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What the Pandemic Taught Us About Value-based Care
By RICHARD ISSACS
You’ll recall that we ran a long piece (pt 1, pt 2) about Medicare Advantage from former Kaiser Permanente CEO George Halvorson earlier this year. Here’s a somewhat related piece from the current head of the Permanente Medical Group about what actually happened there and elsewhere during the pandemic–Matthew Holt
The COVID-19 pandemic has provided important lessons regarding the structure and delivery of health care in the United States, and one of the most significant takeaways has been the need to shift to value-based models of care.
The urgency for this transformation was cle...
Source: The Health Care Blog - February 17, 2022 Category: Consumer Health News Authors: matthew holt Tags: Health Policy Medical Practice Physicians Kaiser Permanente Medicare Advantage Pandemic Richard Isaacs value-based care Source Type: blogs
Reflections on HLTH2021: The Lens of the Patient and Carepartner
By GRACE CORDOVANO
Attending HLTH 2021 in-person in Boston solidified that there is no comparison between attending live vs. virtual conferences. While content and presentations can be solid both virtually or in-person, it is the energy of the connections that are made between scheduled presentations and the conversations that are shared throughout that move the needle. Kudos to the organizers of HLTH 2021 for prioritizing the safety of all in-person attendees with COVID-19 vaccination requirements, proof of negative PCR testing within 3 days of arrival, and mask requirements on-site.
After reflecting on all th...
Source: The Health Care Blog - November 3, 2021 Category: Consumer Health News Authors: Christina Liu Tags: Health Tech Grace Cordovano HLTH Patient advocates patient centered innovation Source Type: blogs
State-Based Marketplaces 2.0 – Part 1: The Coming Expansion in Access, Affordability, and Value
CONCLUSION: LOCAL SOLUTIONS ADVANCING MEANINGFUL REFORM
The ACA gives states the flexibility to implement SBMs and encourage private sector participation. The federal government is responsible for establishing coverage standards, financing subsidies, and operating the HealthCare.gov platform. But it faces some challenges when it comes to innovating.
By contrast, states can be nimble. They can tailor program offerings to meet market demands and dynamics. Factors influencing program design could also include the state’s urban/rural mix, the size of its employer base, the payer mix, social determinants of health, demo...
Source: The Health Care Blog - October 18, 2021 Category: Consumer Health News Authors: Ryan Bose-Roy Tags: Health Policy Obamacare Affordable Care Affordable Care Act American Rescue Plan Biden-Obama Build Back Better Act David W. Johnson Joe Biden Rosmarie Day State-based marketplaces Source Type: blogs
American Primary Care is a Big Waste of Time (When …)
By HANS DUVEFELT
Before Johannes Gutenberg invented the printing press in 1450, books in Europe were copied by hand, mostly by monks and clergy. Ironically, they were often called scribes, the same word we now use for the new class of healthcare workers employed to improve the efficiency of physician documentation.
Think about that for a moment: American doctors are employing almost medieval methods in what is supposed to be the era of computers. Why aren’t we using AI for documentation?
The pathetically cumbersome methods of documentation available (required) for our clinical encounters is only one of several a...
Source: The Health Care Blog - September 27, 2021 Category: Consumer Health News Authors: Christina Liu Tags: Medical Practice Physicians Primary Care Hans Duvefelt Source Type: blogs
Roger Chou ’s Undisclosed Conflicts of Interest: How the CDC’s 2016 Guideline for Prescribing Opioids for Chronic Pain Lost Its Clinical and Professional Integrity
by Chad D. Kollas MD, Terri A. Lewis PhD, Beverly Schechtman and Carrie Judy“I ' m present. Uh … I do have a conflict. I receive funding to conduct reviews on opioids, and I ' ll be recusing myself after the um, director ' s, uh, um, um, uh … update.”- Dr. Roger Chou, Center for Disease Control and Prevention (CDC) National Center for Injury Prevention and Control (NCIPC) Board of Scientific Counselors (BSC) Meeting Friday, July 16, 2021.IntroductionFor those familiar with the controversial relationship between the anti-opioid advocacy group, Physicians for Responsible Opioid Prescribing (PROP, recently renamed, He...
