Dr. DiGiorgio Goes to Washington: Site Neutrality, Stark Law Physician-Owned Hospitals & More
The Doctor's Lounge · The Doctor's Lounge
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Show Notes
Episode Summary
Dr. DiGiorgio returns from testifying before the House Energy and Commerce Subcommittee on Health, the third in a series of hearings on healthcare costs covering the provider landscape. The two break down the major policy levers discussed in his testimony — site-neutral payment, Stark Law reform, physician-owned hospitals, and Certificate of Need laws — and why so many obviously good solutions remain politically untouchable. They also dig into the rural access gap, the failure of the NP independence experiment to solve it, Medicare Advantage risk adjustment, and the new HHS healthcare advisory committee. As always, the diagnosis is clear; the politics are the hard part.
Chapter Markers
0:00 – Welcome back & Dr. DiGiorgio's Congressional testimony
3:16 – Site-neutral payment: why everyone knows it's right and no one acts
6:26 – You can't do site neutrality without also enabling competition
8:20 – How MedPAC's methodology actually works
11:50 – Stark Law explained — and why it creates a double standard
14:32 – Hospice fraud, Armenian gangs, and Nick Shirley
20:30 – The original sin: third-party payment and utilization control
23:52 – The case for allowing physician referral networks
25:15 – Hospitals' self-referral hypocrisy and the Federation of American Hospitals tweet
28:52 – How Section 6001 of the ACA banned physician-owned hospitals
30:13 – The new HHS healthcare advisory committee — will it matter?
37:44 – The rural access gap: how big is the problem really?
42:52 – Why NP independence didn't solve rural shortages
47:58 – International medical graduates and the rural fiction
50:06 – Let prices rise: the market solution to rural primary care
55:25 – Medicaid federal matching rates and state competitiveness
56:38 – How Democrats and Republicans engaged at the hearing
58:57 – The politics of why nothing gets done
Links:
YouTube Dr. Digiorgio Congressional Testimony: https://www.youtube.com/watch?v=sjPr3fK9jjc
@anish_koka | @drdigiorgio
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