Tag Archives: reflection

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 »

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 »

Obesity Continues to Plague our Healthcare Systems

We continue to battle the epidemic of obesity and we have tried countless tactics to impact the ever-growing issue. Unfortunately, effective treatment remains elusive, no matter what models we utilize. Whether it is diets, behavioral modification, or even bariatric surgery, we seem to continue to have a minimal impact. The idea of self-activation and engagement continues to be… Read More »

Violence Prevention IS a Healthcare Initiative

Gun control is a topic fraught with political connotations, however violence prevention is relatively free of it. The health problem of violence presents itself in many forms, including assaults, homicide, suicide, intimate partner violence, child abuse, elder abuse, child and adult bullying, and others. All these injuries and psychological impacts are preventable. Not only is there a human… Read More »

How Can We Improve the Use of Administrative Codes to Measure Quality?

Historically, we have designated administrative codes as methods for reimbursement. However, with the evolution of value-based care, these same codes are now applied for risk stratification for adjustments to value-based payments. This variation of fees is necessary because the degree of illness and complexity drives the clinical needs and, thus, the cost. However, using this methodology has created… Read More »