Tag Archives: reflection

The Value of Physician Certification Examinations

There is an ongoing debate surrounding the American Board of Internal Medicine’s (ABIM) board certification and recertification programs, particularly regarding costs and overall value. Central to this discussion is a critical question; does passing the initial certification exam translate into better clinical outcomes?  And, does maintaining certification through recertification play a meaningful role in improving patient care? These… Read More »

How will the US Supreme Court’s Decision on the Chevron Deference Impact Healthcare?

The US Supreme Court’s decision on Chevron deference isn’t merely a legal technicality, it’s a potential game-changer for healthcare. The implications could be profound, potentially reshaping healthcare policy and regulation as we know it. This situation warrants our attention and understanding. Congress sets the law of the land and federal agencies were created to implement those laws to… Read More »

Navigating the Future of Medicare Advantage Plans

Recently, Medicare Advantage (MA) plans have surged in popularity, accounting for more than 50% of coverage for Medicare beneficiaries. Consequently, this rise has intensified competition among payors, leading to increasingly aggressive marketing strategies. To thrive in this competitive landscape, MA providers must differentiate their plans. Experience shows that targeting specific demographic segments is an effective strategy, and MA plans are… Read More »

Does Tax Exempt for Hospitals Mean a More Holistic Approach to Community Well-being?

In an era where healthcare expenditure looms large and continues to grow, discussions surrounding non-profit hospitals’ tax-exempt status have gained momentum, triggering conversations to the value communities are receiving in lieu of tax revenue generation.  Hospitals were borne out of the social necessity of where to care for people who are sick when they could not be cared… Read More »

Embracing Human-Centered Care: A Paradigm Shift in Healthcare

In our continual pursuit of delivering enhanced value to those we serve; we are embarking on a transformative journey. One that shifts our approach from a solely physiologic model to one more rooted in understanding human conditions and behavioral economics. Rather than solely educating individuals on their disease states, our focus now lies in activating and engaging them… Read More »

The Importance of Quality Adjusted Life Years (QALY) in Healthcare Policy

In the ever-evolving healthcare landscape, value, defined as the relationship between cost and quality, stands at the forefront of discussions. Measuring the cost-effectiveness and the actual value of medical services and treatments has long been a complex endeavor. Enter the Quality Adjusted Life Year (QALY), a gold standard in assessing the benefits of therapies, which has provided invaluable… Read More »

Navigating the Complex Landscape of Prior Authorizations in Healthcare

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 »

Addressing the Growing Need for a Home Care Workforce

In the evolving healthcare landscape, delivering appropriate care at the right time and location is paramount. However, one important model of care, very often overlooked, is the home care workforce. With the increasing demand for home services, it’s essential to acknowledge the significance of caregivers who provide services in the home. While physicians, nurses, and professional clinicians receive… Read More »

Righting the Wrongs of Risk Based Algorithms

As we continue to address health inequities, understanding how algorithms impact races differently is important. One of these inequities revolves around the racial disparities in kidney disease, with Black individuals experiencing a 2-to-4-fold higher incidence of kidney failure than White individuals. Moreover, Black individuals have faced lower referral rates for pre-dialysis transplant evaluation, post-kidney failure transplants, and placement… Read More »

Diagnostic Errors in the Emergency Department

Receiving accurate care in the Emergency Department (ED) is essential because diagnostic errors can have life-threatening consequences. Let’s first examine the role of care within the Emergency Room. In emergency medicine, time is of the essence, and the focus is often on ensuring patient safety, providing follow-up care, and ruling out immediate harm. However, miscommunication and unmanaged expectations… Read More »