Health policy and public health

4,357 articles · Since 2004

Articles, page 155

Implementation of a rational system of medical care

May 9, 2011May 9, 201118

The patient entered her private solo physician’s office and handed her medical ID card to the doctor. He put the card in his desktop reader and reviewed her medical history. All of her visits, vaccinations, medications, tests, x-rays etc from all providers were inscribed on the data chip in the card. The card also included insurance and billing information. At the end of the visit, he updated her information on …

Health policy

Health care coordination under the rules of an ACO

Donald Tex Bryant

May 9, 2011May 9, 20115

On March 31, 2011 CMS issued its proposed rules for Accountable Care Organizations (over 400 pages). There is now a 60-day comment period. Shortly thereafter, the final rules will be issued. I am sure there will be changes in the…

On March 31, 2011 CMS issued its proposed rules for Accountable Care Organizations (over 400 pages).

There is now a 60-day comment period. Shortly thereafter, the final rules will be issued. I am sure there will be changes in the proposed rules as there were changes in the “meaningful use” rules for electronic health records (EHR’s). Yet, much of the intent of …

Health policy

Fewer choices for patients with health care consolidation

John Mandrola, MD

May 6, 2011May 6, 201117

As a specialist, one of the saddest truisms about practicing medicine in the private world has always been how little one’s clinical skills determines referrals. Unfortunately, as our present healthcare climate pushes "providers" to consolidate along the lines of major…

As a specialist, one of the saddest truisms about practicing medicine in the private world has always been how little one’s clinical skills determines referrals. Unfortunately, as our present healthcare climate pushes “providers” to consolidate along the lines of major hospital networks this injustice will only worsen.

A decade-or-so ago when I started private practice it was obvious that referrals came to me because of my association with an established …

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Health policy

National Quality Strategy and Partnership for Patients to improve care

David B. Nash, MD, MBA

May 6, 2011May 6, 2011

One year after passage of the Affordable Care Act, the Department of Health and Human Services (HHS) has unveiled two programs that will most certainly be transformative for U.S. healthcare, affecting both quality and safety. With the announcement of the…

With the announcement of the first-ever National Quality Strategy in March, HHS signaled a strong commitment to improving the quality of healthcare.

In essence, …

Health policy

The government reversal on end of life planning

Naomi Freundlich

May 5, 2011May 5, 20116

After all the ridiculous fear-mongering about "death panels," Congress dropped a proposal to encourage end-of-life planning from the health reform legislation passed last March. But the administration had in fact quietly included reimbursing doctors for end-of-life counseling along with a…

After all the ridiculous fear-mongering about “death panels,” Congress dropped a proposal to encourage end-of-life planning from the health reform legislation passed last March.

But the administration had in fact quietly included reimbursing doctors for end-of-life counseling along with a host of new Medicare regulations. The provision, which authorizes payment for “voluntary advance care planning,” went into …

Health policy

The future of primary care in an ACO model

Kunmi Sobowale, MD

May 5, 2011May 5, 201110

Primary care is a unique field of medicine. Primary care physicians (PCPs) are the gatekeepers to specialized care, provide preventative care, and most importantly, they have the ability to manage patients with multiple chronic conditions. Thus, primary care physicians are…

Primary care is a unique field of medicine.

Primary care physicians (PCPs) are the gatekeepers to specialized care, provide preventative care, and most importantly, they have the ability to manage patients with multiple chronic conditions. Thus, primary care physicians are in prime position to become the point men in the …

Physician voices

Cooperation between patient and doctor is essential today in health care

Paul Dorio, MD

May 4, 2011May 4, 20113

There are many aspects to being a doctor. Just as important are the many aspects that go into being a patient. Of course, the difference is that one has been perceived as being a position of power and the other…

Patients and doctors work …

Physician voices

Why patient satisfaction scores won’t decrease health care costs

Edwin Leap, MD

May 4, 2011May 4, 201110

So now, in addition to the many other bits of medical meddling we have from CMS (Centers for Medicare and Medicaid Services), there’s this. Reimbursements to hospitals, from Medicare, will be partly tied to patient satisfaction scores. We’ve seen payments…

So now, in addition to the many other bits of medical meddling we have from CMS (Centers for Medicare and Medicaid Services), there’s this.

