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mwfriedberg.bsky.social

@mwfriedberg.bsky.social
518 followers 123 following 122 posts

SVP, Performance Measurement & Improvement, BCBSMA. Recovering health services researcher. General internist. scholar.google.com/citations?user=0…

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Reposted by mwfriedberg.bsky.social
Aaron Blackshear @aaronblackshear.bsky.social · 06/10/2026
This is a good summary of the problem, objective without putting all of the blame on payers or providers. The "risk adjustment specialists" and consultants are a problem, looking at you some of my actuary friends, billing $500+/hour to add a bunch of bloat to the system
What we can agree on

This entire enterprise — risk adjustment specialists spamming doctors, who are already nose-deep in documentation burden, to document diagnoses that often do not affect patient care, while insurers publish reports that fail to capture the nuance of the issue, leaving the public angry and confused — highlights a more general problem with respect to how the U.S. health care system works.

By design, hospitals and insurers are meant to compete with each other, with hospitals trying to collect as much money as they can for providing care, and insurers trying to pay as little as possible. Hospitals bolster their side by hiring risk adjustment specialists and employing AI tools, while health insurers hire payment integrity specialists and employ different AI tools.

Patients lose out because the administrative bloat inflates the cost of medical care, while making costs less transparent and harder to contest. Ultimately, the fix should be structural: At a minimum, we need to overhaul the list of secondary conditions that are eligible for bump coding. CMS attempted to do this in 2019, when it proposed downgrading or eliminating many bump codes based on new data showing they were not associated with increased costs. But hospitals pushed back, and the effort eventually stalled.
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 06/10/2026
Tagging the author @leahpierson.bsky.social BWH IM, natch
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 06/10/2026
*attendings, not attendants
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 06/10/2026
Remarkable writing by a resident physician…surprised not to see more attendants blowing the whistle on this. “I’m a doctor. Here’s what I want the public to know about AI tools and health care costs”: www.statnews.com/2026/10/06/a... via @statnews.com
statnews.com
I’m a doctor. Here’s what I want the public to know about AI tools and health care costs
“We can document honestly and still wind up inflating hospital bills,” writes a frustrated doctor.
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Reposted by mwfriedberg.bsky.social
Jeff Linder @jefflinder.bsky.social · 24/09/2026
This NEJM "Clinical Decisions" is about whether you should do a physical exam in an otherwise healthy person. How about the TOTALLY UNNECESSARY testing that's being done here. "Pursue a laboratory workup"?! For what!? ht: @ishaniganguli.bsky.social www.nejm.org/doi/10.1056/...
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 04/08/2026
Surefire ways for vendors to make huge $ in health care without helping anyone: 1. Monetize regression to the mean 2. Monetize selection 3. Monetize the float Level up! These are not mutually exclusive…you can do all three!
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 03/08/2026
Are these government-funded?
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 27/07/2026
Has there ever not been an imminent devastating physician shortage?
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 13/07/2026
There is nothing quite like a national advocate imploring you to do something you already do. If the NAM didn’t write about it, I guess it doesn’t exist 🤷🏻
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 29/06/2026
Health care journos: for the Nth time, don’t ever quote a doctor without checking their Open Payments profile to see if they have a financial conflict of interest on exactly the thing you are quoting them about. It’ll take you a whole 60 seconds…
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Reposted by mwfriedberg.bsky.social
Alicia Ault @aliciaault.bsky.social · 19/06/2026
Bob Blendon, Harvard health policy expert and pollster, has died. via @joycefr.bsky.social #Medsky #politics #healthpolicy #healthlaw #Medicare #Medicaid
medpagetoday.com
Bob Blendon, an Expert in Health Policy and Polling, Dies
He was an 'innovator in research on public opinion,' says Paul Ginsburg
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 19/06/2026
So sorry to hear this. He was one of the most brilliant teachers I ever had.
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 07/06/2026
The second is best. Until you read the third…just wow. Idk how they’re going to pull that off on Netflix
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 05/06/2026
Correction: 6th annual report
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 04/06/2026
Now available: BCBSMA’s 5th annual health equity report www.bluecrossma.org/myblue/equit... As usual, there’s a good amount of methods detail at the bottom, plus links to all previous years of our report.
bluecrossma.org
Health Equity Report | Blue Cross Blue Shield of Massachusetts
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 30/05/2026
Felt it more than heard it
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 30/05/2026
Same. Guessing sonic boom?
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 29/05/2026
Hive mind: who is your go-to expert for detailed knowledge of per diem FQHC payments (PPS)?
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Reposted by mwfriedberg.bsky.social
Michelle Meyer @michellemeyer.bsky.social · 07/05/2026
🚨New paper from our Behavioral Insights Team🚨: we randomized patients without activated patient portals who had new lab results to receive one of two emails emphasizing a key portal feature—immediate access to results—or to no contact beyond usual system efforts to encourage enrollment.
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 20/03/2026
Well reported story on the coding arms race, now fueled by AI www.bostonglobe.com/2026/03/20/b... As usual, the rich systems use this to get even richer…and while not mentioned in the article, this has important implications for quality measurement too.
bostonglobe.com
Sepsis hospitalizations have tripled in Mass. But is it real or a billing game? - The Boston Globe
Hospitals and insurers are harnessing the power of artificial intelligence and other tech tools to protect their businesses.
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 15/02/2026
