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 »
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 »
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 »
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 »
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 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 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 »