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Real Doc Speaks

2 days

This article reviews that Community Health Systems is the first system to purchase inpatient meds that are manufactured by Mark Cuban Cost Plus Drugs. The system is purchasing epinephrine and norepinephrine for use in its hospitals. This is an important…

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Real Doc Speaks

@realdocspeaks

2 months

Mark Cuban's Costs Plus Drugs will start manufacturing two medications in Dallas. This is great news as currently most generic meds are produced in India or China. Both of these countries facilities are plagued by problems with safety and purity and the FDA makes no surprise…

Becker's Hospital Review

@BeckersHR

2 months

Mark Cuban Cost Plus Drug Co. plans to begin manufacturing epinephrine and norepinephrine this week at its 22,000-square-foot drug facility in Dallas, Mr. Cuban confirmed to Becker's on March 5.

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Real Doc Speaks

@realdocspeaks

17 days

@MZHemingway This is a terrible precedent that the left will regret when it is used against them.

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Real Doc Speaks

@realdocspeaks

2 months

@shuntedmdphd You will be a God send for all of the patients. Best of luck and don’t give up, we need you in medicine!

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Real Doc Speaks

@realdocspeaks

2 months

This is a joke. Physicians have had twenty years of pay cuts and are the only entities not indexed to inflation. I would encourage physicians to opt out of Medicare and charge what their services are worth. UNH and PBMs have increasing real earnings, A 1.7 percent increase…

Alejandro Badia, MD

@drbadia

2 months

It is STILL a paycut... Any other profession getting regular paycuts in this inflationary environment?

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Real Doc Speaks

@realdocspeaks

3 months

Credentialing for insurance companies and hospitals is a time-wasting scam. I served on a hospital credentialing committee, and after the 90-120-day waiting period, everyone was credentialled. This could have been done in a few days. It does limit physician mobility and acess.

Lighthouse Direct Primary Care

@LighthouseDPC

3 months

The Healthcare Big Short - “Credentialing”. A word made up by Health Insurance. It’s why Doctors can’t open their own practice and bill insurance and worsens the Doctor Shortage. Health Insurance won’t pay for 3 months because of the “Credentialing” process. Medicare 6 months.…

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Real Doc Speaks

@realdocspeaks

29 days

As an OB who does Ultrasounds in the office, I have interpreted more studies than any radiologist in a community hospital. However, when in the ER, not only do I review the images and talk with the tech, but I also look at the radiologist's report. Many times, they will add…

Leah Houston MD

@LeahHoustonMD

29 days

These people are so full of hubris!!! I am an emergency physician who has treated thousands of patients… yes, I review the initial radiology study and put in my initial read in order to expedite patient care HOWEVER I’m not a radiologist and I am not competent to do the final…

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Real Doc Speaks

@realdocspeaks

14 days

@SPuro88 Because there out playing golf with all the pediatricians!

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Real Doc Speaks

@realdocspeaks

2 months

Terrible but unsurprising news! Optum gets to purchase the Corvallis clininc in Oregon on an emergency basis. The emergency-they weren't getting paid by Optum after the Change Healthcare cyber attack. But don't worry Optum has plenty of money to…

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Real Doc Speaks

@realdocspeaks

2 months

The White House will hold a listening session to find out how to reform PBMs. The issue isn't that we don't know what needs to be done; the issue is that the politicians are addicted to money from PBM lobbyists and will not take the correct action. The…

White House to hold a listening session on reforming pharmacy benefit managers

In a bid to combat prescription drug costs, the White House will hold a listening session on Monday in search of ways to reform pharmacy benefit managers.

www.statnews.com

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Real Doc Speaks

@realdocspeaks

2 months

The WAR on physicians continues! Congress has refused to pass site-neutral payment for physicians. Physicians are paid more for administering medications in a hospital than in an office. The article claims this is a "controversial" policy and was informed by 5 lobbyists that…

STAT

@statnews

2 months

Congress has decided not to pass a site-neutral hospital pay policy along with an upcoming government funding package.

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Real Doc Speaks

@realdocspeaks

1 month

The Physicians always get blamed for the insane costs of healthcare. We do not set the prices, we get a small sliver of the total price and we are your only ally.

GamER MD

@alexandertyler

1 month

Remember folks… physicians count for 6.8% of total healthcare costs… where does the other 93.2% go??? Here:

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Real Doc Speaks

@realdocspeaks

4 days

This is a very disturbing article that raises many concerns. It describes Dr. Debby Day, a long time Medical Director at Cigna and her experience and her reasons for retiring from Cigna. Some of the concerns raised include: 1. The article describes…

A Doctor at Cigna Said Her Bosses Pressured Her to Review Patients’ Cases Too Quickly. Cigna...

Cigna tracks every minute that its staff doctors spend deciding whether to pay for health care. Dr. Debby Day said her bosses cared more about being fast than being right: “Deny, deny, deny. That’s...

www.propublica.org

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Real Doc Speaks

@realdocspeaks

3 months

I just published Dana — Farber Cancer Institute Leadership Lacks Accountability as Scandal Continues

Dana — Farber Cancer Institute Leadership Lacks Accountability as Scandal Continues

As the scandal of the Dana Farber Cancer Institute (DFCI) data manipulation continues to unfold, the Institute’s leadership's lack of…

link.medium.com

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Real Doc Speaks

@realdocspeaks

2 months

UNH never had any credibility with me or my group. They are nothing but bullies because they have an anti-trust exemption and Physicians don’t. They audited me for 30 surgeries dating back four years and wanted 30K. My billers spent hours going through all the records and when…

Ed Gaines

@EdGainesIII

2 months

Whatever shred of credibility @UHC had w/ clinicians & hospitals--a very poor reputation earned long before this cyberattack & via many interactions--is gone.

