At DocSpot, our mission is to connect people with the right health care by helping them navigate publicly available information. We believe the first step of that mission is to help connect people with an appropriate medical provider, and we look forward to helping people navigate other aspects of their care as the opportunities arise. We are just at the start of that mission, so we hope you will come back often to see how things are developing.

An underlying philosophy of our work is that right care means different things to different people. We also recognize that doctors are multidimensional people. So, instead of trying to determine which doctors are "better" than others, we offer a variety of filter options that individuals can apply to more quickly discover providers that fit their needs.

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White House administration ends cost-sharing reduction payments

In a move likely to have many reverberations, the White House administration decided to end cost-sharing reduction payments initiated under the previous administration, claiming inadequate congressional authorization to make those payments. Insurers had been widely predicting increases in premiums should these payments not continue. On one level, the legal issue is whether Congress has actually authorized these payments. One federal judge had ruled in favor of those opposing these payments, but that ruling was appealed and until recently, the payments had continued.

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Sharp premiums hikes for some states

The New York Times reported that a number of states expect substantial increases in next year's premiums for health insurance plans sold on the state exchanges. Some states expect increases of over 50%. While the insurance subsidies will help many, NPR points out that there are some who will experience the cost of these increases: those who are not covered by insurance through their employers but also earn too much to qualify for subsidies. The New York Times raises the persistent question of whether or not these rate hikes are part of the so-called death spiral.

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Innovation in payment models

As Americans continue to face higher health insurance premiums, insurers are looking for alternate payment models that can help contain the growth in costs. The New York Times published an article of health systems' experiences with such an alternate payment model. The piece discusses the danger of the traditional payment model -- known as fee-for-service -- where providers are paid more when they do more, regardless of the actual outcomes:

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Republicans try again

The current big news in the health policy landscape is the Republicans' most recent attempt at repealing the Affordable Care Act, known as the Graham-Cassidy bill. Knowing that the Republicans lack the 60 votes needed for a filibuster-proof vote in the Senate, Republicans have been trying to use a procedure known as budget reconciliation to essentially defund the Affordable Care Act. Budget reconciliation only requires a simple majority, and is not able to overturn all aspects of the Affordable Care Act.

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Insurers pay larger practices more

Kaiser Health News published a piece on how physician practices have become increasingly hospital-owned, while the reimbursement rates for large practices tend to cost insurance companies more. According to some claims data, the publication's analysis found that insurance companies reimbursed physicians employed by a hospital system two to four times more than what they reimbursed independent physicians for a vaginal delivery (the piece followed the story of an obstetrician). I have anecdotally heard that large medical systems have approached independent physicians, offering to buy their practice in exchange for better pay and less administrative overhead. While many physicians may bemoan the loss of independence, that offer will entice many. The reason that the large medical practices can afford to make those offers is that they employ enough of the local market's physicians that they can command much higher rates -- high enough to compensate for the higher salaries and overhead. If these acquisitions were done on a national scale, the Federal Trade Commission might be sufficiently interested to stop the concentration of power; however, given the local nature of health care, these acquisitions tend not to attract regulatory oversight.

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