Tag Archives: redefining healthcare models

Managed Care and Managed Competition Working in Tandem Can Hold Down Costs

Competition and regulation

As we continue to evaluate the cost of healthcare, two main ideas are gaining traction; managed care and managed competition, both are models designed to enhance value in a market. Defined as patient-centered, managed care coordinates care, thereby providing payment incentives that reward achieving cost, quality, and service measures; thus, offering value-based care, whereas, the managed competition model… Read More »

Have we found The Holy Grail in Artificial Intelligence?

A day rarely ends without Artificial Intelligence (AI) and its vast benefit being discussed in some form or fashion. I am all for technological and mathematical advances; however, one needs to remember that we are early on this journey and we would be better served to avoid the “shiny object syndrome”, meaning chasing after an item merely because… Read More »

Can Spending More on Primary Care Help to Reduce Healthcare Costs?

financial risk in healthcare

Recently, there has been a tremendous amount of focus and thought surrounding the idea that if patients use primary care more frequently, healthcare costs will improve. The thought is if more time is spent on prevention it will decrease the need for additional expensive interventions over time. Simultaneously, there is also conversations surrounding a shortage of primary care… Read More »

How do we Reduce Healthcare Spending Waste to Improve the Value of Care?

Learning from mistakes

In today’s healthcare climate, creating more affordable healthcare services and reducing wasteful spending is the utmost priority. Wastefulness accounts for dollars that are not going towards care, meaning they are affecting the unit price of a service without offering a benefit. According to present conversations surrounding healthcare, the nation’s level of waste is 30% of the overall health… Read More »

The Challenges with the “Not-Invented-Here Syndrome” in Healthcare

As we continue to enhance our care models and desire to deliver on value-based care, exactly how we embrace external disciplines in our pursuit of success is crucial. Often called the “Not-Invented-Here Syndrome,” (NIHS) is a situation where a profession only looks for solutions within the context of their own area of expertise. This condition plagues medicine, limits… Read More »

Why is Screening for Social Determinants Difficult?

In the present age of healthcare, we understand that social determinants play a critical role in health and wellness, as well as influencing our ability to treat illnesses. Those who identify with issues such as food insecurity, intimate partner violence, availability or quality of housing, and the ability to pay for necessities such as utilities like heat and… Read More »

How Can Technology Impact the Ever-Changing Specialty Consultation?

Historically, a specialty consult occurred when a physician desired input and would request a specialist examine the patient either in the hospital or as a referral in the outpatient setting. Frequently, as a primary care physician, I would ask a specialist to opine on a particular patient’s situation or diagnosis. Invariably, this request would generate a discussion regarding… Read More »

Why are Private Insurers Paying a Bigger Portion of Healthcare Costs than Medicare?

There is an ever-widening gap between payments made by private health insurers and those made by the federal government. Between 1996 and 2001, payments made by private insurers were 10% greater than Medicare. By 2012, this difference increased to 75%, meaning Private Insurers are paying the majority of healthcare costs over programs like Medicare and Medicaid. We must… Read More »

Is “the Person” the Missing Component in Medical Education?

If one delves back in history, the fundamental component of medical education is focused on holistic care, meaning, caring for those we serve within the context of body, mind, and spirit. In more recent times, the focus has moved to diagnosing and treating the physiologic condition. However, studies have shown a person’s environment, behavior and lifestyle have a… Read More »

Supporting the Healthcare Workforce of the future

If we plan to evolve our care models to focus on embracing those we serve remaining in their environments of their choice, care givers will need to contain different skill sets than those that provide hospital-based care.  Knowing this, with the current landscape, our ability as providers and health systems is unfortunately, more complacent than we should be… Read More »