Dutch Rojas - Healthcare

Dutch Rojas - Healthcare Making healthcare affordable and accessible for all. Email us for information!
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SanoSurgery brokers surgeries and procedures between hospitals and physicians ("Sellers") and private individuals and self-insured employers ("Buyers").

BREAKING 🔥🔥🔥 SITE-NEUTRAL PAYMENTS: A Scam to Crush the Dreams of the Healthcare EliteThe audacity of the peasant class ...
07/09/2024

BREAKING 🔥🔥🔥
SITE-NEUTRAL PAYMENTS:

A Scam to Crush the Dreams of the Healthcare Elite

The audacity of the peasant class never ceases to amaze me.

I have been made aware of a preposterous notion being peddled by these simpletons, something they call "site-neutral payments."

Apparently, this ludicrous idea is supposed to lead to lower healthcare costs and increased access to affordable care. How utterly preposterous!

As the esteemed Head of the Department of Health and Human Services (HHS) and the venerable CEOs of the mighty insurance behemoths (Medicare, Blue Cross Blue Shield, United, Cigna, and Aetna), allow me to set the record straight once and for all.

Our entire business empire, the foundation upon which our opulent lifestyles are built, rests on the sacred principle of ever-increasing premiums.

Year after year, without fail, we have dutifully extracted more and more of your hard-earned wealth, secure in the knowledge that you hapless peons must comply.

Consider the absurdity of our predicament.

The mere thought of lowering healthcare costs sends shivers down our spines.

It's as if we're standing on the edge of a financial abyss, staring into the void of potential ruin. Our private islands reduced to mere beachfront mansions, our fleets of luxury yachts dwindling to a mere handful.

The horror!

But fear not, my dear peasants, for we have no intention of allowing such a calamity to befall us.

We will resist site-neutral payments with every ounce of our immense power and influence.

We will lobby, bribe, and strong-arm through any attempt to disrupt our lucrative racket, er, business model.

And to those of you who dare to dream of a more transparent and competitive healthcare market, we have but one message for you: wake up, you delusional fools!

The notion of transparency and competition is a joke to us, an insult to our carefully constructed monopoly on your well-being.

So, cling to your childish fantasies of affordable healthcare and site-neutral payments.

Meanwhile, we, the true masters of the healthcare realm, will continue to luxuriate in our opulence, secure in the knowledge that you hapless plebeians will continue to line our pockets with your hard-earned dollars, year after year, without fail.

Sincerely,

The MBUCAs
(The Untouchable Overlords of Your Health and Wealth)

We celebrate the 4th of July with fireworks, BBQs, and a sense of national pride.However, the story of American independ...
07/04/2024

We celebrate the 4th of July with fireworks, BBQs, and a sense of national pride.

However, the story of American independence is not just about grand declarations and heroic battles.

It's also about extraordinary personal sacrifice.

The 56 men who signed the Declaration of Independence were labeled "insurrectionists" by the British Crown.

They weren't just putting ink to parchment; they were risking everything.

Their legacy is more than a historical footnote; it's a powerful testament to the resilience and determination required to achieve lasting change.

As I reflect on their sacrifices, I found inspiration for challenges.

These men and their families faced unimaginable hardships, and they persevered…..

The stories we do not oft tell.

The future belongs to those who can see the problems most clearly. And few are better positioned to identify the issues ...
04/08/2024

The future belongs to those who can see the problems most clearly.

And few are better positioned to identify the issues in our healthcare system than physicians on the front lines.

Doctors don't just have insights; they have priceless experiences navigating a broken system.

They live the pain points every single day.

Where others see constraints, they have Xrays into the opportunities.

The visionaries aren't the consultants/analysts/investors theorizing from the outside.

The physicians have been dealing with the frustrations, bottlenecks and failures for years.

They've been taking notes.

But founders need more than observations.

They need the creativity to imagine a better way and the audacity to build it.

Physicians have daring in their DNA - making tough calls is their stock and trade.

Most of all, they have the ethical convictions.

They didn't become doctors for the money but to truly help people.

Now, they can disrupt misaligned incentives and put patients first at scale.

Don't bet against the folks witnessing the most significant points of friction in healthcare.

They've been getting poked by the problems for years.

And the best ones won't stay still - they'll find the solutions we need.


