The triple aim of health care, as defined by the Center for Medicare and Medicaid Services (CMS) is: improving the experience of care, bettering the health of populations, and reducing the per capita costs of health care. This struck me as odd when I first read it.  Why should the stated aim of any system become to decrease the costs associated with that system? Which led to the next logical questions: What should be the stated aim of ...

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The storyline is familiar. An organization is challenged to achieve better results without spending more money.  An executive is committed to obtaining these better outcomes and recognizes that more financial resources aren’t forthcoming .  Faced with the option of near-certain failure if he continues to work within the historic operating framework, he decides that a different approach is necessary.  With the help of a young and visionary analyst, they decide ...

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Why are cancer organizations waiting until it starts to rain before they suggest buying an umbrella? “Join my Medicare Advantage plan and get free membership to a local health club, free glasses and dental care.” This time of year, during Medicare Advantage Annual Enrollment period, the only TV commercials that annoy us more often are for lawyers who want to help us if we were injured at work or in a ...

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While payers and providers are usually in the spotlight when it comes to accountable care, the most successful models will be the ones that place a strong focus on patient accountability. More and more frequently patients are selecting doctors with the best outcomes, asking proactive questions, and taking an active role in their lifestyle and behaviors. Empowering patients with the support and tools to be responsible for and more involved ...

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A guest column by the American Medical Association, exclusive to KevinMD.com. Let me start by wishing you and your families a very happy and healthy new year. This is my first column of 2012 for this blog, and I am excited to talk about a new initiative that is beginning this year. Medicare accountable care organizations (ACOs) have been discussed at length ...

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Most hospital managers have never had the power to exert leverage over their most valuable resource, the physician, who, after all, admits the patients who make the hospital’s economic existence possible in the first place. So I wrote in introducing a chapter in my first book in 1988. I hastened to add, however, at the close of that chapter, these admonishments: 1. The economic powers of the hospital is shifting from those ...

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I am a little fish in a big sea. And so are most of us. Or used to be. For better and for worse, the era of private-practice, outpatient medicine as we know it is coming to an end. And faster than we thought. The choice now: down size or super size. No longer can a doctor operate a private practice as a solo practitioner or in a small group practice. ...

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As the new year starts, I'm eager for a fresh start and working on improving myself both physically and emotionally. I'm also eager for the NFL playoffs and seeing how my favorite team, the New England Patriots, fares under the leadership of Coach Bill Belichick and quarterback Tom Brady. Doctors and health care can learn much from their examples. Over the past decade, the New England Patriots have been dominant ...

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Health care is in crisis. Reimbursements from insurance companies continue to dwindle, while the expenses of running an office continue to rise.  Looming cuts in Medicare are only weeks away, and many physicians may stop taking Medicare.  If these cuts go into affect, it is possible that primary care physicians could lose up to 50% of their salary.  Just recently CNN reported that some doctors are going bankrupt. How ...

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“The moral test of government is how it treats those who are in the dawn of life, the children; those who are at the twilight of life, the aged; and those in the shadows of life, the sick, the needy, and the handicapped.” We all know that health care in America is too expensive and yet ineffective, falling consistently at the bottom of the rankings of industrialized nations when it comes ...

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