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Real Doc Speaks

@realdocspeaks

14 days

A new Virginia law requires the presence of a physician in the ER and not merely on call. It takes effect 7/25. This law should be in effect yesterday and why is ever allowed to have an ER without a physician? I am shocked that JCAHO is ok with no doc in…

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Real Doc Speaks

@realdocspeaks

25 days

An interesting article that discusses the growing concern of hospitals with Medicare Advantage reimbursement. The reimbursement is about 85% of Medicare and includes numerous delays and denials. Hospitals continue to drop plans and the extras the seniors…

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Real Doc Speaks

@realdocspeaks

1 month

I have to respectfully disagree with Blake. PE is NOT allowed to own law firms but they are free to do whatever they want in healthcare. This makes no sense as health systems, hospitals and physician groups should always be patient focused and not profit focused. Physicians…

Blake Madden 🏥

@B_Madden4

1 month

Private equity belongs in healthcare. PE isn't the villain; it's the lack of transparency in healthcare overall, which isn't limited to PE. That's why @mcuban 's @costplusdrugs prioritizes radical transparency in healthcare as a core differentiating factor👇 While radical…

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Real Doc Speaks

@realdocspeaks

23 days

@jjfitzgeraldMD Why not train the generalist better in residency and have them treat the more straight forward cases. For example, a patient with isolated SUI is usually easily treated. The patients who are older, with mixed UI or those who have had previous surgery would be appropriate for a…

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Real Doc Speaks

@realdocspeaks

2 months

. This report claims that a $22 million dollar ransom was paid by UNH to Blackcat for the Change Healthcare cyberattack. If this is true it will be one of the largest ransoms paid and will encourage future cyberattacks on healthcare entities. This is a…

Hackers Behind the Change Healthcare Ransomware Attack Just Received a $22 Million Payment

The transaction, visible on Bitcoin's blockchain, suggests the victim of one of the worst ransomware attacks in years may have paid a very large ransom.

www.wired.com

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Real Doc Speaks

@realdocspeaks

10 days

United Health is a large part of the health insurance, PBM, claims processing, and health IT services. They also crush competitors and increase costs to the end consumer. This is the textbook definition of anti-trust, and there is NO reason they should not be broken into…

Blake Madden 🏥

@B_Madden4

10 days

“we’re a comparatively small part of the $5 trillion healthcare system”

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Real Doc Speaks

@realdocspeaks

3 months

No physician should ever let anyone call them a provider. I did not attend provider school.

Taz

@Suburbanbella

3 months

"Primary care staff" in the UK is equivalent to "Providers" in the U.S. Conflation of professions is the #1 bulls**t strategy in the corporatization of healthcare. Same game, different name. @iDrSunny @Xeon4f145d96s1 @TakeMedBack

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Real Doc Speaks

@realdocspeaks

29 days

We need real PBM reform and it is not complicated. 1. Large payers can't own a PBM, Pharmacy or Health Clinics 2. No Formularies 3. No Spread pricing 4. No kickbacks, rebates or other terms 5. PBMs have to pay Pharmacy costs + for all meds 6. PBM fees can not be related to…

Madelaine Feldman

@MattieRheumMD

29 days

As long as health ins cos/PBMs are publicly traded for-profit cos, OF COURSE they are going choose the most profitable drug (highest price) Until profit is taken out of health ins, none of this is surprising. We can't make them choose to make less money.

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Real Doc Speaks

@realdocspeaks

1 month

Great question Sarah! Medicare Advantage was supposed to save money compared to traditional Medicare but actually cost billions more. It underpays physicians, hospitals and restricts access for patients. It is a cash cow for large insurance companies and is terrible for…

Sarah ten Bensel

@sarah_bensel

1 month

@realdocspeaks I am confused. So that 50% of seniors and disabled can't see a doctor? There must be a better way, no? Increase reimbursement and get rid of Medicare Advantage

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Real Doc Speaks

@realdocspeaks

1 month

This is a very detailed report about Optum, the upcoding of patients, the violation of HIPPA, and employees' interest in unionization. Patient records are shipped to India for coding, nonsecure email is used for results, and much more. Bottom line: Corporate entities should NOT…

MedicalQuack

@MedicalQuack

1 month

If you have not seen or read this report, do so now, excellent whistle blower reporting about Optum and this has been a series done by a real journalist, only sad part is that @CMSGov @OIGatHHS won't be doing anything about it, as they are in bed with OptumServe!

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Real Doc Speaks

@realdocspeaks

20 days

The real money in the healthcare system is spent on middlemen that you never see, and that is how they like it. The CEO of Change Healthcare is paid $9.5 Million a year and has never saved a patient's life. The CEO's of Large insurance companies make 20+ Million a year and I…

Politics, Policies & Pop Culture 🇺🇸✍️

@out2sea90210

20 days

@realdocspeaks I think at some point though you have to admit physicians play a huge part in the overall expenses to the system. Why are billions billed in unnecessary procedures? It's so easy to waste patient's money & the gov'ts. Physicians need some skin in the game. It is what it is.

