Evaluating Quality and Cost Between Medicare Advantage & Traditional Medicare

With enrollment in the Medicare Advantage (MA) program continuing to rise and nearly 50% of all Medicare eligible beneficiaries participating in an MA product, now is the time to evaluate the program’s benefits and possible unintended consequences. Why? A recent study by Landon et al., published in the Journal of the American Medical Association, compared the two programs… Read More »

Patient Satisfaction IS a Quality Metric

As we focus on quality, patient satisfaction continues to be a prominent measure of healthcare experience. In fact, higher patient satisfaction scores seem to correlate with desirable health outcomes. However, the issue arises concerning whether the current clinical care standard does in fact, accurately reflect clinical performance, and does it support efforts to improve the patient experience? A… Read More »

Obesity Continues to Plague our Healthcare Systems

We continue to battle the epidemic of obesity and we have tried countless tactics to impact the ever-growing issue. Unfortunately, effective treatment remains elusive, no matter what models we utilize. Whether it is diets, behavioral modification, or even bariatric surgery, we seem to continue to have a minimal impact. The idea of self-activation and engagement continues to be… Read More »

“Oh, how I remember the Review of Systems!”

Despite being out of direct patient care since 2006, I still can recite the entire review of systems (ROS) in five seconds flat. In fact, our instructors indoctrinated in us that if this documentation did not occur at every visit, one could not fulfill billing and coding requirements. Of course, this was also not the intended purpose of… Read More »

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 »