Tag Archives: Healthcare Quality

Evaluating Quality and Cost Between Medicare Advantage & Traditional Medicare

With enrollment in the Medicare Advantage (MA) program continuing to rise and nearly 50% of all Medicare eligible beneficiaries participating in an MA product, now is the time to evaluate the program’s benefits and possible unintended consequences. Why? A recent study by Landon et al., published in the Journal of the American Medical Association, compared the two programs… Read More »

Patient Satisfaction IS a Quality Metric

As we focus on quality, patient satisfaction continues to be a prominent measure of healthcare experience. In fact, higher patient satisfaction scores seem to correlate with desirable health outcomes. However, the issue arises concerning whether the current clinical care standard does in fact, accurately reflect clinical performance, and does it support efforts to improve the patient experience? A… Read More »

Did the Medicare Bundled Payment Model Decrease Care Quality?

As we continue to focus on value-based payment models, we must always be aware of possible unintended consequences. The Medicare Bundled Payment for Care Improvement Advanced Model (BPCI-A) is a model that has had broad participation since its inception in 2018. It has shown reductions in overall Medicare payments per episode and improvements in clinical outcomes. The question… Read More »

The Role of Healthcare Systems in Supporting Social Safety Nets

Historically, healthcare systems and social safety net providers have worked in parallel to provide care to their constituents. There have been many instances of cross-pollination and mutual support, but this is not the norm, nor is it done in a manner that significantly enhances the value to all involved parties. The need for collaboration in a meaningful way… Read More »

A Bell-Shaped Curve and Healthcare Grading

Healthcare is brimming with competitive clinicians and administrators. CMS and other “grading” agencies pit us against each other concerning benchmarking, penalties, and value-based payments. But does this methodology promote better patient care? Most of our quality and experience metrics are “graded” on a bell-shaped curve; in other words, how we do, compared to others? This constant analysis leads… Read More »

How Can We Lower Administrative Costs?

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 »

Understanding Virtual Primary Care, And the Value It Brings

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 »

When Should We Stop Certain Regulations?

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 »

The Importance of Hope in Patient Care

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 »

Taking a Deeper Look at Inequity within Our Scientific Process

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 »