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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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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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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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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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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Consumers & PatientsFuture of Health CarePopulation HealthValue-Based Health Care
December 5, 2018

Should Value-Based Health Care Help Improve Life Expectancy?

As Americans in a highly developed and prosperous economy, we have ascribed a value to our highly sophisticated, expensive health care system—that it should enable us to achieve better health. If we didn’t believe in the value of our health care system, we would not support health coverage, most people would not visit health care providers, and the public health system would not get be funded. This may sound all too obvious, but it isn’t. Whether our health care system actually achieves that ascribed value of improving health status is now in question. Given last week’s release of Center for…
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ACOsConsumers & PatientsPopulation HealthValue-Based Health Care
October 31, 2018

ACO Population Health Best Practices: More Respect for Physicians and Patients

How important is it to agree on principles and best practices for population health? More important than most providers believe, and here’s why: Population health can be a powerful engine for improving patient outcomes and cost performance in Value-Based Health Care. Failure to create a standard of population health practices means that every ACO or health system scrambles independently to create initiatives, without the benefit of broader experience and results. The outcome? ACOs make similar decisions or duplicate others’ programs with meager results. They may also inadvertently consign population health to safer territory as administrative instead of strategic and innovative…
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Consumers & PatientsFuture of Health CareValue-Based Health Care
October 24, 2018

Consumers Want More Value from Value-Based Health Care: Why Providers Need to Listen

The dramatic rise in personal costs for health care services and coverage, sharpened by political battles over affordable care, is driving consumer health care activism to a new level. Voter projections indicate that health care will be the largest single voting issue in the 2018 mid-terms, with 30 percent of voters saying their decisions will depend on where Congressional candidates stand on health care coverage. While there may be a strong partisan split regarding the solution, broad dissatisfaction with the current system crosses party lines. Health care today takes a huge bite out of most Americans’ personal finances. It is now…
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Consumers & PatientsFuture of Health CareMedical Decision-MakingResearchValue-Based Health Care
October 17, 2018

Wise Patients Really Can Make Medical Decisions

“The numbers in this blog are hard to believe. Why is the medical profession recommending shingles vaccine? It is one thing to say that patients should be their own advocates. But why would medical professionals recommend a vaccine to their patient that has such a paltry risk/benefit outcome? After all, we go to doctors because we presume that they know more about medical conditions, prevention and treatment than we do. If they don’t, what’s the point?” A wise patient reading my blog on the shingles vaccine made the above comments. The adjective “wise” has been defined as “able to make good judgments.”…
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ACOsConsumers & PatientsFuture of Health CareValue-Based Health Care
October 10, 2018

Cost Savings Aren’t the Only Objective for ACOs: Growth Matters, Too

Keeping within expenditure limits is a top priority for most ACOs for Medicare. That makes sense. Savings are the main distinguishing feature of an ACO arrangement, as opposed to straight Fee-for-Service reimbursement. ACOs that accept downside risk can’t afford to exceed the expenditure target. It’s in their best interest to create initiatives to cut costs and control expenses—especially for services outside the ACO, such as post-acute care. But a cost strategy only focused on trimming expenses will likely fail the ACO in the long run. Why? Medicare ACOs face an annually decreasing expenditure limit that mandates them to lower costs…
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