Author Interviews, Electronic Records, Medical Billing / 26.01.2026

[caption id="attachment_72121" align="aligncenter" width="500"]efficient-medical-office-billing.jpg Freepix[/caption] Doctors' offices are not short on responsibility. They manage patient care, compliance, staffing, technology, and the constant churn of insurance rules, all while trying to keep the lights on and the waiting room moving. What often gets less attention is how many of their daily headaches are not clinical at all. They are operational. The good news is that some of the most meaningful improvements happening in medical practices right now are practical, measurable, and rooted in better systems rather than bigger budgets. When Administrative Friction Becomes a Care Issue Front office inefficiencies do more than slow down billing. They ripple outward. A denied claim delays revenue, which stresses staffing. Staffing stress shortens visits. Short visits frustrate patients. None of that helps outcomes, and none of it reflects a lack of effort from medical teams. It reflects a system that asks doctors offices to function like data companies without giving them the right tools. Eligibility errors are a perfect example. Verifying provider credentials across multiple states, plans, and licensing bodies is not glamorous work, but mistakes are costly. Automation and smarter data access are changing that reality. Practices that adopt healthcare payment integrity solutions that boost your payment integrity program with real-time provider eligibility data for all licensed providers across every U.S. state and jurisdiction are seeing fewer denials, faster reimbursements, and far less back and forth with payers. That efficiency shows up directly on the balance sheet, and indirectly in calmer days for staff.
Social Security / 26.11.2025

social-security-beyond-your-diagnosis

When you can no longer work because of a serious health condition, your focus is naturally on your diagnosis, your symptoms, and your doctor's orders. You assume that proving how sick or injured you are is the only thing that matters for a Social Security Disability claim. But what many applicants discover too late is that the Social Security Administration (SSA) has a set of non-medical rules it checks first. Failing this initial screening means your medical file will never even be opened. The fear of being denied for a technicality you didn't understand is a major source of stress. The disability benefits system is a lifeline for millions; in December 2023, disability benefits were paid to more than 8.7 million disabled beneficiaries. This article will demystify the SSA's non-medical requirements for both Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Understanding these rules is the critical first step in determining your eligibility and avoiding a preventable denial. Having a complete picture of these non-medical requirements for Social Security Disability benefits is the first step toward building a strong application.

Key Takeaways

  • The SSA always checks non-medical (or "technical") requirements before they look at your medical records.
  • Social Security Disability Insurance (SSDI) is an insurance program based on your work history and the FICA taxes you've paid.
  • Supplemental Security Income (SSI) is a needs-based program based on your current income and financial resources.
  • Failing to meet the distinct non-medical rules for either program results in a technical denial, regardless of how severe your medical condition is.
Insurance, Medicare / 14.10.2025

[caption id="attachment_70986" align="aligncenter" width="500"]medical-insurance-cigna Photo by Pixabay[/caption] Navigating Medicare can feel like wandering through a maze, even for the most diligent seniors. Between dozens of plan options, coverage details, and deadlines, it’s easy to feel overwhelmed. That’s where can Cigna Medicare Advantage plans stand out. Beyond standard medical coverage, they offer hidden perks that make your healthcare simpler, more rewarding, and surprisingly affordable. Let’s explore the lesser-known benefits that can help you make the most of your plan.

Complete Preventive Care beyond the Fundamentals

Cigna aims to emphasize preventative treatment. This covers immunizations, regular checkups, and wellness visits. Many of these services are free or almost so. What sets these plans apart is the expanded preventive care. They include vision and hearing assessments. Certain programs even cover expenses for corrective aids. These small actions help ward off more significant medical problems later. Members of Cigna could also have access to individualized health evaluations. These tests help older people find the right wellness programs. They help identify potential health issues before they become major. Better health outcomes and fewer long-term expenses follow from this.
Author Interviews, Cancer Research, Cost of Health Care / 16.09.2025

[caption id="attachment_70691" align="aligncenter" width="500"]oncology-cancer-billing-services Pexels image[/caption] Cancer care is going through big changes due to advancement in healthcare research. For many years, the main treatments were surgery, chemotherapy, and radiation. These are still important, but now new options like immunotherapy and targeted therapy are improving results for patients. But with these new treatments also come new challenges.  They have completely changed how cancer clinics handle billing and payments. For oncology providers, keeping up with these changes is important to stay financially secure. This article looks at new cancer treatments, how they affect billing, the challenges clinics face, and how trusted oncology billing services providers help providers handle these issues.
Cost of Health Care, Legal-Malpractice, Medical Billing / 28.08.2025

