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Volume IV, Issue 36

Sept. 4 , 2017
Dear insurance doctor: You are not my peer
Rick Boulay, MD, in a September 1, 2017 KevinMD post:

In efforts to control cost, insurance companies have implemented numerous policies to reduce the number of what they consider to be "nonindicated" tests. My favorite - yes, I'm being facetious - is the peer-to-peer consultation.

According the author:

I have been doing peer-to-peer consultations for at least five years now. In the past, a discussion of the clinical scenario and available patient data would not infrequently overturn the denial. Not so much now.
Providers leverage technology to fight delayed payments
Alex Kacik, in an August 30, 2017 Modern Healthcare post:

Stanford Health has set up kiosks at some of its clinics to help patients understand what their care will cost prior to treatment. The South Dakota-based provider's pilot program shows patients their estimated out-of-pocket costs, co-pays or other balances or collections at a station that looks strikingly similar to an airline check-in kiosk...

According to the article:

Nearly 3 in 5 Americans (56%) delay paying their medical bills, in large part due to high insurance deductibles and confusion regarding insurance coverage, according to an analysis by communication and network infrastructure company West Corp. of revenue-cycle challenges. This adds to the financial stress of hospitals and health systems that are facing dwindling reimbursement levels and rising infrastructure costs related to new payment models.
PURE Shakes Up Nutritional Field: Finds High Fat Intake Beneficial
Sue Hughes reports from Barcelona, Spain for Medscape on August 29, 2017:

A new study of dietary habits in 135,000 people around the world is set to shake up the nutrition field, with results showing high fat intake-including saturated fat-was associated with a reduced risk of mortality. The PURE study, which followed participants from 18 countries for 7 years, also found that high carbohydrate intake was associated with an increased risk of mortality...

Senior author of the PURE study, Dr Salim Yusuf ( McMaster University, Hamilton, ON), commented to Cardiology:
My advice to the general population to lead a healthy lifestyle is don't smoke and take exercise...And then I would say maintain a reasonable weight...Eat a balanced diet-a bit of meat, fish, several portions of fruit and vegetables, but you don't have to be vegan or eat an excessive amount of plants to be healthy...This is good old-fashioned advice. When I showed these results to my mother, she said, 'Why did you bother doing this study? This is what our grandmothers and their grandmothers have been advocating for centuries.' And actually she is right.    

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