Sudeep Bansal

Primary Care Physician | Analyzing How Healthcare Policy Hits Frontline Care | Author, PCP Lens

[Sudeep Bansal @sbansalmd]

VBC is not a "Care Model"
#VBC is a business contract. My simulation shows how contract terms make #ACO survival nearly impossible. Adust the contractual terms and see the effect on ACO survival.
https://t.co/d6iMfiIwFL

#HealthcareFinance #HealthPolicy

[Sudeep Bansal @sbansalmd]

@LighthouseDPC I am seriously considering Direct Primary Care in a few years

[Sudeep Bansal @sbansalmd]

@chrissyfarr PCP here. Happy to discuss more

[Sudeep Bansal @sbansalmd]

@molsjames Here is a table that shows the David vs. Goliath battle in healthcare.

I wrote this in the context of how Value-Based Care increases the total cost of care.

https://t.co/j303PR3LUH

[Sudeep Bansal @sbansalmd]

@DrDiGiorgio @constans This is the piece most people don’t understand. And it's also one of the reasons why many docs keep working past 65.

Delayed gratification and delayed retirement.

[Sudeep Bansal @sbansalmd]

https://t.co/96wMpr0hax

[Sudeep Bansal @sbansalmd]

@DutchRojas Not just denied, insurance can take it back from the physician 2 years later, you know, because the patient forgot to pay their premium and were not covered on date of service - which the insurance conveniently did not update their system to let us know.

[Sudeep Bansal @sbansalmd]

@DrDiGiorgio @RepYoungKim Wait, you are getting paid to be on call? That is amazing. Most places don't even pay docs to be on call!

[Sudeep Bansal @sbansalmd]

@krishnanrohit Look up Bayes theorem and its counterpart in medicine - Positive and Negative Predictive Value.

Then pls read my articles:

https://t.co/4fD6RQ4gQE

https://t.co/2AFSuZWNFb

[Sudeep Bansal @sbansalmd]

@BenMazer Here is the history of the annual physical exam, and how it is being used today for corporate healthcare.

https://t.co/zCiWzCcxEa

[Sudeep Bansal @sbansalmd]

@SaraForTexLege @grok calculate the NNT of statins, cost of prescription, annual physicals and labs to monitor statins are over a 20 year period. Also add cost of additional visits/labs due to statin side effects. Compare that to cost of hospitalization for heart attack.

[Sudeep Bansal @sbansalmd]

@realdocspeaks The money went to Meaningful Use 😉

[Sudeep Bansal @sbansalmd]

We have diseconomies of scale and rationing in healthcare in the US

The only difference is that private companies do it here for profit, whereas governments do it to avoid raising taxes.

A lot of this would be solved in a market based system + safety net system.

Pick your poison.

[Sudeep Bansal @sbansalmd]

@MichaelAlbertMD Equally, if not more important than sensitivity and specificity in clinical care is understanding Positive and Negative Predictive Values.

And they depend on the pre-test probability of disease!

[Sudeep Bansal @sbansalmd]

@gfodor If it was only so easy to define early stage cancer 🤔

https://t.co/4fD6RQ4gQE

[Sudeep Bansal @sbansalmd]

@DrAdamBat There is fair amount of patient selection bias.

People who were really worried and scan was negative, were relieved.

However, if there were incidentalomas, they may end up in a worse situation.

Tradeoffs!

[Sudeep Bansal @sbansalmd]

Happy Friday!

Looking forward to the weekend after dealing with the #administrative burden of #quality measures over #patient care.

[Sudeep Bansal @sbansalmd]

@AnjKhem VBC makes healthcare more expensive. My take:
https://t.co/j303PR3LUH

[Sudeep Bansal @sbansalmd]

@DrDiGiorgio Also, if you participate in insurance, they make it very hard contractually.

I have to start all over and rebuild my panel with people willing to pay out of pocket.

Chicken and egg problem.

[Sudeep Bansal @sbansalmd]

@DrDiGiorgio The only thing stopping me is that my practice is currently part of an IPA that contracts with private insurance.

Because of all the private insurance shenanigans, I am debating whether to keep only Medicare & Medicaid and stop accepting all private insurance.