PERMIT-SION. There's a secret law that most people have never heard of. It's called the Certificate of Need (CON) law, s...
04/08/2024

PERMIT-SION.

There's a secret law that most people have never heard of.

It's called the Certificate of Need (CON) law, strangling healthcare entrepreneurship across America.

States with CON laws have handed powerful incumbents a legal lever to block competition before it even has a chance to be born.

It's the anti-permitsion slip for new hospitals, ambulatory surgery centers, nursing homes, and more.

Think about it this way: you're an entrepreneurial doctor who spots an underserved market desperate for a new healthcare facility.

You've got the skills, the capital, and the burning desire to make it happen. But before breaking ground, you must go hat-in-hand with the state regulatory board and a room full of rival healthcare operators.

They'll judge whether your project meets an arbitrary "need" criteria that they (surprise, surprise) never seem to agree exists. And even if they grudgingly permit you, it comes with so many conditions and constraints that the project is a shadow of your original vision.

CON laws were put in place in the 1960s and 70s with the stated goal of preventing overbuilding and controlling healthcare costs. But they've protected incumbent hospitals and healthcare systems from competition that could disrupt their cozy regional oligopolies.

In states with and without CON laws, costs have risen at the same rate. The only difference is that in CON states, entrepreneurship and innovation have been choked off at birth.

In a cruel irony, many CON laws were first passed with the support of the hospital associations themselves. And now those same associations spend millions lobbying to keep this anti-competitive status quo locked in permitsion.

So the next time you hear giant healthcare systems endlessly complaining about rising costs and lack of access, remember: they've fought hard to keep the fresh air of competition from entering their protected playgrounds.

CON laws place government permitsion over the dreams of healthcare entrepreneurs striving to serve their communities better.

They turn what should be an exciting journey of creation into a disheartening slog of bureaucracy and rent-seeking.

Don't let this ugly relic of 1970s regulation hide in the shadows any longer.

Shine a light on the oppressive impact of CON laws and the systematic permitsion they require. Only then can we clear the way for the healthcare innovators we desperately need.

04/07/2024

Having an insurance card aka health benefits means zilch.

04/07/2024

Healthcare could be solved today.

Billions could have access to affordable care.

Unfortunately the grifters have the upper hand.

For now.

Every child, every family, and every community deserves access to quality healthcare. It's not just a goal; it's a moral...
04/07/2024

Every child, every family, and every community deserves access to quality healthcare.

It's not just a goal; it's a moral imperative we must achieve.


04/07/2024

If I can do it, you can do it.

I am always delighted to share good and optimistic news. The world economy faces the daunting challenge of paying off th...
04/06/2024

I am always delighted to share good and optimistic news.

The world economy faces the daunting challenge of paying off the massive global debt burden, estimated at around $350 trillion.

Consider the following perspectives on this issue:

1. Sheer Scale of Global Debt:

- The world's debt load, surpassing 350% of global GDP, has reached unprecedented levels since the 2008 financial crisis.

- Government, corporate, and household debt levels have risen to finance spending amidst low-interest rates.

- Servicing such high debt diverts resources from productive investments.

2. Global Cooperation Challenges:

- Coordinating fiscal policies across countries to simultaneously reduce debts is difficult due to varying economic conditions and political interests.

- Poorly managed austerity measures, such as spending cuts and tax hikes, can undermine economic growth.

3. Role of Economic Growth:

- Sustained global economic growth can contribute to increased income flows, aiding in the repayment of debt burdens.

- However, challenges like aging populations, climate change impacts, and fallout from events like COVID-19 hinder growth prospects.

4. Debt Restructuring:

- Some economists suggest negotiating debt restructuring with creditors may be necessary, particularly for poorer countries burdened with unsustainable debts.

- This could involve extending maturities, reducing principal amounts, and improving terms.

5. Inflationary Scenarios:

- Certain theories propose that central banks could monetize debts by allowing controlled inflation to decrease the actual value of debt over time gradually.

- However, concerns about uncontrollable inflation are significant with this approach.

6. No Clear Path:

- Given the unprecedented scale of the debt, most economists agree that there are no easy solutions to repay global debt burdens in the near future fully.

- The focus is on implementing policy measures that stabilize and gradually reduce debt levels to manageable amounts over several decades.

