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Analysed 15,566 tweets, tweets from the last 234 weeks.
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Last 50 tweets from @Farzad_MD
Not that you asked, but I think @CDCDirector made the right call
Farzad Mostashari Retweeted ·  
In reply to @Farzad_MD
Not quite as it might appear. Multiple agencies have authority here, not just ONC. As @HealthIT_Policy notes, authority does not equal budget. Our just announced workforce program is $80M.
Vote for this year’s DC Timmy Awards nominees before it’s too late (@AledadeACO is in the running)… via @TechnicallyDC
نذر کردم گر از اين غم به درآيم روزي

تا در ميکده شادان و غزل خوان بروم
In reply to @farnazfassihi
2/ Asked to recite poetry from Hafiz, Masoud recited these lines that he said his father often cited: خرم آن روز کز این منزل ویران بروم راحت جان طلبم و از پی جانان بروم گر چه دانم که به جایی نبرد راه غریب من به بوی سر آن زلف پریشان بروم
Well the Secretary just delegated a bunch of authority to ONC. Notably via ARPA to:
1) improve sharing of public health data & IT modernization
2) administer a $7.66B program to improve & sustain public health workforce

Reminder that ONC’s typical operating budget is around $62M
Farzad Mostashari Retweeted ·  
Patient engagement is worth it
Changing norms is hard & iterative
I deserve control over my own health & have a legal right to my data (and BTW, I paid for the test & data)
Farzad Mostashari Retweeted ·  
What it will take to maintain the accelerated pace of change in health care post-pandemic Featuring insights from @Farzad_MD of @AledadeACO @DrChrisChen of @ChenMed @sacjai of @scanhealthplan and Jon Perlin of @HCAhealthcare @HealthEvolution
In reply to @Farzad_MD
They never found who did it, right?
Replying to @boltyboy
Not definitively, but lots of circumstantial evidence pointing to this guy…
Farzad Mostashari Retweeted ·  
Have some ideas on how to move the data science of health care forward, here is a awesome opportunity. @NLM_NIH is recruiting a new Scientific Director…
In reply to @ManifestMedEx
Wonderful news!!
One of the best episodes of all time in my opinion
ICYMI: The ACO Show features @aehaque, @HITNadine & Dr. Gregory Riggs of Lafayette Internal Medicine Clinic in Lafayette, La, in a discussion with @DrJIsrael about the incredible savings achieved by Aledade ACOs despite a year of turmoil.

Listen now:…
Farzad Mostashari Retweeted ·  
Proud to be a part of @BCBSMA’s efforts to improve the equity of care.
As this story explains, provider financial incentives to reward improvements in the equity of care are an important part of our overall program—by creating a business case for providers to invest in equity…
#wildland is a remarkable book.

@eosnos gets at some deep truths about America and how we got here-- and for those who care about such things, a real tour de force of the craft of writing

Buy it. Read it.
Today, a co-intern greeted me "I heard you want to do geriatrics? I wanted to do geri but there are no jobs in the PNW bc the field is so congested. And, well, you're not from here anyway so..."

Hi let's try not dashing each other's dreams first thing in the morning please ಠ︵ಠ

Jonathan Perlin to lead The Joint Commission… via @modrnhealthcr
In reply to @healthcareandy
What is crazy, is that I know of at least two other companies who sell over-the-counter tests with similar prices and equal / higher accuracy. Media is effectively creating a brand v. generic distinction, when there isn’t one.
Replying to @healthcareandy
I agree with your point entirely. Small technical question- do you know which one has lowest rate of false positives? Might be Binax (which has nothing to do w why it's the brand name)
That was crazy

I still can't believe we had a release of weaponized anthrax

(I saw the first 2 cutaneous cases, as a recently graduated epidemic intelligence service officer)
Just weeks after 9/11, terror struck a second time. Uncover the unbelievable crime story behind the headlines you remember—and the ending you don’t. #TheHotZoneAnthrax, starring @danieldaekim and @tonygoldwyn, premieres Sunday Nov 28 on National Geographic and @Hulu.
Farzad Mostashari Retweeted ·  
Come work with me! (It’s really fun!) Aledade - Regional Medical Director - Remote North Carolina
Farzad Mostashari Retweeted ·  
Agree - move to independent practice, get assistance from entities like Aledade, have better income and more autonomy and greater satisfaction! And better serve your patients!!
Maybe consider leaving hospital employment?

