Todd McGee (@GetHealthcare1) header
Todd McGee (@GetHealthcare1) profile picture

Founder of Complete Allergy and Asthma a medical practice management company, UofU sports fan.

Joined July 2019
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#Allergists and #PracticeManagers we recently started a management company for Allergy practices. Our team has 100+ years of experience working in allergy. Check us out at breathecomplete.com. #ACAAI #AAAAI
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Todd McGee retweeted
I think I found the residency résumé industry. Mount Sinai lists Dr. Ratesh Khillan as a voluntary faculty physician/Assistant Clinical Professor affiliated with Beth Israel and Mount Sinai Brooklyn. Meanwhile, his private Brooklyn USCE business advertises Mount Sinai among its “teaching affiliates” while selling clinical rotations and residency-related services to IMGs. His Brooklyn USCE business currently advertises: $1,550: 4-week clinical rotation +$399: opportunity to participate in research with Dr. Khillan LORs on hospital letterhead for some rotations plus CV review, interview prep, residency signaling guidance and other Match services in larger packages. Then I started looking at the research. Two completely unrelated single-patient case reports, published two months apart, have the exact same 10 Brooklyn Cancer Care authors, just rearranged. One is a liver hematoma case and the other is Stage IV endometrial cancer. And this isn’t even the only company selling residency research credentials. USMLE Wise openly advertises $300 “co-author” placement on an active research project and $800 “lead-author” placement. They say participants perform substantive work and meet authorship standards, but those are literally the products being sold to residency applicants. So foreign medical graduates can now shop for American clinical rotations, research opportunities, publication credits, hospital-letterhead recommendations, interview coaching and Match strategy. Meanwhile we’re told a publication-heavy CV proves who the “best” residency candidate is. How much of the American residency meritocracy is actually a credential marketplace?
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Todd McGee retweeted
1/Over the past 2 yrs, there has been ~$1.47B in #MedicareAdvantage (MA) upcoding settlements w/ many of the “BUCAs” plus “non-profits” (which I call “non-tax paying”), e.g. @aboutKP. The allegations are fairly simple: the plans receive a per member per month (PMPM) but then “risk adjust” the MA patients based on additional diagnosis. The MA plan receives a higher PMPM after the MA member’s care is “risk adjusted.” In the Independence case below, when the plans’ software informed their employees that the risk adjustment was not justified by the member’s differential diagnosis, the employees were told to ignore that per the allegations and the care was upcoded anyway. The whistleblower in the case below rec’d over $3M. The largest MA plan, @UHC, is still under both criminal & civil investigation for MA upcoding fraud + faces a major whistleblower case in which the US DOJ joined. When there is systemic fraud, waste and abuse in the MA plans, why isn’t @CMSGov and Congress addressing these issues? Independence Blue Cross to pay $22.5M over Medicare Advantage coding beckerspayer.com/payer/medic…
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Utah's had receivers in the past that are really good after the catch. I don't know that Utah's had a group of receivers that are collectively this good. It seems each pass catcher can create quality yardage after the catch.
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WTF was that? AI?
Yo, this is a SEEEED from Byrd Ficklin 😳
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Penn State has 42,000 undergrads. Exactly 10 graduated in women's, gender & sexuality studies (WGSS) in 2023–24. The department lists 28 professors. The "studies" department racket is real: every department combined—area, cultural, gender, black, Asian, Native American, Hispanic, ethnic—accounts for just 0.3% of all four-year graduates in the United States. How do departments with 10 majors justify 28 faculty? As @firstthingsmag's @mark_bauerlein points out in @WSJopinion, they do so by colonizing general education. If "Introduction to Queer Theory," "Fashion, Gender, and Identity," and a bevy of other WGSS courses didn't check the gen-ed box, enrollments would vanish. And so would the faculty lines in the department. Public universities are public institutions, answerable to public oversight. Legislatures and trustees should do more to exercise it: reset gen-ed policy by streamlining it back to essentials. wsj.com/opinion/free-express…
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Todd McGee retweeted
Late-night thought. I wonder how many people who think they’re burned out are actually just uninspired. A few years ago, I thought I was burned out too. I didn’t like where I lived. I didn’t like what I was doing (biglaw). I didn’t like who I was surrounded by. I was out of shape, unhappy, and convinced I was trapped. Tonight a random song came on the radio and instantly took me back to that version of myself. Looking back, I don’t think I needed a vacation. I needed a mission. The thing that changed my life wasn’t some massive leap. It was giving myself a quest. Where do I want to live? Who do I want to become? Who do I want to spend my time with? What do I want my life’s resume to look like? Then I just started working backward. One small quest. One inch at a time. One decision that moved me a little closer to the life I wanted. It’s funny how those tiny decisions compound over time. People tell me all the time that I’m going to burn out. Maybe someday. But I honestly don’t think they understand the difference between being exhausted and being uninspired. I’m tired sometimes. The work is hard. Some days are brutal. But five years ago I would’ve done just about anything to have the problems I have today. I get to build something I believe in with people I genuinely enjoy being around. I wake up excited to solve hard problems. There are days that absolutely suck, but they’re my days. This is the life I spent years hoping I could build. I think that’s a different kind of tired. If you feel stuck, don’t try to fix your entire life overnight. Just find your first quest. The rest has a funny way of taking care of itself.
