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Health policy and public health

4,357 articles · Since 2004

Articles, page 166

Health policy

The medical system Donald Berwick prefers in the United States

38

Apart from some apparently radically contradictory expressed views on patient "centeredness" and patients being in control, the newly appointed head of CMS, Dr. Donald Berwick, has made it clear what sort of medical system he would have for the United…

Apart from some apparently radically contradictory expressed views on patient “centeredness” and patients being in control, the newly appointed head of CMS, Dr. Donald Berwick, has made it clear what sort of medical system he would have for the United States.

What he wants is well explained in this commentary from National Review Online as is the authors’ reasoning of why that sort of …

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The medical system Donald Berwick prefers in the United States

Physician voices

Implementing patient centered medical home pilot projects

6

by Robert Graham, MD As the nation works to reinvigorate primary care, a lot is riding on the medical home. Some see it as an answer to a fragmented health care system that is not responsive to patients’ needs for…

by Robert Graham, MD

As the nation works to reinvigorate primary care, a lot is riding on the medical home.

Some see it as an answer to a fragmented health care system that is not responsive to patients’ needs for coordinated, comprehensive care. Others have invested in it as a vehicle to improve both the quality of care and control costs. While we work to address …

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Implementing patient centered medical home pilot projects

Health policy

Insurance does not have incentives to lower costs or improve quality

6

Whether we have commercial insurance through our employer or Medicare, the incentives are poorly aligned to lower costs and improve quality. In fact, they actually encourage greater and greater expenditures. In most instances, our insurance covers everything from prevention to…

Whether we have commercial insurance through our employer or Medicare, the incentives are poorly aligned to lower costs and improve quality.

In fact, they actually encourage greater and greater expenditures. In most instances, our insurance covers everything from prevention to basic routine care to complex care of serious illness. Coverage may not be all that good for some things like preventive care and our primary care …

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Insurance does not have incentives to lower costs or improve quality

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Health policy

The public option dissonance in health reform

12

Health reform will do a lot of things that most Americans don't realize it will do, and it will not do a lot of things that many Americans mistakenly believe it will do. One of the most recognizable components of…

Health reform will do a lot of things that most Americans don’t realize it will do, and it will not do a lot of things that many Americans mistakenly believe it will do.

One of the most recognizable components of health reform that didn’t actually become law is the public option. The public option was the lighting rod in the health reform debate. After all, it had a concise name, and …

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The public option dissonance in health reform

Health policy

Healthcare reform ethical questions

29

Hard choices and healthcare reform are here. Donald Berwick, M.D., has been installed as the administrator for the Centers for Medicare and Medicaid services as a “recess appointment” by President Obama. Dr. Berwick is an academician, a pediatrician who has…

Hard choices and healthcare reform are here.  Donald Berwick, M.D., has been installed as the administrator for the Centers for Medicare and Medicaid services as a “recess appointment” by President Obama.

Dr. Berwick is an academician, a pediatrician who has spent the bulk of his professional existence as the CEO of the Institute for Healthcare Improvement of Cambridge, MA.  He is an outspoken advocate for the single-payer system, admires Britain’s National …

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Healthcare reform ethical questions

Health policy

Health care reform needs cooperation and compromise

2

There are strange things going on in the Massachusetts health care insurance market. For those from out of state, here are some quotes that will give you a sense of the contradictions in the public policy arena. They are, respectively,…

There are strange things going on in the Massachusetts health care insurance market. For those from out of state, here are some quotes that will give you a sense of the contradictions in the public policy arena.

They are, respectively, from two stories that appeared on the same day in the Boston Globe: “Rate cap for insurer overturned” and “Officials give up cutting health perks.”

1. An insurance

…

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Health care reform needs cooperation and compromise

Health policy

Americans will need doctors but physicians are leaving primary care

21

Everyone understands the need for a robust primary care workforce in making healthcare more affordable and accessible while keeping those in our care healthy. With the aging of America and healthcare reform, even more Americans will need primary care doctors…

Everyone understands the need for a robust primary care workforce in making healthcare more affordable and accessible while keeping those in our care healthy.   With the aging of America and healthcare reform, even more Americans will need primary care doctors at precisely the same time doctors are leaving the specialty in droves and medical students shun the career choice.  So as a practicing primary care doctor, I’ve watched with …

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Americans will need doctors but physicians are leaving primary care

Physician voices

PCMH and retainer fee medicine are primary care solutions

16

For years now we’ve been hearing about the trials and tribulations that have evolved in the practice of primary care medicine. However, the discussion has intensified in recent months with passage of national health reform. Recent publications highlight the problems.…

For years now we’ve been hearing about the trials and tribulations that have evolved in the practice of primary care medicine.

