Vascular and interventional radiologist. Enjoy complex vascular interventions. MD, MBA, RPVI, CWSP
Minneapolis, MN
Joined November 2017
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1/6 Site of Service - The biggest grift in healthcare! Why pay more based on where a procedure is done instead of its quality? Ever wonder why your "system" doctor refers you to a hospital? Dive into this series on the absurdity of SOS. @CMSGov @AmerMedicalAssn @DutchRojas
The Hidden Violence In Healthcare
linkedin.com/feed/update/urn…
Michael Cumming retweeted
Thank you for asking this important question.
CPT code 99213 has a time component of 20-29 minutes for an existing patient.
Florida Medicaid would pay $32.56 for this visit.
This amount needs to cover the following:
• Office rent or mortgage
• Staff salaries
• Computer system
• Staff benefits
• Equipment
• Utilities
• Taxes
• Malpractice insurance
• Supplies (office and medical)
This doesn't include that the physician gave up their twenties and has large student debt from undergraduate and Medical school studies.
This is not a sustainable pay rate, and because of this, most physicians are now employed.
Why should you care if this doctor is employed?
Now that the doctors are employed, they have to do the following:
• See as many patients as possible per hour.
• Bill as much as possible.
• Order as many expensive tests and consults as
possible.
• Spend the visit carefully entering data into the EHR
in order to optimize billing.
You have now lost a caring and empathetic physician, and your care has been monetized.
Patients must demand that physicians be reimbursed enough to maintain their independence.
This is the only way patients will get the excellent care they deserve.
Help us out on the consumer side. What do Drs. get paid via medicaid vs. what you believe if fair pay? Lets look at an office visit for a diabetic whos' not controlling there diabetes well. Break down what the reasonable cost should be.
To get folks on your side you're goign to have to show us the real world scenarios.
Michael Cumming retweeted
ICYMI- Tune in for tips on renal tumor ablation from @ajgunnmd:
open.spotify.com/episode/2e8… #VI492 #InterventionalOncology @SIO_Central @Gina_Landinez_ @DonGarbettMD @NaineshParikhMD
Michael Cumming retweeted
.@CMSGov, @BrooksLaSureCMS :
Medicine is delivered by scrubs not suits.
You are hurting patients and helping the corporates.
Just stop.
Do not cut physicians pay.
Site neutral now
Reverse ban on physician owned hospitals
Physicians and patients: start paying attention and squawk accordingly .
Yep, hospitals receiving nearly +3% on their Medicare update w/ CMS concerned about an inflationary update, while physicians face nearly a -3% cut because Congress has not mandated that CMS care about an inflationary update. We must make them care via legislation! beckershospitalreview.com/fi…
Michael Cumming retweeted
Congratulations to Ge Bai for another excellent healthcare article.
This article discusses one of the most destructive issues in healthcare: site-dependent payments.
Site-dependent payments occur when a hospital receives a facility fee and is paid substantially more for a service than another facility.
The other facility includes:
• Physician Offices
• Ambulatory Surgery Centers
• Free-standing imaging centers
• Infusion Centers
If a hospital buys any of the above, the facility fee is also charged.
The site-dependent payments cause the following:
• Drives physicians into employment as they can't
compete with the hospital due to low reimbursement
• The healthcare bills explode as the price of all of these
services are substantially increased.
This article reveals that Medicare and the commercial payers are paying this extra facility fee.
There is no reason for the 178 Million patients covered by commercial insurance to pay this extra fee.
The article mentions a "pervasive failure of employers to procure high-value health benefits for their employees."
Employers have a Fiduciary responsibility to their employees under the 1974 law known as ERISA.
This means that employers must be prudent in the management of healthcare benefits.
If the employers overpay for healthcare benefits, they can be held liable for this.
There have been several lawsuits that claim the employer is not meeting their fiduciary responsibility and include the following plaintiffs:
• Johnson and Johnson
•Wells Fargo
• Mayo Clinic
Hopefully, employers will treat health benefits as an integral part of their business and focus on providing quality and affordable health benefits.
Site-neutral payment laws must be passed for all government programs and all employers should demand this for their employees.
Site-dependent payments—paying more for basic health services when they are delivered in a hospital vs another facility—are hard to explain to the public, let alone justify to anyone concerned with runaway health care costs in the US. The issue has become more salient as media reports highlight patients’ bewilderment at inflated hospital bills for routine services. Additional contempt arises when a hospital purchases a physicians’ office and then inflates health care charges with seemingly unjustified facility fees.
Full text @JAMAHealthForum: jamanetwork.com/journals/jam…
@BarakRichman @JHUCarey @JohnsHopkinsSPH @BSPH_HPM @gwlaw @TCUNeeley
Michael Cumming retweeted
Today on BackTable: Jillian Angeline, a long COVID survivor, shares how @theveinlady recognized her venous symptoms, provided treatment, & helped her regain her quality of life @Interventional2 @IR_Ethics open.spotify.com/episode/2py… #VI493 #LongCOVID #Venous
Michael Cumming retweeted
We are creating monsters by letting these healthcare systems consolidate.
