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Old 05-02-2013, 03:33 PM
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FormLetter FormLetter is offline
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Originally Posted by Dr T Non-Fan View Post
The Risk Adjusters will help a lot as well. In the 80's there was no risk adjustment, and there was an alternative to red tape for the less-healthy folk (thus a lot of selection bias).
Since Risk Adjusters are already being used for Med Advantage (I cannot attest to their predictability), that's one thing my (not FL's) plan has going for it.
Point: me.
I have limited experience with Medicaid, but the few states I've dealt with Medicaid used a form of risk adjusters as well. They're different models than the HCC model CMS uses for MA, but still risk adjusted.
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Old 05-02-2013, 03:34 PM
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Originally Posted by Notus View Post
And I'm sure absolutely no one would object to this over privacy concerns
Privacy isn't really the issue, in my opinion. They basically already do this for Medicare.

Originally Posted by Abraham Weishaus View Post
I thought the actual exam was very similar to one of the last 2 ASM practice exams, but perhaps those underestimate the difficulty of the exam.
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Old 05-06-2013, 07:10 PM
Typikon Typikon is offline
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What made me spit up when I read the article was that for his whole scheme to work, he has the PCP deciding when he wants to see the patient, not the other way around. (p. 27, middle collumn).

So we have a real-life example of an inductive proof from our days of High School Geometry:

Because all the assumptions lead to something as stupid as the doctor calling me for an appointment, somewhere, somehow, his assumptions are off.

Or perhaps all of them.

Also, what on earth is the role of the Health Care Exchange if there is no premium and no cost-sharing? Just differences in administrators? If the doctor is in charge of the patient, why in the heck not make the doctor in charge of picking the administrator? AFter all, we can't expect the patient to keep up with all the details of claims administration, formularies, etc. That way, the doctor would be at risk for picking the most efficient administrator.

His "Health Care Exchange" is nothing more than an enrollment platform for a giant nationwide HMO.
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Old 05-07-2013, 12:57 PM
Dr T Non-Fan Dr T Non-Fan is online now
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Excellent points. Thank you.
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“That is reminiscent of Harry Truman’s famous saying, ‘The buck stops, uh, somewhere over there, maybe?' That is a level of dodging responsibility that Trump has been perfecting ever since he was very much not in Vietnam.” -- LWTwJO
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