However, the discussion has intensified in recent months with passage of national health reform. Recent publications highlight the problems. A paper in the New England Journal of Medicine by Dr. Richard Baron entitled, What Keeps Us So Busy in Primary Care? discusses the time spent by primary care …

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PCMH and retainer fee medicine are primary care solutions

Health policy

Congress is actually increasing physician Medicare pay

19

Recently, the 21 percent cut in Medicare physician reimbursements was replaced with a 2.2 percent pay hike. Later this year, Congress will have to consider the matter once again, just as it has ever year since 2003. This is the…

Recently, the 21 percent cut in Medicare physician reimbursements was replaced with a 2.2 percent pay hike.

Later this year, Congress will have to consider the matter once again, just as it has ever year since 2003. This is the third time this year that Congress has averted Draconian cuts to physician’s payments. What, you might wonder, is going on?

Here is the back-story.  In 1997, Congress enacted a so-called “sustainable growth …

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Congress is actually increasing physician Medicare pay

Health policy

Will pilot programs really lead to innovation and save money?

As might be expected of reform legislation, the Patient Protection and Affordable Care Act (PPACA) places a lot of emphasis on innovation. Reasonably enough, most of the potential changes—at least in Medicare—are to be preceded by pilot or demonstration projects…

As might be expected of reform legislation, the Patient Protection and Affordable Care Act (PPACA) places a lot of emphasis on innovation.

Reasonably enough, most of the potential changes—at least in Medicare—are to be preceded by pilot or demonstration projects designed to test their feasibility. In fact, according to one health care blogger with time on his hands, PPACA includes no less than 312 mentions of demonstrations and 80 mentions of …

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Will pilot programs really lead to innovation and save money?

Health policy

Comparative effectiveness research (CER) in patient care

4

Recently, I was lucky to be invited to a New England Healthcare Institute discussion entitled "From Evidence to Practice: Making CER Findings Work for Providers and Patients" in Washington, DC. How to disseminate and implement Comparative Effectiveness Research (CER) so…

Recently, I was lucky to be invited to a New England Healthcare Institute discussion entitled “From Evidence to Practice: Making CER Findings Work for Providers and Patients” in Washington, DC.

How to disseminate and implement Comparative Effectiveness Research (CER) so that patient care is really improved was the first topic tackled by the expert panel and the moderator, Clifford Goodman of The Lewin Group.

The target audiences for CER findings include: patients, …

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Comparative effectiveness research (CER) in patient care

Health policy

Can a health insurer provide affordable care when its CEO makes millions?

61

In 2005, we entitled a post, "How Can a $124.8 Million a Year CEO Make Health Care More Affordable?" At that time, we contrasted the enormous compensation given to the then CEO of UnitedHealth, Dr. William McGuire, with the stated…

In 2005, we entitled a post, “How Can a $124.8 Million a Year CEO Make Health Care More Affordable?”

At that time, we contrasted the enormous compensation given to the then CEO of UnitedHealth, Dr. William McGuire, with the stated mission of his corporation.  Since then, we have traced the travails of UnitedHealth and its leadership.  Dr. McGuire was eventually accused of receiving backdated stock options (which at one time …

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Can a health insurer provide affordable care when its CEO makes millions?

Health policy

Medicare needs to take the lead for health care cost control

2

One of the big complaints about the recently enacted health care reform law is that it does little to control costs. There is some truth to that because the major focus is on increasing access to insurance. And yet there…

One of the big complaints about the recently enacted health care reform law is that it does little to control costs. There is some truth to that because the major focus is on increasing access to insurance. And yet there is reason for optimism on a couple of fronts:

  • First, with many of the access issues settled, stakeholders can focus directly on cost matters rather than cost-shifting and finger pointing
  • Second, health

…

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Medicare needs to take the lead for health care cost control

Health policy

Can HSAs restore the doctor patient relationship?