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Todd McGee retweeted
1/@BlueCrossNC meanwhile is issuing demand letters to hospital based groups claiming coding errors and demanding literally many millions of $s from these groups. NC Blue has given no explanation of how they are using extrapolation to reach their many $Ms in claimed overpayments. The federal gov’t has a well defined process for using extrapolation and “progressive corrective action” for groups identified with coding issues. The groups vehemently deny the degree and extent of coding errors. Oh and BlueCross NC is threatening to use “voucher deductions” on future claims if the $6.27M demanded from one ED group is not paid. Rumor is that another larger group has been hit w/ a +$10M demand. These groups have no choice but to “lawyer up” to respond to these existential threats. In 3+ decades in this state I have never seen this level of aggressive misconduct by a health plan—one whose CEO is an MD! Blue Cross regains North Carolina’s state health plan contract while Aetna loses out beckerspayer.com/contracting…
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Todd McGee retweeted
Sepsis kills more people in American hospitals than heart attacks. 350,000 deaths a year, and the reason is brutally simple: the early warning signs are almost invisible. A slightly elevated heart rate. A small temperature shift. A lab value drifting in the wrong direction. Each one looks like noise on a busy ward. By the time the pattern is obvious to a human, the patient is hours into a cascade toward organ failure, and every hour of delayed antibiotics raises mortality. Tampa General built a system on Palantir's Foundry that watches roughly 1,000 inpatients continuously. Vitals, labs, medication records, clinician notes, all scanned in real time for the pattern no single nurse can see across 12 beds at 3am. When risk crosses a threshold, a rapid response team gets paged. Humans still make every treatment decision. The software just compresses detection from hours to minutes. The results since 2022: overall sepsis mortality cut in half, 48-hour deaths down 68%, length of stay down 30%, roughly 900 lives saved. At one hospital. Now run the national math. There are about 6,100 hospitals in the US. If even the 500 largest matched these numbers, you'd be looking at tens of thousands of lives a year from a single use case. The treatment for sepsis hasn't changed. Antibiotics and fluids, same as decades ago. The entire gain comes from starting them earlier. The hardest problem in medicine was never the cure. It was noticing in time.
JUST IN: Florida hospital reveals Palantir software has cut sepsis deaths by more than half since it was installed.
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Todd McGee retweeted
Ro Khanna blames Donald Trump for frustration over the Palisades Fire, which makes perfect sense for one of Congress’ least intelligent members because Trump wasn’t in office yet when the fires happened, and has nothing to do with local permitting delays
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250k followers! As thanks, I’m going to giveaway tickets to the MAJOR 😂 the Players Championship! plus some signed @range_finance hats and some of my personal @Titleist gear. Must be a follower. Comment, like, retweet to enter.
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The answer to America’s educational challenges will be found in Hattiesburg, Mississippi, not Harvard, Massachusetts. I visited Woodley Elementary and met an inspiring principal, dedicated teachers, and committed students. With a 96% attendance rate and rising reading and math scores, they’re proof positive what’s possible when we invest in our kids’ literacy, support our educators, and hold ourselves accountable for progress. Let’s take what’s working in Mississippi, Tennessee, Louisiana and make it the national standard. Our kids and their parents deserve nothing less.
