Did the Medicare Bundled Payment Model Decrease Care Quality?

As we continue to focus on value-based payment models, we must always be aware of possible unintended consequences. The Medicare Bundled Payment for Care Improvement Advanced Model (BPCI-A) is a model that has had broad participation since its inception in 2018. It has shown reductions in overall Medicare payments per episode and improvements in clinical outcomes. The question… Read More »

Considering Redefining Primary Care

As we continue our journey of value-based care, we still struggle to find models that significantly move the needle on improving quality and outcomes while also lowering costs. Central to this movement, has been a focus on primary care clinicians delivering services that focus on the holistic needs of individuals they serve, which includes prevention, lifestyle modification, healthy… Read More »

What is Driving the Use of Patient Monitoring?

In healthcare, particularly regarding new technologies, we habitually chase after the latest, greatest shiny object. And we very often accept these innovations as being beneficial even before the data is confirmed, sometimes even failing to terminate usage when it’s not shown to be of benefit. And Remote patient Monitoring (RPM) risks falling into that scenario. Hypothetically, the idea… Read More »

Violence Prevention IS a Healthcare Initiative

Gun control is a topic fraught with political connotations, however violence prevention is relatively free of it. The health problem of violence presents itself in many forms, including assaults, homicide, suicide, intimate partner violence, child abuse, elder abuse, child and adult bullying, and others. All these injuries and psychological impacts are preventable. Not only is there a human… Read More »

Feedback Makes a Difference When Requesting Diagnostic Imaging

As we continue to focus on the cost of healthcare and delivering value, there has been an ongoing interest in ordering ambulatory testing, especially regarding musculoskeletal complaints. What is driving this cost, is the volume of tests ordered and the unit price of those tests. Undoubtedly, it’s worth spending time discussing the degree of pricing; however, it is… Read More »

How Can We Improve the Use of Administrative Codes to Measure Quality?

Historically, we have designated administrative codes as methods for reimbursement. However, with the evolution of value-based care, these same codes are now applied for risk stratification for adjustments to value-based payments. This variation of fees is necessary because the degree of illness and complexity drives the clinical needs and, thus, the cost. However, using this methodology has created… Read More »

Will Diagnostic Artificial Intelligence Ever Become a Real Thing?

The desire to improve diagnostic accuracy, efficiency, and safety is always on the minds of clinicians. Suddenly, artificial intelligence (AI) arrives, and everyone believes we have found nirvana and a solution to all problems. Unfortunately, despite multiple peaks of excitement, AI still has failed to meet our expectations. When we delve into the reasons concerning diagnostic accuracy, it’s… Read More »

Is it Time to Consider the Value of National Licensure?

In a manner that was not possible during “normal” times, the COVID crisis allowed us to implement much-needed changes and the expansion of virtual care is one of them. In addition to the growth of virtual care, increasing the healthcare workforce during a time of crisis was necessary. In all, 45 states extended licenses to out-of-state practitioners. Currently,… Read More »

How Can We Increase our Utilization of Artificial Intelligence for Clinical Care?

Unfortunately, to date, the utilization of artificial intelligence (AI) to improve and reduce inequities in access, quality, and appropriateness of high-quality diagnosis and care, has remained more of an aspiration than a reality. There are numerous reasons for this situation; the newness of AI, the low sensitivity and specificity of the algorithms, the lack of health equity data… Read More »