Addressing the $350 trillion global debt requires a comprehensive and measured approach involving growth-friendly policies, debt restraint, and potential debt restructuring.

This presents a significant coordination challenge for the world's economies in the future.


Medicare Payment Disparities Persist Across Care Settings. Medicare continues to pay varying rates for the same medical ...
04/06/2024

Medicare Payment Disparities Persist Across Care Settings.

Medicare continues to pay varying rates for the same medical procedures depending on where they are performed, reflecting the program's complex payment systems and policymakers' struggle to equalize payments.

At the high end, hospitals receive the most lucrative reimbursement for many treatments under Medicare's inpatient and outpatient prospective payment systems. These systems bundle payments for the procedures and related facility costs like nursing care and hospital overhead expenses.

In contrast, ambulatory surgical centers (ASC) often receive significantly less Medicare reimbursement for identical procedures. While stripping out facility fees, the payment rates here are based on a fee schedule specific to the outpatient surgery center setting.

The lowest payments typically go to procedures performed in physician offices. Under Medicare's Physician Fee Schedule, doctors are paid only for their services, not for factors like staffing or overhead costs associated with maintaining a clinical space.

This payment disparity has been a source of tension and consternation, with hospitals arguing the higher rates are justified by their higher costs and responsibilities like operating emergency departments. Ambulatory surgery centers and physician practices counter that favorable payments to hospitals flow from the healthcare industry's entrenched financial interests and powerful lobbying force.

Over the years, Medicare has moved toward "site-neutral" payments to level the playing field, but change has come gradually. An advisory committee to Congress has repeatedly urged legislators to equalize payment rates for specific procedures across care sites.

Still, policymakers have encountered resistance from hospitals and other industry players. They have sought to preserve payment differentials, which they view as essential to supporting institutional resources that keep the U.S. health system functioning.

As the site-neutral payment debate rages on, medicare beneficiaries often face higher coinsurance costs when the same services are performed in higher-paid settings like hospitals instead of ambulatory surgical centers. This financial incentive, however, hasn't consistently steered patients toward the lowest-cost venues for care.

04/05/2024

Are Private equity (PE) investments good for patients, clinicians, physicians, and facilities?

PE in healthcare has significantly changed the landscape, impacting physician practices and patient care.

The financial priorities of PE firms can challenge the traditional focus on physician autonomy and patient outcomes. This can lead to a shift in focus from patient care to economic returns.

Competition and innovation drive the quality of healthcare—physician practices, designed to be responsive to community needs, foster excellence and patient-centric care.

However, PE firms often consolidate practices, reducing competition and potentially hindering quality improvements and patient-focused innovation.

The physician-patient relationship is crucial, with every decision made in the patient's best interest. PE models, driven by financial targets, may divert attention from patient care.

While PE has been successful in other industries, it can be misaligned with the mission of providing high-quality patient care in healthcare.

It is essential to maintain core values in healthcare while exploring sustainable financial practices that prioritize patient welfare and physician autonomy.


04/05/2024

Founding and investing in a venture capital (VC) fund can be beneficial for physicians for several reasons:

1. Diversification of Investments: Physicians often have a significant portion of their wealth tied up in their practice or the healthcare industry. A VC fund allows them to diversify their investments into startups across various sectors, reducing risk.

2. Leveraging Expertise: Physicians possess deep knowledge of the healthcare sector, which they can leverage to identify and invest in promising healthcare startups. Their expertise can give them an edge in due diligence and making informed decisions about potential investments.

3. Driving Innovation: By investing in healthcare startups, physicians can foster innovation within their field. This can lead to the development of new treatments, medical devices, and healthcare solutions that can benefit the broader medical community and patients.

4. Financial Returns: If successful, investments in startups can yield high financial returns compared to traditional investment vehicles. While VC investing is high-risk, the potential for high-reward can be attractive for those with the financial means to withstand possible losses.

5. Professional Networking: Starting a VC fund can expand a physician's professional network beyond the medical community to include entrepreneurs, other investors, and business leaders. This can open up new opportunities and collaborations.

6. Personal Satisfaction: There can be a significant amount of personal satisfaction derived from helping young companies grow and succeed, mainly if they are in the healthcare space and improve patient outcomes or healthcare delivery.

