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 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 »
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 »
As we continue to examine areas of excessive waste to enhance affordability, it’s crucial to put all areas under the microscope, including pharmaceuticals. Though convenient, single-dose injection vials lead to wasted medication. In fact, in 2018, the Centers for Medicaid & Medicare Services (CMS) reportedly paid $725 million for discarded drugs administered in hospital outpatient clinics and physician… 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 »
There is an ongoing debate surrounding the value of public health in this country. We have seen this play out during the COVID pandemic. During this time, a great deal of focus has concentrated on the science and the speed to which new therapies evolved and the rapid development of a new vaccine, honestly nothing short of miraculous.… Read More »
The cost of healthcare in the United States is exorbitant. There are multitudes of reasons for our elevated unit price. Many believe, waste, makes up a significant part of the problem. And the largest component of wasteful spending is what we identify as administrative costs. These are dollars that are not improving patient care, and yet, they impact… Read More »
As we focus on delivering value-based care; higher quality at a more affordable price, the conversation concerning payment models rapidly pivots to global capitation for a population of lives. The opposite payment model is a fee-for-service model, and currently, there is a belief that service-based fees lead to an over-utilization of services. Consequently, many believe the only possible… 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 »
As we continue to grapple with various disease states like obesity and diabetes, which impact a significant number of people, our ability to change human behaviors is minimal. We continuously design interventions that include education and behavioral modification with limited results. In essence, we appear to be attempting to prevent water from streaming out of the hose by… Read More »