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Real Doc Speaks

@realdocspeaks

4 months

@AshleyGWinter Great question! I want women to come in before attempting pregnancy for a consultation and exam. Check for normal BP, normal glucose if they have DM, review teratogenic meds. review and complete carrier screening, check rubella immunity, get a pap smear, start folic acid and

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Real Doc Speaks

@realdocspeaks

6 days

This article describes the upcoming merger of Mass General and Brigham and how the Physicians are feeling devalued. There is no clarity in how the combined system would consolidate departments, who would lead the departments and if there will be layoffs.…

‘Devalued, disempowered, and unseen’: Mass General Brigham doctors react to latest merger step

Physicians at Mass General Brigham fear demotions and corporatization as hospital system moves to combine departments.

www.statnews.com

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Real Doc Speaks

@realdocspeaks

1 month

Pediatrics is the lowest-paying specialty, and 30% of the residency spots went unfilled in the last match. Medical Students are graduating with increasing student debt and choose higher-paying specialties as a result. Two solutions would be to pay pediatricians more money and…

Daniel Kraft, MD

@daniel_kraft

1 month

30% of pediatric residency programs did not fill their residency positions this year. We need more pediatricians and to pay them better. Rx & prevention of diseases in childhood is the highest yield and most cost-containing of all medical specialties.

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Real Doc Speaks

@realdocspeaks

3 months

The death toll for independent docs came when the AMA supported the ACA. The ACA was anti-independent doc with no tort reform, prohibition on physician ownership of hospitals and on growth of current hospitals, encouragement of risk in ACOs, no patient responsibility in the ACOs…

STAT

@statnews

3 months

Independent doctors are becoming an endangered species.

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Real Doc Speaks

@realdocspeaks

3 months

The safe harbor that PBMs have for kickbacks and their anti-trust exemption allows them to make massive profits for shuffling virtual paperwork. West Virginia dropped the PBMs for their state Medicaid program and save 54 million dollars the first year. This is criminal that

Marion E Mass, M.D. #patientsfirst #scrubsnotsuits

@mass_marion

3 months

“this kickback scheme that ultimately enables and rewards intermediaries and middlemen at the expense of the end-paying consumer," -⁦ @A_Ciaccia ⁩ Why should wealthy #PBM have the government enable them by allowing them to collect kickbacks?

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Real Doc Speaks

@realdocspeaks

2 months

This translates to they pay us more money than you. Having said that I do agree that Physicians need to be more politically active. Our national organizations seldom lobby on issues that affect practicing physicians. We need to form groups of Physicians, set an agenda and meet…

Damian Caraballo MD

@813JAFERD

2 months

@EdGainesIII a Senator’s staffer point blank said to us “they (insurers, hospitals) just lobby better than you (doctors)”

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Real Doc Speaks

@realdocspeaks

2 months

It is crazy that this young man died because he couldn't get an Advair prescription! NO more formularies, NO more charging the US 5 times what you do in other countries, NO more PBMs, NO more convoluted supply chain for meds that allow profiteering, and NO more vertically…

Nena

@Nenaadvocacy

2 months

Wisconsin family speaks out against PBMs after the loss of their son via @WJFW12

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Real Doc Speaks

@realdocspeaks

2 months

The 2 big lies in health care are that physicians control everything, and health care in the US is the most expensive in the world because Physicians are massively overpaid. Remember that physicians make little money until the early to mid-thirties. They miss out on years of…

Tyler Olson

@olsonplanner

2 months

Next time you’re inclined to blame physician compensation for your healthcare costs, take a pause. This study is relevant to Medicare-related procedures.

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Real Doc Speaks

@realdocspeaks

3 months

The PBMs are out of control, and Congress has to step in and fix this. Take away the anti-trust exemption, do not allow payers to own PBMs, and do not allow PBMs to own pharmacies.

RK

@rekesk

3 months

Whats funny is that the PBM outrage is palpable, real, and can be found down the street in any local town. But the fixation is on drug pricing, one component of a massively broken system.

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Real Doc Speaks

@realdocspeaks

1 month

This is exactly why PBMs are not saving money. They are a useless middleman and need to disappear. @PatToomey @MarkCuban

Kevin Pelter, Pharm.D.

@pelterkevin

1 month

Here’s a little snippet of some of those cost differences. For them to keep covering the brand and not generic- the PBM must be getting one Hell of a Rebate!!

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Real Doc Speaks

@realdocspeaks

1 month

The dangers of Private Equity ownership of hospitals is on full display with Steward Health. They have taken a series of safety net hospitals in Boston and stripped them of any assets they could, and avoided paying bills. This led to a maternity death…

Steward Health Care has deal to sell doctor network to UnitedHealth

The troubled hospital operator, with eight Massachusetts hospitals, plans to sell its nationwide physician network to UnitedHealth’s Optum Care unit.

www.statnews.com

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Real Doc Speaks

@realdocspeaks

3 months

This is a disaster for physicians as well as patients. Patients will realize that the employed doc is not the same as the independent. The independent doc can advocate for you and can offer great service at a good price. The employed doc has no ability to go out of their way…

STAT

@statnews

3 months

Independent doctors are becoming an endangered species.

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Real Doc Speaks

@realdocspeaks

2 months

Optum should not be allowed to profit from the cyberattack they failed to prevent! If this is allowed to proceed then there is no question Optum owns the government.