Start with the cafe. Then shop
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 10/02/2026
I dream of a world where this is a top 10 problem. Remember when we used to have debates about this and NYU med school and SPRINT? Golden age
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 10/02/2026
lol. Read the room acp
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Reposted by mwfriedberg.bsky.social
Bob Herman @bobjherman.bsky.social · 21/01/2026
Pretty galling what the first urologist tried to do here. www.statnews.com/2026/01/21/w...
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 13/12/2025
Same wish this year
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 10/12/2025
Why do you hate innovation
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 09/12/2025
Said title…
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 09/12/2025
There’s a lot going on, but I’m going to plug my favorite authors on my favorite esoteric/devastating/unknown-to-HSRs methods issue, with the best paper title I’ve seen in a long time psycnet.apa.org/record/2025-...
psycnet.apa.org
APA PsycNet
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Reposted by mwfriedberg.bsky.social
Behavior Change for Good Initiative @bcfginitiative.bsky.social · 24/10/2025
We hope you can join us & @pennchibe.bsky.social for a virtual keynote presentation from Amy Finkelstein about rethinking common inferences in healthcare. Wednesday 10/29 at 12 PM ET. Register here: bit.ly/3VIvfC2
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 20/10/2025
Predictive model teaching slides
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 19/10/2025
Bold! I thought increasing payment to PCPs would fix all our problems.
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 14/10/2025
Welp. I suppose this is comforting
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 19/09/2025
Yes. And wondering if anybody in the single payer movement is absorbing any lessons here
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Reposted by mwfriedberg.bsky.social
Brendan Nyhan @brendannyhan.bsky.social · 12/09/2025
Friends don't let friends give preregistration a bad name. Exploratory findings are fine; you just have to label them!
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 29/08/2025
Oh yes. And the peculiar failure to cite any of those prior papers
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 26/08/2025
Not a fan of any disease that begins “new world”
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 13/08/2025
Proposition: Hearing the words “best practice” is a near-perfect indicator of terrible decision making.
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 07/08/2025
…but it might work for us
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 04/08/2025
Yes. I don’t think the senders have any appreciation for how much I subliminally hate any politician who allows their name to be used in donation spam. It’s unavoidable even if I like them, rationally. Little by little the spam is hardwiring name-associated revulsion in my reptile brain.
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 04/08/2025
My fealty to the leader who will stop the spam
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Reposted by mwfriedberg.bsky.social
Ole Goltermann @olegolt.bsky.social · 22/07/2025
Serious concerns about a new cortical biomarker for pain sensitivity jamanetwork.com/journals/jam... We (with @tspisak.bsky.social, @christianbuchel.bsky.social) published a commentary on Chowdhury, Bi et al. (2025, JAMA Neurology) raising serious concerns about their reported results. 👇 1/13
jamanetwork.com
Concern About Predictive Performance of a Pain Sensitivity Biomarker
To the Editor Chowdhury et al1 evaluated a biomarker for pain sensitivity, combining peak alpha frequency and corticomotor excitability. The authors report outstanding performance (validation set area...
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 21/07/2025
Kinda misleading headline, but article covers some very important proposed changes to the role of the RUC and other aspects of RBRVS. www.nytimes.com/2025/07/21/u...
nytimes.com
An Attack on the Medical Establishment Buried in an 1,800-Page Regulation
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Reposted by mwfriedberg.bsky.social
grahamabra.bsky.social @grahamabra.bsky.social · 17/07/2025
Ma’am, would you like several fiddly tests whose results about 1% of the medical community can interpret correctly followed by *maybe* a surgery or would you like a once a day pill that will probably sort things?
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 18/07/2025
Yesssss. I cannot describe my satisfaction with this post.
media.tenor.com
a man with a beard and mustache is smiling and looking at the camera .
ALT: a man with a beard and mustache is smiling and looking at the camera .
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Reposted by mwfriedberg.bsky.social
American Statistical Association History of Statistics @hos-asa.bsky.social · 12/07/2025
Time for your yearly reminder that “We need less research, better research, and research done for the right reasons”. #OTD 1948 Douglas Altman b (d 3 June 2018) “One of the most influential medical statisticians of the past 50 years” he led reforms in medical research reliability & reporting. 1/3
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 07/06/2025
#ARM25
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 05/06/2025
Like, what does it mean when a Medicaid program increases its spending on primary care? Seems critical to know if provider taxes also increased and what if anything is known about their incidence on PCPs. Ditto equity investments accompanied by tax hikes. Etc.
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 05/06/2025
Mandatory reading for health services researchers: recent BCBSMA Foundation primer on Medicaid provider taxes www.bluecrossmafoundation.org/about-us/new... This has to be one of the most important aspects of Medicaid policy that almost nobody knows about. Critical to interpreting Medicaid spending
bluecrossmafoundation.org
BCBSMA Foundation Report Highlights Impact of ‘Provider Tax’ on MassHealth Program | Welcome to Blue Cross Blue Shield of Massachusetts
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 28/05/2025
Universal issue: if you increase the returns to gaming… www.nytimes.com/2025/05/27/b...
nytimes.com
Trade Crime Is Soaring, U.S. Firms Say, as Trump’s Tariffs Incentivize Fraud
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mwfriedberg.bsky.social @mwfriedberg.bsky.social · 22/05/2025
Attention health services researchers: funding opportunity here
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