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Todd McGee retweeted
Who Will Build NYC if Builders Are the Enemy? As a New Yorker Jew, I'm surrounded by people who have been in real estate their entire lives. I am not trying to feed a stereotype, but that's my reality. They aren't activists or online commentators. They are people who bought their first buildings with all their savings, carried debt through rate hikes, fixed things themselves when there was no money to hire, and stayed in New York through high crime, recessions, 2008, COVID, rising taxes, insurance increases, and an ever-expanding book of laws and codes. None of them were promised fairness before they started, and none of them were protected from risk. They succeeded very slowly, and painfully, but with responsibly. That experience is exactly what is missing from the worldview of Zohran Mamdani, and it shows in every part of his housing agenda. Mamdani has never built anything. He never signed a personal guarantee, never met payroll, never carried a mortgage through a rough month, never had to choose between fixing a boiler now or hoping it survives another winter because there is no cash. He has only operated in a political world where consequences are abstract and other people absorb the risk. When you have never operated in the real economy, it becomes easy to believe that shortcuts are solutions. It is also why his message resonates with a certain type of voter. The people demanding “housing reforms” are not bad people. They are frustrated renters who feel like the system is rigged against them. I understand the frustration. But frustration doesn't change math. Housing is hard. Ownership is a very slow process. Building anything meaningful in this city takes years of stress, and debt. The people calling for "landlord policies" often want the outcome without the grind, the stability without the risk, and the reward without the years of sweating that every responsible adult who succeeded here had to endure. But it does not work like that. NYC is in housing crisis. Citywide vacancy sits around 1.4 percent, a level economists consider an emergency. Median rents keep rising anyway, with Manhattan near $4,800 and Brooklyn around $3,800, even under an already thick layer of regulation. The reason is obvious. Supply has not kept up. In a good year, New York adds roughly 30,000 units. The city needs hundreds of thousands more over the next decade just to stabilize prices. At the same time, construction costs here are among the highest in the country, financing is extremely difficult, and insurance is wildly expensive Mamdani’s proposals take that fragile situation and make it worse. When you cap upside while leaving downside unlimited, rational people stop participating. Developers do not argue on X. Lenders do not protest. They simply reallocate. Projects stop coming up. Renovations are postponed. New construction dies before a shovel hits the ground. The people I know in real estate are not angry. They are disengaging. Some are buying elsewhere. Some are sitting on cash. Some are done entirely. And when that happens, tenants do not win. Buildings deteriorate, supply tightens further, and rents rise anyway. What Mamdani offers is emotional satisfaction, not solutions. He tells voters that prices are high because someone else is greedy, not because the city has spent decades making housing harder and almost impossible to build. He frames landlords as villains instead of participants in an ecosystem that only works when incentives align. That framing feels good, but it does not produce housing. It produces resentment, fear, and withdrawal. Everyone I know who made it in this city did it the same way. Slowly, without shortcuts. Policies written by people who never did that do not create fairness or affordability. They create shortages. NYC doesn't have a landlord problem. It has a confidence problem. And a city that teaches people to hate the builders while demanding more building is a city sabotaging its own future.
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Good morning @RoKhanna I suppose I’ll need someone to hold my ☕️ You demand literature proving a modest 1 to 2 percent billionaire wealth tax disincentivizes founders and VC, as if none exists. It absolutely does. The OECD’s own 2018 report admits most countries repealed wealth taxes precisely because they crushed savings, investment, entrepreneurship, and sparked capital flight while delivering laughable revenue. Tax Foundation models confirm lower after tax returns shrink the capital stock and kill risk taking. NBER paper 29359 (Stefanie Stantcheva) shows taxes on innovation rewards directly reduce inventor numbers and breakthrough quality. A 2023 Review of Finance study ties higher capital gains taxes (exactly analogous to taxing unrealized gains yearly) to smaller VC deals, fewer startup patents, and reduced innovation quantity and quality. Every real world test failed spectacularly: France, Germany, Sweden, Austria, Denmark all ditched them after watching the damage. No country kept a wealth tax because it boosted growth or innovation; they all ran from the failure. A “modest” rate still means billions in forced sales of illiquid stock, wrecking founder control and screaming to every future risk taker that the ultimate payoff just got slashed. But notice what you completely ignored: every single point from my original rebuttal. You skipped the marginal incentives that actually matter, the ongoing exodus from high tax California, the historical reality that inequality fueled progress not revolutions, and especially the mirror moment: Washington already rakes in record trillions yet blows it on waste, fraud, and bloat while refusing to balance the budget. Private allocators like Jensen and Elon create massive value; government squanders it. You have no answer for why we should invent brand new taxes on creators before forcing fiscal discipline on the spenders. The evidence is overwhelming, one sided, and drawn from actual history, not hypotheticals. Ball’s in your court: contend with the original arguments you dodged, or name the real data studies showing wealth taxes increase entrepreneurship or VC investment. I’m waiting. Links for you:
OECD Report: oecd.org/content/dam/oecd/en…
NBER Paper 29359: nber.org/system/files/workin…
Review of Finance Study: academic.oup.com/rof/article…
Thanks for engaging. Show me the economic literature which says that a modest wealth tax on billionaires of 1-2 percent disincentivizes founders or VC investment? I know plenty of economists who argue the opposite. Id be happy to read papers that make your point.