Reimbursements to hospitals, from Medicare, will be partly tied to patient satisfaction scores. We’ve seen payments already being tied to ‘quality indicators,’ as dictated by the federal government; rewards for doing a better job on care for heart attacks, pneumonia, etc. At least that’s quantifiable, whether scientifically …

Health technology

Why quality did not improve with hospital EHR implementation

Roger Collier

May 4, 2011May 4, 201113

The 2009 Health Information Technology for Economic and Clinical Health Act (HITECH) authorized incentive payments, potentially totaling some $27 billion over ten years, to clinicians and hospitals when they implement electronic health records in such a way as to achieve…

But, are EHRs really “meaningfully useful” or are …

Health policy

Direct primary care and a do it yourself health plan

Dave Chase

May 4, 2011May 4, 20112

Now that I'm well out of my reckless youth phase of my life, I try to preserve the efficacy of my brain. With my lifestyle, there's three actions I take to ensure the integrity of my brain. Always wear a…

Now that I’m well out of my reckless youth phase of my life, I try to preserve the efficacy of my brain. With my lifestyle, there’s three actions I take to ensure the integrity of my brain.

Always wear a bike helmet when I bike
Avoid over-consumption of alcohol
Avoid looking at doctor bills and insurance “statement of benefits”

The first two …

Health policy

End of life care is being influenced by politics

Kevin Pho, MD

May 3, 2011May 3, 201111

A version of this op-ed was published on April 12, 2011 in USA Today. “Would you like to discuss your end-of-life plans today?” It’s a question that I ask my patients, although not as often as I would like. Talking…

A version of this op-ed was published on April 12, 2011 in USA Today.

“Would you like to discuss your end-of-life plans today?”

It’s a question that I ask my patients, although not as often as I would like. Talking about death may be uncomfortable, but it’s a conversation that needs to happen more often.

We can never know …

Health policy

Medicine’s paradigm shift is a microcosm of a trend occurring in society

Paul Fischer, MD

May 3, 2011May 3, 20116

In 1994 Jeff Bezos revolutionized how consumers shop. He founded Amazon.com. Shortly after, Ebay followed suit—solidifying a paradigm shift that has redefined shopping from an in-person to online experience. In 2004, Facebook capitalized on another trend: individuals were becoming more…

In 1994 Jeff Bezos revolutionized how consumers shop. He founded Amazon.com.

Shortly after, Ebay followed suit—solidifying a paradigm shift that has redefined shopping from an in-person to online experience. In 2004, Facebook capitalized on another trend: individuals were becoming more comfortable sharing personal information online. Interestingly, people did not wake up one morning and decide it would be convenient to shop from home, or that sharing pictures with their friends online …

Health policy

People feel anger and fear over our health care situation

Aldebra Schroll, MD

May 3, 2011May 3, 20113

During the election season, the biggest loser appears to be civility. Anger, attack ads and name calling ruled the day. We are faced with enormous and complex challenges, issues not easily addressed in sound bites. Yet that is what we usually get from our representatives. I find myself asking are we not willing or able to do the hard work of examining the issues before us?

During the ongoing discussions over …

Health policy

Physician responsibility and leadership is critical for ACO implementation

Jeffrey L. Cohen, Esq

May 3, 2011May 3, 2011

by Jeffrey L. Cohen The current fixation on Accountable Care Organizations (ACOs) is causing an enormous amount of two things: 1) talking, and 2) inactivity. Yes, the concept of delivering care in a manner that reduces or at least controls…

by Jeffrey L. Cohen

The current fixation on Accountable Care Organizations (ACOs) is causing an enormous amount of two things: 1) talking, and 2) inactivity.

