Veteran analyst Vince Kuraitis recently reviewed a report from the consulting firm Oliver Wyman (OW), arguing that the trend toward reconfiguring health systems to deliver more accountable care is more widespread than any of us suspect:

The healthcare world has only gotten serious about accountable care organizations in the past two years, but it is already clear that they are well positioned to provide a serious competitive threat to traditional fee-for-service medicine. In ...

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I can truly say logging on to the National Commission on Certification of Physician Assistants website and seeing I’ve passed the boards was one of the happiest moments of my life. All of the hours invested learning to take great care of patients was worth that feeling. Like an entire generation of young new MD/DO/PA/NP graduates looking to make a positive ...

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Many years ago, I wrote this essay in which I wondered why I receive so few gifts from my patients in the holiday season. I was prompted to write the essay by the memory of my father, an orthopedic surgeon in solo practice, whose patients showered him every December with foil-wrapped bottles of booze, tins of cookies, and all manner of goodies, including a "World's Greatest Doctor Figurine." I speculated ...

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I recently attended Primary Care Progress’s Gregg Stracks Leadership Summit. The summit brought together chapter leaders from around the country to get coaching in how to lead our chapters to accomplish our individual goals. I went to the summit knowing that PCP values teams – the team-based model of organizing to improve the primary care profession and the team-based model of primary care delivery.  In both cases, there would be a ...

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Although members of the Obama team are now celebrating their election victory, the next four years will not be smooth sailing. Ignoring the campaign rhetoric, there is still much more work to be done in order to reshape our health care system; the effect on academic medical centers and teaching hospitals will be significant. The political conscience is still being driven by ...

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American Medical News featured an article with the disturbing title, "Massive health job losses expected if Medicare sequester prevails." I wasn't entirely sure what a "sequester" was, since I thought it was a verb. Sequestration, I thought, was the noun. (I hear a loud knock. It must be the grammar police.) The story, as I understand it, is that when our government decided to pull together and raise the debt ceiling, ...

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What will health insurance cost in 2014? Will the new health insurance exchanges be ready on time or will the law have to be delayed? There will be sticker shock First, get ready for some startling rate increases in the individual and small group health insurance marketplace due to the changes the law dictates. In a November 2009 report, the CBO estimated that premiums in the individual market would increase 10% to 13% ...

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Several physicians contribute regularly to BMJ. One of my favorites is a GP in Glasgow named Des Spence. Through their writings, I have gained a glimpse of the challenges faced by GPs in the UK, and the broader culture in which they work. In two of his columns this summer, he railed against various early detection movements in the UK. In one column, he protests against Alzheimer’s disease advocates who ...

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I’ve been getting emails about the New York Times piece and my quotation that the penalties for readmissions are “crazy.”  It’s worth thinking about why the ACA gets hospital penalties on readmissions wrong, what we might do to fix it—and where our priorities should be. A year ago, on a Saturday morning, I saw Mr. “Johnson,” who was in the hospital with a pneumonia.  He was still breathing hard ...

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Costs and revenue: This is the oxygen of any business, any organization. What are your revenue streams? How much does it cost you to produce them? Life is not just about breathing, but, if you don’t get that in-out equation right, there is nothing else life can be about. Right now this enormous sector is turning itself inside out. It has turned the “transmogrification” setting to “warp.” Why? It’s all about ...

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