Pharmaceutical costs continue to rise and are increasingly becoming a significant portion of medical spending for care. There have been many attempts to stem this ever-increasing portion of the total cost of care including, increased generic utilization, value-based incentive models, and the use of drug step therapy protocols. Specifically, this latter model requires the administration of specific agents… Read More »
Over the past several years, chronic pain and the use of opioids have been a dominant topic of conversation and a primary focus in healthcare. Tragically, in our attempt to improve the pain management in those we serve, an epidemic of narcotic misuse, abuse, and dependency occurred. To stem the rapidly increasing opioid crisis, the focus on fixing… Read More »
In healthcare, we have become accustomed to ongoing Medicare regulatory oversight and changes. Many of these regulations are implemented to drive specific behaviors that are focused on improving quality and/or reducing costs. One such measure is the Medicare Two-Night Rule. This rule, created in 2013, was designed to replace the inappropriate inpatient admission status stays with what they… Read More »
As we continue focusing on improving care for those we serve, public policy and advocacy are two areas in which healthcare professionals and organizations avoid, especially if they are fraught with political connotations. Without question, gun control is one such area. There is an abundance of literature that addresses the value of specific legislation regarding firearms that are… Read More »
Recently, I commented on the subject of hope and its polarity with reality. This comment elicited a response from a sagacious person who responded with an incredibly poignant statement, “Empathy without emotional attachment is extremely difficult.” Hence, I began to contemplate the meaning of this within how we as clinicians must deal with those that are managing the… Read More »
As we continue to focus on value-based care, how we design our value-based payment models continues to be critical. Historically, we have oversimplified the polarity by placing a fee-for-service on one end of the spectrum and global capitation payments on the opposite side. Thus, creating the idea that these two payment mechanisms are counter to each other, and… Read More »
Both for clinicians and patients, hope is a forceful emotional driver. The psychological benefits of hope are associated with improved physical and mental health, relationships, functional status, and coping. As with any type of emotion, extremes can be detrimental. Patients might become unrealistic, the same with clinicians. So, the question becomes, what is the right amount of hope… Read More »
Advanced payment models are designed to align reimbursement with the desired outcome of value (quality, service, and cost) for individuals. However, our current insurance models do not account for the desired short-term financial outcomes aligning with the much longer duration of care which is necessary to see clinical improvement. For example, to prevent heart disease, cholesterol management requires… Read More »
Out of the numerous learnings from the pandemic, COVID has highlighted several issues within our social structures; one of the most significant findings is the discrepancies in vaccination rates among minorities. For many appropriate reasons, there is a great amount of mistrust. This behavior originates from historical occurrences leading to fatal outcomes. Another issue being that those that… Read More »
As we live longer, certain disease states will continue to become more prevalent in the elderly, such as dementia. Unfortunately, our health care system is focused on episodic care versus the needs of those with chronic conditions, especially when they need long-term services outside of a care setting. The question arises concerning who delivers such care, are they… Read More »