Manage Medical Bills Kent is known as one of Washington's busiest suburban hubs, and like many cities, it experiences accidents that lead to personal injury claims. Injury settlements often take considerable time due to investigations, negotiations, and legal procedures. Meanwhile, medical bills can pile up quickly, creating financial stress for individuals and families. In such cases, working with a Kent personal injury attorney provides legal direction, but we must also manage our medical expenses carefully while waiting for a resolution.
Cost of Health Care, Insurance / 21.08.2025

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Key Takeaways

  • Long-term care insurance is increasingly important as more people live longer.
  • Assessing your personal, financial, and family situation can help you choose the right policy.
  • Understanding policy features and exclusions is crucial to avoid surprises later.
  • Comparing providers and working with agencies or licensed professionals may offer added support.
  • New technology and public policies are changing how long-term care is delivered and financed.
  • Reading recent reviews and news can keep you informed about industry trends.
AI and HealthCare, Electronic Records, Medical Billing / 12.07.2025

Data fragmentation among EHRs, claims, and device feeds presents enormous issues for healthcare businesses. A comprehensive approach based on healthcare data aggregation and backed by a digital health platform is needed to address this. Providers can improve productivity and outcomes by integrating disparate information using a uniform data model, improved lakehouse architecture, semantic curation, and AI enrichment. records-healthcare-aggregation The healthcare sector lacks insights despite the volume of data. Because data is scattered across EHRs, claims, devices, and patient-reported systems, clinicians often do not have a complete picture of the patient. This fragmentation leads to delays, inefficiencies, and missed opportunities for early action. A truly connected environment requires meaningful healthcare data aggregation that can standardize, curate, and activate data across the care continuum. The cornerstone of this shift is the use of a robust digital health platform that can combine data from several sources into a single, intelligent stream. Data fragmentation causes needless expenses, delays the delivery of treatment, and impairs decision-making. When important information is scattered between payer files, EHRs, siloed systems, and remote monitoring platforms, clinicians are operating blindly. This challenge affects every touchpoint of patient care. Solving this calls for an advanced aggregation architecture that consolidates and refines all clinical, claims, and device data into a single intelligent patient view. The foundation of this transformation is a Healthcare data platform built for real-time intelligence, not just storage.
Cost of Health Care, Diabetes, Pharmaceutical Companies / 28.05.2025

Reasons for the  Price Increase of Insulin .jpg The price of insulin keeps on skyrocketing every year. According to the American Diabetes Association, spending on insulin tripled within a decade. By 2022, the cost had hit a staggering $22.3 billion. Between 2017 and 2022, the inflation-adjusted cost of insulin increased by 24%. This is a significant problem since millions of people suffering from Type 1 and Type 2 diabetes can’t go without the drug. Over the years, people have initiated an insulin overpricing lawsuit. In 2023, Eli Lilly settled for $13.5 million and agreed to cap its price at $35 for four years. So why is insulin so expensive in the United States, and what can you do about it?
Cost of Health Care, Education / 17.03.2025

Business Side of HealthcareImage Source

Medicine is about saving lives, but it’s also a business. Behind every appointment, insurance claim, and prescription is a system that runs on strategy, budgets, and management. Today’s healthcare isn’t just about doctors and patients. It’s a network of administrators, insurers, and policymakers working to keep hospitals running and treatments accessible. With rising costs, policy shifts, and new technologies reshaping the industry, strong leadership is more important than ever. In this blog, we’ll explore why understanding the business side of medicine matters, how healthcare leaders shape the industry, and what professionals can do to stay ahead.
Cost of Health Care, Medication Costs / 05.03.2025

[caption id="attachment_66993" align="aligncenter" width="500"]medication-costs-discuss-with-doctor Photo By: Kaboompics.com[/caption]

