The United States far outspends peer countries on health care. When American politicians complain about these high health care costs, they often vilify pharmaceutical and insurance companies for profiting at the expense of the general public. As I wrote earlier, such vilification is misguided, pushing too much of the blame on individual actors rather than on the system that incentivizes individuals to act those ways. So what it is ...

Read more...

Just as the U.S. health care system is about to make performance measurement a central feature of … well, just about everything doctors do … some prominent and highly influential physicians are asking for a pause and reassessment. Writing for the New York Times, Dr. Bob Watcher argues that, "Two of our most vital industries, health care, and education, have become increasingly subjected to metrics and measurements. Of course, ...

Read more...

May I whine for a few sentences, please? My staff and I have a high-deductible medical insurance plan. As the costs of coverage increased each year, we had to find a product that we could afford for our small private practice. As any small business owner knows, margins are tight, revenue is declining and expenses inexorably rise. And physicians, unlike other retailers, cannot raise our fees. Would you want to ...

Read more...

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 ...

Read more...

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 ...

Read more...

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 ...

Read more...

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 ...

Read more...

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 ...

Read more...

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 ...

Read more...

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, ...

Read more...

Most Popular