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 […]
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 […]
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 […]
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 […]
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 […]
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 […]
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 […]
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 […]
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 […]
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 […]










