Narasim Murthy

Father, radiologist, open wheel racing fan. Eagles fan. Beach bum.

[Narasim Murthy @XraycingDoc]

@SalaryDr A- Diagnostic Radiology-Body Imager who still is a generalist.

21 years out

[Dutch Rojas @DutchRojas]

You can walk into the same building, see the same doctor, use the same MRI machine… and pay 6x more, just for using the wrong door.

The same MRI at an independent location is $450 and $2,800 in a hospital.

Same machine.
Same radiologist often.
Same 45 minutes.

The difference is not medicine.
It is billing architecture.

Across the 1990s and early 2000s, Congress and CMS created a second payment lane for hospital outpatient departments: a facility payment layered on top of the professional fee.

Then health systems discovered the trade.
Buy the independent practice.
Designate it as a hospital department.
Keep the service in the same building.

Bill it as a hospital.

Section 603 of the 2015 Bipartisan Budget Act tried to slow the game by applying site-neutral payment to new off-campus departments.

But existing departments were grandfathered. The old money stayed protected.

Twenty years ago, roughly 80% of outpatient care lived in truly independent settings.

Today, true independence is closer to 12%.

That did not happen by accident.
It happened because the payment system rewards ownership status more than clinical work.

The Congressional Budget Office has scored site-neutral reform at massive savings over ten years. Congress keeps circling it.

The hospital lobby, with the lawmakers they have purchased, keep killing it.

You are not paying for better healthcare.

You are paying rent on a billing code.

[Joshua Reed Eakle 🗽 @JoshEakle]

They told us Democrats would turn America into a show-your-papers society.

They told us Democrats would strip away the Second Amendment.

They told us Democrats would jail us for what we say.

They told us Democrats would drag us into more foreign wars.

They told us Democrats would cover up a child sex trafficking ring.

And then Republicans took power and decided to do all of it themselves.

[ian bremmer @ianbremmer]

@StephenM “the party told you to reject the evidence of your eyes and ears. it was their final, most essential command." - george orwell, 1984

[Narasim Murthy @XraycingDoc]

@TomPelissero Where’d the punt stat come from?

[Navroop Singh @TheNavroopSingh]

Sect of State Rubio comment that Brazil is trading with China outside the Dollar that is the problem. And US would lose the ability to enforce sanctions on these countries.

As i said non dollar trade between BRICS+ is the crux of everything !

[Narasim Murthy @XraycingDoc]

@ThePhillyPod He looks like when Madden switches you to the wrong player and you move him in the wrong direction.

[Narasim Murthy @XraycingDoc]

@thomasrp93 We noticed LOL

[Thomas R. Petersen @thomasrp93]

Take a bow, Vic Fangio and the entire defense.

You deserve much, much better.

#Eagles

[Les Bowen @LesBowen]

The tragedy here — and it might doom the Eagles in the postseason — is that I’m sure Sirianni thinks he won because he played it smart.
That’s 180 degrees from the truth.

[Narasim Murthy @XraycingDoc]

@RealDGunn That was DPI hands on chest

[Narasim Murthy @XraycingDoc]

@steelers @Lions How isn’t that offsetting PI with the guy who was knocked down on the pick play ripping Metcalf’s jersey off with the hold.

[Narasim Murthy @XraycingDoc]

@JeffKerrPHL That’s the most fight I’ve ever seen out of Steen.

[Narasim Murthy @XraycingDoc]

@EliotShorrParks That’s because the Steen and Jurgens combination is a liability. Cam got stood up on the tusk push. He clearly isn’t playing well and hurt. Steen although healthy isn’t as big as Becton and not as strong of a run blocker. Add to that that Dickerson is playing at 60%. No run game

[Shane Haff @ShaneHaffNFL]

Remember last week when the Eagles went under center and ran play action? Yeah, that was fun.

[👨🏼‍🦲Jeff✌🏼☝🏼🖐🏼 @Philly_Bul215]

The biggest threat to the Eagles in the NFC are the Philadelphia Eagles

[Miss Ally @MissAlly_01]

Ian Fleming's original James Bond novels haven't aged well. For example, Moonraker, published 70 years ago in April 1955, features a villain who's a super-rich industrialist & rocket-maker seeking to cause chaos because he's a secret Nazi.
Such a silly idea! 😆

[Shane Haff @ShaneHaffNFL]

Btw, snapping with 0 on the play clock is very helpful for the DL getting a good jump. Too bad it takes 40 freaking seconds to call a vanilla run up the middle

[Jordie @jordiebarstool]

Tyler Steen standing straight up looking backwards until there’s 1 second left on the play clock every snap seems like an ill advised strategy

[The Giovanni Show Podcast @GioThePodcaster]

at this point… i’m not even mad, just embarrassed