A consumer-driven culture shift is emerging in health care that will change the dynamics of health care purchasing decisions and impact providers’ bottom line. It is being fueled by policies that are increasing the share of health care expenses paid by consumers. Benefit plans with higher deductibles and copayments, choices narrowed to providers who demonstrate lower […]
Physicians Aren’t Engaged in Performance Because Measure Results Aren’t Real
According to management guru Peter Drucker, “If you can’t measure it, you can’t fix it.” Quality measurement and reporting have been rooted in similar reasoning. The idea is that we find out what’s wrong, and then we launch programs to improve it. That’s the linear route mapped out by Medicare starting with Meaningful Use, PQRS […]
Can Academic Medical Centers Be a Force for Health Care Reform?
Can Academic Medical Centers (AMCs) survive Value-Based Health Care and its metamorphosis to financial risk? That’s the question many industry watchers have been asking for several years, as margins have slimmed and some university-based programs have sold off their facilities and physician groups to private interests. But a number of economic and policy impacts are […]
How to Evolve MACRA MIPS Quality Reporting for Better Physician and Patient Value
Critics are pushing back against Medicare quality reporting, deeming it burdensome and time-consuming to meet confusing quality measures. One survey asserts that barely a majority feel knowledgeable about MACRA or prepared to achieve long-term success. Indeed, CMS is pulling back on program requirements, with the stated desire of making it easier for physicians. So, here’s […]
The Future of MACRA: Will MIPS Survive?
Will MIPS survive as Medicare’s overarching performance measurement and improvement program for physicians? That’s the question as providers finalize their plans for meeting requirements in 2017 and beyond. MIPS Is in Adjustment Mode MIPS is undergoing a significant transition. How do we know? First, the ink is hardly dry on the huge rewrite of various […]
Narrow Networks and Rationed Health Care, Version 2017
For decades, our nation’s health care system has been highly valued for its bounty. Access to the most advanced technology, surgery and expertise has been a point of pride. The concept of rationing health care, by contrast, has been taboo. We accused the British of rationing in their universal health system when people had to […]
Who Will Fill the Leadership Void in Health Care Reform if MACRA Rolls Back?
Amidst the political cacophony over health care coverage for American consumers, a fundamental question has been relegated to a soundbite: How can we control cost? Everyone (in the industry or participating in the debate) knows that cost drives our health care system problems, including affordable insurance coverage. The fallacy at the heart of all the […]
The Doctor Will See You Now, But Don’t Stay Long or Ask Too Much
Something has been happening with physician medical visits. Maybe I’m just noticing it because my doctor quit and I had to find a new one, which put me on a treadmill of repeat appointments—because, as my new physician told me, she was out of time for our visit. But here’s the rub: Apart from seasonal […]
Can Consumers Help Reduce Rising Costs of Medical Technology?
In years to come, the current health care financial scene may seem like the “good old days” of health care for middle class Americans. Despite escalating consumer costs, proposed cuts in coverage, and an ever-rising cost of care, most Americans can still access health care services. They believe health care will be there for them, […]
Can Consumers Get Essential Information to Make Good Health Care Decisions?
In the rancorous public debate about how to provide health care to Americans—and especially to vulnerable people with higher risks, lower income, or both—there is a common explanation for rising costs: it’s the patients’ fault. According to this argument, we need to stop the “overuse” of health care services by consumers that are causing our […]