Understanding the Importance of Transparent Communication

The conversation around medication costs is often overlooked, yet it is an essential aspect of effective healthcare management. Transparent communication with your healthcare provider can pave the way for finding affordable options while ensuring that the quality of care is not compromised. Patients often hesitate to bring up financial concerns, fearing it may affect the quality of treatment offered. However, discussing medication costs openly allows your doctor to consider various factors that could lead to more cost-effective treatments. For instance, health providers, with the patient's consent, can explore alternative medications or treatment plans that are equally effective but less expensive. Additionally, transparent communication fosters a stronger doctor-patient relationship where the patient feels supported in all aspects of their care. Using resources like BuzzRx further enhances your ability to find savings on prescriptions, ultimately aiding in more manageable healthcare costs.
Accidents & Violence, Cost of Health Care, Legal-Malpractice, Medical Billing / 11.12.2024

[caption id="attachment_64521" align="aligncenter" width="500"]pay-bills-after-car-accident.jpg Image Source[/caption] If you are involved in a car accident, you have to worry about the medical expenses that follow, especially if you have sustained severe injuries. Medical bills quickly accumulate, which can cause uncertainty and financial stress for an individual. Medical Payments coverage offers an option for accident victims to deal with medical expenses after an accident. Given the high cost of healthcare in the US, your best option might be to consider medical coverage offered through any option available. This post is a rundown of these options in this article.
Cost of Health Care / 05.12.2024

  [caption id="attachment_65327" align="aligncenter" width="904"]Image Source Unexpected medical expenses are a reality for millions of Americans. Whether it’s an unplanned emergency room visit, an unexpected diagnosis, or a sudden procedure, medical bills can add significant stress to an already challenging financial situation. For many, these expenses are not just a financial burden but also a barrier to accessing necessary care. Why Medical Bills Are Often a Surprise Medical billing in the U.S. can be complex and opaque. Even with insurance, out-of-pocket costs can catch patients off guard. Common reasons for surprise bills include: ● Out-of-Network Providers: Even during planned procedures, patients may unknowingly receive care from out-of-network specialists, resulting in much higher costs. ● High Deductibles: Many insurance plans come with deductibles that must be met before coverage kicks in, leaving patients to cover significant costs upfront. ● Ambulance Services: Emergency transportation is often not fully covered, leading to bills that average hundreds or even thousands of dollars. ● Hidden Fees: Charges for tests, medications, or consultations may not be clearly communicated beforehand. These surprises can leave patients scrambling to manage their finances, especially if they’re already living paycheck to paycheck. Strategies for Managing Surprise Medical Bills If you’re facing an unexpected healthcare expense, here are steps you can take to minimize the financial strain: 1. Understand Your Options for Unpaid Bills Leaving bills unpaid can damage your credit score and lead to collections. However, you can manage this by researching resources that help you stay informed about outstanding debts. Knowing how to find unpaid medical bills is especially important, as these can often go unnoticed until it's too late. Try setting reminders or using apps to track due dates and avoid missing payments. 2. Review Your Bill Carefully Mistakes in medical billing are surprisingly common. Look for errors such as duplicate charges, services you didn’t receive, or incorrect insurance processing. If you find discrepancies, contact the billing office immediately to request corrections. Make sure to compare the bill to your insurance explanation of benefits (EOB) to double-check what was covered. Taking a little extra time to review your bill can save you money and stress later. 3. Negotiate with Providers Hospitals and clinics often have financial assistance programs or are willing to negotiate payment terms. Explain your situation and ask if they offer discounts for paying upfront or provide interest-free payment plans. Many providers are open to adjusting costs to make bills more manageable. You might also be able to set up smaller monthly payments that fit your budget. 4. Leverage Insurance Benefits Double-check what your insurance covers. Sometimes, insurers deny claims due to errors in coding, and these can often be resolved by contacting both your provider and your insurer. It’s also a good idea to keep all your medical bills and insurance documents organized. This makes it easier to review charges and spot any mistakes. 5. Explore Assistance Programs Nonprofits and government programs, such as Medicaid or state-level healthcare assistance, can help cover unexpected costs. Research what’s available in your area and whether you qualify. Many programs also offer help with things like prescriptions or medical equipment. Don’t be afraid to ask questions or reach out for support—you might be surprised by what’s available. Avoid Surprises While not every medical expense is avoidable, planning ahead can reduce the financial impact of emergencies: ● Know Your Insurance Coverage: Understand the details of your plan, including in-network providers, deductible amounts, and out-of-pocket maximums. ● Save for Emergencies: Building an emergency fund, even in small increments, can provide a safety net for unexpected costs. ● Choose Transparent Providers: When possible, opt for providers who offer clear pricing and billing practices. Be Proactive Medical emergencies are stressful enough without the added burden of financial uncertainty. By staying proactive, seeking assistance, and utilizing available resources, you can better manage surprise medical bills and protect your financial well-being. The key is to act quickly, communicate openly with providers, and explore every option available to reduce the financial strain. Image Source[/caption] Unexpected medical expenses are a reality for millions of Americans. Whether it’s an unplanned emergency room visit, an unexpected diagnosis, or a sudden procedure, medical bills can add significant stress to an already challenging financial situation. For many, these expenses are not just a financial burden but also a barrier to accessing necessary care.

