Vascular Surgeon - Fayette Surgical Associates
Lexington, KY
Joined November 2020
- Tweets150
- Following203
- Followers174
- Likes1.9K
Mark Iltis, DO retweeted
๐๐๐๐ข๐๐๐ซ๐ ๐ข๐ฌ ๐ฉ๐๐ฒ๐ข๐ง๐ ๐๐จ๐๐ญ๐จ๐ซ๐ฌ ๐๐๐๐ ๐ฐ๐๐ ๐๐ฌ ๐ญ๐จ ๐ฉ๐ซ๐๐๐ญ๐ข๐๐ ๐๐๐๐ ๐ฆ๐๐๐ข๐๐ข๐ง๐.
๐๐ข๐ง๐๐ ๐๐๐๐, ๐ข๐ง๐๐ฅ๐๐ญ๐ข๐จ๐ง ๐ก๐๐ฌ ๐ซ๐ข๐ฌ๐๐ง ๐๐.๐%.
Medicareโs physician payment formula (the Conversion Factor)?
Down 9.9%.
Thatโs not โfiscal responsibility.โ
Thatโs institutional gaslighting.
๐๐๐๐ง๐ฐ๐ก๐ข๐ฅ๐, ๐๐๐๐๐ง๐ฌ๐ ๐๐จ๐ง๐ญ๐ซ๐๐๐ญ๐ฌ, ๐๐๐ ๐ฌ๐๐ฅ๐๐ซ๐ข๐๐ฌ, ๐๐ง๐ ๐ข๐ง๐ฌ๐ข๐๐๐ซ ๐ญ๐ซ๐๐๐๐ฌ ๐๐ฅ๐จ๐ฎ๐ซ๐ข๐ฌ๐ก.
But the doctors treating Medicare patients?
Theyโre being asked to do more with less, year after year, because โ๐ก๐๐ฒ, ๐ฐ๐ ๐๐จ๐งโ๐ญ ๐ก๐๐ฏ๐ ๐ญ๐ข๐ฆ๐ ๐ญ๐จ ๐๐ซ๐ข๐๐ ๐๐จ๐ง๐ ๐ซ๐๐ฌ๐ฌ ๐ฅ๐ข๐ค๐ ๐๐ฏ๐๐ซ๐ฒ๐จ๐ง๐ ๐๐ฅ๐ฌ๐โ, while the cost of running a practice skyrockets.
If the American people want Congress to preserve access to care for aging Americans, itโs time to speak up and tie Medicareโs payment formula to inflation, just like their own salaries.
๐๐ง๐ญ๐ข๐ฅ ๐ญ๐ก๐๐ง, ๐ ๐จ๐จ๐ ๐ฅ๐ฎ๐๐ค ๐๐ข๐ง๐๐ข๐ง๐ ๐ ๐๐จ๐๐ญ๐จ๐ซ ๐ฐ๐ก๐จโ๐ฅ๐ฅ ๐ญ๐๐ค๐ ๐๐๐๐ข๐๐๐ซ๐.
Theyโre busy trying to survive the 20th century in the 21st.
#HealthcarePolicy #Medicare #PhysicianBurnout #InflationMath #FixTheFormula
Mark Iltis, DO retweeted
Congress fails patients and physicians. 2.8% medicare cuts will go into effect. ama-assn.org/press-center/prโฆ (via @AmerMedicalAssn) @SoCalSurgeons @AmCollSurgeons
Mark Iltis, DO retweeted
Basically everyone one of those specialities calls Vascular Surgery. #callvascular
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Mark Iltis, DO retweeted
Warning: The tactics of the sales team persuading patients to switch from their @CMSGov plan to a private #advantage plan are deeply concerning. I strongly advise patients to steer clear during open enrollment. @vascularpodcast #MedTwitter โ at Houston, TX
Mark Iltis, DO retweeted
Educational imperatives -less scut. Operate more. I donโt recall learning anything from scut. Trainees canโt be the glue holding a hospital together which is the point of scut. Operate, operate, and then operate more. #vascsurg.
Mark Iltis, DO retweeted
We lost the battle for quality healthcare in the legislature. Our last battle will be in the Judiciary. #healthcare #business #failure
Missouri NP, โDr. Secilโ, boasts liposuction procedure she is neither qualified for or legally credentialed to perform
stlthwc.com/dr-secil-schodroโฆ
@AGAndrewBailey
#MedTwitter
#StopScopeCreep
#NPsLead?
Mark Iltis, DO retweeted
Until you make them liable for causing bodily harm (a liability every other company in the country contend with) nothing will change.
UnitedHealth pressured employees to cut off payments for seriously ill patients in lockstep with a computer algorithmโs calculations, denying rehab care for older and disabled Americans as profits soared.
Read: trib.al/zNxpK1Y
ALT An illustration shows a man with glasses and a walker walking out of a hospital. Text reads "EXCLUSIVE: UnitedHealth pushed employees to follow an algorithm to cut off Medicare patients' rehab care. By Casey Ross and Bob Herman"
Mark Iltis, DO retweeted
Please support A1255 - Prior Authorization Legislation Reform so we can remove barriers between doctors and patients. There is no reason that patients should be waiting so long for life-saving treatment
Visit votervoice.net/mobile/MSNJ/cโฆ
And share your support before Nov 20th. #A1255
Mark Iltis, DO retweeted
๐#FixMedicareNow The time for #Congress to act is NOW. Patientsโ access is at risk.
