Tag Archives: reflection

Is it Time to Consider the Value of National Licensure?

In a manner that was not possible during “normal” times, the COVID crisis allowed us to implement much-needed changes and the expansion of virtual care is one of them. In addition to the growth of virtual care, increasing the healthcare workforce during a time of crisis was necessary. In all, 45 states extended licenses to out-of-state practitioners. Currently,… Read More »

How Can We Increase our Utilization of Artificial Intelligence for Clinical Care?

Unfortunately, to date, the utilization of artificial intelligence (AI) to improve and reduce inequities in access, quality, and appropriateness of high-quality diagnosis and care, has remained more of an aspiration than a reality. There are numerous reasons for this situation; the newness of AI, the low sensitivity and specificity of the algorithms, the lack of health equity data… 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 »

How Can We Overcome the Unintended Consequences of Medicare Advantage Expansion?

Since the formation of the Medicare Advantage (MA) program, there has been continuous growth in the number of Medicare beneficiaries that have chosen this model of care. The reasons are numerous. For instance, the pace of growth in the number of company offerings and members has picked up over recent years, and the current projection is that MA… Read More »

Does Telemedicine Really Improve Access in All Neighborhoods?

For many of us, certain technologies, including telemedicine, are viewed in a highly positive light as a methodology to increase access in a consumer-centric manner. However, there are concerns that such technology will potentially increase health disparities because of the lack of broadband access, hardware, and functional literacy. As a result of the pandemic, access to office-based visits… Read More »

Looking into Diagnostic Excellence and Aligning Incentives

There is considerable discussion regarding aligning incentives to lower the total cost of care, and even more specifically, on the importance of diagnostic testing, the value it might bring, its accuracy, and the shared decision-making when ordering tests. Therefore, aligning incentives around appropriate diagnostic testing is critical to both diagnostic excellence and affordability of healthcare. Additionally, an important… Read More »

Determining the Effectiveness of Diagnostic testing

As clinicians, we spend a significant amount of our time attempting to diagnose what is ailing those we treat. And we have an armament of tests to select from and an extensive list of differential diagnoses, ranging from the probable, to the extremely rare yet, potentially fatal. Understanding the effectiveness of our diagnostic tests is important from multiple… Read More »

The Value of Nonprofit Hospitals

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 »

Do Value Based Payment Models Really Work?

For those in the value-based payment (VBP) world, we are constantly asking the question; “Is what we are doing impactful and adding value to quality, service, and costs, to those we serve?” A recent study in Health Affairs analyzed 20 years of commercial VBP studies and found mixed results. And from this information, it’s possible to formulate a… Read More »

A Deeper Look at Structural Racism in US Health Care Policy

Structural racism refers to, “The totality of ways societies foster racial discrimination through mutually reinforcing systems of housing, credit, media, health care, and criminal justice.” One of the leading structural components that has led to the inequitable distribution of health services is healthcare financing, i.e., insurance coverage. Inadequate health insurance coverage is one of the most prevalent barriers… Read More »