Why Medical Bills Are Often a Surprise

Medical billing in the U.S. can be complex and opaque. Even with insurance, out-of-pocket costs can catch patients off guard. Common reasons for surprise bills include:
  • Out-of-Network Providers: Even during planned procedures, patients may unknowingly receive care from out-of-network specialists, resulting in much higher costs.
  • High Deductibles: Many insurance plans come with deductibles that must be met before coverage kicks in, leaving patients to cover significant costs upfront.
  • Ambulance Services: Emergency transportation is often not fully covered, leading to bills that average hundreds or even thousands of dollars.
  • Hidden Fees: Charges for tests, medications, or consultations may not be clearly communicated beforehand.
These surprises can leave patients scrambling to manage their finances, especially if they’re already living paycheck to paycheck.
Cost of Health Care, Diabetes, Pharmacology / 21.10.2024

[caption id="attachment_64143" align="aligncenter" width="500"]diabetes-insulin Source[/caption]

Access to affordable insulin remains a challenge for millions of people living with diabetes around the world, particularly in middle-income countries. To bridge this gap, platforms are emerging that connect patients with high-quality insulin at reduced prices. For individuals struggling to afford their life-saving medication, these services offer a convenient and affordable solution, making a significant impact on global health.

The Global Insulin Crisis

Diabetes affects millions worldwide, and the demand for insulin continues to rise. Major insulin manufacturers, including Novo Nordisk, Eli Lilly, and Sanofi, dominate the global market, producing essential medications for managing blood sugar levels. However, in many parts of the world, including countries like India, Mexico, and the Philippines, insulin prices remain prohibitively high. This leaves a substantial portion of the population without access to the medication they need to live healthy lives. Data shows that insulin prices are often out of reach for people in middle-income countries. The situation is particularly dire in regions like Kenya, Malaysia, and Vietnam, where the cost of insulin may equal a month's salary. With nearly three major companies controlling the insulin market, competition is limited, and prices remain high. As a result, many patients with type 1 and type 2 diabetes face inconsistent access to insulin, which can put their health at significant risk.
Alzheimer's - Dementia, Author Interviews, Cost of Health Care, Medicare, UCLA / 15.10.2024

MedicalResearch.com Interview with: [caption id="attachment_64014" align="alignleft" width="150"]Frank F. Zhou  |  he/himMD Candidate, Class of 2025 David Geffen School of Medicine at UCLA Frank F Zhou[/caption] Frank F. Zhou   he/him MD Candidate, Class of 2025 David Geffen School of Medicine at UCLA MedicalResearch.com: What is the background for this study? What is Lecanemab used for?  How is it given to patients? Response: Lecanemab is a new infusion therapy for Alzheimer's disease. Its dosing is based on each patient's body weight (10 mg/kg every two weeks), but the drug is only available in 500 mg and 200 mg single-use vials, meaning that any leftover drug in vials must be thrown away. Given that lecanemab is expected to cost Medicare billions of dollars each year, we hypothesized that discarded drug could result in significant wasteful spending.
Geriatrics, Medicare / 26.09.2024

