Dave Chase

How to avoid HMO gatekeeper problems in medical homes

by | in Policy | 5 comments

There's a great deal of planning and testing of new models of care and delivery to respond to healthcare's ever increasing costs. We've all heard about Accountable Care Organizations (ACO) and medical homes. The common concern is that they become a repeat of HMOs with the accompanying misaligned incentives undermining their effectiveness. An exciting new medical home model is rapidly expanding that avoids the dreaded "gatekeeper" that was the undoing of ...

Designing a friendly patient portal for consumers

by | in Tech | 2 comments

More and more providers see the value of providing patient portals. In an attempt to be responsive, EMR vendors are providing patient portals that have some limited capabilities (get lab results, email your doctor and possibly fill out a form requesting an appointment). However, just as the ability to design an airplane cockpit is radically different from a car dashboard, so to is designing an EMR geared towards medical professionals ...

Overcoming barriers to building a direct primary care practice

by | in Physician | 2 comments

The federal health reform bill included a little-noticed clause allowing for Direct Primary Care (DPC) models to be a part of the state health exchanges. I believe this will fundamentally alter the health insurance market and is leading to what I call a "Do it Yourself Health Reform" movement. That little-noticed clause (item #3 in 1301(a) of HR 3590) should have the effect of massively ...

Why primary care is due for a renaissance

by | in Physician | 3 comments

At a time when half of primary care doctors say they'd leave medicine if they had an alternative and the NY Times reports on a family physician who can't give away his practice this hardly seems like the obvious time to claim that primary care is positioned for a renaissance. However, if there's one thing savvy investors have demonstrated, when everyone says to invest in something that is usually the time to ...

Domestic medical tourism saving employers money and improving outcomes

by | in Patient | 2 comments

Over 1.5 million Americans travel abroad each year for medical procedures.Services typically sought by travelers include elective procedures as well as complex specialized surgeries such as cardiac surgery, dental surgery, joint replacement, and cosmetic surgeries. However, virtually every type of health care, including alternative treatments, psychiatry, convalescent care and even burial services are available.U.S. based healthcare providers have taken notice as have self-funded employers and health plans. The ...

Direct primary care and a do it yourself health plan

by | in Policy | 2 comments

Now that I'm well out of my reckless youth phase of my life, I try to preserve the efficacy of my brain. With my lifestyle, there's three actions I take to ensure the integrity of my brain.

  1. Always wear a bike helmet when I bike
  2. Avoid over-consumption of alcohol
  3. Avoid looking at doctor bills and insurance "statement of benefits"
The first two ...