Adebayo Fasanya, MD

Many individuals experiencing DGBI find themselves ensnared in repetitive cycles. Two prevalent patterns merit discussion: 1️⃣ Cycle of Medical Evaluation: Patients consult healthcare providers, undergo various tests, and are informed that no underlying condition is identified—leading to a frustrating cycle of repeat visits. This occurs when patient and provider approach DGBI from a dualistic standard, i.e, either medical or psychiatric. We can break this cycle by understanding these disorders as relating to dysregulation of the brain-gut axis. A p[ositive diagnosis is made using the Rome criteria, not by repeated tests to exclude other disease. 2️⃣ Cycle of Chronic Pain and Mental Health: Individuals suffering from chronic pain may experience associated depression and anxiety. Patient and provider need to understand that chronic pain can produce emotional distress which in turn lowers pain thresholds. It is not "cause and effedt" but a dysregulated control symptom that repeates the cycle. The positive aspect is that there are effective strategies to extend and potentially break these cycles. By addressing the underlying factors and fostering a comprehensive approach to both physical and mental health, we can facilitate enduring relief and improve overall well-being. To learn more, check out our video below: https://lnkd.in/eqqt4aWF #DGBI #PatientCare #Healthcare #Gastroenterology #ChronicPain

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🌟 Whether you’ve determined now is the time for you to begin the process toward FACHE or you’re still deciding, the next stop on your journey is our FACHE Overview Webinar. This webinar is free for you to attend but it requires registration. Learn more and save your place here: https://bit.ly/3MkxxT8

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If you have a heart problem, you DO NOT go to an orthopedic surgeon hoping that he can treat your heart, right? You go to a cardiologist… makes sense, right? You also ensure this cardiologist is qualified with certifications, hospital affiliations, reputation, etc. You will do this due diligence Because it is your freaking heart! Well, SAME EXACT logic applies when you are working with contract manufacturers and suppliers. You must do due diligence and qualify them and Ask questions like THESE: https://lnkd.in/gQVfSsJ What challenges have you had with your contract manufacturers? #QualityManagementSystem #GeniusShield #Healthcare #innovation #medicaldevice #biomedicalinnovation #FDA #changetheworld #Femtech #medicaldeviceregulation #womenentrepreneurs #medicaldeviceinnovation #innovatormindset #biomedicalentrepreneur

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If you have a heart problem, you DO NOT go to an orthopedic surgeon hoping that he can treat your heart, right? You go to a cardiologist… makes sense, right? You also ensure this cardiologist is qualified with certifications, hospital affiliations, reputation, etc. You will do this due diligence Because it is your freaking heart! Well, SAME EXACT logic applies when you are working with contract manufacturers and suppliers. You must do due diligence and qualify them and Ask questions like THESE: https://lnkd.in/gQVfSsJ What challenges have you had with your contract manufacturers? #QualityManagementSystem #GeniusShield #Healthcare #innovation #medicaldevice #biomedicalinnovation #FDA #changetheworld #Femtech #medicaldeviceregulation #womenentrepreneurs #medicaldeviceinnovation #innovatormindset #biomedicalentrepreneur

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➡️ Whether you’ve determined now is the time for you to begin the process toward FACHE or you’re still deciding, the next stop on your journey is our FACHE Overview Webinar. This webinar is free for you to attend but it requires registration. Learn more and register here: https://bit.ly/4fVBYRC

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Interesting what comes to light when you “throw some data on it.” Metrics like this have unintended consequences. Queuing theory and it’s application have always made more intuitive sense to me…Queuing theory considers factors like arrival rates, service rates, queue length, and waiting time to predict system performance and find the most efficient configurations. How medicine can be so innovative in some areas and so arcane in others baffles me. But as long as we pay hospital leaders to achieve short-term metrics for bonus money, we will stifle innovation. You get what you pay for…

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Next big neurosurgery/spine meeting only 6 days away. Curious as to how many meetings private practice surgeons make industry sponsored and otherwise. I make 1-2 a year and 1-2 that are for startups and maybe 1 industry sponsored. More than that and it's time away from family and the practice. We need less meetings. If you look at the agendas, a lot of duplication.