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As healthcare continues to evolve, more attention is being given to senior health, and wellness programs are increasingly becoming a cornerstone of comprehensive senior care. Wellness programs focus on improving quality of life and managing chronic conditions through proactive measures such as exercise, nutrition, mental health support, and preventive care. For seniors, these programs are especially valuable because they address the unique challenges that come with aging. As part of senior health plans, wellness programs are not only a way to treat existing issues but also a way to prevent future problems by promoting healthy lifestyles. These programs offer a broad range of benefits, from improved physical health to enhanced mental well-being. Seniors enrolled in wellness initiatives often experience better control of conditions such as diabetes, heart disease, and arthritis. In addition, wellness programs can help reduce hospital visits, lower healthcare costs, and increase overall longevity by encouraging proactive health management. Seniors who engage in regular fitness activities, for instance, are less likely to experience falls, fractures, and other mobility-related issues, which are common concerns in older age.
Medicare / 20.09.2024

  [caption id="attachment_63416" align="aligncenter" width="500"]medicare-insurance-agent.png Source[/caption] Using Medicare can be quite challenging for those without experience dealing with this system and its numerous programs, plans, and services. Hiring a Medicare insurance agent is one of the best ways to guarantee that you get the right Medicare plan suitable for your needs. However, the problem of choosing the right agent might be even more daunting than the task of comprehending the insurance plans. This guide is designed to help you select the best Medicare insurance agent and make the right decision.
Cost of Health Care, Pharmacology / 12.09.2024

When you’re at the pharmacy, it’s normal to feel a bit of confusion about whether you would like to receive generic or brand-name medication when the pharmacy technician asks you the usual question. While health professionals, from pharmacists to doctors, nurses, and students of RN to MSN programs, will understand the differences between the two, it's important that you, as a patient, know them, too. In this article, we will break down the differences between generic and brand-name medications so that you will be more aware when you visit the pharmacy.

Medicare / 20.08.2024

[caption id="attachment_62903" align="alignleft" width="200"]retirement-medicare_pexels-cottonbro-6158648 Source[/caption] Medicare can often seem like a maze of deadlines and enrollments, especially for retirees. Missing critical Medicare enrollment periods can lead to fines and gaps in coverage. Understanding why these specific time frames exist can save a lot of hassle and ensure continuous healthcare access. The Initial Enrollment Period (IEP) is a seven-month window that allows retirees to enroll in Medicare. Specifically, it starts three months before the month you turn 65, includes your birth month, and ends three months after. Missing this period usually results in penalties that could affect your healthcare costs for the rest of your life. Understanding this window is crucial because it shapes the foundation of your healthcare plan. To make the most of your IEP, it's advisable to start planning as soon as you approach 65. Setting reminders and being proactive can help you take full advantage of this period, avoid future complications, and ensure you receive medical coverage without interruptions or financial strains. 
Medical Billing / 15.08.2024

[caption id="attachment_62854" align="alignleft" width="300"]medical-billing_pexels-karolina-grabowska-7195369 Image Source[/caption] Once upon a time, outsourcing physician medical billing services was seen as a novel concept. Many physicians initially viewed it as an unnecessary expense, believing it only benefited larger institutions like hospitals, clinics, and group practices. However, in recent years, it has increasingly become a standard practice. Even independent solo practitioners are now considering outsourcing for their medical billing and coding needs. If you are a solo practitioner finding healthcare billing and coding challenging, you are not alone. Many in the field struggle to deal with the complexities of coding and billing, often failing to maximize revenue in medical billing services for solo practices. It's important to recognize that the healthcare market is changing, with regulations and rules for medical billing and coding constantly developing. Implementing an effective medical billing and coding system is therefore crucial for physicians seeking a strategic advantage. Outsourcing medical billing services is no longer just about cutting costs; it has become a vital tool that provides numerous benefits to practicing physicians. Moreover, these advancements can be incorporated into oncology medical billing systems to ensure precise and efficient billing for cancer treatments and diagnostics.
Abuse and Neglect, Cost of Health Care, Race/Ethnic Diversity / 06.08.2024

