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 »
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 »
In our present financial models of healthcare reimbursement, the setup frequently places the physician and their practice staff in a real predicament. Consumers request that they deliver care during their time of need in a reverent and life-giving manner. Additionally, they are required to collect your co-pay and/or co-insurance while simultaneously understanding your benefit plan, including how much… Read More »
As we continue to struggle with vaccination rates, the debate rages over individual rights and the politicization of the present situation. Because of this it is essential to step back and decide upon our goals. Are we attempting to eradicate, eliminate, cohabitate, or conflagrate with the virus? With each of these, the endgame is drastically different. For instance,… Read More »
As value-based payment models have continued to expand, this expansion has occurred in the more affluent communities. Additionally, communities with more socioeconomically vulnerable individuals were less likely to be selected for joint replacement bundles, another form of a value-based payment. A big reason for this lack of equitable distribution of value-based care, can be linked to the absence… Read More »