Dr. Niran Al-Agba

There are Ways to Save – and Expand – Medicare

First, the Balanced Budget Act of 1997 capped the number of residency slots in teaching hospitals which were eligible for Medicare payments. This mistake has facilitated a shortage of primary care physicians across the country. A larger supply of primary care physicians is associated with a lower mortality rate. In fact, adding 10 primary care physicians per 100 000 population increases life expectancy by nearly two months, whereas the same increase in specialty physicians only improves life expectancy by 19 days.

Niran Al-Agba2020-05-15T01:25:50+00:00May 17, 2019|Categories: Patient, Policy|Tags: Balanced Budget Act, CMS, Corporatization, Healthcare Costs, Hospitals, Medicare, Part A, Physician Shortage, Residency|

The ‘Hybrid’ Approach to Universal Health Care

The country bearing the closest resemblance to the U.S. proposal, where decision-making is centralized, is France, where the government is responsible for 77% of total health expenditures. There is an out-of-pocket cost share for patients though it is relatively low, at 7% annually. The Netherlands, Singapore, and Taiwan are also highly centralized; however, they are smaller in scale–with populations similar to that of individual U.S. states – and their relative affluence allows them to sidestep long wait times.

Niran Al-Agba2020-05-26T01:24:37+00:00April 23, 2019|Categories: Patient, Policy|Tags: Canada, CMS, Medicare, Universal Care, US healthcare|

Building Better Metrics: Focus on Patient Empowerment

Over the last century, health care has morphed from a system valuing individual responsibility to one grounded in physician dependency. Patients are viewed as clients who ravenously consume scarce resources, while physicians dispense answers and guidance for a price deemed too high by bureaucrats to be sustainable. Knowing how invested patients are in understanding their conditions and their willingness to take responsibility for their good or bad choices are metrics worth tracking. It is important to remember physicians make recommendations, educate their patients, and would do best by engaging in shared decision making with those patients. That entire process saves money and improves how patients view their quality of care.

Niran Al-Agba2020-05-14T03:19:26+00:00September 27, 2016|Categories: Policy|Tags: CMS, Corporatization, Metrics, Patient Empowerment|

CMS + MIPS/APM = Death of the Private Practice Physician.

We should pay physicians for time spent engaging patients in conversation, instead of rewarding them for checking boxes on a computer screen. Physicians were trained to care and comfort people, not chase blood pressure numbers and pain scale scores. Changes masquerading as meaningful have only increased physician workload. We are widgets in the ever expanding assembly line. Do you think the MIPS will give us more time to practice medicine? If you believe it will, then I have a bridge to sell you.

Niran Al-Agba2020-05-03T16:56:12+00:00June 27, 2016|Categories: Policy, Practice|Tags: CMS, Health Policy, Independent Practice, MACRA, MIPS, Physician Advocacy, Physician Autonomy, Rural Care|