MedicalResearch.com Interview with: [caption id="attachment_62764" align="alignleft" width="200"]Benjamin Ukert PhDAssistant Professor
Department of Health Policy and Management
Texas A&M University, School of Public Health
Texas 77843-1266 Dr. Ukert[/caption] Benjamin Ukert PhD Assistant Professor Department of Health Policy and Management Texas A&M University, School of Public Health Texas 77843-1266 MedicalResearch.com: What is the background for this study? Response: The Affordable Care Act (ACA) was enacted in March 2010 with one major goal to increase access to insurance coverage. This was done through the expansion of the Medicaid program for low income individuals and the establishment of formal health insurance marketplaces for individuals without access to employer sponsored insurance. Texas did not expand Medicaid for low income individuals, but the health insurance marketplace should have led to increases in insurance coverage, due to generous federal subsidies that cover a large share of the health insurance premium. Gaining insurance coverage can affect providers, such as hospitals, who treat a large share of uninsured individuals. We focused on the inpatient setting and evaluated whether the ACA led to changes in demand for hospital care, and whether the ACA led to reduction in the share of uninsured individuals treated by hospitals.
Medicare, Primary Care / 23.07.2024

Navigating the complexities of Medicare can be challenging, especially when it comes to finding and choosing the right primary care doctor. This guide will help you understand the different parts of Medicare, how it covers primary care services, and provide actionable steps to find and evaluate primary care doctors that accept Medicare.

Understanding Medicare and Its Different Parts

Medicare is a federal health insurance program primarily for individuals aged 65 and older, though it also covers certain younger people with disabilities. Medicare consists of four parts:
  1. Medicare Part A: Covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
  2. Medicare Part B: Covers certain doctors' services, outpatient care, medical supplies, and preventive services.
  3. Medicare Part C (Medicare Advantage): An alternative to Original Medicare that offers all Part A and Part B services through private insurance companies. These plans often include additional benefits like vision, dental, and prescription drug coverage.
  4. Medicare Part D: Covers prescription drugs.
Author Interviews, Cost of Health Care, Telemedicine / 09.07.2024

The United States currently has a doctor-patient ratio of 2.6 in 1000, and although it is above the recommended 1:1000, medical practitioners are still having a hard time finding the right system to balance administrative tasks and patient care. Healthcare providers are struggling to keep up with the ever-increasing demands of their patients. That is why there is now a fast-growing demand for Virtual Patient Coordinators. Virtual Patient Coordinators are skilled individuals who work remotely to assist medical practices in managing their patients' needs. They are responsible for a wide range of tasks, including scheduling appointments, coordinating referrals, and organizing medical records. By utilizing advanced technology and secure communication platforms, virtual patient coordinators are able to efficiently handle these tasks from anywhere in the world, ensuring that patients receive the care they need in a timely manner. Let’s find out the ways they are changing the game for busy medical practices.
Cost of Health Care, Medical Billing / 04.07.2024

Patient insurance coverage frequently changes, which can lead to missed details when tracked manually. This often results in claim denials and subsequent reimbursement issues. This article explores the benefits and effectiveness of automated eligibility coverage tracking platforms designed to address these challenges effectively.

The Problem: Manual Tracking Just Doesn't Cut It Anymore

Determining a patient’s status as well as his or her insurance is a crucial but time-consuming process in the billing department. Previously, it included calling insurance companies, verifying the data in different systems, and entering the information into spreadsheets. Since patient details are dynamic and various claims need to be addressed every week, it becomes impossible to manage information updates through traditional methods. Some of the problems include:
  • Time-Consuming Process - Verifying coverage manually can take up to 30 minutes per patient. For large billing companies, this may translate into big time losses.
  • Human Error - Manually compiling and updating records inevitably leads to inaccurate or outdated information falling through the cracks.
  • Claim Denials - Incorrect policy details lead to higher denial rates, payment delays and lost revenue.
  • Lack of Visibility - With records scattered across systems and spreadsheets, billing teams lack clear visibility into coverage changes.
Traditional ways of checking eligibility can't keep up with increasing patient numbers and complexity. Billing teams handling medical billing denials and solutions urgently require automation support to manage this crucial data.
Author Interviews, Cost of Health Care, JAMA, Kidney Disease, Transplantation / 01.07.2024

