Orthopedic Surgeon. Bioethicist. Health Policy Wonk Wannabe. Opinions my own. @pennmedicine @AOFAS @OurAMA
Baltimore, MD
Joined January 2017
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Casey Jo Humbyrd retweeted
This video is incredible.
Everyone should RETWEET it so the whole *world* sees it.
Casey Jo Humbyrd retweeted
NAACP IS GIVING OUT FREE LYFT RIDES FOR YOU TO VOTE!!!
CODE: NAACPVOTE24
NAACP IS GIVING OUT FREE LYFT RIDES FOR YOU TO VOTE!!!
CODE: NAACPVOTE24
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CODE: NAACPVOTE24
⭐️Valid for 2 rides up to $20 ($40 total)⭐️
Casey Jo Humbyrd retweeted
A century ago, Germany’s democracy was hijacked by a bombastic and charismatic tyrant — and in this five-minute video, you’ll learn how he did it. Why did I produce this? Because I believe that history is speaking to us, and all too often, those who refuse to learn from it are doomed to repeat it.
As you watch, imagine filling out a Bingo card filled with Germany 1933/USA 2024 parallels: big rallies, rage-filled and hateful rhetoric, simple answers promising quick and easy solutions to complicated problems, empty promises of a great-again future, scapegoating outsiders, and political enemies silenced on day one. And notice the caring wisdom and concern from my German friends as they share these lessons from their dark history.
It’s hard to understand how Trump could, on the eve of a tight election, paint a picture of Liz Cheney before a firing squad by actually saying, “Let’s put her with a rifle standing there with nine barrels shooting at her, OK? And let’s see how she feels about it when the guns are trained on her face.” You can’t get into the mind of a dictator with an insatiable appetite for power — but you can recognize the playbook they all seem to follow.
Just watch this clip. It’s excerpted from my hourlong public television special “The Story of Fascism in Europe,” which is streaming free (and ad-free) at ricksteves.com/fascism. If you care about our democracy and love our country, it’s hard to stop watching.
When I produced this in 2018, I hoped this day would never come in our country. But November 5th is upon us. Please share this with anyone in your life who might need a reminder that the stakes are high...and this is very real.
Casey Jo Humbyrd retweeted
I’m not going to sit here and say I love Liz Cheney with all my heart— but it’s absolutely bullshit that she’s out there for the most part standing alone because men like Mitt Romney and George Bush don’t have the courage to stand up for the constitution.
Casey Jo Humbyrd retweeted
BREAKING: The Minas Tirith Post will not be making an endorsement in this year's contest between Aragorn son of Arathorn and the Dark Lord Sauron.
Casey Jo Humbyrd retweeted
Physician conversion factors:
2000: $36.6173
2003: $36.7856
2006: $37.8975
2009: $36.0666
2012: $34.0376
2015: $35.7547
2018: $35.9996
2021: $34.8931
2024: $32.7442
UHC stock up 8,556%
Insurance premiums up 342%
Inflation up 86%
Physician pay down 10%
We should keep cutting physician pay so families have more money in their pockets through reduced costs and reduced premiums based on the last 25 years of experience.
Average US family health insurance premium...
2000: $6k
2003: $9k
2006: $11k
2009: $13k
2012: $16k
2015: $18k
2018: $20k
2021: $22k
2024: $26k
That's a 342% increase since 1999 (6.1% per year).
(Note: US CPI inflation has increased 2.5%/year)
youtube.com/channel/UCRoWRnX…
Casey Jo Humbyrd retweeted
I’m hearing so many people cite conflict of interest as the reason physicians shouldn’t own hospitals. This also happens to be the main strategy the American Hospital Association used to lobby Congress to ban POHs in the Affordable Care Act, paving the way for the consolidated corporate nightmare we enjoy today.
The conflict of interest argument is absurd in a for profit healthcare system. Hospitals force their employed physicians to refer to other specialists within their own hospital system. Physicians recommend surgery then do the surgery themselves collecting both a clinic fee and a surgery fee. Optum forces patients to see their doctors, use their pharmacies, and be admitted to their own hospitals. If there is profit to be made in patient care, there will be a conflict of interest among the entities/people collecting that profit. The closest thing to a conflict of interest free system is one that is devoid of profit. Call me cynical, but that will not happen in the US.
