Future of Health CarePopulation HealthResearch
May 29, 2019

Here’s One Way to Do Better Science

Clinical research with randomized trials (RTs), as opposed to basic or bench research, is the science of comparison. RTs ask a fundamental question: Is “x” better than “y”? They do more than observe how treatments work; they also require methods that control the research environment. Finding an independent contribution of one action over another demands random, stratified populations in order to find truthful differences, as medical care advances on these differences. But the way that patients are typically recruited for RTs can undercut the validity of the study’s findings. I propose we take a different approach, one I call “Gallup…
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Future of Health CareMedical Decision-MakingPopulation HealthValue-Based Health CareWomen and Health Care
March 28, 2019

Women with Autoimmune Diseases Fight Uphill Battle on Every Health Care Front

Our articles on women’s health care issues have focused on areas that must change in order to provide better quality and outcomes, to lower costs, to advance treatment, and to treat women respectfully and equitably as patients and providers. We have demonstrated how women have been sidelined from getting the right health care because of two key systemic obstacles that must be addressed: Cultural bias that prevents accurate clinical assessment of symptoms and diagnosis, adoption or use of protocols relative to women’s biology, and effective health care therapies, and Inadequate basic science and clinical research that will illuminate sex-differentiated biology…
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ACOsFuture of Health CarePopulation HealthValue-Based Health CareWomen and Health Care
March 13, 2019

Women’s Health Research Needs an Infusion: How Health Systems and ACOs Should Help Correct Gender Disparities

Women receive health care that is below par, and the consequences are unnecessary morbidity and death. It is fact, not fiction—borne out by significant data that reveal disparities across many major conditions—that inattention to women’s unique symptoms, risk factors, disease biology and treatment effects are causing harm to women. Despite the reality, a poor body of research exists to point women’s health in the right direction. Value-Based Health Care (VBHC) assumes that we can measure providers’ delivery of health care against clinical standards. What if we don’t even know how half the population exhibits disease or responds to therapies? At…
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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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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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ACOsFuture of Health CarePopulation HealthValue-Based Health Care
November 28, 2018

Can ACO Population Health Solve Patient Engagement?

Personal attitudes inform our strategies for improving patient health. As ACOs move forward in Value-Based Health Care, attitudes about patients and providers set the stage for collaboration or conflict. And with ACOs taking on financial risk for patients, those attitudes and strategies can make the difference between success and failure. As we discussed in a previous post on the importance of involving physicians effectively in population health initiatives, alliances with physicians start with building trust and clinical leadership. Failure to do so will ultimately undercut both the ACO and their patients. So, too, must we be responsive to patients’ needs—not…
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ACOsPopulation HealthValue-Based Health Care
November 14, 2018

How to Involve Physicians Effectively in ACO Population Health

In a recent post, we addressed the many types of population health initiatives and some guidelines for creating the most benefit. Now let’s take a closer look at one of those guidelines: integrating population health into regular or routine care of patients—specifically, with greater involvement and communication by the patients’ physicians. ACOs and their participating physicians have an opportunity to break with the historical obstacles between the physician’s employer organization and the physician, especially in hospital-directed ACOs. Even in physician-led ACOs, working seamlessly with physicians to achieve better health for ACO patients is key to achieving both quality and cost…
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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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Performance ImprovementPersonalized MedicinePopulation HealthRegistry ScienceResearch
August 30, 2016

Personalized Medicine v Population Health: Opposites or Complements?

If personalized medical care is the goal, how does that fit with the concept of “population health,” the darling of the health care industry’s drive toward better results and lower costs? Are these two concepts really at odds, or do they work in tandem? This is not a rhetorical question; in the current environment of keeping costs under control, lives are at stake. How Personalized Medicine Should Work We know that best outcomes occur when individuals are appropriately assessed and allowed to make choices based on their personal characteristics. Personalized medicine is not a concept of averages; it is a…
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ACO ReportingAlternative Payment Models (APM)Future of Health CareMACRAMeaningful UseMerit-Based Incentive Payment System (MIPS)Population HealthPQRS ReportingQualified Clinical Data Registry ReportingValue ModifierValue-Based Health Care
June 7, 2016

Proposed MACRA Rules: Your APM Strategy for Risk Readiness

If you chose not to participate in Medicare ACOs or Bundled Payments in recent years, CMS is planning to change your mind. Proposed MACRA Rules reveal a complex carrot-and-stick approach to inducing providers into risk models. Make no mistake: it’s just a matter of when, not if, you participate in one of the Alternative Payment Models (APMs). It will pay (literally) to begin planning your path to risk now. Here are five important provisions in the Proposed Rules that you need to understand: Full qualification as an Advanced APM earns a 5 percent lump sum bonus, exemption from participation in…
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