Today’s network sizes determined by value

Unfortunately, many of us remember the late 1990s and early 2000s when we used the term “narrow” networks, which were designed to be very narrow to decrease cost by decreasing utilization and trading volume for pricing. They worked. We saw a reduction in spend, but many argued this model withheld needed services. Those of us in these narrow… Read More »

The Fourth Aim

Value-based care must meet both consumer and provider needs As we move to value-based care, we need to think differently around our “workforce.”  Consumers do not look at their need for care as a weekday, 9 to 5 service. They view their needs as 24/7, and thus want access in that same fashion. Illness does not take a… Read More »

Healthcare payment wargames

Drastically changing healthcare landscape turns payment wargames into reality As a kid, I remember watching a movie about how a computer that was simulating a war game went hay wire and almost started World War III. When I attended business school, part of our initial class was a healthcare simulation game where we all represented a different part… Read More »

Life vs. Non-Death: Evaluating quality of life based on patient wishes

Western medicine is focused on diagnosing and treating illnesses.  We have been taught that way, trained that way, and act that way.  Diagnosing accurately and treating appropriately are done in an attempt to prevent early death.  But, if we are successful in preventing untimely death, what have we created? If asked what the opposite of death is, most… Read More »

Diseases of life: Life situations act as barriers to care

Healthcare today has become disease-centric. We not only focus heavily on the biomedical needs of our patients, but we do it from a disease-defining perspective. We have pathways and guidelines that are disease specific, we have specialty clinics that are disease specific, and our treatments are very focused on treating a disease. Working from this disease-based paradigm has… Read More »

Shifting to value-based models can eliminate waste

Over the past many years, there has been a belief that there is harm and waste within our healthcare delivery model. The Institute of Medicine supported these views in their landmark publication. Most reformers believe that one of the causes of these issues is the fact that our payment models have been designed to pay for services, based… Read More »

Words are important: Patient vs. person

“Use your words,” we say to our children when they are young. “Choose your words carefully,” we say to them as they grow. Words are used in the most common modes of communication, spoken and written. Words have specific meaning and, frequently, words are taken out of context. As healthcare continues to evolve, there are two words that… Read More »

Sister, Thank You

I am blessed to work for an organization that was founded on the principles of the Catholic Church. As time has gone on, there has been a direction of turning over the leadership of the organization to lay leaders. As part of my personal growth, I was asked to journal about how I feel as this transition and… Read More »