With all the debate about how to best implement coordinated care that benefits patients while being feasible for providers and economical for the government, it’s ironic that little attention has been given to a decades-old managed care model that does all this.
But as Medicaid reform progresses in New York and elsewhere, that may be about to change.
The program is called PACE, or the Program of All-inclusive Care for the Elderly, …
And progressives should want health reform to fail.
No, you read that right.
Counter-intuitive? Let me explain. As the fate of the Affordable Care Act hangs in the balance in the Supreme Court, both progressive and conservative pundits have been working overtime to discern the future of health reform.
The traditional thinking is that progressives direly want health reform to move forward, and …
The following column was published on March 26, 2012 in CNN.
With the Supreme Court set to hear oral arguments about the constitutionality of the President Obama’s health care law, more patients than ever have been asking for my thoughts about health reform.
I practice primary care in southern New Hampshire near the Massachusetts border, which gives me a firsthand look at how health reform has impacted my neighboring state. Despite flaws …
I am often fascinated by the simplified dichotomies and ironies of the health care discussion. Some argue that the individual mandate infringes on individual rights yet one could argue that tying health insurance to a particular employer is in itself a violation of individual liberty. When Patrick Henry stated, “Give me Liberty or Give me Death” in protest of the Stamp Act of 1775, he helped swing the assembly (including …
Imagine an America with no health insurance companies.
What do health insurance companies do?
They take as much money as possible from people who want health insurance coverage. They pay out as little money as possible — so-called medical loss — to settle claims from creditors for health services and products that have been delivered.
They keep as much money as possible for the incomes of their executives and other employees, and to …
Recently, The Doctors Company (TDC), the country’s largest insurer of physician and surgeon medical liability, decided to survey doctors to determine what they are thinking and feeling about health reform. The results are pretty gloomy.
To put this in context, it is important to understand a bit about how TDC conducted the survey. First of all, the universe of doctors they reached out to were doctors insured by The Doctors Company. That means …
Although my team, the New England Patriots lost Super Bowl XLVI to the New York Giants in one of the most exciting and tense games in recent memory, reviewing both the pre and post game coverage provided even more learning for doctors and healthcare than my prior post. One can demand excellence and still fall short. When one fails to achieve the intended goals, the learnings can be as …
In a bid to save money, health insurers are coming out with what’s known as “focused networks,” which typically exclude the highest cost hospitals.
In the Boston area, one such plan comes from health insurer Harvard Pilgrim Health Care, whose plan excludes Partner’s Health Care institutions. That’s significant, since Partners includes the famed Massachusetts General Hospital as well as Brigham and …
Today and for the next few years the weather of this industry will be dominated by pervasive, discontinuous change. Structures, revenue streams, relationships of every level: All are shifting in fundamental ways. Specifically, the weather will be driven by:
i) invention and propagation of new business models;
ii) shifting risk onto both the provider and the patient, accompanied by building of new risk-based relationships, contracts and alliances;
iii) smart primary care coming to …
Your doctor’s exam room is getting overcrowded. Modern US health care means that, like it or not, you and your physician are sharing that once private space with an insurance executive constantly hissing in your doctor’s ears to move it along. You are also sharing it with pharmaceutical marketers, lobbyists from the food industry … special interest groups of every stripe.
Now move over and make room for one more interested …
Author of the new book “The Future of Health Care Delivery” and the former CEO of the University of Maryland Medical Center, Stephen C. Schimpff, MD, FACP, says effective care coordination, especially for patients with chronic illness, requires technology, more involvement of primary-care physicians and a health-care system – not a medical-care system.
A physician, educator and cancer researcher for more than 40 years, Dr. Schimpff shares his insights …
There are an awful lot of reasons that led up to my eventual resignation from a career in primary care medicine. I don’t know that any one of them is more important than the other (it really just depends on which day you ask me). One that stands out for me though as a universal problem shared by millions is Managed Health Care, and the imposition it has posed on …
The United States Preventive Services Task Force (USPSTF) is a federal committee composed of private sector experts in prevention and primary care. Its mandate is to make recommendations as to which preventive services are beneficial, which are useless and which are harmful. Disconcertingly, there is a small but vocal opposition to the USPSTF as embodied by an op-ed piece in the Wall Street Journal by Dr. Scott Gottlieb.
Dr. Gottlieb’s main argument against the USPSTF is …
Last year, Ann Mathews wrote a brilliant piece in the Wall Street Journal about the future of medical care in the United States. It is an extremely informative study and provides the reader with a very fine 50,000-foot view of the current condition of its subject.
What she did not mention, or truly highlight, is the threatening trend that is taking place with ever increasing rapidity, of hospital conglomerates, both …
The Patient Centered Medical Home is supposed to be the solution to our primary care woes.
Endorsed by both the American Academy of Family Physicians and the American College of Physicians, this new model of primary care creates a team-based approach to patient care, with a cadre of care managers and nurses assisting physicians to manage patients with chronic disease. If …
For centuries, hospitals have served as a cornerstone of the U.S. health care system. During various touch points in life, Americans connect with a hospital during their most intimate and extraordinary circumstances. Most Americans are born in hospitals. Hospitals provide care after serious injuries and during episodes of severe sickness or disease. Hospitals are predominately where our loved ones go to …
Ever been put on hold when calling your insurance carrier? Or had so little time with your physician that you could not discuss everything you thought was important?
Our care is generally good in the United States but not as good as it could be nor as good as it should be. There are multiple problems to consider.
First, ours is a medical care system not a health care system. It is …
It will come as no surprise to many of you that it can take a very long time to get things accomplished in Washington, D.C. However, a recent policy change from the Department of Health and Human Services (HHS) shows that when physicians join together for a common cause we can …
The New Yorker’s Dr. Atul Gawande outlined how, at the turn of the 20th century, more than forty per cent of household income went to paying for food and food production consumed nearly half the workforce. Beginning in Texas, a wide array of new methods of food production were piloted. Today, food accounts for 8% of household budgets and 2% of the workforce. As a wide array of small innovations …
There has never been a more hectic time to be in the business of healthcare. Healthcare reform has brought many players to the table. And the “game” is bound to have winners and losers. This game is analogous to the board game Monopoly — a number of health care companies are buying up property (i.e., hospital and smaller providers) to position themselves as winners in the new shared savings payment …
And progressives should want health reform to fail.