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💫 Weekend Grind = New Capability Drop!! 🧑‍💻 2022 - 2025 CMS MSDRG Rates Calculated 💡 9,823,187 Rates Across 3,797 Hospitals (Details👇) Hospital Count and MSDRG Rates by Year: 🔷 2022: 3,269 hospitals, 2,500,785 rates 🔷 2023: 3,213 hospitals, 2,457,945 rates 🔷 2024: 3,199 hospitals, 2,444,036 rates 🔷 2025: 3,151 hospitals, 2,429,421 rates 🧑‍💻 Leveraging these MSDRG rates enables us to benchmark inpatient (IP) rates for clients against Medicare. Using either medical claims or transparency data, we can compare services across providers and geographies to uncover pricing variations. Once these are identified, they serve as the foundation for implementing effective cost-saving strategies. 📊 Below is a screenshot of the annual % change in base rates from 2022 to 2025. 🤝 Interested in insights from this data? Let’s connect!

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It’s TOMORROW!!!!!!!!! Hundreds of physicians from all of the country (and many international too) will gather in one of the most powerful rooms for physicians. On the other side of this event, they will be clear on: ✅ the roadmap for their first or next million in revenue ✅ the revenue generation strategy of savvy entrepreneurs ✅ how to stop their dream business from cannibalizing their dream life They will network with some of the most brilliant physicians entrepreneurs and meet several speakers who are living walking vision boards for physicians everywhere. The ripple effect of this will be felt throughout the healthcare space because a new breed of physicians is emerging. A breed of physician who run the most impactful, most innovative and most profitable businesses inside and outside of healthcare. See you tomorrow!!!!!! Didn’t register yet? 😮😮😮😮😮😮 The time to take care of that is right now. Type NEW BREED in the comments and my team will send you the details.

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CMS is proposing to allow payment for the complexity add-on code G2211 during office or outpatient evaluation and management visits, even when performed on the same day as an annual wellness visit or preventive services. This change aims to support providers in delivering comprehensive care, improving service delivery and patient outcomes. For more details, explore the proposed updates https://lnkd.in/exYBvZvH #HealthcareUpdates #MedicareNews #PhysicianFeeSchedule #HealthcareProviders #MedicalBilling #CMSUpdates

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Running your wound center with just an EMR? It’s time for a better approach. Get an EMR and wound care expertise you need with WCA https://lnkd.in/gM7hdy4M

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Most employed physicians don’t understand how health systems manipulates the Medicare site of service reimbursement variations… and dramatically add cost for the patient and the health care system. The, at times, purposeful ignorance leads to a lot of the issues we see today. The physician and providers encouraging referal to services that are within the system and significantly more expensive. Let’s look at some of the abuses and reflect on their impact. ……. a. Site of Service Shifting: • Hospitals acquiring physician practices: • Physicians previously working in independent offices shift their billing to the hospital’s HOPD system, resulting in higher reimbursement rates. • Example: A simple imaging study billed by a physician’s office might cost $100, but as part of an HOPD, it might cost $300. b. Upcoding and Overutilization: • Providers are encouraged to select higher-cost sites unnecessarily to receive higher reimbursements. • Services that could be safely performed in lower-cost settings (like ASCs or offices) are performed in hospitals, increasing costs without improving care quality. c. Split Billing: • Facility Fee + Professional Fee: • Hospitals charge a facility fee for services in addition to the physician’s professional fee, leading to double billing for what might be a single service in a physician’s office. d. Increased Patient Financial Burden: • Higher reimbursement rates often translate to higher copayments and deductibles for patients, especially for services performed in hospital settings. e. Consolidation of Providers: • Larger systems monopolize services and prevent competition by absorbing smaller physician practices, increasing costs systemically. ****** The current system has led to increased manipulationand abuse. It has also led to increased decreased options for our patients. And continues to take away from your autonomy Our lack of willingness to understand and act on these issues is a big problem of why. #OrthopedicSurgery #neurosurgery #spinesurgery #Medicare #healthcare