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Real Doc Speaks

@realdocspeaks

1 month

The DOJ is suing Apple Computer for anti-trust violations through their actions in the iPhone arena. I think the DOJ's resources would be better spent on addressing the harm that mega-insurance companies cause. The major payers are all vertically…

Justice Department Sues Apple for Monopolizing Smartphone Markets

The Justice Department, joined by 16 other state and district attorneys general, filed a civil antitrust lawsuit against Apple for monopolization or attempted monopolization of smartphone markets in...

www.justice.gov

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Real Doc Speaks

@realdocspeaks

23 days

Because the margins for primary care are terrible. The expenses are high, labor cost and supply cost have skyrocketed. That 100 dollar payment isn’t received that day of service. It may come in 30-60-90 or sometimes not at all. If your costs go up you can’t raise your prices.…

Stuart Blitz

@StuartBlitz

23 days

There are 300M Americans with health insurance. The average PCP visit gets reimbursed for about $100. If you can just build a practice that sees 1% of all US patients each month, you can create a $3.6B company pretty quickly. Why isn't anyone doing this?

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Real Doc Speaks

@realdocspeaks

2 months

We need Congress to perform 3 tasks 1. Pass REAL PBM reform 2. Rescind the anti-trust exemption for payers and PBMs 3. Mandate that Medicare and Medicaid negotiate the price of ALL meds to that of the average paid by Comparable other Countries

ArthritisCenterSTL

@ArthritisSTL

2 months

LOVE this “WE don’t NEED #PBM reform, WE NEED 2 🛑 STOP dealing with PBMs and go around them”. Let’s show THE BIG 3 PBMs the DOOR in 2024! @mcuban

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Real Doc Speaks

@realdocspeaks

3 months

The FTC needs to break up the three largest PBMs and decouple them from the payers and their specialty and mail order pharmacies.

Kevin Pelter, Pharm.D.

@pelterkevin

3 months

“CVS Caremark is committed to working with our retail network pharmacy partners to help mitigate the unintended consequences with CMS Medicare Part D changes in 2024”… If you cared THAT much, then why don’t you just eliminate your DIR fees that you purposely STEAL from us?

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Real Doc Speaks

@realdocspeaks

2 months

The average person has NO idea about the change healthcare hack! If only T Swift could write a song about it!

Doctor Money Matters

@drmoneymatters

2 months

Where is the @nytimes @NPR or @WSJ coverage about the change healthcare hack? Physician practices are at a financial standstill and no coverage. Why? It’s a major issue🤷🏽‍♂️ Don’t want to piss of your advertisers?🤔

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Real Doc Speaks

@realdocspeaks

1 month

Medicare Advantage plans costs more, provide less care for patients and less reimbursement for Physicians and Hospitals. Some things are clear, outlaw Medicare Advantage! Do you thing the salesmen for MA inform the senior that they only have one opportunity to purchase a…

Alex Shteynshlyuger MD

@DrAlexUrology

1 month

The bottomless @CMSGov budget has an unlimited amount of money to pay @BMAlliance with no evidence of improved patient outcomes. In fact, the only legitimately "measurable" quality is time on hold, quite a "measure" of quality.

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Real Doc Speaks

@realdocspeaks

2 months

Mark Cuban did a fantastic job of clearly making the case against the large integrated PBMs. We all know that Mark is 100% correct and we all know what reforms are needed. Now it is up to Congress to ban the lobbyist and do their job! Put Americans before greed for once and…

Loretta Boesing

@BoesingLoretta

2 months

❗️Many comments from supporters on my TikTok are seriously asking @mcuban to run for president after today's listening session. America is exhausted with congress & many presidents failing to take action on PBMs. It's time. @WhiteHouse @TheJusticeDept

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Real Doc Speaks

@realdocspeaks

1 month

Optum admits to a $14 Billion backlog of payments from the 2/21/2024 cyber attack on Change Healthcare. Since Optume knows of the backlog they should pay NOW! The Maryland Medical Society reports they are offering only a bad 10-day loan program. The Sec of HHS needs to demand…

MedicalQuack

@MedicalQuack

1 month

Maryland has issued more than 500 loans due to Change Healthcare cyber attack “All Optum has done, who owns Change Healthcare, is offer a really bad 10-day loan payment program as their solution"

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Real Doc Speaks

@realdocspeaks

1 month

Senator Ron Wyden wants answers to how the Change Healthcare cyberattack occurred. He wants the CEOs of UNH and, presumably, the subsidiaries to be held responsible. I join the Senator in this quest but would also ask why UNH and Change Healthcare were…

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Real Doc Speaks

@realdocspeaks

17 days

@doclauravater Also, for a man in medicine. We all need a very patient, caring spouse to pick us up when we stumble and who reins us in when we are a little too confident!

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Real Doc Speaks

@realdocspeaks

2 months

This one-page order of denial of the DOJ case allowed United Health to purchase Change Healthcare. We now have a crippling cyberattack that has affected more than 900,000 Physicians, 33,000 Pharmacies and 5,500 hospitals. Unlike Physicians, Federal…

DOJ v. UnitedHealth Change - motion to block denied

www.documentcloud.org

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Real Doc Speaks

@realdocspeaks

9 days

@DrDiGiorgio Involving the government in any service will guarantee that the costs of that service will rise faster than inflation. The cost curve of healthcare and higher education are remarkably similar because of government involvement.