Patients and independent physicians will get crushed, and there will be no chance for a quality sustainable healthcare system in the future @RogerMarshallMD
beckershospitalreview.com/ho…
Michael Cumming retweeted
Today on BackTable: @ajgunnmd shares his expertise on renal tumor ablation and the EMBARC study (embo before ablation of RCC) @UABRadiology @FiveNada @kantonIR @DonGarbettMD open.spotify.com/episode/2e8… #VI492 #RenalTumor #RCC #InterventionalOncology
Michael Cumming retweeted
Wealth is not just about money.
According to James Clear, there are actually 4 types of wealth:
1) Financial
2) Social
3) Time
4) Physical (health)
Don't let chasing number 1 deprive you of 2, 3, and 4:
Michael Cumming 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…
Michael Cumming retweeted
It's official. BIG NEWS.
Resolution 814, with an amendment, is on the agenda for the upcoming @AmerMedicalAssn meeting in November 2024.
"Legislation for Physician Payment for Prior Authorization"
See the resolution text below:
1/3
Michael Cumming retweeted
Today on BackTable: @MinaMakaryMD discusses the importance of raising public awareness about how IR can enhance treatment options and improve patient care #VI489 @JMichaelBarraza @CHICKVIR @nlradIR open.spotify.com/episode/4dP…
Michael Cumming retweeted
Disturbing article today from Stat News. Physician dashboards utilized by United Healthcare to identify who could diagnose the most chronic conditions in their patients, reaping billions for insurers. These schemes continue to ruin the Medicare Advantage program and steal money from the physician fee schedule, which so desperately needs a long term inflationary update.
“At one clinic, UnitedHealth shared with doctors a dashboard comparing the percentage of chronic diseases they found among their Medicare Advantage patients to other practices within the company. Those who completed the most appointments with older patients got a “SHOUT OUT!!” in the messages and were eligible for up to $10,000 in bonuses. Doctors at the bottom of the dashboard were offered remedial training.”
statnews.com/2024/10/16/unit…
Michael Cumming retweeted
Becker Review gets it right. Physician consolidation hurts everyone. Unfortunately many physicians have no choice due to legislative and regulatory initiatives that have long favored consolidation. It’s past time to reverse this trend
beckersasc.com/leadership/wh…
Michael Cumming retweeted
If only I could stick this sign in my office and charge and get paid 3-10x what I get paid for my services. Boom! Except this corruption is only for hospital consolidation. We need site neutral payments! @DutchRojas @realdocspeaks
Michael Cumming retweeted
Today on BackTable: Teri Yates and @bahetimd discuss high-yield tips for revenue cycle management in your OBL/ASC! Tune in for real-world examples of RCM challenges and solutions: open.spotify.com/episode/7q2… #VI486 @LessneVIR @DrLipman1 @IR_Doctor @t_intheleadcoat @DonGarbettMD
Michael Cumming retweeted
Dr. Kevin Herman discusses the similarities and differences in chronic limb-threatening ischemia (CLTI) treatment strategies between hospital and outpatient-based lab (OBL) settings.
Stream the episode: ow.ly/qfQv50TBKW3
#VI484 #interventionalradiology #vascularsurgery
GAE - interesting variant - looks like the superomedial genicular artery is arising the the descending GA as a variant. Haven't run into this before.
Michael Cumming retweeted
"So get this, folks. We live in a country where the people who spent their entire lives studying medicine, who know every inch of the human body, who've seen more f-$ckedup 💩than a war correspondent - these people are told they can't own the very buildings where they work their magic.
Isn't that a kick in the nuts?
Physicians can't own hospitals.
Let that sink in.
The ones who actually know what's going on inside those sterile walls are told, 'Nah, you just stick to cutting people open and stitching 'em back up. Leave the big business decisions to the suits who couldn't tell a scalpel from a butter knife.'
It's like telling a chef he can't own a restaurant, or telling a mechanic he can't own a garage. 'Sorry, doc, you're too qualified to run this joint. We need someone who majored in bullshit and minored in screwing people over.'
And why is this?
Oh, they'll feed you some line about conflicts of interest. As if the current owners - big corporations and investment groups - don't have any conflicts of interest! No, they're just interested in your health, not your wallet. And I've got a bridge to sell you in Brooklyn.
This is America, land of the free market - unless you're a doctor trying to enter the hospital market. Then suddenly it's, 'Whoa there, Hippocrates! You can't play in this sandbox. It's reserved for the big boys who know how to turn pain into profit.'
So next time you're in a hospital, remember: the folks who own the place probably can't tell the difference between your ass and your elbow. But don't worry, they sure as hell know the difference between your insurance card and your credit card.
Welcome to American healthcare, where the people who heal you can't house you, but the people who've never seen the inside of an OR can decide how much your life is worth. Ain't that a lovely bedtime story?"
-George CarlinAi
#health #care
#AI