Roji Intel Blog

Thomas Dent, M.D. 0
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Future of Health CareMedical Decision-MakingPerformance ImprovementQualified Clinical Data Registry ReportingValue-Based Health Care
January 17, 2018

Time Out! How Strategic Pauses Can Enhance Medical Decision-Making to Improve Outcomes 

Health care providers are under increasing pressure to improve outcomes for patients with chronic conditions. There is pressure to meet quality measures, to establish programs that improve outcomes, to decrease costs for these conditions (utilization as an outcome)—or a combination of goals. At issue: what works, what is affordable, what is acceptable to patients and clinicians. The answers are elusive because there are many factors involved in the care of patients who have numerous chronic conditions, co-morbidities and medications, as well as multiple healthcare professionals providing their care. Adding to this complexity, any outcomes improvement for patients with chronic conditions…
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Theresa Hush 0
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Future of Health CareMedical Decision-MakingValue-Based Health Care
January 10, 2018

Reining In Medical Costs Might Work If We Could All Agree What “Cost” Means

A few days ago, a couple of providers commented on my recent posts about cost performance improvement in health care. The first of these posts reviewed obstacles to provider strategies for managing costs and how to overcome them, and the second addressed technology that providers would need to both measure and improve performance. One commenter took issue with my statement that providers have not embraced cost reduction because the reimbursement system rewarded growth and more services. Another stated that providers have undertaken cost control for years, and they have invested heavily in accounting and financial systems, as well as aggregation of…
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Theresa Hush 0
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Future of Health CareMedical Decision-MakingPatient EmpowermentValue-Based Health Care
January 3, 2018

Can the New Year Bring A Real Solution to Affordable Health Care–From Providers?

Every New Year, we commence another round of solutions to fix our expensive health care system.  2018 will be no different.  A predicted 5.5 percent increase in medical costs over last year will no doubt spawn new efforts to contain direct payments to providers or transfer costs to consumers—or both. No solution has appeased health system stakeholders, including employers, health plans, consumers and providers. No matter where the system is pinched, another part reacts, and costs continue to outpace inflation. Most solutions, however, have been implemented by payers—government and commercial health plans, as well as employers—against providers and consumers. Why…
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Theresa Hush 0
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Future of Health CareMedical Decision-MakingPatient Empowerment
December 20, 2017

The Crux of Shared Decision-Making: Who Is Actually Deciding?

Shared Decision-Making is an emotionally charged topic for both physicians and patients. Physicians believe they have their patients’ best interests at heart by guiding them into better health through therapies to improve their conditions. Physicians may believe, in fact, that by explaining health status and treatment alternatives (followed by asking the patient to decide), they are already using a Shared Decision-Making process. Patients, in turn, are facing a higher share of costs, yet an ever-worsening health status that requires improvement to avoid financial disaster. Imagine a typical physician-patient discussion about an important medical decision or the path for improving outcomes…
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Theresa Hush 0
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Future of Health CareMedical Decision-MakingPatient EmpowermentPerformance Improvement
December 14, 2017

Is Shared Decision-Making the Path to Improved Provider Performance?

As an escalating percentage of Americans (including children) are diagnosed with diabetes and hypertension, the health care system is straining to control costs and demonstrate good clinical outcomes. No surprise that providers blame patients for lack of compliance with therapies or lifestyle changes that will improve their health status. Hence the uptick—some say warranted—in incentives or penalties assessed by insurers or employers on patients who don’t “behave.” But this punitive finger pointing is neither equitable nor productive. Just as it’s unfair to hold physicians, alone, to be fully accountable for patient outcomes in quality reporting and cost, without giving them…
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Robert McNutt, M.D. 0
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Medical Decision-MakingPatient EmpowermentResearch
December 6, 2017

For Tough Medical Decisions, Hard Choices Require Hard Facts—Not Conventional “Wisdom”

What matters in medical decisions is what we know, not what we think. In the late 1980’s I cared for a pregnant woman with breast cancer. Breast cancer is the most common form of cancer in pregnancy, but uncommon in frequency, occurring in about 1 in 3,000 pregnant women. Providing and receiving treatment is certainly a complex emotional experience; at that time, uncertainty about how to treat was the norm. The woman had a mastectomy but did not take chemotherapy based on concern for her baby. Three months after her delivery, now receiving chemotherapy for her aggressive breast cancer, the…
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Theresa Hush 0
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Clinical Data RegistryFuture of Health CareMedical Decision-MakingValue-Based Health Care
November 15, 2017

Choose the Right Strategies and Technology to Improve Cost Performance in Health Care

Fee for Service (FFS) reimbursement is going the way of the dinosaurs, but many providers are ignoring the signals. Here are two clear indicators: Medicare’s adoption of episodic cost models and the planned movement to financial risk models for both Medicare and Medicaid. Indeed, most Medicaid plans have now transitioned the majority of beneficiaries into managed care plans. Private health plans, many of which were burned by capitated HMO plans in years past, are aligning with providers to develop ACOs and moving again toward risk. Recent health care mergers and acquisitions evidence a blurring of lines between health plans and…
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Theresa Hush 0
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Future of Health CareMACRANarrow NetworksPerformance ImprovementValue-Based Health Care
November 1, 2017

Providers Should Believe in Health Care Cost Control Now—If They Want to Stay in Business

Despite MACRA and other Value-Based Health Care efforts, many health care providers believe that controlling health care costs is impossible to do. They cite lack of comprehensive data about their patients and where they obtain services, and lack of control of patients’ decisions. But the real issue that providers have with cost control is much simpler: Why give up revenues under Fee for Service by reducing volume of services? That system has rewarded them well, fueling the growth of consolidated health systems, technology expansion and purchase of physician practices by ensuring a patient base. Controlling costs is now a relatively…
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Robert McNutt, M.D. 0
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Future of Health CareMedical Decision-MakingPatient Empowerment
October 25, 2017

Medical Treatment Should Be Based on More Than Just “Doing Something”

Memory is malleable. This was made quite clear to me at my recent 50th high school reunion. Despite my fallacious recollections, I could not dispute the data of my forgotten activities, awards and foibles captured in pictures and written comments in my high school yearbook. Then there were the comments about my behaviors “back then,” interpreted or misinterpreted by my former high school comrades. These conversations reinforced for me how difficult it is to correctly intuit the motives and thoughts of others, when my own are occasionally tarnished or refurbished. None of us can truly read another’s mind. Even if…
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Theresa Hush 0
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Patient EmpowermentPerformance Improvement
October 18, 2017

What the Dog Show Taught Me: Performance Improvement Is Not Just Science, But Art

Last week I attended the Bearded Collie Club of America National with my two highly energetic and driven dogs, along with about two hundred other competitors. A calm vacation it was not. My dog athletes enjoyed multiple days of performance competition, capped off by show competition. For people who believe dogs are pets and don’t have emotional lives, let me introduce you to my beardies. They have goals. It’s my job to help them achieve those goals. To do that I need to understand how to get performance, and to improve it. I have learned a lot about meeting goals…
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