Recently, a colleague shared an article with me, “The Two Words That Can Make Health Care a Nightmare,” by Chris Stranton, highlighting the challenges posed by prior authorizations (PAs) in healthcare. While I agree that PAs can be problematic, it’s crucial to delve deeper, and consider the broader context surrounding their use. Prior authorizations have long been a… Read More »
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 »
There has been a great deal of focus on whether nonprofit hospitals bring value to the communities they serve in proportion to their tax-exempt status. The argument is that the tax dollars are necessary and properly utilized for community benefit; therefore, a tax-exempt status requires community benefit in replacement of payments. The measure used as a metric for… Read More »
As we focus on improving the care for all, with a lens toward health equity, it’s essential to examine the root causes of health inequities and their existence. And Racism is a contributing factor that has led to our present situation. To progress, we need to have an understanding and commonality of definitions. Referencing a recent article by… Read More »
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 »
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 »
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 »
Last week I shared a post, Understanding and Instilling Trust in Our Patients, today’s post takes a deeper look at how to build that trust between patient and clinician. As we continue to focus on building patient trust, it’s necessary to recognize that one’s own characteristics play a critical role. For those times that we are dealing with… Read More »
As we continue to focus on improving the quality of care we deliver to those we serve, having benchmarks and external comparisons are essential. Granted we all aspire to zero harm; however, we are not here yet. Comparing our improvement to ourselves is laudable but does not give a clear indication of progress. Unquestionably, for those of us… Read More »
As we focus on delivering value, and decreasing waste, clinical appropriateness needs to be considered on a daily basis. Unfortunately, much variation is due to the lack of health care providers following evidence-based guidelines. There are various reasons this occurs, including a lack of consensus between medical societies, ease of disseminating new information when it is published, as… Read More »