11

Is it possible that some do not understand that to promote Healthcare Savings Accounts is the most effective thing we could do to preserve traditional medical practice? In a true doctor-patient relationship only doctors and patients discuss the options agree…

Is it possible that some do not understand that to promote Healthcare Savings Accounts is the most effective thing we could do to preserve traditional medical practice? In a true doctor-patient relationship only doctors and patients discuss the options agree to the treatments and handle the money. No third party touches any of these.

If everyone had a HSA it would be just like the good old days, only better. Everyone …

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Can HSAs restore the doctor patient relationship?

Health policy

Patients will skip care with higher deductibles and copays

35

The Wall Street Journal reported that overall medical use fell as patients had fewer doctor office visits, lab testing, and maintenance medications possibly due to the recession or as a result of consumer driven healthcare in the way of higher…

The Wall Street Journal reported that overall medical use fell as patients had fewer doctor office visits, lab testing, and maintenance medications possibly due to the recession or as a result of consumer driven healthcare in the way of higher deductibles and copays.

This is very worrisome.  Certainly patients should have some financial responsibility for their care, but skimping on care will only result in Americans not becoming healthier, but sicker.  …

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Patients will skip care with higher deductibles and copays

Health policy

Will Medicare really lose physicians because of the SGR?

10

For years, physicians have argued that the specter of annual cuts in Medicare will cause many of them to leave the program, or at the very least, to limit how many new Medicare patients they will accept in their practices.…

For years, physicians have argued that the specter of annual cuts in Medicare will cause many of them to leave the program, or at the very least, to limit how many new Medicare patients they will accept in their practices. Yet, for the most part, measures of seniors’ access show that the vast majority enjoy good access to care.

For instance, in May of this year, the Medicare Payment Advisory Commission …

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Will Medicare really lose physicians because of the SGR?

Health policy

ABIM: Patient centered care is crucial in health reform

5

A guest column by the American Board of Internal Medicine, exclusive to KevinMD.com. The concept of patient-centered care was catapulted into the mainstream by the publication in 2001 of the seminal Institute of Medicine report Crossing the Quality Chasm: A…

A guest column by the American Board of Internal Medicine, exclusive to KevinMD.com.

abim logoThe concept of patient-centered care was catapulted into the mainstream by the publication in 2001 of the seminal Institute of Medicine report Crossing the Quality Chasm: A New Health System for the 21st Century.  This report identified six aims of improvement for the U.S. …

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ABIM: Patient centered care is crucial in health reform

Health policy

Pay specialists less to save primary care

53

Since 1997 the number of US medical students choosing to go into primary care has decreased by more than 50%. It seems that sources as diverse as the Obama Administration and the Wall Street Journal think that we should find…

Since 1997 the number of US medical students choosing to go into primary care has decreased by more than 50%.

It seems that sources as diverse as the Obama Administration and the Wall Street Journal think that we should find a way to encourage medical students to choose primary care specialties in order to allow Americans to have the best and most cost effective care. This is very problematic when primary …

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Pay specialists less to save primary care

Health policy

How healthcare reform affects women

by Joyce Frieden An estimated 30 million women will be helped by the new health reform law over the next 10 years, according to a report from The Commonwealth Fund. "While women are just as likely as men to be…

by Joyce Frieden

An estimated 30 million women will be helped by the new health reform law over the next 10 years, according to a report from The Commonwealth Fund.

“While women are just as likely as men to be uninsured, they are more likely [than men] to have trouble buying coverage on the individual market,” Karen Davis, PhD, president of the fund, said in a teleconference announcing the report’s release. “This …

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How healthcare reform affects women

Health policy

Greed is not good when it comes to doctors, patients and medicine

18

Gordon Gekko is wrong. Greed is not good. Not when it comes to health care providers. The socioeconomic study of what motivates people is a fascinating field of study, not the least of which is because of how counter-intuitive it…

Gordon Gekko is wrong. Greed is not good. Not when it comes to health care providers.

The socioeconomic study of what motivates people is a fascinating field of study, not the least of which is because of how counter-intuitive it is. For example, it seems normal to assume that the more someone is rewarded for their efforts, the more effort they will put forth toward those rewards.

These rewards (increasing salary, bonuses, …

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Greed is not good when it comes to doctors, patients and medicine

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