7. Strategic Partnerships: Physicians with stakes in healthcare startups may be able to form strategic partnerships between these companies and their practices or hospitals, potentially improving their primary business's efficiency or capabilities.

8. Influence on Healthcare Direction: Through strategic investments, physicians can influence the direction of healthcare innovation, ensuring that it aligns with patient needs and improves the standards of care.

9. Educational Growth: Engaging with startups can keep physicians at the forefront of new technologies and business models, which can be intellectually stimulating and provide personal growth opportunities.

10. Tax Benefits: Tax advantages can be associated with investing in startups, such as potential tax breaks for investing in qualified small businesses or opportunities for favourable capital gains treatment.

Disclaimer:
It's important to note that VC investing has risks. It requires a significant amount of capital, due diligence, and a high tolerance for risk, as many startups fail. Physicians considering this path should consult financial advisors and conduct thorough research.


04/04/2024

Capitalism has demonstrated significant efficacy in fostering economic growth and development.

Historically, markets free from regulatory capture have played a pivotal role in lifting populations out of extreme poverty.

The healthcare sector stands to make substantial gains in affordability and accessibility once market forces are allowed to operate without undue interference.

In the United States, approximately 160 million citizens currently benefit from commercial insurance coverage, with a significant proportion of these individuals enrolled in self-funded plans.

Under such arrangements, employers bear the financial responsibility for the healthcare services utilised by their employees.

The introduction of competitive dynamics into single-payer systems could potentially yield substantial benefits.

Empirical evidence suggests that competition is a fundamental driver in creating superior products and services.

Moreover, the global economy would benefit from the proliferation of commodities exchanges, e-commerce platforms, and direct-to-consumer communication applications that facilitate more efficient interactions between healthcare professionals and patients.

It is essential to recognise the fundamental principles of supply and demand as cornerstones of economic theory and practice. The distortion of these principles through regulatory capture and legislation serving corporate interests can result in detrimental outcomes, including reduced access to necessary services.

As HC leaders, it is incumbent upon you to understand the complex interplay of market forces and to advocate for systems that minimise the negative impacts of such distortions, ensuring that economic prosperity is both inclusive and sustainable.


04/04/2024

The Unintended Consequences of the No Surprises Act on Physician Practices

The No Surprises Act, effective January 1, 2022, aimed to protect patients from unexpected and costly out-of-network medical bills. It aimed to resolve reimbursement disputes between healthcare providers and insurers by prohibiting surprise billing for most emergency services and certain non-emergency situations involving out-of-network providers. However, analysing the law's implementation reveals unintended negative impacts on physician practices nationwide.

A key issue is the payment dispute resolution process outlined in the legislation. The act mandates a "baseball-style" arbitration approach where the arbiter must select the reimbursement amount closest to the median in-network rate for the region. This methodology disregards provider-specific factors or case acuity that may justify charges exceeding typical in-network rates. Consequently, the process favours insurance companies by anchoring payments to lower median in-network levels, disadvantaging providers.

Due to restricted insurance payments and unfavourable arbitration outcomes, many physicians are forced to reduce or cease providing out-of-network care. This threatens patient access, especially in areas already facing provider shortages. These consequences undermine the objectives of the No Surprises Act and worsen existing issues in the U.S. healthcare system.

Notably, surprise medical billing was not initiated by physician practices. It emerged due to a flawed reimbursement landscape characterised by opaque pricing policies among insurers and a lack of meaningful rate regulation. While the No Surprises Act attempted to address this issue, its arbitration process fell short, further hindering fair compensation negotiations for providers.

To ensure patient access to care and establish a more equitable reimbursement framework, congressional lawmakers should revise the No Surprises Act in consultation with frontline healthcare providers. The revised approach should prioritise pricing transparency, foster insurer competition, and implement an impartial arbitration model considering relevant provider- and case-specific factors. Through these reforms, the legitimate interests of patients, physicians, and payers can be appropriately balanced.

Not

04/03/2024

Capitalism rewards entrepreneurial spirit and risk-taking.

By offering potential profits and rewards, it motivates individuals and businesses to invest in research, development, & experimentation.

This encourages the creation of cutting-edge technologies, transformative inventions, and game-changing discoveries.