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Real Doc Speaks

@realdocspeaks

3 months

It is not a minor deal when the PBM pays the independent rural pharmacy less than its wholesale cost and drives them out of business. Of course, the patients can always use the PBM mail order or specialty pharmacy. PBMs add NO value. West Virginia got rid of them for the

HokiePharm

@HokiePharmacist

3 months

Hey Pete, if PCMA is tweeting your quotes then you are doing something very wrong. Downplaying PBMs impact on drug pricing shows a lack of awareness usually reserved for health economists. I would expect better from @Public_Citizen @Maybarduk @truthrx #TwitteRx #Pharmacy

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Real Doc Speaks

@realdocspeaks

2 months

It is interesting that the PBM story is so ignored by the mainstream media. This is a story of greed, monopoly, raising drug prices beyond people’s ability to pay, dropping crucial medications from formularies (Flovent), anti-trust and kick backs, overseas entities and…

Beth Joyner Waldron

@BethWaldron

3 months

“CVS rage” is not limited to their retail store experience. Just wait until @bostonglobe @BethTeitell learn behind the scenes CVS Health’s PBM controls the prescription benefits for 1 in 3 Americans (no matter where you pick up your medication) & they are even more frustrating.

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@realdocspeaks

3 months

The doctor-patient relationship is the key to all of healthcare. However, the exam room has gotten very crowded with payers, PBMs, policy wonks, attorneys, politicians, pharmaceutical companies, consultants, EMR consultants, regulators and a host of others lurking in the shadow.

Gavin Preston, M.D.

@GavinPrestonMD

3 months

In the US through the 1970s, it was considered so anathema that anyone would interfere in the doctor-patient relationship that corporate medicine was illegal in most states.

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Real Doc Speaks

@realdocspeaks

1 month

I was thinking about Cole in Appleton, WI. He was the young man who died because a generic advair was NOT on the formulary. A PBM reform bill never came up for a vote in the Wisconsin Assembly. Politicians do not want to have to vote against PBM reform because they know it is…

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Real Doc Speaks

@realdocspeaks

22 days

Physician practices should only be owned by physicians. Nothing good comes of corporate ownership. The patients become an after thought and it is all about maximizing the revenue.

Scott Strumello

@sstrumello

22 days

Another challenge to United Healthcare's growing monopoly of doctor's practices...

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Real Doc Speaks

@realdocspeaks

3 months

Lina Khan, this is all you need to know. Stop your PBM investigation and take action. You are fiddling while Rome burns!

Grassroot

@Grassro51522643

3 months

PBMs reimbursing Indy’s avg -19.80 below the acquisition cost on #GLP1 Indy’s are punished, abused & forced to pay out of pocket by PBMs while taking care of insured patients on Diabetes and obesity. Indy’s have to skip a meal every time they fill GLP1. @FTC @HHSGov @TruthRX

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Real Doc Speaks

@realdocspeaks

2 months

The DOJ sued to prevent UNH from purchasing Change Healthcare, and their concerns have been proven by the large impact of this cyber attack. A Federal Judge threw The suit out, and the DOJ didn't appeal. At the very least, large health insurance companies and PBMs need to lose…

STAT

@statnews

2 months

Hospitals and pharmacies are getting stuck in an insurance processing logjam after UnitedHealth Group cyberattack. And it's caught the attention of federal law enforcement agencies.

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Real Doc Speaks

@realdocspeaks

2 months

The preferred solution to increasing Medicare cost is to eliminate useless greedy middleman. We do NOT need Pharmacy Benefit Managers, consultants, GPOs, and a host of other hidden cost centers. Then we should NOT pay more for medications than comparable other countries, we…

Michael Zorn

@michaelZorn12

2 months

@realdocspeaks @fuzzymittens Interesting and compelling arguments/opinions... What is the preferred solution and how can it ever be implemented?? Insurance is too high for many and yet Europe seems to be more effectively grappling with these same issues....or are they??

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Real Doc Speaks

@realdocspeaks

2 months

Non competes make no sense. Most of the employed Physicians work with a large employer who can afford to onboard a new physician without any difficulty. For example the largest employer of physicians is United Health through their Optum division. Noncompetes restrict the…

MedBitter

@MedBitter

2 months

Cardiologist signs 3-year contract. His non-compete is 4-years. So if he leaves in 3 years, he must relocate to work. If the government cares so much about healthcare access and the critical physician shortage, ban NON-COMPETE CONTRACTS #MedX

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Real Doc Speaks

@realdocspeaks

8 days

@jjfitzgeraldMD There are few surgeries as complicated and frought with hazzard as a Cesearean Hysterectomy! I have done a few and they all went well, but they are nerve racking to perform as a generalist in a community hospital. We used to put Woman and Children in the lifeboats first and…

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@realdocspeaks

22 days

I think this is just incredible luck on their part, and no malfeasance is involved. I also believe that Nancy Pelosi and other members of Congress and the Senate are also incredibly lucky. I know that if you or I were ever that lucky, we would be in an Orange jumpsuit.

Bijan Salehizadeh

@bijans

22 days

UnitedHealth Chair, Executives Sold $102 Million in Stock Before US Probe Became Public There’s no indication that the trades were executed according to scheduled trading plans in filings related to the transactions. UnitedHealth said officers and directors must get clearance…

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Real Doc Speaks

@realdocspeaks

2 months

This is incredible and very sad. The PBMs are destroying the delivery of prescription medications and add no value. @LinaKahn No more need to investigate PBMs!

