Parents have finally been informed that tomorrow, one week after we first got it approved and five days after Caremark reversed that decision, this medication will be delivered. She is getting an emergency echocardiogram today to determine if any damage was caused by this delay.

A new low huh.

Point is, no insurer has ANY incentive to lower health care costs. The more we all spend on health care, the more high premiums are justified, and the bigger their 20% slice of the pie can be. Come back in a few years, and I promise @AjKavanaugh’s numbers will be even higher.

Doctors at a major US insurance company deny tens of thousands of claims a month without even looking at patients’ files. “We literally click & submit,” a former Cigna doctor told @ProPublica & The Capitol Forum. “It takes all of 10 seconds to do 50 at a time.” The inside story 🧵

14/ In one corporate document, Cigna estimated that only 5% of people would appeal a denial resulting from a PXDX review.

This is pretty much the only reason for denial and pre-authorization--it's more likely people will just go without insurance or forego care, leading to more profits for insurers.

“This leaves us as a society with an important and difficult question—how we will we survive if you go into an emergency department, and there are no doctors or nurses left to care for you? “ Janice Blanchard scientificamerican.com/article/fewer-…

My name is Muhil, and I first came to the United States when I was 2 years old. Despite living here lawfully for two decades, I did not receive my green card with my family because I aged out.

Higher hospital surge preparedness is associated with over one third reduction in excess mortality. #SAEM23 by Alex Janke Arjun Cc Jeremy Faust MD MS (ER physician)

180% in utilization of ED observation stays over from 2006/7 - 2018/9. #Neurology complaints were an important driver. Great work by Andrew Luo. HAEMR Andrew Chou

AMCs transfer admitted patients to community hosp for capacity management. NHB and Hispanic pts were more likely to be deemed eligible for transfer by MDs and more likely to consent to transfer. Raising Q on systemic bias & need for levers to mediate. #SAEM23 HAEMR

Officially offline from Brigham and Women's Emergency Medicine. Special mention to Scott Weiner, Jay Schuur, MD 🟧, Peter Chai, the numerous Andrews' and many more who have been a friend to me. See you all around :)

One of those things you'd think we don't need a trial to show... But sadly we do.

Why are emergency departments still so overcrowded? "This is not because, you know, we're not moving quick enough.... it should probably be called health system overload." Patients - and healthcare workers - deserve better. ACEP Members Aisha Terry 👏 npr.org/2023/06/25/118…

Guns kill people.

The latest in health insurers trying to practice medicine: journals.lww.com/em-news/fullte…