Clinical Endocrinologist/Researcher, Educator, Small Business Owner, Taxpayer, Job Creator, Entrepreneur, Healer, Problem-solver
Joined September 2012
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Arvind Cavale retweeted
47% of DPC doctors earn less than they did before.
99% say the care got better.
That's the American Academy of Family Physicians' 2026 Direct Primary Care survey. Work-life improved for 89%. Paperwork for 86%. Only 17% chose the model for income. Ninety-six percent chose care quality. Ninety-four percent chose autonomy.
The sample is friendly — doctors who stayed in DPC — and 47% is still a hard number. Forty percent call panel growth a major challenge. An owner filling a panel is carrying rent, staff, and malpractice that a salary used to hide.
Patients feel the care side. Doctors feel both.
47% is a price. So is a panel that finally fills. Neither one is a reason to keep billing the oil change through the collision policy.
directcare.org/blog/view/113
Arvind Cavale retweeted
Dear Physicians:
Your Medicare cut must be devastating for the hospital CEO who hasn’t bought you yet.
Thankfully, @CMSGov is working on making you more affordable.
I, for one, applaud @DrOzCMS and @SecKennedy for their commitment to affordable, accessible healthcare. Every struggling independent practice brings a tax-exempt hospital empire one step closer to an affordable acquisition.
Please consider the hospital’s position. Buying the competition takes money.
Then there’s the expense of replacing your sign and explaining why your patients now need a facility fee to visit the physician they’ve seen for 20 years.
You wouldn’t understand.
You went to medical school.
These people understand medicine at a much higher level. The holding-company level.
And honestly, physicians, your timing is terrible. You’re complaining about reimbursement while a nonprofit executive has to walk into a board meeting and explain why you still own your practice.
Have some compassion.
Sell.
Arvind Cavale retweeted
Frank Pallone thinks a surgeon who owns the operating room is a conflict of interest.
A hospital that owns the surgeon is apparently a business model.
In 2007, Pallone took the gavel of the House health subcommittee and cosponsored CHAMP, which would have frozen physician-owned hospitals in place.
In 2008, he called those hospitals "overutilized." In 2010, Section 6001 of the ACA shut the door on new ones and froze the beds and operating rooms of the ones already built.
Meanwhile, hospital systems kept buying physician practices. Prices for services from acquired physicians rose an average of 14.1%. Nobody in Washington froze anything.
Ownership in one direction met a federal barrier; ownership in the other remained an ordinary business strategy.
The conflict of interest Pallone described never disappeared.
A hospital that employs the surgeon, owns the operating room and collects the facility payment holds every incentive he accused physicians of having. The difference is who gets to keep the money.
New in The Rojas Report. Link below.
Arvind Cavale retweeted
Op-ed in @WSJ by @HHSGov Chief Economist and Chief Regulatory Officer @caseybmulligan: wsj.com/opinion/you-pay-when…
"Provider taxes are supposed to finance the nonfederal share of Medicaid payments. States obtain federal matching funds based on those proceeds, then return money to providers through supplemental payments. Hospitals can receive more than they paid in taxes, while states draw additional money from Washington. Little wonder that hospitals sometimes lobby to be taxed...
Medicaid policy should be evaluated for what it does to workers as well as to government budgets. The costs of financing gimmicks like provider taxes reach beyond government balance sheets and onto your paycheck."
@HHS_ASPE study: aspe.hhs.gov/reports/financi…
Recording of the event discussing the study: teapawt.net/HHSGov/status/21125365…
@HHSGov @CMSGov
ASPE Health Economics and Policy Forum - October 20, 2026 teapawt.net/i/broadcasts/1OxwbnjjX…
Arvind Cavale retweeted
H-1B is the visa US employers use to hire skilled workers from abroad. Workers approved in the FY2021–24 lotteries were far more credentialed than the US workforce overall: 58 percent held a master's degree or higher, compared with 14 percent of US native-born and 15 percent of total foreign-born in the US.
Most earned those degrees here — 71 percent of master's-and-higher petitions went to someone already in the US on a student visa.
Hoover Policy Fellow Sarah Alla @Iagudaeva has the full analysis of what these workers studied and where they ended up working: hoover.org/research/h-1b-wor…
Arvind Cavale retweeted
PAMED President Arvind R. Cavale, MD, FACE, FCPP, PCEO recently shared his perspective on PennLive, regarding reimbursement for out-of-network care.
Read the full Op-ed here: pamedsoc.org/docs/default-so… #PAMED #Pennsylvania
Arvind Cavale retweeted
Physicians, you keep asking insurers to send you patients.
Have you met the employers paying the premiums?
Arvind Cavale retweeted
"Where ACGME calls for 'current' board certification, delete “current” and replace it with 'initial,' while bringing back a nuanced, holistic, and comprehensive evaluation of those who wish to serve." kevinmd.com/2026/10/time-for…
Arvind Cavale retweeted
𝐎𝐍𝐄 𝐖𝐎𝐑𝐃 could help remove barriers for qualified physicians in academic medicine.
In a new @KevinMD article, NBPAS’s Karen Schatten calls on physicians to ask @ACGME to replace “current” with “initial” ABMS/AOA board certification—a change that could remove MOC-related barriers to recruiting and retaining experienced residency faculty and program directors.
Physicians, your voice matters. Submit your comments by October 22.