Yes, the concept of delivering care in a manner that reduces or at least controls costs is important and interesting. Yet, the marketplace is replete with people and businesses that have adopted …

Health policy

How the ACO model can be successful

Justin Chang, MD

May 1, 2011May 1, 201110

by Justin Chang, MD I think we can all agree — physician, payer, provider, patient, etc. — that the ultimate goal of regulations and reform should be to improve the delivery of healthcare, lowering costs and ultimately, making patients healthier…

by Justin Chang, MD

I think we can all agree — physician, payer, provider, patient, etc. — that the ultimate goal of regulations and reform should be to improve the delivery of healthcare, lowering costs and ultimately, making patients healthier and more satisfied.

Coupled with driving toward the results defined by CMS, this requires some fairly significant changes …

Read more…

How the ACO model can be successful

Physician voices

Interviewing a primary care doctor to better understand her professional day

Pearl Korn

May 1, 2011May 1, 20116

As a young primary care doctor in Kiev, Ukraine (then part of the Soviet Union), Dr. Elena Rogova learned her craft well, working in a hospital that catered to scientists, celebrities, artists, musicians and senior government officials. As a top…

As a top medical student, this hospital had sought her services, and she enjoyed her work there. Dr. Rogova had no intention of leaving …

Health policy

How the IPAB takes policy and puts it in the hands of health care experts

Shadowfax, MD

April 29, 2011Apr 29, 20112

Everyone knows that the excess growth in health care costs is driving the fiscal crisis in our country. The problem is that while everybody wants to somehow cut the cost of Medicare/Medicaid, in theory, when it comes time to actually…

Everyone knows that the excess growth in health care costs is driving the fiscal crisis in our country.

The problem is that while everybody wants to somehow cut the cost of Medicare/Medicaid, in theory, when it comes time to actually make cuts, the courage of our politicians fails in the face of unrelenting public opposition to cuts in Medicare.

…

Health technology

Organizations that link their IT systems to share electronic health records

George Lundberg, MD

April 29, 2011Apr 29, 20116

Glory be. There's good news tonight in American healthcare. It did not come from laws, regulations, or government edict, although there has been much government activity in the field; it did not come from the behemoths of information technology like…

Glory be. There’s good news tonight in American healthcare.

It did not come from laws, regulations, or government edict, although there has been much government activity in the field; it did not come from the behemoths of information technology like Google, Microsoft, Oracle or Cisco, although much hard work in IT did precede it; it did not come from the for-profit healthcare industry giants like GE, Big Pharma, United Healthcare, or …

Conditions and diseases

Why depression continues to go undiagnosed and untreated in primary care

Steve Wilkins, MPH

April 28, 2011Apr 28, 201119

What medical condition is the most costly to employers? I’ll give you a hint. It is also a medical condition that is likely to go unrecognized and undiagnosed by primary care physicians. If you guessed depression you are correct. If…

What medical condition is the most costly to employers? I’ll give you a hint. It is also a medical condition that is likely to go unrecognized and undiagnosed by primary care physicians.

If you guessed depression you are correct. If you mentioned obesity you get a gold star since that comes in right behind depression for both …

Physician voices

The advance directive is only a part of end of life decision making

Richard N. Fogoros, MD

April 27, 2011Apr 27, 2011

On January 1, the White House announced a new policy that would have paid doctors for discussing end-of-life planning during their Medicare patients’ annual wellness visit. Under this policy, physicians would be paid to encourage their patients to establish an…

On January 1, the White House announced a new policy that would have paid doctors for discussing end-of-life planning during their Medicare patients’ annual wellness visit.

Under this policy, physicians would be paid to encourage their patients to establish an advance directive, which would guide medical care if the patient became incapacitated from illness, and could …

Health policy and public health

Articles, page 155

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