Save Independent Pharmacy

@BrandiChane

2 months

Just one more piece of evidence showing how PBMs are intent on destroying independent pharmacies & they shamelessly post these reimbursement rates on their website. Why? Because…who’s going to stop them? They have more $$ & legislators in their pockets @FTC @CMSGov @TruthRX

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Real Doc Speaks

@realdocspeaks

2 months

The administration's response to the Change Healthcare cyber attack has been inept. Physicians, Pharmacies, and Hospitals are not getting paid despite premiums still flowing into the coffers at UNH. It doesn't help that the Secretary of HHS is an attorney, not a physician or…

STAT

@statnews

2 months

The president's budget includes $1.3 billion to support hospitals’ cybersecurity efforts, and proposes to penalize hospitals that do not meet minimum requirements.

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Real Doc Speaks

@realdocspeaks

16 days

The AMA reports that the majority of physicians 60.8% have a negative view of Private Equity. This means the other 39.2% of Physicians don't know what private equity is.

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Real Doc Speaks

@realdocspeaks

2 months

Taking out non-competes is vital for physicians and patients. Most of the State laws will add provisions to the laws that will excluded physicians. For example they will allow non-competes if the employee makes more than $250K. It is laughable that an employee of a large…

Dr. Glaucomflecken

@DGlaucomflecken

2 months

Oregon HB 4130 not only limits corporate ownership in medical practices, it outlaws non-compete and non-disparagement clauses from employment contracts, a favorite tactic among private equity firms

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Real Doc Speaks

@realdocspeaks

1 month

Physicians were told EHRs will make us more productive, increase quality and safety, and benefit patients. However, this was the opinion of elites and those who produced the systems, and the EHRs were never tested before being mandated. They are a constant source of frustration…

Anthony DiGiorgio, DO, MHA

@DrDiGiorgio

1 month

We are having the wrong conversation. Limiting working hours isn't the way to improving physician well-being. Instead, replace EHR with something user-friendly. Simplify the documentation requirements, allow voice-driven notes & order entry, and eliminate burdensome busywork.…

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Real Doc Speaks

@realdocspeaks

2 months

Washington could care less that 39 State Attorneys General send a letter asking for PBM reform. This is the ultimate screw-you move by Congress to the States and to all of us. The state attorney Generals should come together and file a class action suit…

A Bipartisan Coalition of 39 State Attorneys General Urge Congressional Action on Pharmacy Benefit...

For Release: Feb. 21, 2024 Twitter: @NatlAssnAttysGn WASHINGTON, D.C. – The National Association of Attorneys General (NAAG) sent a letter to Congressional leaders on behalf of 39...

www.naag.org

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Real Doc Speaks

@realdocspeaks

24 days

@cscla I agree that the costs of higher education are unreasonably high. The main driver of that is student loans. The government increases the amounts that can be borrowed, and the schools build a new student center and increase tuition. The rise of tuition has greatly outpaced…

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Real Doc Speaks

@realdocspeaks

2 months

This tells us that the 3 large PBMs play by their own rules. They OWN the politicians and have no fear. They are more Al Capone than Al Capone ever was!

David Balat

@DavidBalatHC

2 months

Not a single PBM has complied with a federal order to produce documents needed for an investigation into their practices. My perspective - At least they're consistent. PBMs and Insurers alike are abysmal at producing documents and data necessary for employers, advisors, and…

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Real Doc Speaks

@realdocspeaks

2 months

We are seeing the carnage of the vertically integrated UNH with the Change Healthcare disaster. Not getting paid, no problem here is % f your billings, can’t survive, we will buy you at pennies on the dollar. Wake up Congress and FTC, this is healthcare. It is one thing for…

Doctor Money Matters

@drmoneymatters

2 months

The monopoly gets bigger and the gov remains silent. @linakhanFTC How much control are you gonna allow UNJH to have. Is “Too big to fail” only an issue in finance? @SenWarren

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Real Doc Speaks

@realdocspeaks

10 days

If you are a physician who is employed by a nontaxing paying hospital, formerly known as a non-profit, and they are able to enforce non-competes, then start a union!

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Real Doc Speaks

@realdocspeaks

13 days

@Suburbanbella I can guarantee that the patient with abdominal pain never had a thorough history or physical exam. As an OB/GYN, I had many referrals for PID because it was a young woman with abdominal pain, and no pelvic exam was ever done. The last patient was a kindergarten teacher who…

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Real Doc Speaks

@realdocspeaks

2 months

YES! EHRs have a very poor user interface and are not intuitive to use. For common tasks, it takes too many clicks and screens, and it is difficult to find information. The problem is that Physicians were never involved in the development of these products; it is always the…

Emily Fridenmaker

@emily_fri

2 months

I get upset when healthcare workers are told to adapt their work and their practices around bad technology. Just make/pay for better technology.

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Real Doc Speaks

@realdocspeaks

1 month

This is a tragic example of why corporate Healthcare is bad for patients. A 66 year old man presented with chest pain to the ER at Mission Hospital in North Carolina. He was not seen by hospital staff for over an hour and underwent cardiac arrest and…

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Real Doc Speaks

@realdocspeaks

2 months

Value based care means putting uncontrolled risks on the backs of physicians and giving the money to the payers. Docs are not insurance companies and should not be forced to act as one. There is nothing wrong with fee for service. Get your car fixed and refuse to pay for the…

Francis Anthony Toto

@francisatoto

2 months

Value-based healthcare is an impossible-to-work, failed, hyper-complex, boondoggle that WILL NOT adequately reduce surging costs and boost value. It diverted management focus away from the looming threat that will destroy America's biggest, critical industry. Proof:…

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Real Doc Speaks

@realdocspeaks

2 months

This is a major smash and grab, we don’t need PBMs we need Indy pharmacies!

