Mike Weathers M.D. FAAOS

Orthopaedic Sports Medicine Doc in Cache Valley, UT. former Northwest Permanente Employee. Faith, family, sports. Bonneville, BYU, UTHSCSA, OC, NWP

[Jonny Linehan @jlinehan9]

#SCTop10

[Mark Cuban @mcuban]

Share this with your governor. Share this with every politician you know. It will cut the healthcare costs in your state.

We started Cost Plus Drugs because the prescription drug market is too complicated, too opaque and too expensive.
Our model is simple: we show what we pay for a drug, add a transparent markup and pharmacy fee, and show the customer the price.
No games. No hidden spread.
And a large percentage of our customers already have insurance.
They come to us because our cash price is often lower than what their insurance plan asks them to pay.
That tells you something is wrong.
Here are five things Texas can do about it.
1. Let patients shop for cheaper drugs
If someone's insurance says a prescription costs $500, but they can buy the exact same drug for $100 cash, let them buy it for $100.
Then credit that $100 toward their deductible and out-of-pocket maximum wherever Texas has authority to do so.
Patients should be rewarded for saving themselves and their health plan money.
They shouldn't be punished for it.
That's how you create something healthcare desperately needs:
Price competition.
2. Standardize PBM and TPA contracts
Texas should require the state, cities, counties and school districts to use standardized model contracts and mandatory terms for PBMs and TPAs.
I've reviewed these contracts.
They routinely run hundreds of pages.
I've seen contracting packages longer than a thousand pages.
There is no human being—or group of human beings—on this planet who can stay awake and understand every provision in contracts that complicated.
I don't care how much coffee they drink.
I call it contractual terrorism.
The vendor only has to sneak a couple of tricks through hundreds of pages.
The employer has to find every one.
It can't.
I've developed a model PBM contract designed to eliminate the major tricks and hidden economics we've identified.
Texas can have it for free.
Use mine. Improve it. Open source it.
I don't care.
Just stop making every government entity negotiate these contracts from scratch.
3. Make the economics public
If taxpayers are paying the bill, taxpayers should know the price.
Pricing. Fees. Rebates. Guarantees. Pharmacy reimbursement. Affiliate compensation. Audit rights.
Make them public.
I'm not talking about patient information or legitimate security information.
I'm talking about the money.
You cannot have an efficient market without price discovery.
Without price discovery, you get information asymmetry.
And when one side knows dramatically more than the other, guess who wins?
Not taxpayers.
Not employers.
Not patients.
Open the contracts up and let competitors see what they have to beat.
That giant sucking sound you hear will be money moving away from healthcare conglomerates that are too big to care and back toward taxpayers, employers and patients.
In the immortal words of Charles Barkley:
I guarantee it.
4. Kill the gag clauses
PBM contracts are like Fight Club.
The number one rule of Fight Club is that you can't talk about Fight Club.
The number one rule of many PBM contracts seems to be that you can't talk about your PBM contract.
That's insane.
Let employers compare pricing, rebates, fees, guarantees and reimbursement terms.
Markets work better when buyers know what other buyers are paying.
5. Make enforcement hurt
If a healthcare company commits a serious violation, give them one mulligan.
But after a second material federal or Texas enforcement action within a defined period, make them ineligible for new Texas government contracts for a period of time.
Two strikes.
You're out.
Today, some of these companies can make billions, get caught, pay a fine and write it off more easily than I wrote off an NBA fine.
That's not deterrence.
That's a cost of doing business.
And Texas should spend more on enforcement.
If Texas spends $10 million auditing contracts and analyzing claims and prevents $100 million in unnecessary spending, that's not overhead.
That's a 10x return on investment

[Mike Weathers M.D. FAAOS @Orthomig]

@TrentMano @mattsuthe 1 of 1 in Utah. Real Texas bbq.

[The BMA @TheBMA]

Doctors have suffered the biggest salary reductions of any profession in the last 20 years, when inflation is considered.

This new research will come as no surprise to our members, but will the Government finally take notice? https://t.co/AbNqQfT5SU

[Overly Trev’s Future @OverlyTrev]

IF Tesla committed with a BIG 3 Row SUV based on the Cybertruck chassis it would absolutely destroy any Range Rover, Hyundai, Lucid, Rivian.. pick a name it wouldn’t be close.

