Next in a series. I have developed a framework, which I call the Healthcare Incentives Framework, that helps me understand health care systems. It outlines the jobs we expect a health care system to do for us and identifies which parties in the health care system have the primary incentive to fulfill each of those jobs. This is helpful because, if we are unsatisfied with how ...

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Next in a series. In my previous post, I explained the basics of my Healthcare Incentives Framework, which enumerates the jobs we want a health care system to do for us and links them to the parties in the health care system that have the greatest incentive to fulfill those jobs. If you haven’t read that post, I recommend you read it first. For those ...

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First in a series. Way back as a business strategy undergrad and then as a medical student, I developed a framework for understanding health care systems. I call it the Healthcare Incentives Framework, and I believe it clarifies the big-picture components of health care systems that people need to grasp to be able to understand the sources of problems, which then leads to appropriate solutions. The whole thing cannot be explained ...

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As an American medical student doing an elective in Thailand, I was initially troubled when I saw how Thai patients were treated. I'm not speaking of the way Thai physicians apply medical science, mind you -- they rely on UpToDate and sundry U.S. guidelines just as we do -- but that was mostly where the similarities ended. Morning rounds with the team of residents (sans attending, but apparently there was one ...

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When someone is arguing that our health system needs an overhaul, one of the most common reasons they cite is because it is "built on a flawed foundation of fee for service." Of course we blame fee-for-service reimbursement for the rampant overtesting, overtreating, and fragmentation (among other things) in our health system, but this doesn’t mean that it is inherently bad, and here’s why. First, a little contextualization will help. Fee ...

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While attending the Institute for Healthcare Improvement Annual Forum recently, my friend, Jared Conley, and I had the good fortune of finding ourselves standing a table away from Don Berwick in a relatively empty conference room. As MD/PhD in Health Policy students, we were interested in asking him a question about ACOs, so we approached him and introduced ourselves, hastily adding, "We know you’re busy, so we just have ...

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