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 »
As we continue to address health inequities, we must also consider underlying structural issues. If I am to deliver care focusing on equity, the basis for my treatment must be grounded in science. However, if my science is flawed due to underlying systemic biases and flaws in study design, we will never progress. Since inequities are pervasive and… Read More »
In 1973, an article entitled, “Does Race Interfere with the Doctor-Patient Relationship,” was published in the Journal of the American Medical Association. It pointed out systemic biases that impact the care for those in minority groups. Almost 50 years later, have we improved? Though the article delineated a significant amount of attention that addresses health inequities and the… Read More »