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Did you know that you are a “telemedicine provider”? No? I can’t blame you for not knowing, but you are, and always have been. Well, maybe not always, but certainly since Alexander Graham Bell invented the telephone. Better yet, you provide free telemedicine services. Here is an idea: on the home page of your practice website, you should add a big huge flashing banner saying “Free Telemedicine Services!” Still hesitating because you are not using fancy monitors when you take calls from patients? First, telemedicine does not necessarily imply multimedia, but if you want to be sure, just turn on FaceTime on your iPhone and ask your patient to do the same. Much better… Look at you now, providing the latest and greatest telemedicine service like a pro, for free. But wait a minute; didn’t the largest private insurer in the country just announce that it will begin paying for telemedicine services? Yes and no. UnitedHealthcare will pay for telemedicine encounters provided through a handful o...

On April 16, 2015, President Obama signed into law H.R. 2, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), effectively sentencing Fee for Service (FFS) to death. The best explanation for how FFS is destroying the nation comes from Charles Munger , vice-chairman of Berkshire Hathaway and ad-hoc health luminary, who is equating what American doctors do, to raising rattlesnakes so they can collect the bounty for dead rattlers offered by the government in an effort to combat a growing snake problem. Based on this, and other equally compelling insights, FFS was found responsible for willful destruction of our great nation. A few months before Congress delivered its coup de grâce to the FFS system, the Secretary of Health and Human Services, explained to the elite group of NEJM paying customers, how “30% of Medicare payments should be tied to quality or value through alternative payment models by 2016 (50% by 2018)”. Other than transforming traditional Medicare into a vi...