So we can wring our hands about the potential corruption and malfeasance evil greedy doctors will inflict upon our great country if physicians owned hospitals, while ignoring the actual corruption and malfeasance already displayed by hospital corporations.
We can ignore data that shows POHs as a whole (~250 in the US, holdovers from pre-ACA times) have better outcomes at lower costs.
Or we can introduce some actual competition in the healthcare marketplace to give patients a chance for better care from people who actually got into this business to treat patients, care that is not dictated by a private equity company or insurance company.
Just give physicians a chance to show that we can do a better job. That’s all we’re asking. If we suck at it, we won’t get very far, right? Isn’t that what the free market is for?
Repeal the ban on physician owned hospital.
Casey Jo Humbyrd retweeted
Amazing first few weeks at Vanderbilt! VUMC made a bold investment in the Center for Transplant Science - this new center will bring together the diverse disciplines that make organ transplantation a phenomenally innovative field.
Casey Jo Humbyrd retweeted
Facts are important. 🚨
There is no such thing as abortion after birth.
I deliver babies and provide abortion care.
Casey Jo Humbyrd retweeted
From Jennifer Carter, a teacher at Apalachee High School in Winder, Georgia.
What the hell are we doing?
Casey Jo Humbyrd retweeted
We will keep beating the drum until those in power listen. This is a threat to the health of our country and the health of the economy. Small businesses are being pushed out. Consolidation is increasing costs. The economy will suffer. Time to get this fixed!
🚨🧵”Facing a 5th consecutive year of Medicare payment reductions, @AmerMedicalAssn issued a clarion call today to @CMSGov urging the agency to be fully transparent about the impact of these payment cuts on physicians and patients.”
Casey Jo Humbyrd retweeted
Proposed Conversion Factor of $32.26. in 2025. It was $36.69 in 1998.
So even w/o inflation adjustment, doctors in 1998 made more from Medicare than doctors in 2025.
Adjusted for inflation, it should be $71.33 ($32.26 in 1998 would be $17.05)
#MedTwitter
Breaking: CMS has again proposed a negative Medicare physician fee schedule update for 2025 with dangerous implications for beneficiary access to care. A 2.8% reduction to the conversion factor would be alarming in the best circumstances, but to propose doing so at a time when 92% of medical groups report increased operating costs and are otherwise struggling to remain financially viable is critically short-sighted.
Medicare physician reimbursement is on a dire trajectory and these ongoing cuts continue to undermine the ability of medical practices to keep their doors open and function effectively — the need for comprehensive reform is paramount. @MGMA is once again calling on Congress to pass the Strengthening Medicare for Patients and Providers Act to implement an annual inflation-based physician payment update tied to the Medicare Economic Index, and modernize Medicare’s antiquated budget neutrality policies by enacting the Provider Reimbursement Stability Act.
From CMS: cms.gov/newsroom/press-relea…
Casey Jo Humbyrd retweeted
To bring you up to speed today #MedTwitter, hospitals and ASCs get a 3% raise, we get a 3% cut and @uhc committed 8.7B dollars worth of Medicare fraud in 2021 alone. But yes tell us how it’s all the doctors fault. #notaprovider @DOJCrimDiv @DrCorriel @pppforpatients @Suburbanbella @fuzzymittens @MayaBabuMD @neurosurgery
Casey Jo Humbyrd retweeted
Our new paper in @NEJM examines the widespread acquisitions of medical practices by UnitedHealth, Humana, Cigna, and other insurers—what’s driving this trend and what are its implications for patients and clinicians? 1/x
Casey Jo Humbyrd retweeted
Today my team sat down with our insurance broker. My health insurance premium for my employees went up 30% for our renewal.
The government cut their pay to me and all doctors by 3.37% this year for the first two months then reduced the cut to 1.66% for the remainder of the year.
I’m tired of paid mouthpieces telling Congress and Americans that doctors are the reason for our high healthcare costs. If you agree with me, share this post and let your friends and colleagues know where the money in healthcare is going.