We @AledadeACO might help you set up your own practice focused on practicing medicine the way you want, and getting a fair share of the value you create

(DMs are open)
Because many employed family physicians have not seen the increased investment in #primarycare expected from the 2021 E/M code revaluation, we’re asking @CMSGov to take action.
Farzad Mostashari Retweeted ·  
The 24 largest tax-exempt hospital systems made a collective net profit of $11.9 billion in the second quarter alone. They used to be called non-profits; now the correct label is tax-exempt for obvious reasons.
Great analysis by @bobjherman
In reply to @Farzad_MD
agree macro but tech transfer of mRNA vaccines is very daunting - was an entirely new capability here in US and EU. Much easier to transfer to existing global manufacturing is traditional egg-based vaccine manufacturing like this effort…
Replying to @bijans
Are we 100% sure that India, China, etc can't handle the tech transfer? I guess the question is, given the need to develop this capability internationally (for future pandemics if not COVID-19), and the number of manufacturers eager to start, wouldn't it be good to start now?
Tom's really raising the question here.

What's the counter-argument?
In reply to @DrTomFrieden
While focusing on selling expensive vaccines to rich countries, Moderna and Pfizer are doing next to nothing to close the global gap in vaccine supply. Shameful.
Adding benefits to Medicare increases the cost per enrollee, making it harder to expand eligibility. Wish those resources were instead targeted to covering more people (my preference would be children).
Replying to @KeithNHumphreys
The way we treat our children in the dawn of their lives and the way we treat our elderly in the twilight of their lives is a measure of the quality of a nation. Hubert H. Humphrey We can do both
In reply to @Farzad_MD
Note that most of that $1.1 billion is for alleged fraudulent claims of DME, testing, & pain meds. Criminals use phone calls or sham visits to generate fake orders for those items and services.
Replying to @vanman0254
do you have the breakdown?
Farzad Mostashari Retweeted ·  
An incredible thread from @dougstreat that shows what happens when you empower and finance primary care in a meaningful manner.

Primary care is not a myth - it works for patients, it works for vulnerable communities and it works for health systems.

c: @PC4America
Farzad Mostashari Retweeted ·  
The same science we teach our kids in schools is being ignored in our communities.

This science shows that vaccines and masks are safe and effective.

In my new role as co-chair of @GovLauraKelly’s Safer Classrooms Workgroup, we will use data & #science to keep kids safe.
So, some personal news. She said yes.
In reply to @dougstreat
how were these five physician-led ACOs chosen for inclusion? Others? Compared to non-Aldelade doc led MSSPs? Not discussed in paper--would be helpful to know.
Replying to @BradleyFlansbau @dougstreat and 9 others
this was the first large cohort of ACOs we started, so all the ones we signed up in 2016, and therefore have 5 years of data for
Farzad Mostashari Retweeted ·  
#InteroperabilityHero Spotlight on Dr. Karen Smith:

Listen in as she shares her experience as an early adopter of tech, and a recent story where #interoperability created a positive care experience for her patient.

Learn more this #InteropHero at
In reply to @Farzad_MD
💯 Important role for quality measures here, too. We don’t need a lot of them, they need to be actionable and available to patients, purchasers.
Replying to @kempann
absolutely! we focus on the measures that matter most. Blood pressure control is #1 cause of preventable deaths - and racial disparities in mortality.…
In reply to @dougstreat
14/ PART EIGHT: QUALITY No pretty graphs here, but A1C control improved 20% from 2017 to 2019 and blood pressure control improved 9%!
In reply to @Farzad_MD
Is there good data showing that more pcp visits results in fewer hospitalizations or better outcomes?
Replying to @Docjoshsoc
I would guess that it's not automatic, but a necessary component of a new payment and delivery model Ie just turning up the dial on FFS primary care visits may not reduce hospitalizations substantially, but there is no way to decrease hospitalizations without more primary care
Farzad Mostashari Retweeted ·  
I just signed this open letter from scientists, academics and researchers calling for a #FossilFuelTreaty. Add your name today @fossiltreaty to achieve #COP26 and #COP15 ambitions, as well as the #SDGs
Farzad Mostashari Retweeted ·  
Come work with me, Richard Frank, & @MattAFiedler at Brookings.

We're hiring a Post-Doc Fellow in health policy to start next Summer/Fall…
Farzad Mostashari Retweeted ·  
Fascinating case study.