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Senator, your state has had a Hospital Construction Moratorium since 1984. Not certificate of need. A moratorium. No one builds a hospital. No one adds a bed. Unless your legislature says so. 35 exceptions in 40 years. Each one required a lobbyist. Each one protected the people already inside. Your state’s population grew by 810,000. Hospital beds fell by 921. Your non-profit health systems own the insurance companies denying claims. •HealthPartners runs hospitals and the health plan. •Allina partnered with Aetna. •Fairview owned PreferredOne, then sold it to UnitedHealthcare. The villain and the hero are the same person. In your backyard. 35 states run the same CON. And Congress killed the federal mandate in 1986. The states kept the laws because the hospital associations wanted them kept. You don’t need a plan. You need to stop protecting them.
The time for talk is over, the time for action is now. If Congressional Republicans don't act to extend the health care tax credits by next week, millions of Americans will see their premiums double or even triple.
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Anyone who has spent time on the phone with a health insurance company knows the frustration of red tape. At Surgery Center of Oklahoma, we're here to help you say goodbye to insurance hassles. Experience our transparent pricing and outstanding care, all without the red tape. Price your procedure today at SurgeryCenterOK.com
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Marion, CMS just announced that if clinicians were perfect (100%) on reporting MIPS measures in ‘24, their ‘26 Medicare payment adjustment would be slight greater than 1%. So, per a recent JAMA cross sectional study, to achieve that completely underwhelming +1%, physicians spent over 200 hours & $12,800 per year. MIPS was a disaster when it launched and has continued to hold the crown for one of the worst Medicare programs ever.
Here is why I’m not crying in my coffee over losing govt employees: I went to a conference called reimagining healthcare“ about six years ago, and there was a whole panel of CMS people on the stage. After they were done yapping about “quality measures“ I raised my hand to ask a question. Me: I get it, Medicare is expensive so you wanted to make sure we are getting a good bang for our buck and someone invented this MIPS (see * below) stuff. So can you CMS people tell me how much money the American taxpayer paid to plan launch and continue to implement MIPS, and what kind of proof do you have that it’s saving us money? Them: ( after confused looks between panel members) we’re not sure how much it cost, maybe it’s on our website. And we’re hoping that in a few years we can show some proof that we’ve saved some money. Are you hoping more federal bureaucracy will change things? *MIPS= Merit Incentive Payment System in which physicians had to document a whole lot of useless stuff in order that they prove that they are providing quality and therefore can get a higher payment, even though the government has still come along and knocked back the Medicare payment for physicians. I’m pretty sure the AMA backed up that slop.
