Tag Archives: healthcare delivery

Is Our Racial Divide Worsening in Healthcare?

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 »

Should Physician Offices Be Bill Collectors?

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 »

What is our COVID Endgame?

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 »

Healthy Equity is A Critical Part of Value-Based Payment Models

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 »

How Do We Support Primary Care?

Primary care in the United States accounts for more than one-half of all outpatient visits. Moreover, regardless of the clinical models, primary care is at the core. Unquestionably, primary care is at the center of health equity and preventive care. However, it receives a relatively modest proportion of resources, possesses no federal coordinating capacity, no dedicated research support,… Read More »

CMS STARS ratings – It’s Time for a Change

In 2016, the Centers for Medicare and Medicaid Services (CMS) introduced the Overall Hospital Quality Star Rating Program to create transparency on hospitals’ quality, by summarizing dozens of metrics on the Hospital Compare website. There was considerable consternation over the validity of the data. In addition to comparing all hospitals to each other, regardless of unique dynamics, all… Read More »

Understanding the Design Characteristics of Primary Care Capitation

Capitation, as a value-based payment model, has been around for decades. Many of us have experimented with variations of capitation, ranging from full capitation for all healthcare services to specialist capitation, to primary care (PCP) capitation. Currently, Primary Care Clinicians are much more comfortable with the nuances of these models because of the expansion of Medicare Advantage. This… Read More »

Taking a Look at What Causes Low-Value Care

Low-value care is defined as the utilization of health services that harm or in which the costs outweigh the possible benefits and there are many reasons for these actions. The desire for clinicians to eliminate situations that might cause harm is a driving factor. Although they may be unable to inform you of precisely what is occurring in… Read More »

Why Using Social Determinant Metrics in The Hospital Readmission Penalty Calculation Matters?

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 »

Does the Usage of Telemedicine Visits Increase Follow-up Visits?

During the COVID pandemic, in-person visits were not recommended so telemedicine rapidly evolved into an ideal way of delivering care safely and expanding access while reducing exposure to pathogens to both patients and staff. And tremendous enthusiasm exists for the continuation of such a model. There is no doubt that there is a significant enhancement to access with… Read More »