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sarahkliff's profile
Sarah Kliff
Sarah Kliff
Sarah Kliff
Verified account
@sarahkliff

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Sarah KliffVerified account

@sarahkliff

Senior Policy Correspondent @voxdotcom. Running a year-long project on emergency room billing. Help out by sharing your bill!

Washington, DC
erbills.vox.com
Joined January 2009

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    Sarah Kliff‏Verified account @sarahkliff 4 Dec 2017

    Spending on emergency fees rose by $3 billion between 2009 and 2015 — even though ER visits remained steady, even declined a bit. https://www.vox.com/health-care/2017/12/4/16679686/emergency-room-facility-fee-monopolies …pic.twitter.com/5KVT2WpXWp

    8:40 AM - 4 Dec 2017
    • 94 Retweets
    • 85 Likes
    • We Are Not Amused Terese Zimmerman Justin Schuh 🗑 Josh Braun PatCapello Libel Darrell Williams Carol Forden Smartaceutical
    18 replies 94 retweets 85 likes
      1. New conversation
      2. Tarak Trivedi, MD‏ @TarakTrivedi 4 Dec 2017
        Replying to @sarahkliff

        Increasing ED costs are concerning, but we have to be very careful of potentially dangerous solutions: http://time.com/5017365/insurance-er-visits-patient-decide/ …

        1 reply 0 retweets 5 likes
      3. Sarah Kliff‏Verified account @sarahkliff 4 Dec 2017
        Replying to @TarakTrivedi

        I’m planning to make my next ER story about these insurance denials. Agree it’s important to show multiple sides of the issue - and am trying to find patients already who have run into problems being turned away.

        0 replies 0 retweets 4 likes
      4. End of conversation
      1. New conversation
      2. Steve Pitts‏ @chowkydar 4 Dec 2017
        Replying to @sarahkliff

        I've known a hundred ER docs in my career, and only 2 or 3 of them were ever as greedy as the billing companies. This corruption is fundamentally due to E&M coding, a dingbat invention of the 90s.http://bit.ly/1PM8o0n 

        4 replies 12 retweets 26 likes
      3. barttels‏ @barttels2 4 Dec 2017
        Replying to @chowkydar @rvaughnmd @sarahkliff

        @VinayPrasad82 @jpkassirer Some first 100 words!!!!!pic.twitter.com/Kdg3JEklu9

        2 replies 2 retweets 5 likes
      4. ChristosArgyropoulos‏ @ChristosArgyrop 4 Dec 2017
        Replying to @barttels2 @chowkydar and

        Published 6 months before my internship.

        1 reply 0 retweets 1 like
      5. barttels‏ @barttels2 4 Dec 2017
        Replying to @ChristosArgyrop @chowkydar and

        It's all better now, right? 😳

        1 reply 0 retweets 1 like
      6. ChristosArgyropoulos‏ @ChristosArgyrop 4 Dec 2017
        Replying to @barttels2 @chowkydar and

        Troll 😀

        1 reply 0 retweets 1 like
      7. barttels‏ @barttels2 4 Dec 2017
        Replying to @ChristosArgyrop @chowkydar and

        I've been called that only once before, and I did not realize it was a compliment. 🤣

        1 reply 0 retweets 2 likes
      8. ChristosArgyropoulos‏ @ChristosArgyrop 4 Dec 2017
        Replying to @barttels2 @chowkydar and

        It was meant to be

        1 reply 0 retweets 1 like
      9. Steve Pitts‏ @chowkydar 4 Dec 2017
        Replying to @ChristosArgyrop @barttels2 and

        Bob Berenson, CMS director at the time, to this day wonders why we put up with it.http://bit.ly/1EX63Kr 

        1 reply 2 retweets 4 likes
      10. 11 more replies
      1. New conversation
      2. Brad Pickar‏ @bpickar 4 Dec 2017
        Replying to @sarahkliff

        Keeping an ER open is expensive and many costs are fixed. Can't reduce hours or services. If # of visits go down because simple cases now handled elsewhere (as they should be), prices need to rise. Doesn't explain steep rise in total spend, esp. as # of hospitals is declining.