Lauren Colee Young

@LaurenDC5

2 months

$9.5 Billion stolen from small business pharmacies in 2020 alone by PBMs that never make or distribute a drug, or counsel a patient during the 1st year of the pandemic. $6.389B of that would have stayed in 19,400 independent pharmacies to help patients & employees. 1/x

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Real Doc Speaks

@realdocspeaks

2 months

I can't believe that the Federal Government would allow the PBMs to not turn over requested documents. That evasive action makes one think that the PBMs have something to hide. The FTC needs to step up and obtain the documents ASAP to protect patients,…

FTC says pharmacy benefit managers are stonewalling requests for information

A much-anticipated FTC inquiry into pharmaceutical industry middlemen has been stymied because the companies have failed to provide many of the documents.

www.statnews.com

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Real Doc Speaks

@realdocspeaks

24 days

Medicare Advantage was supposed to save money over traditional Medicare but that has not happened. Last year Medicare Advantage programs costs $80 Billion more than traditional Medicare. Medicare Advantage programs are popular with those who can’t afford a medigap policy. It…

Mark Cuban

@mcuban

24 days

@realdocspeaks Why don't large hospital systems offer their own version of MA?

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Real Doc Speaks

@realdocspeaks

2 months

The anti-trust exemption for payers and PBMs needs to be taken away, and they need to be busted up. Politicians need to stop taking "campaign contributions" from Big Pharma, Big Payers, and healthcare middlemen. The country is broke, and we can't afford to continue this con…

RK

@rekesk

2 months

Dear @FTC , $UNH entire operating premise is based on unfair trade practices. Please address with the utmost of urgency.

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Real Doc Speaks

@realdocspeaks

11 days

The office of the Inspector General of HHS annouced an audit of vertically integrated Medicare part D sponsors that includes PBM. The six largest PBMs control 94% of all prescriptions filled and they are being scrutinized by the FTC. It is a positive…

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Real Doc Speaks

@realdocspeaks

3 months

Let me help you Scott. The PBMs receive a kick-back. Kick-backs are usually illegal under Federal law but PBMs have an exemption. The story of rebates going to lower insurance premiums is a common one that I have NEVER seen proof of. The PBMs are so secretive that Express…

greeny

@JoePharmer

3 months

Literally everyone that knows what PBMs are agree they’re worthless and cause people money. YET NO ONE DOES ANYTHING CAUSE PBMS ARE PAYING PEOPLE OFF

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Real Doc Speaks

@realdocspeaks

4 days

Insurance company denials of care should be rare and thorough. The entire record should be reviewed by a physician in the same specialty. The goal of denial of care should not be to save money but to ensure the patient is receiving the correct care. The peer-to-peer should…

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Real Doc Speaks

@realdocspeaks

2 months

It is imperative that patients not find out the true costs of their medications. If people had to pay out of pocket for meds, the price would drop precipitously. It would be similar to consumer goods. No one pays $100.00 for a Coke; if that was the price, everyone would drink…

HokiePharm

@HokiePharmacist

2 months

Pharmacies lose money on medications for years and nobody panics, because it's all part of the plan. A switch goes down, forcing patients to pay for their medication for one week, and everyone loses their minds #TwitteRx #Pharmacy

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Real Doc Speaks

@realdocspeaks

2 months

There is NO reason to pay insurance companies a premium for Medicare Advantage. They are insurance companies and insurance companies take risk, sometimes you lose money. It is not the job of the taxpayer to make sure that the major insurance companies don't lose money. MA…

Social Security Works

@SSWorks

2 months

"[United Healthcare] gets far more money from Medicare and Medicaid than from employers and individuals who buy coverage in the private market. This means that all of us as taxpayers are contributing to United’s massive profits." @wendellpotter @PplsAction #careovercost

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Real Doc Speaks

@realdocspeaks

22 days

. . This story describes a private equity-owned data analytics company named MultiPlan. The company calculates the price that major insurance companies will pay for out of network claims. The problem is that the company charges fees based on the discount…

Insurers Reap Hidden Fees by Slashing Payments. You May Get the Bill.

Weeks after undergoing heart surgery, Gail Lawson found herself back in an operating room. Her incision wasn’t healing, and an infection was spreading. At a hospital in Ridgewood, New Jersey, Dr....

news.yahoo.com

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Real Doc Speaks

@realdocspeaks

25 days

Dutch is correct the ACA was not about the patient. Physicians were punished by the prohibition of hospital ownership, by forcing risk on physicians through value based care, by lack of tort reform and by tracking money paid by industry to physicians. The medical loss ratio…

Dutch Rojas

@DutchRojas

25 days

The ACA was never about patients. It removed the caps and added a moratorium on physician owned hospitals. Removing caps was a deal with and for the pharmaceutical companies. The results of which made coverage nearly impossible to obtain (see first dollar coverage disappear…

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Real Doc Speaks

@realdocspeaks

3 months

Time for a trial, what happens if you get rid of PBMs say in West Virginia and Kentucky MA, oh wait a Minute that already happened and they saved millions. Just say NO to PBMs, GPOs and the rest of the cartel!

Brashear's Pharmacy

@BrashearsRx

3 months

PBM rebates are the missing number between the US and Canadian prices.

