As we focus on delivering value-based care; higher quality at a more affordable price, the conversation concerning payment models rapidly pivots to global capitation for a population of lives. The opposite payment model is a fee-for-service model, and currently, there is a belief that service-based fees lead to an over-utilization of services. Consequently, many believe the only possible… Read More »
As we continue to focus on value-based payment models, there is a strong belief that moving away from fee-for-service payments towards a per-patient rate for primary care providers will decrease overall costs. The counter concern is that this may also lead to reduced care because of the financial incentive to avoid services. Primary care providers (PCPs) have the… Read More »
Radiology services play an essential role in value-based care. Yet, some believe that such services fall into the category of cost; however, if we change our perspective, we can consider such activities may elevate the overall value we deliver. In fact, diagnostic radiology can have a clinical benefit because it can help to refine differential diagnoses, define and… 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 continue to focus on value-based care, with special attention put on the social needs of those we serve, how these investments occur becomes paramount. Historically, the buckets of allocated dollars for social needs lived in the public health sector, either by governmental or philanthropic funding. However, as we move towards value-based payment models, other delivery entities… Read More »
Healthcare is an industry where innovation and technology continue to progress and create an opportunity to improve lives. However, the cost of such products continues to rise and thus impacts the overall cost of care. But, suppose one surmises the purpose is to enhance care in a manner that delivers value, i.e., where the expense plays a significant… Read More »
As the healthcare industry continues to focus on value (improved quality and service, and decreased cost), understanding the human dynamics of physician healthcare providers will enhance our ability to drive change. Incentives are foundational, however, money is not always the primary motivator. Behavioral Science postulates that different people respond differently to similar incentives. We know there is a… Read More »
A commonly held premise of shared decision-making is that the healthcare profession neither adequately gives specific treatment options nor discusses the trade-offs of surgical intervention. Predominantly, the thought is that if more in-depth conversations were to occur concerning the trade-offs, and there is more appropriate management of expectations, the chosen solution would be the more conservative approach. With… Read More »
Undeniably, individual rights are foundational to our civil liberties. However, we are also socially minded, meaning thinking beyond individual needs, and therefore, we must bridge this polarity. From a care perspective, these dualities remain in two different verticals,1. medical care/treatment, and 2. public health. For example, when I discuss a condition and treatment options with a patient, the… Read More »
“Hot-spotting” is a method in healthcare to identify areas for intervention. The premise suggests, if I can identify a segment that is responsible for most of a situation and change its trajectory, a positive outcome will occur. This premise is the basis for disease management, and now value-based care concerning social determinants of health. However, a recent randomized… Read More »