Health policy and public health

4,357 articles · Since 2004

Articles, page 145

What should be the stated aim of health care in America?

January 20, 2012Jan 20, 201210

The triple aim of health care, as defined by the Center for Medicare and Medicaid Services (CMS) is: improving the experience of care, bettering the health of populations, and reducing the per capita costs of health care. This struck me…

This struck me as odd when I first read it. Why should the stated aim of any system become to decrease the costs associated with that system?

Which led to the next logical questions: What should be the stated aim of …

Health policy

How Moneyball applies to healthcare

Gregory R. Weidner, MD

January 20, 2012Jan 20, 201211

The storyline is familiar. An organization is challenged to achieve better results without spending more money. An executive is committed to obtaining these better outcomes and recognizes that more financial resources aren’t forthcoming . Faced with the option of near-certain failure if he continues to work within the historic operating framework, he decides that a different approach is necessary. With the help of a young and visionary analyst, they decide …

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How Moneyball applies to healthcare

Health policy

The problem of insurance gaps in cancer patients

Richard Leff, MD

January 19, 2012Jan 19, 20123

Why are cancer organizations waiting until it starts to rain before they suggest buying an umbrella? “Join my Medicare Advantage plan and get free membership to a local health club, free glasses and dental care.” This time of year, during…

Why are cancer organizations waiting until it starts to rain before they suggest buying an umbrella?

“Join my Medicare Advantage plan and get free membership to a local health club, free glasses and dental care.” This time of year, during Medicare Advantage Annual Enrollment period, the only TV commercials that annoy us more often are for lawyers who want to help us if we were injured at work or in a …

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Health policy

Implementing strategies to encourage patient accountability

Miles Snowden, MD

January 18, 2012Jan 18, 20122

While payers and providers are usually in the spotlight when it comes to accountable care, the most successful models will be the ones that place a strong focus on patient accountability. More and more frequently patients are selecting doctors with the best outcomes, asking proactive questions, and taking an active role in their lifestyle and behaviors. Empowering patients with the support and tools to be responsible for and more involved …

Health policy

AMA: A new model of patient care

American Medical Association & Peter W. Carmel, MD

January 17, 2012Jan 17, 20124

A guest column by the American Medical Association, exclusive to KevinMD.com. Let me start by wishing you and your families a very happy and healthy new year. This is my first column of 2012 for this blog, and I am…

A guest column by the American Medical Association, exclusive to KevinMD.com.

Let me start by wishing you and your families a very happy and healthy new year. This is my first column of 2012 for this blog, and I am excited to talk about a new initiative that is beginning this year. Medicare accountable care organizations (ACOs) have been discussed at length since the passage of the Affordable Care Act. Until recently, …

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AMA: A new model of patient care

Health policy

How hospitals are gaining leverage over physicians

Richard Reece, MD

January 16, 2012Jan 16, 201233

Most hospital managers have never had the power to exert leverage over their most valuable resource, the physician, who, after all, admits the patients who make the hospital’s economic existence possible in the first place. So I wrote in introducing…

So I wrote in introducing a chapter in my first book in 1988. I hastened to add, however, at the close of that chapter, these admonishments:

1. The economic powers of the hospital is shifting from those …

Health policy

Doctors are forced to choose between really small or super big

Anonymous

January 14, 2012Jan 14, 201252

I am a little fish in a big sea. And so are most of us. Or we are used to be. For better or worse, the era of private practice, outpatient medicine as we know it, is ending. And faster…

I am a little fish in a big sea. And so are most of us. Or we are used to be. For better or worse, the era of private practice, outpatient medicine as we know it, is ending.

And faster than we thought. The choice now: downsize or supersize. No longer can a doctor operate a private practice as a solo practitioner or in a small group practice. We are getting …

Health policy

What health care can learn from the New England Patriots

Davis Liu, MD

January 13, 2012Jan 13, 20126

As the new year starts, I'm eager for a fresh start and working on improving myself both physically and emotionally. I'm also eager for the NFL playoffs and seeing how my favorite team, the New England Patriots, fares under the…

As the new year starts, I’m eager for a fresh start and working on improving myself both physically and emotionally. I’m also eager for the NFL playoffs and seeing how my favorite team, the New England Patriots, fares under the leadership of Coach Bill Belichick and quarterback Tom Brady. Doctors and health care can learn much from their examples.

Over the past decade, the New England Patriots have been dominant …

Health policy

A concierge or boutique label is discredits retainer medicine

Matthew Mintz, MD

January 11, 2012Jan 11, 201243

Health care is in crisis. Reimbursements from insurance companies continue to dwindle, while the expenses of running an office continue to rise. Looming cuts in Medicare are only weeks away, and many physicians may stop taking Medicare. If these cuts go into affect, it is possible that primary care physicians could lose up to 50% of their salary. Just recently CNN reported that some doctors are going bankrupt.

How …

Health policy

Addressing the needs of the disadvantaged in our health system

Emily Lu

January 9, 2012Jan 9, 201221

“The moral test of government is how it treats those who are in the dawn of life, the children; those who are at the twilight of life, the aged; and those in the shadows of life, the sick, the needy,…

We all know that health care in America is too expensive and yet ineffective, falling consistently at the bottom of the rankings of industrialized nations when it comes …

Physician voices

Why the physician shortage is a perfect storm

Patrick W. Hisel, MD

January 7, 2012Jan 7, 201228

In the past few years, the small rural community where I practice has seen five primary care physicians close their practice. This phenomenon is not an anomaly. Why do doctors close their practices? There are many reasons. Doctors can be…

In the past few years, the small rural community where I practice has seen five primary care physicians close their practice. This phenomenon is not an anomaly.