MedicalResearch.com Interview with: [caption id="attachment_62111" align="alignleft" width="200"]Amal Trivedi, MD, MPHProfessor of Health Services, Policy & Practice Brown University School of Public Health Prof. Trivedi[/caption] Amal Trivedi, MD, MPH Professor of Health Services, Policy & Practice Brown University School of Public Health MedicalResearch.com: What is the background for this study? Response: On January 1st, 2021, the Centers for Medicare & Medicaid Services (CMS) launched the mandatory End-Stage Renal Disease Treatment Choices (ETC) Model, which randomly assigned approximately 30% of U.S. dialysis facilities and managing clinicians to financial incentives to increase the use of home dialysis and kidney transplantation. The program is set to run through 2027, with financial incentives and penalties increasing as the model progresses. Our study sought to assess the ETC’s effect on these outcomes of interest in the first two years, as well as to examine outcome changes by race, ethnicity and socioeconomic status.
Author Interviews, Cost of Health Care, Gastrointestinal Disease, Health Care Systems / 20.05.2024

MedicalResearch.com Interview with: [caption id="attachment_61735" align="alignleft" width="183"]Laura Targownik, MDLead author and Clinician-Investigator Mount Sinai Hospital in Toronto Departmental Division Director, Gastroenterology and Hepatology University of Toronto Dr. Targownik[/caption] Laura Targownik, MD Lead author and Clinician-Investigator Mount Sinai Hospital in Toronto Departmental Division Director, Gastroenterology and Hepatology University of Toronto MedicalResearch.com: What is the background for this study? Was there a difference in the types of patients or need for surgery seen by the female/male physicians? Response: The background for this study is that there is an emerging body of literature that having a female physician leads to better patient outcomes in many health care settings, especially amongst patients undergoing surgery or being admitted to hospital.  However, this has not previously been evaluated in gastroenterology.  Female and male gastroenterologists may have different styles of practice on average, and this potentially could lead to differences in how patients engage with the health care system following an initial assessment.
Author Interviews, Cost of Health Care, JAMA, Kidney Disease, Medicare / 11.01.2024

MedicalResearch.com Interview with: [caption id="attachment_61226" align="alignleft" width="134"]Kalli Koukounas, MPHPh.D. Student, Health Services Research Brown University School of Public Health Providence, RI Kalli Koukounas[/caption] Kalli Koukounas, MPH Ph.D. Student, Health Services Research Brown University School of Public Health Providence, RI MedicalResearch.com: What is the background for this study? Response:  On Jan. 1st, 2021, the Centers for Medicare and Medicaid Services (CMS) implemented the End-Stage Renal Disease Treatment Choices (ETC) Model, one of the largest randomized tests of pay-for-performance incentives ever conducted in the US. The goal of the model was to enhance the use of home dialysis and kidney transplant or waitlisting among kidney failure patients in traditional Medicare. The model randomly assigned approximately 30% of US dialysis facilities and nephrologists to receive financial incentives, ranging from bonuses of 4% to penalties of 5%, based on their patients’ use of home dialysis and kidney transplant/waitlisiting. The payment adjustments apply to all Medicare-based reimbursement for dialysis services. Prior research has demonstrated that dialysis facilities that disproportionately serve populations with high social risk have lower use of home dialysis and kidney transplant, raising concerns that these sites may fare poorly in the payment model. Using data released by CMS, we examined the first year of ETC model performance and financial penalties across dialysis facilities, stratified by the measured social risk of the facilities’ incident patients.
Author Interviews, Cost of Health Care, Pharmacology / 09.12.2023

MedicalResearch.com Interview with: [caption id="attachment_61125" align="alignleft" width="125"]Joseph T. DiPiro, Pharm.DAssociate Vice President, Faculty Affairs Virginia Commonwealth University Dr. DiPiro[/caption] Joseph T. DiPiro, Pharm.D Associate Vice President, Faculty Affairs Virginia Commonwealth University Dr. DiPiro is an editor for Pharmacotherapy: A Pathophysiologic Approach MedicalResearch.com: What is the background for this study? Response: The ASHP/ASHP Foundation Pharmacy Forecast Report is constructed from a survey of health-system pharmacy leaders who were asked to rate the likelihood of events, scenarios, and trends occurring in the next five years. The purpose is for health-system pharmacists and pharmacy leaders to inform their strategic planning efforts. The Pharmacy Forecast is not intended to predict future events. Rather, the report is intended to be a provocative stimulant for the thinking, discussion, and planning that must take place in every health system. Leaders must be informed of potential developments to help position their organizations to care for patients, enhance population health, and improve medication outcomes.