“Pay for performance” made headlines again this week, when Health and Hospitals Corporation (HHC), the multi-billion dollar corporation which operates New York City’s public hospitals, announced that they will be linking physician reimbursement to pre-determined “quality” metrics and patient satisfaction…
“Pay for performance” made headlines again this week, when Health and Hospitals Corporation (HHC), the multi-billion dollar corporation which operates New York City’s public hospitals, announced that they will be linking physician reimbursement to pre-determined “quality” metrics and patient satisfaction scores.
This announcement comes quickly on the heels of details recently released by the Centers for Medicare and Medicaid Services (CMS) regarding its first Medicare payment adjustment to hospitals under the …
“He’s dead, Jim.” So here’s my beef. At the recent Forbes Healthcare Summit there was a lot of focus on speakers and vendors offering very cool new tech, from future “Tricorders” that can diagnose multiple diseases, is non-invasive, and hand-held;…
“He’s dead, Jim.”
So here’s my beef. At the recent Forbes Healthcare Summit there was a lot of focus on speakers and vendors offering very cool new tech, from future “Tricorders” that can diagnose multiple diseases, is non-invasive, and hand-held; personal genomics, where data from your own genome is cheap and easy to get and can be integrated with clinical knowledge to produce better care; targeted therapies for various diseases, …
How many businesses do you know that want to cut their revenue in half? That’s why the healthcare system won’t change the healthcare system. -Rick Scott, Governor of Florida Former CEO, Hospital Corporation of America The Washington Post recently reported…
How many businesses do you know that want to cut their revenue in half? That’s why the healthcare system won’t change the healthcare system.
-Rick Scott, Governor of Florida
Former CEO, Hospital Corporation of America
The Washington Post recently reported that health plan lobbyists, charts at the ready, are working to convince legislators that unreasonable health care costs are everyone else’s fault. Karen Ignagni, the Executive Director of America’s Health Insurance Plans (AHIP) declared: “If you’re …
The ultimate cure to the perversions inherent in U.S. health system economics is cracking the risk code – optimizing the financial risk allocation for any given disease across payer, health system, physician and patient. After years of payer and more…
The ultimate cure to the perversions inherent in U.S. health system economics is cracking the risk code – optimizing the financial risk allocation for any given disease across payer, health system, physician and patient. After years of payer and more recently health system effort, the heat is increasing on doctors and patients.
Despite vigorous effort on wellness and prevention, it’s fair to say the industry has so far missed the mark …
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…
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 …
We physicians like to think that we are really different from other workers. We physicians, perhaps thinking back to that medical school application essay we all wrote, really believe that we went into this career to simply help others. We…
We physicians like to think that we are really different from other workers. We physicians, perhaps thinking back to that medical school application essay we all wrote, really believe that we went into this career to simply help others. We physicians truly believe that we always put our patients first.
Because we sincerely believe all of the above, we are shocked when someone like Uwe Reinhardt points out that collectively we …
A guest column by the American College of Physicians, exclusive to KevinMD.com. Two years ago, my practice became a patient-centered medical home (PCMH), or more accurately, my practice began the transition towards delivering patient care under this new model. While…
Two years ago, my practice became a patient-centered medical home (PCMH), or more accurately, my practice began the transition towards delivering patient care under this new model. While that process is far from complete at this point, it’s been a positive experience. This month, I’d like to share some observations that might help those of you who are …
The Patient Protection and Affordable Care Act cleared two major hurdles in 2012: the Supreme Court ruling on constitutionality and the reelection of President Barack Obama. However, in 2013 there is a very good chance that Courts will see much…
The Patient Protection and Affordable Care Act cleared two major hurdles in 2012: the Supreme Court ruling on constitutionality and the reelection of President Barack Obama. However, in 2013 there is a very good chance that Courts will see much more of the health care reform law due to objections regarding the contraception mandate. Despite the bills legal successes in the past, there are (at publication) more than …
Today, I come back to the tragedy of medical economics in this country. And I would apply that word "tragedy" in at least two ways. The first tragedy is that we are headed for fiscal disaster in this country because…
Today, I come back to the tragedy of medical economics in this country. And I would apply that word “tragedy” in at least two ways.
The first tragedy is that we are headed for fiscal disaster in this country because of healthcare costs.
We now spend twice as much per person on healthcare as the average per person cost of all developed countries. During the past several decades, the inflation rate for …
Some physicians will make over 7 times what the average college dropout will earn over a lifetime. Even within medicine there are significant differences in lifetime earnings between primary care, surgery, and specialty care. With the recent Powerball lottery jackpot…
Some physicians will make over 7 times what the average college dropout will earn over a lifetime. Even within medicine there are significant differences in lifetime earnings between primary care, surgery, and specialty care. With the recent Powerball lottery jackpot at a record high, there was a lot of daydreaming going on recently for many Americans, maybe even some doctors: What would you do if you actually won it all? …
Physicians and the public are urging doctors to bring cost into consideration at the bedside when ordering laboratory tests and imaging studies. Although diagnostic testing represents an important component of the rising cost of medical care, asking what a test…
Physicians and the public are urging doctors to bring cost into consideration at the bedside when ordering laboratory tests and imaging studies. Although diagnostic testing represents an important component of the rising cost of medical care, asking what a test costs is the wrong question.