One big gap in our knowledge, I think, is how these utilization shifts compare to those achieved for Medicare Advantage enrollees (with and w/o PCP risk)

Could tell us a lot about the relative impact of prior auth and narrow networks vs. PCP influence.
In reply to @Farzad_MD
In the narrow frame of dialysis, my concern has been that the focus on hospitalization is so intense (justifiably so, considering rate/expense) that there is less focus on chronic disease management and more on the acute response to volume overload, etc.
Replying to @eric_weinhandl
If you take a long view, that's short-sighted! There or some things that can produce short-term cost savings, but if you bent the ark of disease progression through things like blood pressure and diabetes management, your gains compound over years as we have seen
Farzad Mostashari Retweeted ·  
In reply to @dougstreat
16/ Over 4 years, we equated this work with an estimated prevention of 10,917 hospitalizations, 19,338 ED visits, and 8,859 SNF visits compared with the region — through the delivery of more primary care. That's thousands of real people who had a better healthcare experience.
There are sometimes concerns around whether people are going to get less care in global risk contracts.

Not the case.

More primary care (more engaged, more informed primary care) is HOW we get fewer ED visits, fewer hospitalizations.

More care, less suffering, lower costs.
In reply to @dougstreat
12/ PART SIX: PRIMARY CARE VISITS By 2019, 34% above the regional average.
True decrease in cost over 5 years vs counterfactual = 13%

Practices got credit from @CMSGov vs benchmark ~ 9%

Govt is getting a great return on the program (+ spillovers), but can help it expand further by setting benchmarks more fairly (see "the rural glitch")
In reply to @dougstreat
7/ PART ONE: COST By 2019, 13% reduction in risk adjusted cost trend vs. the region’s trend.
Farzad Mostashari Retweeted ·  
In reply to @dougstreat
6/ [Brief nerd alert on methods 🤓] So we used the CMS Virtual Research Data Center — which contains 100% of Medicare claims! — to perform a difference-in-differences analysis on various cost and utilization endpoints for these ACOs compared to their regions. The results?
Farzad Mostashari Retweeted ·  
In reply to @dougstreat
5/ So we examined a cohort of five geographically disparate ACOs that all shared one characteristic: they began working with @AledadeACO in 2016. And we asked the question: what was the experience of these ACOs on cost of care, utilization, and quality of care over five years?
First in-depth analysis case study of multiple accountable care organizations across 5 states and 5 years- comparing primary care utilization, ED/Inpatient events, and total cost of care in a diff-in-diff (baseline - performance year, ACO vs non-ACO patients in same region).
1/ 🧵ICYMI: 🚨 NEW 🚨 in @AJMC_Journal last week — a retrospective cohort study on five years with five @AledadeACO Medicare accountable care organizations (ACOs) with @Travis_Broome, @chiglinsky, and @Farzad_MD…
Hey, internet!
Give me your opinions on Jeeps. Yay or nay?
Statistically, they stand out in one way "average depreciation rate of a vehicle over five years is 49.6%, but the four-door Jeep Wrangler only depreciated at a rate of 30%."
Farzad Mostashari Retweeted ·  
“Roughly 2 percent of school-based close contacts ultimately tested positive for the virus, researchers found, which means that schools were keeping 49 uninfected students out of class every time one student tested positive.”…
Not a good trend. Testing has slowed in the US, but the % positivity has actually gone up to 14.2%. We aren’t testing enough people to know true community disease transmission.

Please get tested for any new symptoms or high-risk exposures.
Replying to @NatashaBhuyan
I wonder if dramatically higher use of rapid antigen tests (which is a good thing, though we lack reporting visibility) --with confirmatory PCR if positive-- could explain both.
How many companies will irrefutably reduce total healthcare spending (net of admin fees), at scale?

It’s a lot harder than you might imagine.
In reply to @Farzad_MD
I never could figure out why awards were given for perfect attendance. It is highly unlikely you never had a cold or the flu so if you went in and spread it then do you deserve an award. I have so many cold viruses my first year of nursing after graduating it was crazy
It’s been jarring to watch tennis authorities ignore serious, detailed allegations of domestic abuse vs this player. But for this tournament to promote itself as such when allegations involve what happened during its own last edition, in Geneva precisely……
Replying to @Taniel
Federer does not shine here
Farzad Mostashari Retweeted ·  
We know about the social, environmental, and building factors that drive spread, but what about genetic? Why do some get it and some don't, when equally exposed? Could it be this wide variability in ACE2 gene expression?

--> Some people had 'almost none' (!)👇
In reply to @kennylinafp
I believe you know Dr. Ted Epperly. He was chairman of the AAFP board. I was dismayed to learn he was dismissed from a top health board in Idaho for supporting evidence-based public health measures. They replaced him with an unvaccinated pathologist who promotes ivermectin.
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