04/03/2024

Capitalism fosters healthy competition among businesses.

In their quest to attract customers, companies strive to differentiate themselves by developing innovative products, services, & solutions.

This leads to continuous improvement & pushes the boundaries of possibility.

04/02/2024

Capitalism remarkably fuels innovation, creating a breeding ground for groundbreaking ideas and advancements.



Hippocratic AI raised $53 million in a Series A funding round at a $500 million valuation, bringing their total funding ...
04/02/2024

Hippocratic AI raised $53 million in a Series A funding round at a $500 million valuation, bringing their total funding to $120 million.

Is the start of replacing nurses and physicians?

- They launched their first product - a staffing marketplace for healthcare where systems can hire generative AI agents to complete low-risk patient tasks and help address staffing shortages.

- The funding will be used to further develop products and conduct phase three safety testing of their large language model (LLM) for healthcare.

- Phase one and two safety testing with over 1000 medical professionals found the AI to be as or more effective than human nurses based on subjective measures.

- Their approach involves a primary LLM supervised by specialist models totaling over 1 trillion parameters to improve accuracy and reduce hallucinations.

- Phase three testing will involve 5000 nurses and 500 doctors from their 40+ health system partners thoroughly evaluating the staffing marketplace product.

- Their goal is to develop the safest focused LLM for healthcare to improve global access and outcomes through bringing deep expertise to all.

- They have physician and nurse advisory boards from top hospitals to guide product development and safety governance.

- Investors were selected based on alignment with prioritizing safety over short-term profits.

Company releases first product: Generative AI-powered staffing marketplace for healthcare and will use funds to accelerate further product development and...

04/01/2024

The majority of people I encounter desire a healthcare system that adheres to moral and ethical standards.

I concur that our world necessitates a healthcare system that upholds principles of morality and ethics.

Many individuals in our society lack a clear moral framework, and in this post-modern era, ethical standards seem to fluctuate constantly.

However, the question remains:

How can we establish a system that caters to individuals who lack morals or ethics?


Prior to the ACA, self-insured employers had the discretion to cover pre-existing conditions, but they were not required...
04/01/2024

Prior to the ACA, self-insured employers had the discretion to cover pre-existing conditions, but they were not required to do.

Post-ACA, coverage for pre-existing conditions became mandatory for all health insurance plans, including self-insured employer plans.

Physician-Owned Hospitals versus Traditional Hospitals in 2019. - If traditional hospitals were reimbursed at the same p...
03/31/2024

Physician-Owned Hospitals versus Traditional Hospitals in 2019.

- If traditional hospitals were reimbursed at the same prices as POHs, Medicare expenses would have decreased by $1.1 billion (12.2%) for these 20 high-cost DRGs.

- The study analysed 2019 Medicare claims data to compare costs of care for 20 high-cost diagnostic-related groups (DRGs) between physician-owned hospitals (POHs) and traditional hospitals.

- Total costs included amounts paid by Medicare plus any beneficiary or primary insurer payments. Over 730,000 discharges across 186 POHs and 1230 traditional hospitals were analysed.

- Regression models controlling for patient demographics and comorbidities found total payments were 8-15% lower in POHs than in traditional hospitals in the same regions.

- Differences in patient populations between POHs and traditional hospitals regarding age, s*x, race and comorbidities were minor and did not account for payment differences.

- Previous studies also found POHs provided higher quality care at lower or comparable costs, especially for cardiac and orthopedic services.

- Two reports submitted to hospital associations found some cost and quality differences favouring traditional hospitals, but this study found consistently lower costs in POHs.

- For all 20 DRGs, POHs received significantly lower average total payments than traditional hospitals after controlling for patient factors.

- Payment differences between facility types across the 20 DRGs ranged from 8.6-15.2% on average after adjustments.

- Results suggest POHs may offer an opportunity to achieve lower costs of care across a range of health conditions and patient populations.

https://buff.ly/43kJAaQ

03/31/2024

Why has the cost of family premiums in the US increased from $8,000 with comprehensive coverage to $20,000 with high deductibles?

Throughout my lifetime, I've witnessed three instances of our healthcare system being compromised:

1. The implementation of the Affordable Care Act.

2. The COVID lockdowns.

3. The "we cant pay" crisis by United and Change Healthcare.

Not

03/31/2024

The feds are investigating?

