Imagine you’re a CEO in charge of a health care organization with thousands of physicians and 19 hospitals. Overall, the quality of care delivered is good. Prices and costs are low. But there is a problem: Patients rate your service below average. Making matters worse, a swarm of low-priced competitors have moved in, challenging your market share. You’re going to need to improve patient satisfaction to survive. What do you do? About ...

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Like prep sports or prime-time television, medical meetings have seasons. In the spring and fall, my calendar fills with invitations to speak. I try to get to the venue a few hours before I’m scheduled to speak, so I can “take the pulse” of fellow doctors, asking them about their practices, patients and the future of medicine. Figuratively speaking, the industry’s pulse is racing with fear. I’ve observed that in just the past ...

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While walking through the duty-free at Dulles International Airport in Washington, DC, I happened upon the price tag of an imported French purse. Looking around, I wondered how many travelers could afford a $2,000 handbag.At the gate, I found a seat and logged on to the internet, where I happened upon a story about the CEO of Nostrum Laboratories, Nirmal Mulye. In an interview, Mr. Mulye explained why he raised the ...

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Have you ever been the only customer in your local supermarket? Although the experience can be a bit unnerving, at first, you soon start to notice the advantages: No line at the deli, no pushy shoppers, no carts jamming up the produce section. As you breeze through checkout, you think to yourself, “Gee, I could get used to this.” Now, imagine walking into an empty waiting area at your local emergency ...

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When news broke that Dr. Atul Gawande had been named CEO of the Amazon-Berkshire-JPMorgan Chase health care partnership, industry insiders were quick to raise doubts about his credentials. Some pointed to his limited administrative experience, questioning how someone who has never managed a hospital or health system could oversee the care of some 1 million patient-employees. They also noted that the surgeon and bestselling author doesn’t know much ...

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About 30 miles east of LA, on the quiet tree-lined campus of Claremont Graduate University, sunlight pierces the ornately covered windows of a lower-level classroom in Harper Hall. A glow is cast upon the 25 students of Dr. Debbie Freund’s health policy course; PhD candidates and practicing physicians among them. Many of these bright young scholars will go on to take leadership roles in health policy, public health, IT and medical research. I ...

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Physicians have a love-hate relationship with the electronic health record (EHR). On the one hand, doctors know they can't provide the best possible medical care without them. And on the other, today's EHR systems are cumbersome, clunky and slow physicians down. Indeed, there's much to love and much to hate about today's EHRs, alongside a variety of ways to address the problems they create. One solution may lie in blockchain, the technology currently ...

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Hospitals serve as the economic lifeblood of their communities. They are the second-largest source of private-sector jobs in the United States, employing 5.4 million Americans who, together, embrace a virtuous mission to heal and help others in need. And yet, every year, more and more of them are forced to shut their doors. With soaring costs, eroding margins and mounting pressure from competing providers, the American hospital industry is on life ...

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All eyes are on interest rates as investors look for more signs of trouble ahead. If their concerns over higher-than-expected inflation prove accurate, many players in the U.S. economy will suffer the burden of higher costs. But perhaps no sector would feel the strain more than health care. Higher costs would be just the start of many problems to come for providers, insurers and, eventually, patients. Surging inflation would create a vicious ...

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In the early 1960s, President John F. Kennedy said, “The time to repair the roof is when the sun is shining.” It was a clarion call, a full-throated warning against national complacency in an era of great prosperity. It was during this same period that community hospitals stood as the dominant force in American health care. By the mid-20th century, some 6,000 inpatient facilities had spread throughout the country, often serving ...

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A strange thing happened last year in some the nation’s most established hospitals and health systems. Hundreds of millions of dollars in income suddenly disappeared. This article, part two of a series that began with a look at primary care disruption, examines the economic struggles of inpatient facilities, the even harsher realities in front of them, and why hospitals are likely to aggravate, not address, health care’s rising ...

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Over the past seven seasons, Game of Thrones fans have demonstrated the ability to spot an emerging threat early on -- a quality more leaders in health care need to possess. If you've tuned into the popular HBO series from the beginning, you likely recall Ned Stark (Lord of Winterfell) forecasting doom and gloom in the show's opening episode, appropriately titled “Winter Is Coming.” Right then, you knew something bad was ...

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For its many users, health care’s fee-for-service reimbursement methodology is like an addiction, similar to gambling, cigarette smoking, and pain pill abuse. Doctors and hospitals in the clutches of this flawed payment model have grown dependent on providing more and more health care services, regardless of whether the additional care adds value. I don’t use this metaphor lightly, nor wish to trivialize our nation’s growing problem with addiction. Rather, as a ...

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The “doctor-patient” relationship is tightly woven into the culture and history of medicine. But that special bond is under enormous pressure today. And to keep it from fraying, we need periodically to examine the fabric. Last month, the Council of Accountable Physician Practices (CAPP), representing 28 of the nation’s largest and best medical groups in the U.S., did just that. Annually, CAPP sponsors a meeting in Washington D.C. where it invites ...

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For years, health care reform has pursued the holy grail of higher quality at lower cost. I’ve always believed it’s achievable, and now it’s needed more than ever. The U.S. health care system is failing. Costs continue to increase faster than our nation’s ability to pay, and the quality of our outcomes lag those of most other industrialized nations. People increasingly ask me what concrete steps could make a difference. The ...

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“Pigs get fat, but hogs get slaughtered,” the saying goes. And so may it prove to be true for the pharmaceutical industry. Three articles, all published May 3, illustrate the greed and egregious pricing by certain drug companies that are gaining public recognition and scrutiny. As an example, Marathon invested $370,000 to obtain the license for the data on “deflazacort,” a steroid available for about $1,200 a year in the United Kingdom. ...

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For much of the first 100 days of the new Congress and administration, the news has featured health care and the frequently rancorous debate on its future. Will the Affordable Care Act (ACA) be repealed, replaced, revised or remain essentially intact? Will funding be cut or will subsides and cost-sharing reduction payments stay the same in order to encourage insurers to stay on the health care exchanges? At this point, we’re ...

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Recently, I heard from a student in her third year of medical school. To date, she has borrowed more than $100,000 to fund her education. She is in the top 10% of her class, with honors in all of her subjects and high scores on her national exams. She would be a valued resident in the most competitive specialty training programs. Her goal is to become a primary care physician ...

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It sounds great, almost too good to be true: Coverage for all with lower costs, a broad choice of providers, and minimal paperwork. The problem is that it won’t work. For more than half a century, advocates for a government-run, single-payer approach to health care coverage have touted its potential. With debate over the Affordable Care Act heating up by the day, progressives, both at the state and federal levels are now ...

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Rationing of health care services according to an individual’s ability to pay — or, as the case may be, the inability to do so — is becoming more prevalent in the United States, both in the public and private insurance spheres. Commercial payers, for example, increasingly require doctors to follow a complex and time-consuming authorization process. Recent surveys show that 75 percent of doctors complain about this often unnecessary step. Insurance ...

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