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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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The continued rise of the deductible

by jerry on May 12, 2019

NPR published a piece about rising deductibles. The author makes the point that while many people have health insurance, the deductibles have been rising quickly over the last "dozen years," to the point that people put off medical care despite having insurance. The piece also reported on the results of a poll that found that 20% of respondents depleted savings into order to pay medical bills.

NPR published a piece about rising deductibles. The author makes the point that while many people have health insurance, the deductibles have been rising quickly over the last "dozen years," to the point that people put off medical care despite having insurance. The piece also reported on the results of a poll that found that 20% of respondents depleted savings into order to pay medical bills.

The overall cost of medical care continues to rise, and people look for ways of curbing the effects. The monthly health insurance premium is one area that can look attractive, but if not coupled with enough money to cover the deductible (e.g. with a health-savings account), the policyholder can be in for
a very unpleasant surprise. American society increasingly hears about and experiences the continued increases costs of health care (whether through insurance premiums or through deductibles) and Democratic politicians have gained favor among many voters for their pledges to do something. Perhaps the industry is ripe for a change.

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Open Payments

by jerry on May 04, 2019

In response to the Physician Payments Sunshine Act, Centers for Medicare & Medicaid Services (CMS) has been disseminating information about payments and gifts that companies give to providers, starting around 2014. Payments and gifts could take many forms, such as an honoraria for speaking, ownership stakes in joint ventures, or even simply meals. CMS has been releasing subsequent data annually. We are pleased to announce that earlier this week, we released our first integration of this data with provider profiles on our site.

In response to the Physician Payments Sunshine Act, Centers for Medicare & Medicaid Services (CMS) has been disseminating information about payments and gifts that companies give to providers, starting around 2014. Payments and gifts could take many forms, such as an honoraria for speaking, ownership stakes in joint ventures, or even simply meals. CMS has been releasing subsequent data annually. We are pleased to announce that earlier this week, we released our first integration of this data with provider profiles on our site.

The Physician Payments Sunshine Act was passed in response to concerns that pharmaceutical and medical device companies might be unduly influencing doctors to prescribe certain medications or devices, even when such prescriptions might not be in the best interests of the patients.

You can see the source data via CMS' OpenPayments site. While CMS' site has interesting tools to explore the data through different angles, it lacks the functionality of a general doctor finder website. We believe that this data can be helpful to patients in potentially uncovering conflicts of interest, and that this integration is a more natural way for patients to learn more about their prospective providers.

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Site-neutral payments

by jerry on April 28, 2019

Kaiser Health News reported on Medicare eliminating an extra facility fee that it has paid out for services performed in clinics that are owned by hospitals. The extra facility fee was not paid out for the same services performed in otherwise similar clinics that are not owned by hospitals.

Kaiser Health News reported on Medicare eliminating an extra facility fee that it has paid out for services performed in clinics that are owned by hospitals. The extra facility fee was not paid out for the same services performed in otherwise similar clinics that are not owned by hospitals.

The original thought was that hospitals have to maintain a higher capacity for medical care, and so services performed at hospitals should be compensated more than the same care performed at clinics. For example, if a complication arose during a procedure at a clinic, the patient could be sent to the hospital for further treatment. Hospitals then saw this extra facility fee as a means of further enriching themselves and proceeded to buy clinics, imposing that fee on services performed at those ancillary clinics. This differential in payments made it more difficult for independent clinics to compete.

Medicare's elimination of the facility fee ("site neutral payments") might even the competitive field and slow down the consolidation of clinics into larger hospital networks. However, some hospitals are probably still buying clinics to help secure referrals to the hospitals themselves.

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High-deductible plans associated with delays

by jerry on April 21, 2019

NPR published a piece showing that women with high-deductible plans often delayed screenings and treatment. The effect was true, regardless of whether the women or low-income or high-income (although high-income participants tended to delay less). There is no particular reason to think that this effect is limited to only women.

NPR published a piece showing that women with high-deductible plans often delayed screenings and treatment. The effect was true, regardless of whether the women or low-income or high-income (although high-income participants tended to delay less). There is no particular reason to think that this effect is limited to only women.

I did not read the study itself (payment required), but one question is what benchmark the authors measured the delay from (e.g. from the control group or from a triggering event or diagnosis). Regardless, the study highlights one of the challenges of high-deductible health plans, which is that people may delay appropriate medical care because of the high deductible. Ideally, people would be more cost-sensitive (e.g. comparison shop for non-emergency procedures) without compromising their health. Unfortunately, there is not an inexpensive and reliable way for everyone to know whether they really need to seek treatment.

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On the dearth of clinical quality information

by jerry on April 12, 2019

STAT published an opinion piece highlighting the lack of clinical quality information available to patients. With all of the talk about high-value medicine, we need to be cognizant that value involves both price and quality. While it is true that information on both fronts is lacking within the practice of medicine in the US, there is at least some more pricing information that is available. Except for the few small pockets of information outlined in the piece, there is very little clinical quality information that is available to consumers.

STAT published an opinion piece highlighting the lack of clinical quality information available to patients. With all of the talk about high-value medicine, we need to be cognizant that value involves both price and quality. While it is true that information on both fronts is lacking within the practice of medicine in the US, there is at least some more pricing information that is available. Except for the few small pockets of information outlined in the piece, there is very little clinical quality information that is available to consumers.

While there have been large efforts to define clinical quality metrics (e.g. the National Quality Forum), actual physician performance data on those metrics is rarely disseminated publicly. Organizations outside of the medical establishment (such as Propublica and Consumers' Checkbook) have tried to rate surgeons, drawing criticism from the medical community. It is possible that the most successful measures will come from large self-insured employers who mandate disclosure of some information.

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