despite always leaving it all out on the field, residents have inspired by giving even more this year. And they are just getting started
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Great news for @RASACS! Along with other @AmCollSurgeons supported priorities, #Congress recognized the importance of #GME by including 1,000 new residency slots! Read more ->aamc.org/news-insights/… @hari_keshava @juliacolemanmd @jnathanmd @YewandeAlimiMD @raphaelcsun @Jad_Sattar
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@Shalgian Incredible that the usual slandering of physicians continues, even after we have given so much. Author wants to pick and choose when we should be heard. A terribly biased piece that refuses to acknowledge legitimate need for meaningful, fair dispute resolution
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Why do these “patient advocates” care about arbitration process … patients are out at that point .. between doc and ins comp - & ins comp gaming system
Analysis | The Health 202: Surprise billing reforms look set to be included in year-end spending bill washingtonpost.com/politics/2020/…
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@drchadb Congrats!! Excellent accomplishment that deserves to be broadcasted. Your work has helped me improve pre and postoperative management and inspired research questions. I'm lucky to have been able to learn from you, and many more students to come will feel the same
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Thanks! Promotion to professor and endowed professorship months ago. Buried by #COVID19. While I am proud of these recognitions, they seem small with all that has been happening.
Kim Dupree Jones@kjnursingdean
@drchadb I understand from Afton that you were promoted . Well deserved. Update your Twitter description 😂
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