Do it @elonmusk

[Mike Weathers M.D. FAAOS @Orthomig]

@Kintsugijin At least in Utah

[Mike Weathers M.D. FAAOS @Orthomig]

@Kintsugijin Email went out a few weeks ago. It is true

[Robert Berry, DO @txsportsdoc]

Nothing to see here. 111 degrees in North Texas and youth football practice going on in full pads. Truly unreal. Something has to change to keep these kids safe. I’ve spent my entire career caring for amateur to NFL football players. We wouldn’t let pros practice outside in this, why are we letting kids?🤷‍♂️

[Mike Weathers M.D. FAAOS @Orthomig]

It’s amazing how little this is employed in the communities. Should be part of every high school strength and conditioning programs.

[AOSSM @aossm1972]

What if the best #ACL injury treatment is prevention?

From neuromuscular training and movement screening to evidence-based prevention programs, reducing ACL injuries starts long before an athlete steps onto the field.

The article, “Stopping ACL Injuries Before They Happen,” featured in the latest issue of
#SportsMedicineUpdate, examines the strategies sports medicine professionals can use to help keep athletes healthy and in the game.

Read the full article:
https://t.co/YlC0T31aSx

[Mike Weathers M.D. FAAOS @Orthomig]

@Evautoalex Shade would be nice. Been in chargers where the AC has to blast just to keep in comfortable, leading to longer charge times.

[Mike Weathers M.D. FAAOS @Orthomig]

@Evautoalex Logan to St George adds about an hr

[Mike Weathers M.D. FAAOS @Orthomig]

https://t.co/q8BxBGrQwf

[PRB 🇺🇸 @datanotion]

Prayers don't work....right?

Left: Fire area
Right: The only rainstorm we've had in a month - RIGHT over the storm - no more, no less.

#rockycanyonfire

[Mike Weathers M.D. FAAOS @Orthomig]

@Evautoalex Windshield wipers

[Mike Weathers M.D. FAAOS @Orthomig]

@Evautoalex Saw one of your Fiskers in a church parking lot in PC today. First time seeing one in the wild!

[Christian Pean MD,MS @DrChristianPean]

$523.

That's what the physician work of a total knee replacement pays under Medicare's proposed 2027 fee schedule. The surgery, the risk, and every visit for 90 days after.

A total hip: $505.

[Adam Bruggeman, MD @DrBruggeman]

CMS just dropped the CY 2027 Physician Fee Schedule proposed rule. At 1,592 pages, it is one of the most consequential rulemakings in years for independent physician practices, and almost none of the headlines are capturing what is actually at stake.

The long and short of it is that Congress let the 2.5% conversion factor fix expire, so non-APM physicians are looking at a -1.68% cut on January 1. That alone would hurt. Buried in this rule are structural changes that compound the damage in ways that will outlast any year-end patch.

This week I am walking through what matters most for independent practices:

Tuesday: The conversion factor cut and what Congress has to do about it before year-end.

Wednesday: The proposal to slash payment 50% when you bill an E/M and a procedure on the same day, and why we beat this back in 2019 and can do it again. Plus, the new JAMA data showing how much uncompensated post-op work physicians are already doing that CMS is not counting.

Thursday: The two biggest structural threats buried deeper in the rule. A complete overhaul of how practice expense RVUs are calculated, and a comment solicitation that could let CMS define "employed" vs. "independent" in ways that devastate facility-based independent practices in 2028.

Friday: Fix It Friday. Specific comment asks and legislative actions with real deadlines.

Comment deadline: September 14, 2026. You have eight weeks. Let's make them count.

[Arthroscopy Journal @ArthroscopyJ]

ACL continuity on MRI is not synonymous with functional stability. This editorial emphasizes that nonoperative management of ACL tears should be reserved for patients who demonstrate "early mechanical control on clinical examination."
https://t.co/MHokOLu8Se
#ACLTears

[Troll Football @TrollFootball]

NO CARD RED CARD

[Alexi Lalas @AlexiLalas]

‘Sup.