A Look at the Progression of Value-Based Payment Models

For those in the value-based world, we have been on this journey for years. And we have witnessed and participated in CMS and CMMI creating and implementing various models.  Undoubtedly, some have been more successful than others, and there has been an ongoing debate concerning the impact on value-based payment models. Two of the major concerns that have… Read More »

Embracing the Invisible Workforce

Currently, we are at a crossroads in our workforce when it comes to the care required for those we serve.  Especially when it comes to situations when family members and friends are delivering care upon hospital discharge. There is also the dynamic of the same type of service provided while a loved one is in the hospital and… Read More »

Using Artificial Intelligence in a Manner that is Helpful

In all honesty, I am exhausted over the conversations regarding Artificial Intelligence (AI). It is the latest shiny new object. However, those of us that have been utilizing it are disappointed with the results. This displeasure is occurring for numerous reasons, beginning with the reality that we are early on, in the development of AI for healthcare. Additionally,… Read More »

A Bell-Shaped Curve and Healthcare Grading

Healthcare is brimming with competitive clinicians and administrators. CMS and other “grading” agencies pit us against each other concerning benchmarking, penalties, and value-based payments. But does this methodology promote better patient care? Most of our quality and experience metrics are “graded” on a bell-shaped curve; in other words, how we do, compared to others? This constant analysis leads… Read More »

Do We have the Definition of Diagnosis All Wrong?

Almost daily, there are articles addressing the need for healthcare to be more consumer centric. We envision the topic within the context of service, access, and affordability. Yet, there remains a component that encompasses how we engage those we serve from a clinical perspective. Diagnosing and treating has been the primary focus of clinicians’ training. But, as we… Read More »

How Can We Lower Administrative Costs?

As we continue to focus on healthcare affordability, the topic of administrative waste rises to the forefront of many discussions. These are the costs associated with the delivery of healthcare and its associated payment functions that do not directly impact the outcome of care. Furthermore, one can view these dollars as detrimental to care because they drive up… Read More »

Is Our Need for Choice Driving Up the Cost of Healthcare?

We are a country founded on individual rights. As a society, we have also decided that healthcare is a right of citizenship; we do not permit the denial of care based on one’s ability to pay. Unfortunately, the cost of the administrative components of the healthcare ecosystem is a burden on the overall cost of care. Many of… Read More »

Understanding Virtual Primary Care, And the Value It Brings

As we continue to identify the benefits of telehealth, we must delineate how this form of technology most efficiently impacts primary care services. One can view such digital interventions as either substitutive or additional. If one utilizes an electronic visit instead of an in-person visit, this is an example of substitution. We are now categorizing this modality as… Read More »

Is Evidence-Based Medicine Being Used in Drug Step Therapy?

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 »

Opioid Use disorder, has it improved?

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 »