Cost-saving shouldn’t begin at the bedside, it should begin by training the next generation of doctors to think in terms of value; not bang-for-buck or potential …
It is always a treat, particularly when living on the West Coast, to watch the New England Patriots football team play on national television in their home stadium, Foxborough, Massachusetts. On Monday Night Football, the match-up was between the Patriots…
It is always a treat, particularly when living on the West Coast, to watch the New England Patriots football team play on national television in their home stadium, Foxborough, Massachusetts. On Monday Night Football, the match-up was between the Patriots and the Houston Texans, which had the best record in the AFC and undefeated in all away road games. As previously …
I hope my patients are satisfied. This is everything. Improving the lives of people is why doctors do what they do. How much we help our patients is the metric. It’s the peg we hang our self-esteem on. So yes,…
I hope my patients are satisfied. This is everything. Improving the lives of people is why doctors do what they do. How much we help our patients is the metric. It’s the peg we hang our self-esteem on.
So yes, of course, patient satisfaction is really important.
But that doesn’t mean it’s a good idea to link it with dollars.
In fact, on a list of well-meaning but really dumb …
Fourth year medical students are starting the interview process to match into a residency program - their next and potentially final stage of training. Over the next few months, these students will rank the programs they visit based on features…
Fourth year medical students are starting the interview process to match into a residency program – their next and potentially final stage of training.
Over the next few months, these students will rank the programs they visit based on features such as geography, research funding, and hospital affiliations. But there’s another factor to consider – one that gets little attention but that probably matters more for the kind of doctors they’ll become. …
The Bipartisan Policy Report titled “What is Driving US Health Care Spending? America’s Unsustainable Health Care Cost Growth” issued in September lists seven factors increasing American health care costs. The “fiscal cliff” debates include many of these arguments. While these…
The Bipartisan Policy Report titled “What is Driving US Health Care Spending? America’s Unsustainable Health Care Cost Growth” issued in September lists seven factors increasing American health care costs. The “fiscal cliff” debates include many of these arguments.
While these factors do indeed play roles in American health care, almost all are at work in other industrialized countries, all of whom provide better care to more people for half what we …
When the marketing of ObamaCare began in 2009, I always believed that the end game was for a federal single payer system. Since the present Affordable Care Act, (ACA), was passed in 2010, there has been nothing to convince me…
When the marketing of ObamaCare began in 2009, I always believed that the end game was for a federal single payer system. Since the present Affordable Care Act, (ACA), was passed in 2010, there has been nothing to convince me otherwise. The only reason single-payer wasn’t passed two years ago was because it was hard enough to arm-twist and bribe even …
As millions of Americans gain health care coverage under the Affordable Care Act, we have an unprecedented opportunity to work on eliminating health disparities based on race, income and insurance status. Several states, including California, soon will begin marketing their…
As millions of Americans gain health care coverage under the Affordable Care Act, we have an unprecedented opportunity to work on eliminating health disparities based on race, income and insurance status. Several states, including California, soon will begin marketing their Health Benefits Exchanges (in our state it’s called “Covered California”). Through these exchanges, millions will enroll in health plans and expanded Medicaid programs for coverage that takes effect in January …
The Affordable Care Act comes with the promise of a dramatic overhaul in what many see as a broken health care system. It promotes the potential for “better all around” – better care, easier access to hospitals, and affordable treatment.…
The Affordable Care Act comes with the promise of a dramatic overhaul in what many see as a broken health care system. It promotes the potential for “better all around” – better care, easier access to hospitals, and affordable treatment. It also comes with a price. For one reason or another, the turbulence within the American health care system is causing doctors to shut down, downsizing or sell their practices …
The 21st century challenge for the American health care delivery system is to deliver higher quality care for less money. Republican and Democratic experts agree that payment reform involving transitioning from fee-for-service to global, value-based systems is necessary for us…
The 21st century challenge for the American health care delivery system is to deliver higher quality care for less money. Republican and Democratic experts agree that payment reform involving transitioning from fee-for-service to global, value-based systems is necessary for us to achieve that goal. Accountable care organizations (ACOs) are the new entities that will receive the new global payments and distribute them to the doctors, allied health professionals, hospitals, and …
Prior to heading out West for my postgraduate medical training, I spent four amazing years in Chicago absorbing everything I could about becoming a doctor. Throughout this time in medical school, I was taught everything from the smallest components of…
Prior to heading out West for my postgraduate medical training, I spent four amazing years in Chicago absorbing everything I could about becoming a doctor. Throughout this time in medical school, I was taught everything from the smallest components of atoms to the largest organs of the human body. Academic physicians spent countless hours teaching me the art of bedside patient care and the scientific evidence behind clinical decision-making.