Hint: it isn’t to doctors
Casey Jo Humbyrd retweeted
Today is the day…. The “Prior Authorization Bill” has been dropped. It passed the House unanimously last session right as the CBO scored the bill at $16B. The Senate declined to take it up due to cost concerns. The new score, due to Biden administration actions, should be 0.
This is the result of years of hard work by many medical and patient organizations as well as the various Congressional offices. Thank you to everyone who made this possible. It’s not the final page in this chapter… More work is still needed…. But it is a great start and a culmination of lots of incredible work.
marshall.senate.gov/newsroom…
Casey Jo Humbyrd retweeted
Attention all health policy docs…. This is your chance to turn your online voice into action. Next month we have our House Call on the Mall. The event is led by Congressman John Joyce, MD, and is fully focused on health policy. The meeting kicks off with a breakfast then a reception with a VIP round table at the end of the day. In between those events, there is no set legislative agenda and you are welcome to schedule Hill visits with your Members! Congressman Joyce will block out his entire day and multiple legislators will swing by throughout the day. If you are interested, please click the link:
form.jotform.com/22115336698…
Questions? Contact Stacie Monroe at monroe@thedocshop.org
Last year we had nearly 100 attendees and over 20 legislators, but I want to show an even greater number this year. Please get out and tell Congress what is important to you as practicing physicians!
Casey Jo Humbyrd retweeted
This post has been getting quite the attention.
Want to know why your office visit doesn't run on time?
Take a seat... this may take a while...
Healthcare consolidation means doctors are no longer owner/operators of their own small business, able to cater to their patients' needs.
They can't even set the prices they want.
With the physician fee schedule being imposed on us by CMS, we are beholden to the price assigned to our CPT codes. For your beloved pediatrician, those E&M CPT codes reimburse very very poorly. Sure, some clinics can negotiate better rates with insurance companies, but for the most part it's a fraction of what is needed to run a small business.
Econ 101 tells us that price caps cause shortages. Here it is in action.
The price cap set on E&M codes means that doctors can no longer generate enough revenue off of professional fees to run their E&M-based practice. Additionally, they have more and more regulatory burdens that increase the price of running a practice (mandated EHR uptake, quality metrics, etc) while reimbursement declines.
That's not all.
The large hospital conglomerates have rules written in their favor, giving a competitive advantage. They get to charge more for those E&M visits due to "facility fees." They get to be tax-exempt entities. They get massive discounts on drug purchases that they can resell for profit. They get "economies of scale" in operating EHR & quality metrics. They can absorb the cost of a financially underperforming clinic by ensuring they capture downstream revenue from referrals, imaging and labs.
It doesn't take a policy expert to see that the small, independent practice has no chance of surviving.
So they sell out. The physicians become employees of a system which tells them how many patients they must see. They say they can't see patients in that small of a time frame, but the corporation doesn't care. It plans on replacing them with NPs or PAs soon anyway.
The other option is they open a concierge clinic. They stop taking government funds and get away from the price caps. They charge what they feel is needed to give the patients the attention they deserve.
So, what can you, healthcare policy expert and consumer of healthcare goods, do for the situation?
Take your business to a practice which runs on time.
If you have to pay for it, pay for it. That's the beauty of the free market. You're free to take your business to a concierge practice or cash-pay clinic. Nobody is forcing you to go to the practice which is chronically late.
And if your answer is: "but healthcare is a RIGHT! It should be free!!"
Just remember, you'll get what you pay for.
@anish_koka @DrBrian4Health @cscla @DutchRojas @LighthouseDPC
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Casey Jo Humbyrd retweeted
Things that have gone down since ACA was passed:
1) physician ownership in hospitals
2) physician pay compared to inflation
3) access to care
Things that have gone up since ACA was passed:
1) insurance company profits
2) consolidation/vertical integration
3) insurance premiums
4) US healthcare spend
5) hospital profits (particularly nonprofit)
All of this being said, the ACA didn’t do everything wrong. The real problem is our inability to admit that the ACA needs reform. Let’s fix the issues with common sense solutions.