What are the odds anything happens?

Other than bankrupting private practices.

- The US Department of Health and Human Services is investigating whether a cyberattacked healthcare firm, Change Healthcare, complied with federal law to safeguard patient data.

- Change Healthcare, which handles one in every three patient records in the US, has been disrupted by the cyberattack, leading to payment delays from insurers to health providers.

- The investigation will focus on whether a breach of protected health information occurred and whether the company complied with the federal law requiring health care providers to protect patient information.

- Change Healthcare and its parent company, UnitedHealth Group, confirmed their cooperation with the investigation and prioritised restoring their systems and data protection.

- The Health Insurance Portability and Accountability Act (HIPAA) is one of the principal regulations used by federal officials to enforce security measures in the healthcare industry.

- Change Healthcare attributed the hack to a criminal group known as ALPHV or BlackCat, responsible for ransomware attacks globally.

- A hacker affiliated with ALPHV claimed that Change Healthcare had paid a $22 million ransom to recover stolen data, but the company has not confirmed this.

- The ransomware attack has hampered insurance payments for prescription drugs, resulting in significant financial losses for healthcare providers.

- The federal investigation follows a meeting between senior Biden administration officials and healthcare providers to address the payment issues caused by the cyberattack.

In the meanwhile, practices are not being paid. This reminds me of the lockdowns where governors appeared on TV and notified the public they were shutting down elective procedures.

A recent poll shows that out of the 50 governors, only two knew that electives did not mean cosmetic.

As many of you know, short-term plans have long played an essential role in filling gaps in coverage for people between ...
03/31/2024

As many of you know, short-term plans have long played an essential role in filling gaps in coverage for people between jobs or life stages.

They were an affordable stop-gap option that gave peace of mind during transitions. However, there have been ongoing debates about their appropriate use and role.

With their new rule, the Biden administration is attempting to curb the long-term reliance on short-term plans not intended for that purpose.

They want to encourage people to choose ACA-compliant coverage instead, which, as we know, provides broader protection but at a higher price point.

While the intention is understandable, limiting plans to just three months may end up hurting some of the people it aims to help.

Many individuals and families rely on short-terms as a temporary solution to keep essential coverage while their work or income situation remains unsteady.

There is concern this change could increase the rate of uninsured. History shows that a coverage gap, even if brief, can lead to delayed care down the road or financial issues from unexpected medical bills.

Whether premiums in the individual market go up also depends on healthy people migrating away, which is an uncertainty.

The reality is affordability remains challenging for many under current arrangements.

I hope we find alternative models that balance comprehensive care, personal responsibility and viable short-term solutions for coverage gaps.

The proposal to limit short‐​term plans is not an attempt to protect consumers. It is the opposite: an attempt to punish consumers who choose a perfectly legal and valid product that competes with the product the Departments favor.

1. Blackstone is the world's largest private equity firm with $1 trillion in assets under management and has been expand...
03/30/2024

1. Blackstone is the world's largest private equity firm with $1 trillion in assets under management and has been expanding globally through opening new offices.

2. Blackstone is targeting the $80 trillion in global individual investor wealth that is currently idle in places like Europe and Asia in order to continue its growth.

3. Blackstone has pioneered perpetual capital vehicles that don't have maturity dates like traditional private equity funds, allowing it to invest for the long-term. These now make up 38% of its assets.

4. Blackstone's credit and insurance businesses have $319 billion in assets by offering higher yields than public bonds to insurance companies.

5. Blackstone co-founder Steve Schwarzman wants to make the firm the dominant global capital provider by directly competing with banks.

6. Blackstone president Jonathan Gray invented the perpetual fund model and is leading the overseas expansion into places like India, Japan and Europe.

7. Blackstone is Europe's largest landlord and investor in logistics real estate and is building relationships locally through offices in major cities.

8. Perpetual funds are changing Blackstone's operating model from transactional to long-term ownership and helping it win deals from families and consortiums.

9. Blackstone reported $1.04 trillion in assets under management for 2023 with perpetual funds rising to $400 billion as its growth driver.

10. Schwarzman's global vision is to maximize opportunities through expanding into new markets and industries using Blackstone's scale and data resources.

https://buff.ly/3VlUF9z

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