Roji Intel Blog

Theresa Hush 0
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Consumers & PatientsFuture of Health CareValue-Based Health CareWomen and Health Care
February 27, 2019

How Gender Discrimination Against Women Physicians Handicaps Value and Patient Care

We need to get women’s health care right. This is not a parochial issue, important only to women, and disconnected from Value-Based Health Care. Gender disparity in health care is real, with significant ramifications for outcomes—for the patients, certainly, as well as for providers’ ability to succeed under risk. Just as quality measurement is necessary to improving quality, achieving the triple aim of quality, cost and patient experience must include both measurement and elimination of gender and gender-race impediments. ACOs and providers accept that they must help patients overcome social attributes of health if those patients are to improve. Yet…
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Theresa Hush 0
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ACOsFuture of Health CareValue-Based Health CareWomen and Health Care
February 20, 2019

Providers, Take Note: Prepare for the Future Health Care of Older Women

Our review of women’s health care has called attention to disparities in risk factors and biological disease differences, treatment variances, and lack of adequate research. Gender and race have obscured perceptions of women’s symptoms, creating delays in diagnoses and treatments and even early death. A serious gap in gender-specific research and gender-analyzed data contributes to this profound lack of understanding of differential biology and treatment options. Even for conditions that are more specific to women, such as breast cancer and maternity, clinical care and research funding is heavy on front-end detection and prevention but fails to focus on women at…
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Robert McNutt, M.D. 0
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Consumers & PatientsFuture of Health CareMedical Decision-MakingResearch
February 13, 2019

If Not Now, It’s Too Late: Clinical Science Needs Fixing

In 1967, the year I graduated from high school, my family’s television required “rabbit ear” antennae with perched aluminum foil. Our farming family had little time to watch TV, but when we did, the ritual included a side trip to reset the antennae’s angle to ensure good reception. Today, I watch a clear picture on myriad devices, no antennae needed. In the 1980s, my trips to a library to find medical literature were few. A single trip to the library would take hours and net only a small number of papers. Now, I obtain articles on any topic in a…
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Theresa Hush 0
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Population HealthRiskValue-Based Health CareWomen and Health Care
February 6, 2019

Higher Risks, Worse Disease, Fewer Choices: Health Care Fails African American Women the Most

No matter how we measure disparity in health care for women in the U.S, African American women stand out. Across the board, they have higher risk factors for disease and poorer outcomes, including much higher mortality for many conditions. African American women contract cardiac disease and cancer at a younger age and, often, in worse forms. Their risk of maternal death after giving birth is three or four times greater. Health care for African American women is complicated by racial and gender prejudices as well as by poverty and inadequate insurance coverage. But even among African American women who are…
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Theresa Hush 1
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Consumers & PatientsFuture of Health CareMedical Decision-MakingWomen and Health Care
January 30, 2019

Lessons in Health Care Empowerment from Women With Breast Cancer

For the one in eight women who will get breast cancer—more than 242,000 new cases were reported in 2015, alone, according to the CDC’s most recent data—the treatment is bad enough. Even more frightening is the uncertainty of what lies ahead. Will the cancer recur? And if so, when, and what’s next? Breast cancer kills 40,000 American women each year. Fear is a powerful motivator, because many women experience a recurrence of disease years after they were declared “cancer free.” Nonetheless, women with breast cancer have created an extraordinary movement that has changed how people see the disease and how…
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Theresa Hush 2
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Future of Health CareValue-Based Health CareWomen and Health Care
January 23, 2019

Silent, Deadly Heart Disease in Women: How Population Health Can Help

Cardiovascular disease (CVD) is the leading cause of death among women. But we hardly talk about it. Indeed, CVD offers a remarkable lesson about complex, broad-based gender disparity that contributes to poorer health care for women. For acute myocardial infarctions (AMI or heart attacks) in particular, sex-specific health risk factors, disease variants tied to gender biology, limited medical research on sex differences in CVD, and cultural attitudes all contribute to the prevalence of heart disease among women—and increased mortality risk. CVD Affects Women Differently Than Men Cardiovascular disease was once assumed to occur predominantly in men rather than women. But…
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Theresa Hush 0
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Consumers & PatientsFuture of Health CareWomen and Health Care
January 16, 2019

The Real Trend to Watch in 2019: #MeToo for Health Care

Health care pundits need to sharpen their game. Year-end trend predictions are mostly old news. Growth of Artificial Intelligence and other technologies, entry of non-traditional business in health care, and pressure on the bottom line from Value-Based Health Care—all have been well underway for several years. Further, these developments only reinforce health care providers’ inward focus on managing internal machinery and health care financing, instead of real health care. But consider this underreported trend that promises to reshape demand and shake up the supply of health care services: We are in the midst of a dramatic transformation of health care…
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Dave Halpert 0
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ACOsAdvanced Alternative Payment ModelsRiskValue-Based Health Care
January 9, 2019

Pathways to Success: How CMS is Encouraging ACO Participation Despite Impending Financial Risk

CMS closed 2018 with a farewell to upside-only ACOs. Perhaps the biggest surprise in the “Pathways to Success” Final ACO Rule is its consistency with the Proposed Rule, which floated the revamped ACO Track back in August. Citing superior performance among two-sided participants, as well as the belief that upside-only tracks reduce patient choice and increase costs, CMS has finalized its proposal to push all ACOs into two-sided arrangements. Not coincidentally, this rule was simultaneously released with NextGen ACO model results, which showed that these 44 downside-risk ACOs saved $164 million. The rule, which will go into effect on July…
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Thomas Dent, M.D. 0
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Future of Health CareMedical EducationPerformance Improvement
December 19, 2018

There’s More to be Learned from Good Results than Bad—and Why It Matters

Becoming a physician requires passing many tests, beginning with premed studies, all the way through residency and, ultimately, board certification. You spend countless hours focused on passing examinations or rotations and learning to avoid pitfalls. As a residency program director, I and my colleagues invested considerable effort to determine which residents were struggling and to develop strategies to help them. We focused on finding deficiencies that would impede them from being excellent physicians. A fellow faculty member ran a Morbidity and Mortality conference that he nicknamed the “boo-boo” conference. This process of identifying and analyzing medical errors produced competitive physicians,…
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Robert McNutt, M.D. 0
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Consumers & PatientsMedical Decision-MakingValue-Based Health Care
December 12, 2018

Conflict of Interest in Medical Practice Is Hardwired: Unless We Acknowledge It, Nothing Will Change

In philosophy class, we were asked to choose which of two children falling out of a boat, unable to swim, should we save. Kant believed all people share the same moral equivalency, and a choice cannot be made to save one or the other based on morality. They must be treated the same. This question was paired with a second question forcing a choice between sacrificing one to save others, or many to save one. Tough moral questions. However, both questions were moot if the one being saved or sacrificed was your child. No matter what moral principle studied, whether…
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