𝐑𝐞𝐚𝐝 𝐭𝐡𝐞 𝐚𝐫𝐭𝐢𝐜𝐥𝐞:
kevinmd.com/2026/10/time-for…
𝐂𝐨𝐦𝐦𝐞𝐧𝐭𝐬 𝐚𝐫𝐞 𝐝𝐮𝐞 𝐎𝐜𝐭𝐨𝐛𝐞𝐫 𝟐𝟐!
nbpas.org/acgme-comment-peri…
Arvind Cavale retweeted
Comparison of Ambulatory Surgery Center Operational and Financial Characteristics by Ownership Type
Full study in @JAMAHealthForum: jamanetwork.com/journals/jam…
New study in @JAMAHealthForum: Profitability of Nonprofit and For-Profit Ambulatory Surgery Centers
jamanetwork.com/journals/jam…
h/t Elizabeth Plummer & Kahler Doyle
@JHUCarey @JohnsHopkinsSPH @NeeleySchoolTCU
Arvind Cavale retweeted
Aggregated revenue, spending, and charity care patterns by hospital ownership: Can you tell which is nonprofit and which is for-profit?
Three findings from our study in @JournalGIM:
1️⃣For-profit hospitals spent less on both labor and non-labor expenses than nonprofit and government hospitals.
2️⃣For-profit hospitals earned a sizable profit margin, while nonprofit hospitals operated with a thin margin and government hospitals incurred a small loss.
3️⃣Nonprofit hospitals, despite receiving generous tax-exempt benefits, in aggregate provided less charity care than government and for-profit hospitals.
Study link: link.springer.com/article/10…
Thank you, Adam Olson, Elizabeth Plummer, & @JohnXJiang1
@JHUCarey @JohnsHopkinsSPH @JohnsHopkins
Arvind Cavale retweeted
Three findings from our study in @JournalGIM:
1️⃣For-profit hospitals spent less on both labor and non-labor expenses than nonprofit and government hospitals.
2️⃣For-profit hospitals earned a sizable profit margin, while nonprofit hospitals operated with a thin margin and government hospitals incurred a small loss.
3️⃣Nonprofit hospitals, despite receiving generous tax-exempt benefits, in aggregate provided less charity care than government and for-profit hospitals.
Study link: link.springer.com/article/10…
Thank you, Adam Olson, Elizabeth Plummer, & @JohnXJiang1
@JHUCarey @JohnsHopkinsSPH @JohnsHopkins
Arvind Cavale retweeted
Physicians who have achieved initial ABMS or AOA board certification have another choice when it comes time to maintain it.
NBPAS offers a physician-led pathway built around meaningful, specialty-specific accredited CME.
More choice. Less unnecessary burden.
Learn more: nbpas.org
Arvind Cavale retweeted
Our Health Care Advocacy Webinar Series is now available as a free, 4-part on-demand program designed for endocrinologists and health care professionals.
Strengthen your voice in health care advocacy with expert-led insights on driving impact at the institutional, state, and national levels. This series explores emerging issues, including AI, team-based care, and telemedicine, and features live Q&A discussions with AACE experts.
Learn more: pro.aace.com/advocacy/aace-h….
Arvind Cavale retweeted
We provided funding for a documentary series titled Bucks County, USA, that follows several families navigating the tensions that have come to define our politics.
At the center of the story are two teenage girls whose parents have become bitterly divided over their kids’ education.
The adults disagree about nearly everything, but the kids have figured out something many of us seem to have forgotten: you can disagree profoundly with someone and still care about them, listen to them, and remain friends.
We can and must learn from our children.
It starts streaming tomorrow, Sept 20th, on PBS.org and then on public television stations across the country. Join the conversation @BucksCountyUSA #BucksCountyUSA
Don’t miss it.
Arvind Cavale retweeted
The AMA stayed silent, at best, when the government pushed COVID vaccines + boosters on teens + young adults at the time when there were warning signs about COVID vaccine risk/benefit ratio in that population.
Today, the AMA joined the Vaccine Integrity Project in announcing the completion of an independent, vaccine evidence review process for the 2026–27 respiratory virus season.
The Vaccine Integrity Project conducted a thorough scientific review of RSV, flu, and COVID-19 vaccines — examining the risks and benefits.
The evidence showed that immunizations against these respiratory viruses continue to provide meaningful protection against severe illness, hospitalization and death, with no new safety concerns in comparative studies with currently recommended immunizations.
The evidence reviews helped inform new 2026–27 recommendations released by leading medical societies. The AMA also created new resources to help clinicians and patients put the latest evidence and recommendations into practice.
Now more than ever, the public deserves clear, credible vaccine guidance grounded in the best available evidence and developed through a transparent process.
Learn more: spr.ly/6043B17mgF
Arvind Cavale retweeted
Observational Evidence/Studies, not RCTs is the right test for a nutrient like vitamin D - Review.
✅ Vitamin D causally reduces the risk of 9 diseases – confirmed by Bradford Hill's criteria- while RCTs (which are NOT the way to evaluate micronutrients) say no. Isn't this surprising
✅ Wrong study designs provide wrong answers.
✅ Why most vitamin D RCTs were designed to fail--because RCTs are NOT the right way to evaluate micronutrients.
mdpi.com/2072-6643/18/17/290…
Nutrients 2026, 18(17), 2902; doi.org/10.3390/nu18172902
Arvind Cavale retweeted
WASHINGTON — CMS Asks Hospitals To Voluntarily Explain Where The 340B Money Went, Hospitals Voluntarily Decline
Federal officials announced a new repository where hospitals may report what happened to billions of dollars in federal drug discounts.
Participation is voluntary.
“We strongly support transparency,” said a hospital spokesman. “We just do not personally participate in it.”
CMS may make reporting mandatory in 2027 after officials complete a two-year study confirming that hospitals prefer receiving public subsidies without publicly accounting for them.
The repository goes live October 1. It will contain everything hospitals want patients to know.