Why do doctors close their practices? There are many reasons. Doctors can be broken down into demographics like everyone else.

Baby Boomers

Most of my boomer patients are not retiring right now. In fact, they are financially hurting and looking for work, or for a second …

Physician finance

Doctors: Don’t be ashamed about going bankrupt

Kevin Pho, MD

January 5, 2012Jan 5, 201224

Are doctors really going broke? According to this piece from CNN Money, some are: "Doctors list shrinking insurance reimbursements, changing regulations, rising business and drug costs among the factors preventing them from keeping their practices afloat. But some experts counter…

Are doctors really going broke?

According to this piece from CNN Money, some are: “Doctors list shrinking insurance reimbursements, changing regulations, rising business and drug costs among the factors preventing them from keeping their practices afloat. But some experts counter that doctors’ lack of business acumen is also to blame.”

That’s all entirely true.

Pressure on reimbursement, combined with a lack of …

Health policy

Our healthcare system is unfair and unbalanced

Mark Ryan, MD

January 5, 2012Jan 5, 201221

About six weeks ago, while in clinic, I developed pain in my stomach -- specifically, in my right upper quadrant, just below the ribs. I had experienced this a few times before, but this time it seemed more persistent than…

About six weeks ago, while in clinic, I developed pain in my stomach — specifically, in my right upper quadrant, just below the ribs. I had experienced this a few times before, but this time it seemed more persistent than usual. Following the rule that physicians make the worst patients, I kept working through it until my nurse told me I looked poorly, and made me see my own primary …

Medical education

The value of continuity of care is priceless

Carol J. Duh

December 26, 2011Dec 26, 20118

During my first week on a pediatric outpatient clinic as a third year medical student, I spent an average of 140 minutes caring for each patient. Looking back at that first week, the amount of time I spent with each patient ranged from a “brief” 79-minute visit to one whopper 188-minute visit where I reviewed several journals in the workroom and sought two attending physician opinions to be completely sure. …

Health policy

The patient reality of a Medicare payment cut

Mike Sevilla, MD

December 25, 2011Dec 25, 201133

Dear United States House of Representatives and Senate: I really hope that you enjoy your Christmas break going back home to your families. While you're home, I really hope that you will hear from those constituents who will be affected…

Dear United States House of Representatives and Senate:

I really hope that you enjoy your Christmas break going back home to your families. While you’re home, I really hope that you will hear from those constituents who will be affected by the 27.4 percent Medicare physician pay reduction that is schedule to take effect January 1st. I really hope that the American Academy of Family Physicians, the American Medical Association, …

Health policy

How companies try to curb health care costs

Barbara Ficarra, RN, MPA

December 23, 2011Dec 23, 20116

How do companies curb health care costs? Do healthier employees lead to increased productivity? Several progressive companies believe so and have committed to providing employees with programs to help engage them in a healthier lifestyle. As part of the incentives…

How do companies curb health care costs?

Do healthier employees lead to increased productivity? Several progressive companies believe so and have committed to providing employees with programs to help engage them in a healthier lifestyle.

As part of the incentives to lead a healthier lifestyle some employers have instituted a penalty and reward system tied to the companies’ benefits. For example, smokers may incur a significant surcharge to the cost of their …

Health policy

Dropping out of Medicare will break my heart

Stewart Segal, MD

December 22, 2011Dec 22, 201142

I met with my staff yesterday to discuss the effect of a 27% cut in Medicare reimbursement on our patients and our office. I had a really lousy day, explaining to my elders what would happen if Congress fails to act. One of my patients aptly pointed out that Congress has not acted responsibly in the last 20 years and that it would take a miracle for them to get their …

Health policy

The primary care doc fix is in

Dave Chase

December 20, 2011Dec 20, 201110

Matthew Mintz, MD recently shared how primary care doctors are set to lose more than half of their salary. It's well documented how primary care has faced a number of challenges with half of primary care physicians saying they'd leave…

Matthew Mintz, MD recently shared how primary care doctors are set to lose more than half of their salary. It’s well documented how primary care has faced a number of challenges with half of primary care physicians saying they’d leave medicine if they could as was mentioned in an earlier piece. There’s talk of a “doc fix” as physicians believe the debt ceiling deal is …

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The primary care doc fix is in

Physician voices

Quality indicators can harm the elderly

Ken Covinsky, MD

December 19, 2011Dec 19, 201112

Quality indicators are used to measure the quality of health care delivered to patients. Quality indicators are used extensively in the VA health system, and efforts are underway in Medicare to tie reimbursement levels to performance on quality indicators. The…

The motivations for using quality indicators are guided by the best of intentions. There are many problems with the quality of health care in the US, and quality indicators aim to improve …

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Quality indicators can harm the elderly

Physician voices

Let physician assistants be part of the primary care answer

Sharon Bahrych, PA-C, MPH

December 19, 2011Dec 19, 201140

There has been so much change in medicine, physicians are leaving primary care, and new ideas are being bantered about such as patient centered medical homes (PCMH) and accountable care organizations (ACO), in an attempt to try to address the problem. To add to this strain, is the knowledge that medicine is going to have to be ready to absorb thousands of additional patients in the near future …

Health policy and public health

Articles, page 145

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