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 »
We hear about conflicts of interest on the news all the time. And in medicine, we have addressed this topic in relation to the pharmaceutical industry and its interactions with physicians. As a result, one can now review these connections as part of the ever-increasing desire for transparency. However, as technology progresses, we must also be attuned to… Read More »
Currently, there is an ongoing debate whether Medicare readmission penalty policy is equitable to all hospitals. The greatest argument and concern is the lack of social determinants of health (SDOH) factors in the calculation. Many contend including SDOH is essential to create greater equality amongst the comparisons. In contrast, others do not believe they are impactful or state… Read More »
According to the Center for Disease Control and Prevention, preventive care services can save 100,000 lives a year. Daily, healthcare systems and providers focus on how to deliver primary prevention services best and how to ensure that the coordination of the payment model is providing such care. However, for optimal success to occur, we need to expand our… Read More »
There are several external rating agencies such as CMS STARS, Healthgrades, Leapfrog, and US News and World Report that inform the public concerning the quality of healthcare facilities and physicians. Unfortunately, many of these rating agencies rarely measure the same metrics, so it can be extremely confusing both for the provider and the consumer to decipher. And being… Read More »
With the first month of the New Year nearly behind us, and new transparency regulations becoming law, Healthcare faces increasing challenges when it comes to consumerism. Using such a framework is appropriate as the persons to whom we provide services of our “goods” do “consume” them; however, compared to consumers of other types of products it is not… Read More »
Periodically, there are discussions regarding the critical component of trust in healthcare. Currently, the present pandemic is a prime example of the issue. Some, we observe, inherently trust science; others prefer the approach, I need to distrust you until you prove to me you are trustworthy. A third category proclaims I trust you; however, I must verify the… Read More »
Recently, there is a tremendous amount of focus on the value of social interventions and healthcare costs. To be of optimal help to the greater society, it is important for us to thoroughly understand how to investigate the value of such interventions. In the journal, Health Affairs, a recent study by Kangovi et al. investigates the return on… Read More »
The healthcare market continues to consolidate, which is causing an uptick in Private Equity (PE) investment, particularly in dermatology and ophthalmology. PE firms have a tremendous amount of unspent capital and are seeking diversification of their portfolios. Furthermore, their model is to purchase a large physician practice and then add on medium and smaller groups, usually within the… Read More »
Overall, we focus a considerable amount of time and energy on physician accountability for delivering value to those we serve. However, with consistently increasing costs to the consumer, there is less conversation concerning their responsibility. Currently, there is a societal debate asking what exactly, are the duties of individuals involving their own health and well-being. Undeniably, patients’ behavior… Read More »