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A message from a Kindergarten teacher: After forty years in the classroom, my career ended with one small sentence from a six-year-old: “My dad says people like you don’t matter anymore.” No sneer. No malice. Just quiet honesty — the kind that cuts deeper because it’s innocent. He blinked, then added, “You don’t even have a TikTok.” My name is Mrs. Clara Holt, and for four decades, I taught kindergarten in a small Denver suburb. Today, I stacked the last box on my desk and locked the door behind me. When I started teaching in the early 1980s, it felt like a promise — a shared belief that what we did mattered. We weren’t rich, but we were valued. Parents brought warm cookies to parent nights. Kids gave you handmade cards with hearts that didn’t quite line up. Watching a child sound out their first sentence felt like magic. But that world slowly slipped away. The job I once knew has been replaced by exhaustion, red tape, and a kind of loneliness I can’t quite describe. My evenings used to be filled with construction paper, glitter, and glue sticks. Now they’re spent filling out digital reports to protect myself from angry emails or lawsuits. I’ve been yelled at by parents in front of twenty-five children — one filming me with his phone while I tried to calm another child mid-meltdown. And the kids… they’ve changed too. Not by choice. They arrive tired, anxious, overstimulated. Their tiny fingers know how to swipe a screen before they can hold a crayon. Some can’t make eye contact or wait in line. We’re expected to fix all of it — to patch the gaps, heal the trauma, teach the curriculum, and document every move — in six hours a day, with resources that barely fill a drawer. The little reading corner I once built, full of soft beanbags and paper stars, was replaced by data charts and “learning metrics.” A young principal once told me, “Clara, maybe you’re too nurturing. The district wants measurable results.” As if kindness were a weakness. Still, I stayed. Because of the small, holy moments that no spreadsheet could measure — a whisper of, “You remind me of my grandma.” a shaky note that read, “I feel safe here.” a quiet boy finally meeting my eyes and saying, “I read the whole page.” Those tiny sparks were my reason to keep showing up. But this last year broke something in me. The aggression grew sharper. The laughter in the staff room turned to silence. The light went out of so many eyes. I watched brilliant teachers — my friends — vanish under the weight of burnout, their joy replaced by survival. I felt myself fading too, like chalk on a board that’s been wiped one too many times. So today, I began my goodbye. I pulled faded art off the walls and tucked thirty years of handmade cards into a single box. In the back of a drawer, I found a letter from a student from 1998: “Thank you for loving me when I was hard to love.” I sat on the floor and cried. No party. No applause. Just a handshake from a young principal who called me “Ma’am” while checking his notifications. I left my rocking chair behind, and my sticker box too. What I carried with me were the memories — the faces of hundreds of children who once trusted me enough to reach out their hands and learn. That can’t be uploaded. It can’t be measured. It can’t be replaced. I miss when teachers were partners, not targets. When parents and educators worked side by side, not in opposition. When schools cared more about wonder than numbers. So if you know a teacher — any teacher — thank them. Not with a mug or a gift card, but with your words. With your respect. With your understanding that behind every test score is a heart that cared enough to try. Because in a world that often overlooks them, teachers are the ones who never forget our children.
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Well, you’re wrong. Although, I know where you’re getting this idea, it’s just wholly misinformed. You’re referring to a rule in the Affordable Care Act (ACA) and it is known as the Medical Loss Ratio (MLR) requirement. The ACA mandates that insurers spend at least: 80% of premium revenue on medical claims and quality improvement in the individual and small-group markets, and 85% in the large-group market. If an insurer fails to meet that threshold, it must rebate the difference to policyholders. However, what everyone fails to notice is the little phrase “…and quality improvement…” The ACA and HHS regulations (45 CFR §158.150) define quality improvement activities as those that are “designed to improve health outcomes”, including: 1.Wellness and disease management programs – e.g., diabetes management, smoking cessation, obesity prevention. 2.Case management and care coordination – nurse hotlines, chronic care support, discharge planning. 3.Reducing hospital readmissions or complications 4.Improving patient safety and outcomes 5.Adopting and maintaining health information technology – data systems that track and monitor care outcomes. All of those activities are already provided by the payer. So that 80% and 85% MLR - a significant part of that never leaves the insurance company in the form of reimbursement for medical services. It’s supplanted cost masked as a service-line. They use clever cost-based accounting to allocate costs to services that they already provide, and overhead, such as certain software and technology infrastructure, and call that “quality improvement”; and, therefore always magically exceed the 80% and 85% MLR threshold (but even then just barely). The “quality improvement” costs vary by payer, but to be sure it’s a significant part of the 80% and 85% MLR. Insurance companies aren’t in the business of paying claims or what they refer to as “liabilities.” They’re in the business of retaining every possible dollar that they can - that is the entire business model. Thank you for your attention to this matter!
Replying to @HeathVeuleman
UHC may deny 33% of claims yet pays out 85% of all premiums collected on claims. If they denied zero claims, they would still pay out 85%. That's required by law. They'd simply raise premiums.
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We at @SDirectionsRx are excited to announce our partnership with Pharmacy Hub! We will save pharmacies a fortune by eliminating price gouging vendors and give independent pharmacies technological superiority to survive the fight for PBM reform! pharmacyhub.app
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