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Real Doc Speaks

@realdocspeaks

2 months

Between Physicians, Pharmacies, Hospitals, and insurance companies, the vast majority of patient data moves through Change Healthcare. Even though we don't have single-payer healthcare, data exchange is very close to that. Therefore, we need to simplify and diversify our…

Brian Gantwerker, MD, FAANS, FACS 🟧🇮🇱

@cscla

2 months

In case you are curious what single payer shutdown could look like, we are seeing it right now #MedTwitter In case you are wondering WHO administers Medicare, there are 5 jurisdictions, run by INSURANCE COMPANIES, not HHS. These companies are left to their own devices pretty…

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Real Doc Speaks

@realdocspeaks

1 month

The mainstream media is corrupt and lazy. There are people who can’t afford their meds because of PBM policies. They will not allow generics on the formularies and this prohibits inexpensive meds from being offered. Instead of addressing this issue they decide to do a…

RK

@rekesk

1 month

@Varro_Analytics @JohnArnoldFndtn @statnews @matthewherper @NPLB_org @PeterKolchinsky @realdocspeaks @DrugChannels CBS News also did the same, zero PBM reform questions. Like the issue doesnt exist.

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Real Doc Speaks

@realdocspeaks

3 months

@marklewismd I saw a 21 year old patient on a Friday afternoon with obstruction of the rectum from endometriosis. Took her to the OR with a general surgeon and she had metastatic colon cancer. No one took her pain or obstipation seriously because she was young. My wife and I went to her

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Real Doc Speaks

@realdocspeaks

2 months

Reform proposal: if the PBM pays less than the medication costs, they have to reimburse the pharmacy three times the loss within 30 days. Congress, this isn't difficult, either you take the PBM money or you vote to lower drug prices, increase access and save Indy pharmacies!

Kevin Pelter, Pharm.D.

@pelterkevin

2 months

@BethWaldron Just declined to fill a Xarelto 5 minutes ago. 30 day supply we would have lost $26 90 day supply we would have lost $181 Some PBMs are slightly above cost but the majority are $20-$40 under for a month supply in Medicare Part D or MA plans.

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Real Doc Speaks

@realdocspeaks

2 months

What a surprise! Optum was the PBM that would not allow Advair to be prescribed to a young man who died shortly after. It is not enough for Optum to not pay Docs, Pharmacies and Hospitals during the Change Healthcare attack, they have to ruin this entire family in Wisconsin. I…

Nena

@Nenaadvocacy

2 months

The #PBM is #Optum . More to come on this.

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Real Doc Speaks

@realdocspeaks

1 month

I wonder if Healthcare CEOs ever walk into a store and look at the mess they are in. The CEO of Walgreens wants to expand the role of Pharmacist to providers, that is to get reimbursed for treating diseases. I have been in a number of Walgreen pharmacies…

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Real Doc Speaks

@realdocspeaks

2 months

This is a story that really tells you nothing. What we, the humble taxpayers and health care deliverers, want to know who, why, and how much. Who are the key Congressmen or Senators that blocked PBM reform, why did they claim they blocked the legislation, how much did the PBMs…

STAT

@statnews

2 months

Congress has abandoned its attempt to reform how PBMs operate in an upcoming package to fund the federal government, 11 sources said.

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Real Doc Speaks

@realdocspeaks

1 month

Rollups of Physician groups may be a good deal for retiring physicians but are usually a disaster for those left behind. Physicians will find that giving up 20-30 percent of gross really decimates the take-home pay. The support the PE group promised is illusory at best. There…

Sean X. Luo

@seanluomdphd

1 month

@realdocspeaks Existence of PE rollups is really due to old physicians want to retire and cash out and new physicians don’t have capital to acquire the practice and desire to be owners.

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Real Doc Speaks

@realdocspeaks

3 months

Independent pharmacies are a staple of communities in America. They will take the time to compound meds and explain them to an elderly patient. They are part of the health care delivery system. We can't afford to lose them to fatten the bottom line of a faraway conglomerate.

Kevin Pelter, Pharm.D.

@pelterkevin

3 months

Imagine owning a used car dealership and selling cars for $6,750 each. On each transaction, you lose $275. That’s retail pharmacy in a nutshell right now, except the $6,750 car is actually Humira. Thanks @CVSHealth for doing your part to ruin healthcare for everyone.

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Real Doc Speaks

@realdocspeaks

28 days

Mark Cuban has done a great job informing the public what a PBM is and what exactly they do. They quietly sit in the background and make lots of money. What they fear is transparency and education of the public! This is what Mark Cuban is doing and that is going to lower…

Nena

@Nenaadvocacy

28 days

CVS Caremark leader is misinformed. His company buys NOTHING. That’s why they r called “middleman”. These guys, on the other hand, do! #SelfFunded #Employers @mcuban

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Real Doc Speaks

@realdocspeaks

10 days

@DGlaucomflecken This is what healthcare is about! Not the suits.

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Real Doc Speaks

@realdocspeaks

2 months

And the carnage of the vertically integrated monstrosity known as UNH continues! The Change Healthcare unit is wreaking havoc on the entire system of Physicians, Pharmacist, and Hospitals, and the DOJ is investigating UNH for anti-trust. Bust em up…

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Real Doc Speaks

@realdocspeaks

29 days

This is criminal! UNH and the other big insurance companies got to earn interest on the money they knew was owed to physicians and hospitals. UNH should have sent out what the physician practices bills on an average month and then figured out the proper amount later. UNH owns…

Carrie de Moor

@cdemoormd

29 days

This is fun… UHC system crashes for over a month. They get billions behind in payments. Then deny claims not “filed timely” during the time they were unable to process claims… and docs have to waste time to appeal this stupidity. 😡 #insurancefail

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