Category Archives: Blog entry

The Double-Edged Sword Behind Quality Metric Reporting

In our unwavering commitment to delivering high-quality healthcare, the industry has seen an influx of quality metrics implemented by government agencies and private payors. While the intention behind these metrics is commendable, we must pause to reflect on their actual value, as the costs associated with their implementation can potentially worsen the care they seek to improve. A… Read More »

The Importance of Quality Adjusted Life Years (QALY) in Healthcare Policy

In the ever-evolving healthcare landscape, value, defined as the relationship between cost and quality, stands at the forefront of discussions. Measuring the cost-effectiveness and the actual value of medical services and treatments has long been a complex endeavor. Enter the Quality Adjusted Life Year (QALY), a gold standard in assessing the benefits of therapies, which has provided invaluable… Read More »

Navigating the Complex Landscape of Prior Authorizations in Healthcare

Recently, a colleague shared an article with me, “The Two Words That Can Make Health Care a Nightmare,” by Chris Stranton, highlighting the challenges posed by prior authorizations (PAs) in healthcare. While I agree that PAs can be problematic, it’s crucial to delve deeper, and consider the broader context surrounding their use. Prior authorizations have long been a… Read More »

Considering the Value of Generative AI in Healthcare

Generative AI is sparking intriguing discussions in healthcare, particularly in its role within chatbots for diagnostic and decision-making purposes. The potential benefits are vast, but it’s essential to recognize and address the accompanying risks and complexities. Diagnostic accuracy and adherence to evidence-based medicine have been central issues in recent healthcare conversations. As we strive to enhance outcomes and… Read More »

Addressing the Growing Need for a Home Care Workforce

In the evolving healthcare landscape, delivering appropriate care at the right time and location is paramount. However, one important model of care, very often overlooked, is the home care workforce. With the increasing demand for home services, it’s essential to acknowledge the significance of caregivers who provide services in the home. While physicians, nurses, and professional clinicians receive… Read More »

The Sustainability of Medicare Advantage Benchmarks: Balancing Costs and Services

Since its inception, more than 50 years ago, Medicare Advantage (MA) has experienced significant growth, surpassing the number of beneficiaries in traditional Medicare. This situation has sparked a debate regarding the sustainability of MA benchmarks and their impact on the Medicare Trust Fund. There are two schools of thought regarding the purpose of MA.   The first suggests… Read More »

Righting the Wrongs of Risk Based Algorithms

As we continue to address health inequities, understanding how algorithms impact races differently is important. One of these inequities revolves around the racial disparities in kidney disease, with Black individuals experiencing a 2-to-4-fold higher incidence of kidney failure than White individuals. Moreover, Black individuals have faced lower referral rates for pre-dialysis transplant evaluation, post-kidney failure transplants, and placement… Read More »

Diagnostic Errors in the Emergency Department

Receiving accurate care in the Emergency Department (ED) is essential because diagnostic errors can have life-threatening consequences. Let’s first examine the role of care within the Emergency Room. In emergency medicine, time is of the essence, and the focus is often on ensuring patient safety, providing follow-up care, and ruling out immediate harm. However, miscommunication and unmanaged expectations… Read More »

The Value of Funding Social Drivers of Health

As we continue to focus on delivering health in a manner that is equitable, we have come to realize the importance of social drivers of health, known as those diseases of life, that occur outside of the physiologic realm and impact an individual’s health and wellness. Presently, investments in methodologies that address these conditions have revolved around governmental… Read More »

Educational Debt Has a Greater Impact Than Meets the Eye

Educational debt is an intriguing concept; borrowing money to pay for education now that will benefit one later when their degree is earned. In essence, future earnings will compensate for the necessary debt required to achieve that degree and, consequently, those earnings. Unfortunately, the debt load of those graduating from medical schools (well into the six-digit range) is… Read More »