Think about every health care reform effort we’ve been working on for the last decade or two, including accountable care organizations (ACOs) and the value-based purchasing models from CMS. The vast majority of them use one or both of the following strategies in an attempt to financially reward providers for delivering higher value (it’s like they’ve realized that financial incentives need to be fixed!):

• Quality bonuses: For providers who deliver …

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This week at work, I had a patient in the hospital who had been through a pretty challenging illness, and he was going to have to be discharged to a skilled nursing facility (SNF) to rehab for a few weeks. Sadly, SNFs in my area do not currently allow any visitors due to the pandemic. The patient is very close to his daughter, who lives out of state, and she …

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Next in a series.

The Healthcare Incentives Framework helps show how to fix incentives in health care systems. It starts by enumerating the five jobs we expect a health care system to do for us and then identifies which parties in the health care system (providers or insurers) have a natural incentive to fulfill each of those jobs. Those incentives arise naturally, but the big challenge …

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Next in a series.

In prior posts, I described my Healthcare Incentives Framework. If you haven’t read those, I recommend you check them out first to have the full context for this post. But here’s a refresher of the main points of the framework without re-explaining all the rationale:

The Healthcare Incentives Framework helps show how to fix incentives in health care systems. It starts by enumerating …

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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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