We physicians live in the shadow of rising health care costs.  Hospitals want us to cut length of stays and somehow become more efficient.   Insurance companies ask us to accept less money for patient visits, forcing us to see more people in fewer hours.  The government wants us to check a slew of electronic boxes to prove that we’ve performed what they deem to be best practices, even though there is ...

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Health care in America is fracturing right down the middle, and doctors are going to have to figure out if or how long they can straddle the divide between what patients want and what the government and corporate America want them to have. Up until this point, the momentum has been with the payers, Medicare, and the insurance industry. But the more heavy-handed they become, the more inevitable the public backlash ...

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At the J.P. Morgan Healthcare Conference in San Francisco, Mr. Andrew Slavitt, acting administrator at the Centers for Medicare & Medicaid Services (CMS), announced on January 11th that, “The meaningful use program as it has existed will now effectively be over, and replaced with something better,” and later clarified on Twitter that, “In 2016, MU as it has existed-- with MACRA-- will now be effectively over and replaced ...

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An excerpt from How Physicians Can Fix Health Care: One Innovation at a Time. I’ve studied lots of industries. In general, cost and quality compete on equal terms. Some companies emphasize cost, others quality, but both are always in the picture. And then there is health care. Uniquely among industries, health ...

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Consumers spend 16 times as long choosing a computer as they do selecting a health plan for themselves and their family. And it should not be a big surprise. For decades, nearly all insurance companies offered similar choices of in-network physicians and hospitals. And as a result, plans differed only minimally in clinical quality, access and service. And even when clinical outcomes varied, consumers had no easy way to access ...

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An excerpt from How Physicians Can Fix Health Care: One Innovation at a Time. In 2011, Shreya Kangovi hired her first two community health workers, or CHWs, at the University of Pennsylvania Health System. Their role was to develop partnerships with low-income hospitalized patients who were at high risk of ...

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recent study of health care organizations showed that most are not prepared to deliver standardized longitudinal care across multiple provider systems. Shared care plans will be the centerpiece of coordinated care delivery, incentivized by the move from fee-for-service to value-based care. In 2015, Medicare unveiled its plan to transition to quality-based payments via the Merit-Based Incentive Payment System (MIPS), which will sunset and subsume earlier quality-encouraging programs, ...

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My friend Jeremy went to an emergency room with belly pain, and soon learned he'd been blessed with a kidney stone. The staff summoned a urologist, but none was available, so they sent him home with a pain prescription. Continuing nevertheless to writhe in agony, Jeremy phoned urologists and learned to his dismay there were only three in the region who accepted his insurance, and none at all in his ...

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UnitedHealthcare (UHC), the nation’s largest health insurer, will likely pull out of Obamacare in 2017. Citing high costs and huge potential losses, they warned that 2016 will probably be their last year offering health insurance through the Obamacare exchanges. Is this another example of greedy insurance companies with fat cat CEOs gouging the system? Or are economic realities interfering with the “hope and change” of Obamacare? UHC isn’t really selling insurance. Instead ...

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With fewer than 100 days until the first primaries, the leading candidates have received ample airtime to address the important issues our nation faces. But even though health care accounts for around 18 percent of our nation’s GDP and consumes close to half of the total tax revenue collected by the federal government, their silence on providing solutions to the most pressing health care challenges our nation faces continues with ...

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