TY to moderator @wunderwil, panelists @KatieOrrico of @AANSNeuro @CNS_Update @DocRayC of @texmed & Todd Askew of @AmerMedicalAssn
โ๏ธTake action here tinyurl.com/3m2n5udw
โ๏ธLearn more here๐
Thread unrolled:
threadreaderapp.com/thread/1โฆ
Mark Iltis, DO retweeted
Medicare Advantage is a Government sanctioned scam against our most vulnerable, elderly patient population. Prove me wrong. #MedicareAdvantage.
Mark Iltis, DO retweeted
Anyone ever win a peer to peer with @UHC ?
Today they went with, โYouโre academic & too smart for me. They didnโt hire me to look at data, so why donโt I deny & you can appeal & talk to someone elseโ โ at San Antonio, TX
Medicare disadvantage plans
apple.news/AQ9ELAYxJSACc2yxjโฆ
Mark Iltis, DO retweeted
Calling all vascular trainees, name that sign! Hint: one of these pictures is not normal. @DrAliAzizzadeh @DonaldBaril @DonnaBahroloomi @VascularSurgCS @FutureVascSurgn
Mark Iltis, DO retweeted
#padawareness poll question: How often do you rely on Intravascular ultrasound (IVUS) in your arterial practice?
20%I don't have IVUS
21%Less than 33% of cases
22%About 33-66%
37%Over 66% of cases
104 votes โข Final results Mark Iltis, DO retweeted
Healthcare is not expensive.
Insurance carrier salaries are expensive.
Hospital administrators are expensive.
Health systems buying up private practices is expensive.
Health system consolidation is expensive.
Medical care is not expensive.
#healthcare
Mark Iltis, DO retweeted
Join OEIS and support the movement
Join OEIS, your ally for the delivery of safe, cost effective outpatient vascular care. (1 of 3) @BobTahara @bretwiechmann @Watts_IR @DrRAO_MD
Mark Iltis, DO retweeted
98% of the American population doesnโt know the following information:
1. Health systems, PBMs, and carriers want and need prices to continually increase.
2. Medicare pays health systems 3-5x more than private practice physicians for the same treatments.
3. New physicians contracting with Medicare receive way less than 100% of Medicare.
4. Physician may not own hospitals after 2010.
5. The cap on residency budgets has existed since 1997.
6. Coverage is not care.
7. The vast majority of lawmakers are owned by the healthcare and lobby.
8. 33 states still have CON laws that prohibit competition.
9. Price transparency laws have been on the books for 3 years and the laws are not obeyed.
10. The difference between self-insured and fully-insured.
Keep posting & keep educating.
We will win.
#health #SaturdayMorning
Mark Iltis, DO retweeted
For everyone doing CEA and CAS, this CMS National Coverage Determination (NCD 20.7) is an important topic, and you should consider weighing in.
This proposal:
-Will expand CMS coverage to patients previously only eligible for tf-CAS in a clinical trial.
-Will expand coverage to standard surgical risk individuals
-Will remove facility standards and approval requirements
-Provides no requirement for registry participation or reporting of outcomes
A few important points to consider before we open the proverbial flood gates for tf-CAS:
-Currently, there is no level 1 evidence that supports the use of tf-CAS over CEA or TCAR or medical management in standard surgical risk patients as this would allow.
-The preponderance of existing literature demonstrates a higher 30-day stroke risk of tf-CAS over CEA (nice relatively recent review here: ejves.com/article/S1078-5884โฆ)
-There is an ongoing NIH funded clinical trial (CREST-2; clinicaltrials.gov/study/NCTโฆ) that would provide Level 1 evidence towards this question. Why are we making this decision before this multi-million dollar trial is complete?
-This proposal provides no requirement of ongoing monitoring of outcomes.
-There is a significant learning curve for CAS (journals.sagepub.com/doi/10.โฆ among others), highlighting the importance of proper credentialing and following outcomes (especially for low-volume operators)
-Ultimately, there is a significant risk of increased stroke in CMS beneficiaries with this change, with no method to capture the additional potential harm to our Medicare beneficiaries. At the very least, registry participation and reporting (as has been done very successfully with TCAR) should be required so that we can follow outcomes and change course in the future, if necessary.
-We are currently learning lessons related to unfettered use of percutaneous procedures in outpatient settings. This seems to be begging for a repeat of that history, only in the world of CAS: propublica.org/article/marylโฆ
nytimes.com/2023/07/15/healtโฆ
Submit your comments to CMS here:
cms.gov/medicare-coverage-daโฆ
There are 8 days left to submit a public comment about @CMSGov proposed carotid artery stenting expansion. I just submitted my opinion - have you submitted yours?!? #DelayTheExpansion #CarotidEd @VascularSVS
cms.gov/medicare-coverage-daโฆ
Mark Iltis, DO retweeted
CLTI patients keep flooding our hospitals. @MedicareGov we need centers of excellence to responsibly care for these patients found hostage to fractured care models, politics and turf wars. #HOPE #HOPEhtx #HOPEglobal #multidisciplinarycare #toeandflow โ at Texas Medical Center, Houston