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Astute words from Dutch Rojas. Will there be unethical physicians? Of course, but they won't be alone. Like other healthcare bad actors, they should be exposed and dealt with appropriately. This notion that POHs and other physician-led business and innovation endeavors are ethical bridges too far is a diversion pushed by those looking to protect their own interests. Put more succinctly, it's protectionist fearmongering. Data suggests these fears aren't warranted. Physican-led VBC models like ACOs and bundled payments outperform those without physician leadership. Doctors with autonomy, ownership, and representation are happier and more effective than those without. POHs deliver high quality, cost-effective care. Concerns over cherry-picking are valid but not widely supported by the literature. Increasing regulation, declining reimbursement, and rising overhead have reduced physician autonomy and ownership. Our healthcare system is demonstrably worse for it. Few could rightfully argue that we're better off now than we were before these regulations went into effect. We've thrown any number of policies, programs, and care models at the wall -- not many have stuck. All options should be on the table. Otherwise, one can only assume efforts to "fix" healthcare aren't being pursued in good faith. #medicine #healthcare #health #healthcarepolicy (Look for my discussion with Dutch on these issues on an upcoming The Surgeon's Record webinar presented by Commons Clinic!)

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Here’s what I think nephrologists don’t understand about value based care. Everything here forward is speaking primarily about all other contract arrangements except for CKCC (traditional Medicare A&B innovation model) as that approach is still primarily negotiated with nephrologists/nephrology practices. ❗️It’s happening with or without you.❗️ When a care management company wins a contract with a payor, those members (patients) are purchased like a box of chocolates. The care management company never knows (fully) what they’re going to get. When they find out what they got (claims review, data analytics, risk assessment/stratification), they are looking for key relationships to help them better manage their portion of patients to try and widen the margin between expenses and savings. So when you receive a pitch deck and it has all this data on your patient population but you’ve never signed a contract, that’s because those patients are no longer only yours. They are now intertwined with another entity that is extending resources on behalf of the payor in the name of potential cost savings (and hopefully improvement in quality of care for the patient). Remember when medicine was primarily a relationship between a physician and a patient? Gone are those days. One day we’ll wake up and what we see in dialysis consolidation will exist in primary nephrology care.

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It is not a positive step 1. When physicians and NP and PA delivering the care and their teams are selected out for harm after years of marginalization 2. When basic health access is harmed by the continued 41 years of cost cutting the most convenient and lazy way possible - across the board 3. When vulnerable populations continue to grow past half of the US population and their remaining providers are not spared from cuts, compromises, meaningless micromanagement, lower payments, and penalties because of the populations that they serve 4. There is nothing that we should be proud of for 40 years of lazy ineffective designs That have failed to stop the horror of twice too much health spending That defeat budgets at all levels of the ability to invest in Americans That have added discrimination and worsening of disparities by design.

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DHMO: So they can refer more $49 filling patients to you? This is the problem with HMOs. They suck. Some capitation plans are so bad that you end up doing free fillings unless you nickel and dime patients by charging for desensitizer for every filling. Then some of these patients will argue and say I don't want the desensitizer. Who can blame them? I am so glad I don't work for a place that takes HMOs anymore. The materials cost more than waft the patient pays. I have done $10 surgical extractions, $75 anterior root canals, $125 molar root canals, and $180 crowns. And I only got 25% of those fees. Thank goodness I was on a daily minimum for part of the time I worked at this place. The best part is these patients complained about those fees and would try to barter with you. The dental insurance companies, especially HMOs, have made it a race to the bottom. Who can be the cheapest? And you wonder why the general public doesn't value our services.

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