        1 reply 1 retweet 1 like
      3. NE Resistanista‏ @NEResistanista 4 Dec 2017
        Replying to @bpickar @meganranney @sarahkliff

        True, but things like this can be fixed with better budgeting (factoring equipment leases vs purchases, flex time, efficient triage practices). The problem is that many hospitals boards bring in MBAs, etc who focus on the bottom line rather than understanding processes.

        1 reply 0 retweets 2 likes
      4. Megan Ranney MD MPH‏ @meganranney 4 Dec 2017
        Replying to @NEResistanista @bpickar @sarahkliff

        I love the ideas of @TheBIF on this: we need to maximize value. Unfortunately, we are hamstrung by both regulation and by insurance companies. Lose-lose for US ED docs. Right @choo_ek @MDaware ? 😐

        3 replies 1 retweet 4 likes
      5. NE Resistanista‏ @NEResistanista 4 Dec 2017
        Replying to @meganranney @bpickar and

        Absolutely, which account for higher prices. Hospitals have no choice but to charge high rates given insurance companies have far too much control over what they choose to reimburse. Hospitals rarely recoup the costs incurred.

        0 replies 0 retweets 3 likes
      6. End of conversation
      1. New conversation
      2. Steve Pitts‏ @chowkydar 4 Dec 2017
        Replying to @sarahkliff

        Thanks for the attention to neglected corner of medicine, Sarah. Re: cost growth, better resource=http://bit.ly/2BHO5yY . Regarding number of visits, see http://bit.ly/2AMsrfi . HCCI total is off by factor of 10, and NCHS data=>ED visit vol increase continues.

        1 reply 0 retweets 5 likes
      3. Steve Pitts‏ @chowkydar 4 Dec 2017
        Replying to @chowkydar @sarahkliff

        Here are most recent NCHS ED volume estimates: http://bit.ly/2jMoD34  And here correction of bad cost growth link JAMA 2017;318:1668 Dieleman et al.

        1 reply 0 retweets 2 likes
      4. Alli Gator  🐊 🌐‏ @PoliticalPup415 4 Dec 2017
        Replying to @chowkydar @sarahkliff

        this has 102B for ED spending http://ihmeuw.org/49qt  (it's the interactive version of the chart here: https://jamanetwork.com/journals/jama/fullarticle/2594716 …)

        1 reply 1 retweet 2 likes
      5. Steve Pitts‏ @chowkydar 4 Dec 2017
        Replying to @PoliticalPup415 @sarahkliff

        Yep, out of 2 trillion = 5%

        0 replies 0 retweets 1 like
      6. End of conversation
      1. When God Plays Dice‏ @RKLindgren 4 Dec 2017
        Replying to @sarahkliff

        This is a survival game by many rural hospitals. Urgent care and community health centers have put the squeeze on them for less-critical "emergency" care that isn't, but pays the night bills. Maybe fund 24-hr care directly rather than make them "earn" it?

        0 replies 2 retweets 3 likes
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      1. New conversation
      2. Steve Carroll DO MEd‏ @embasic 4 Dec 2017
        Replying to @sarahkliff

        Ummm...those “visits to the ER” is off by more than a factor of 10

        2 replies 0 retweets 5 likes
      3. Jim Makinen‏ @JimMakinen 4 Dec 2017
        Replying to @embasic @sarahkliff

        Per HCUP (cited in the graph), there were 137.8 million ED visits in 2014, a 14.8% increase from 2006. Where did you get these numbers from? https://www.hcup-us.ahrq.gov/reports/statbriefs/sb227-Emergency-Department-Visit-Trends.pdf …

        0 replies 0 retweets 1 like
      4. End of conversation

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