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Damian Caraballo MD Profile picture
Damian Caraballo MD
@813JAFERD
#BAFERDLife in the ED. Med education, Health policy, sports, Florida man. Views my own. “Healthcare” should be two words & run by people who see patients.
Dec 5 • 11 tweets • 2 min read
If you want to see why people are so vicious towards United Healthcare right now, let's do a thread on some of the most egregious health insurer behaviors 🧵 1) United Healthcare is 8th largest company by revenue in the WORLD. It made $389B last year...$2B less than Apple. It made more money than Exon, Microsoft, Samsung, JPM

United Healthcare also denies 32% of its claims...highest among health insurer
Sep 25, 2023 • 11 tweets • 2 min read
US Health Insurers have managed to create a new "Surprise Bill" for patients--walk w/ me through this thread: 1) Step one was passage of No surprises act. This ended balance billing and essentially killed off Envision and Team Health. Except insurers didn't plan on having Ind. Dispute resolution (IDR, ie arbitration)
Jul 17, 2023 • 10 tweets • 3 min read
About 7 years ago, after Zach Cooper’s “Surprise” Bill paper, media & Congress started reporting costs as %Medicare rate. Ever wonder why? 🤔 (thread) #MedTwitter Image 1/ Med Economists love using % of medicare for physician reimbursement instead of actual price. Why? Medicare rate is a made up, mandated rate by CMS. Image
May 17, 2023 • 11 tweets • 5 min read
Time for some dystopian health insurer fun facts…topic today is prior authorizations (PA’s for this thread) 🧵

kff.org/medicare/issue… 1/ in ‘21, more than 35 M prior auth requests were submitted on behalf of Medicare advantage enrollees. That’s over 1 prior authorization for EVERY SINGLE MA enrollee (30.12 M)
Feb 1, 2023 • 23 tweets • 8 min read
After our @HCMADocs meeting with local legislators, it's time for a PBM thread: 1/ First off...it's really complicated. On purpose. B/c every arrow in this flowchart is money Image
Nov 30, 2021 • 9 tweets • 2 min read
Highlights from Teamhealth vs United Healthcare lawsuit 🧵 globenewswire.com/news-release/2… 1/ United colluded & had editorial control over @Yale professor Zach Cooper’s Surprise Billing study which became basis for No Surprises Act. This study was heavily cited by insurers in both passing law & HHS IFR ruling, which we argue sets price ceiling on MD reimbursement
Nov 30, 2021 • 9 tweets • 1 min read
Medical Myth of Day: Increasing access to Urgent Cares & After Hours Practices saves money by eliminating unnecessary ER visits 🧵 1/ Wang et al recently studied affect of increasing Urgent Cares (UC’s near an ER
Aug 18, 2021 • 13 tweets • 4 min read
Here's a thread taking down main arguments made during Matt Walsh'ss impassioned but misguided school board speech at MNPS Board THREAD 1/ “covid poses no risk to children at all”. Actually, CFR in pediatric cases is .03% to .26%, meaning between best case 1/3000 kids to worst case 1/384 kids w/ covid will die. downloads.aap.org/AAP/PDF/AAP%20…
Aug 16, 2021 • 5 tweets • 1 min read
Did you know every major side effect in history of vaccine immunology in past 300 years has occurred in first 8 weeks?
(1/4) 2/4 Did you know MRNA vaccines have been safely tested on humans in safety trials for past 10 years (in HIV, ebola, Zika vaccines) w/o serious long term side effects. https://www.… See More
Aug 15, 2021 • 9 tweets • 3 min read
Psst #medtwitter (vaccine efficacy thread) 2/ Relative risk reduction hospitalization for 2 shot mRNA vaccine & hospitalization is ~96%, probably closer to 90% w/ Delta vaccinated compared to unvaccinated cdc.gov/mmwr/volumes/7…
Aug 3, 2021 • 8 tweets • 2 min read
ICU beds update by state: 1/ #Oklahoma
Jul 25, 2021 • 13 tweets • 4 min read
Since I’m sick of seeing #Covid patients tonight, here are #COVIDVaccine myths busted (thread) 1/ “the (mRNA) vaccine was rushed” - no, it wasn’t. It went through standard stage 2 FDA process, which is typically 3-6 months. n= 43,258. There were 10 “severe” reactions—9 were in placebo group
Aug 2, 2020 • 19 tweets • 8 min read
And now I make every argument @Jabaluck made about physicians making too much and adding to healthcare costs, only with professors adding to higher education costs (THREAD) 1/ Did you know the US pays more in tuition for college than any other country in the world?!?
Jun 25, 2020 • 7 tweets • 3 min read
Imagine if there was a magical #COVID19 pill that reduced your chances of getting it by 85%! Would you take it? Well folks let me introduce you to the magical world of...#masks ! (Thread) 1/ that’s right—with this amazing technology, you magically reduce the chance of spreading Covid by 85%—as these international team of researchers found!
Jun 22, 2020 • 9 tweets • 3 min read
Yes our health system has lots of waste. But @sjauhar’s op-Ed makes incorrect assumptions that are just flat out wrong (thread) 1/ Back in late March/early April, I saw the most string of codes (or patients who essentially were had died at home) in my career. Why is that? 🤔
May 13, 2020 • 14 tweets • 6 min read
Let’s recap what’s happening again w/ Surprise Billing developments, May 2020 (thread) 1/ 2/ a *prominent academic physician whose image is to be an advocate for pts by exposing the problems in the system, is taking grants from a foundation who supports the commercial payors, who want more consolidation, which will raise profits for them and costs for patients.
Mar 20, 2020 • 26 tweets • 10 min read
Thread on some ED Doc's thoughts on dealing with #COVID19US on frontlines 1/ First PPE: At this point, everyone should be wearing a surgical mask at your desk and in ED. No eating or drinking unless in Staff lounge, away from patient care
Jan 15, 2020 • 21 tweets • 5 min read
Mythbusting: Doctors are the reason healthcare costs are high in US. THREAD 1/ seeing lots of Tweets like this one
Dec 12, 2019 • 19 tweets • 10 min read
TWEETORIAL: In honor of @zackcooperYale pointing out some COI’s & biases in @ACEPAdvocacy past presidents, it’s only fair we extend the courtesy to Healthcare economists & the media 1/ we already know @LorenAdler works for Schaeffer Center for Health Policy & Economics, started by former Wellpoint CEO. Won’t even mention Wellpoint Owner Anthem made $5 billion in Net income (5x more than Envision owner KKR, BTW)
Dec 5, 2019 • 16 tweets • 4 min read
TWEETORIAL: Why tying “fair payment” to Medicare is disingenuous at best, & dishonest at worst 1/ Here’s CPI vs Medicare (credit @EdGainesIII). Pretty much flat since 1992. If it followed inflation, it reimburse 2.5 for every dollar reimbursed 2/
Aug 17, 2019 • 25 tweets • 12 min read
Why Health Insurances can’t be trusted for Benchmarking—a thread #SurpriseBilling #surprisemedicalbills 1) Senate version of Balance Billing ban plans to use Benchmarking OON rates to 125% of median In-Network rates. khn.org/morning-breako…