Just had a patient visit that illustrates some of the worst of our health care system. High risk CKDG3b/A3 patient with DM, HFrEF. Have spent the last three months and hours of staff time fighting to get SGLT2i and GLP1a covered. @Humana has fought us every step of the way. 1/n Finally got them the medications using patient assistance programs. Humana sent a doctor to her house for a "care management" visit. Patient says this doctor spent bulk of time raving about the benefits of apple cider vinegar.

Lessons from #RPA22 which just wrapped up in Dallas, a 🧵 1) Value-based care (#VBC) has injected a jolt of energy into the private practice sphere. Half the exhibitors on the convention floor were new since 2019. It was THE topic of conversation during the breaks - who are you working with, have you signed up with anyone? The 3/25 deadline for KCE participation added to the frenzy, as did news of the Cricket-Interwell-Fresenius merger. Talks about VBC and the new payment models were well attended and garnered lots of questions and discussion.

Fantastic real world application of the financial implications of the #ETC model - what’s the dollar amount of the penalties/bonuses? By the wonderful Terry Ketchersid at #RPA22 And with these numbers personally the relevance of #ETC drops significantly.

Nephrologists: we need to prepare to stop our routine CKD and HTN clinic visits. I've been diving into options for #telehealth. I am by no means an expert but here's what I've learned. Would love more experienced people to chime in. A thread: 1/n Disclaimer: I'm in private practice and I'm thinking about revenue. I'm committed to paying my staff their full salaries plus paid sick leave throughout this, and I expect to stay closed for two months. It would help to have some income coming in. 2/n