Source: Pallimed: A Hospice and Palliative Medicine Blog - September 17, 2021 Category: Palliative Care Tags: CDC judy kollas lewis opioid pain schechtman Source Type: blogs
Roger Chou s Undisclosed Conflicts of Interest: How the CDCs 2016 Guideline for Prescribing Opioids for Chronic Pain Lost Its Clinical and Professional Integrity
by Chad D. Kollas MD, Terri A. Lewis PhD, Beverly Schechtman and Carrie JudyI ' m present. Uh I do have a conflict. I receive funding to conduct reviews on opioids, and I ' ll be recusing myself after the um, director ' s, uh, um, um, uh update.- Dr. Roger Chou, Center for Disease Control and Prevention (CDC) National Center for Injury Prevention and Control (NCIPC) Board of Scientific Counselors (BSC) Meeting Friday, July 16, 2021.IntroductionFor those familiar with the controversial relationship between the anti-opioid advocacy group, Physicians for Responsible Opioid Prescribing (PROP, recently renamed, Health Pro...
Source: Pallimed: A Hospice and Palliative Medicine Blog - September 17, 2021 Category: Palliative Care Tags: CDC judy kollas lewis opioid pain schechtman Source Type: blogs
George Halvorson HIMSS Changemaker Lifetime Achievement Award Acceptance Speech, Part 2
Former Kaiser Permanente CEO George Halvorson has written on THCB on and off over the years, most notably last year with his proposal for Medicare Advantage for All post-COVID. This month he was given a lifetime achievement award by HIMSS and we are running his acceptance speech in two parts. We ran part one last week, and here’s part two– Matthew Holt
We also initially have an important and continuously improving sense of the epigenetic processes that exist in all of us to develop our own responses to the world we are in at a biological level, and we should be able to use that information to improve ou...
Source: The Health Care Blog - August 23, 2021 Category: Consumer Health News Authors: matthew holt Tags: Health Tech Health Technology Early Childhood Education George Halvorson HIMSS Changemaker Lifetime Achievement Award payment models Source Type: blogs
If Lawmakers Really Want to “Follow the Science” They Will Repeal Codified Opioid Guidelines
This study documents a relationship between opioid prescribing and opioid overdose in a large, national, prospective cohort of individuals receiving opioid therapy for a variety of medical conditions. The risk of opioid overdose should continue to be evaluated relative to the need to reduce pain and suffering and be considered along with other risk factors.University of Alabama Professor of Medicine Stefan Kerteszpointed out thatfollow up research led by Bohnert found the median overdose dosage was 60 MMEs and 86 percent occurred under 90 MMEs. Yet he cautioned policymakers:Reliance on a simple binary dose metric is an ext...
Source: Cato-at-liberty - May 24, 2021 Category: American Health Authors: Jeffrey A. Singer Source Type: blogs
Let ' s Talk About Hospitals And Rural Healthcare (Particularly Mother-Baby Care): My Letter To The NC Government Commission/NC State Treasurer In Support Of Randolph County ' s Application For A Loan To Save Randolph Health
Author ' s Note: The lawyers have a saying, " Res Ipsa Loquitur " " . Translated from Latin, it means, " The thing speaks for itself " . This is the text of the letter I sent to theNC Local Government Commission (embellished with a few links and additional comments in red) . . .in support of the state of North Carolina granting a loan to Randolph County (via the NC Rural Healthcare Stabilization Act) . . . for purposes of assisting in the " rescue " of Asheboro ' s Randolph Health - in a bankruptcy Court-approved buy-out of Randolph ' s assets by American Healthcare Systems, LLC.On May 4th, afte...
Source: Dr.J's HouseCalls - May 7, 2021 Category: American Health Tags: Asheboro Atrium Health Bankruptcy Cone Health Duke Lifepoint LGC Medical Whistle-blower Mother-Baby Care NC Rural Heatlh NCDHHS Non-profit Randolph Health UNC Health Wake Forest Baptist Source Type: blogs
As One Licensed NC Physician To Another Unlicensed One (Dr. Mary Johnson to Dr. Mandy Cohen/NC DHHS Secretary): PROTECT MEDICAL WHISTLEBLOWERS NOW!
Related to mylast post - which went up (after much soul-searching and trepidation) on 2/28/20201 one of the biggest complaints (coming largely from folks reading on mobile phones) was that the post was " so long " . They wanted something more " concise " . The post relates my own horrific pandemic experience with Central Carolina Hospital/ApolloMD and Duke Lifepoint in Sanford, North Carolina. It ' s my third dance as a medical whistle-blower in 23 years. And much like the first two cases (Asheboro in 1998, and ETSU/Ballad Health in 2017), it ' s really NOT " soundbite " material (it would ...
Source: Dr.J's HouseCalls - March 4, 2021 Category: American Health Tags: ApolloMD Central Carolina Hospital CMS Dr. Seuss Duke Lifepoint HIPAA Mandy Cohen Medicaid Medical Whistleblower NCDHHS Pandemic Pediatric Hospitalist Source Type: blogs
A North Carolina Pediatric Hospitalist Tells Her Pandemic Story to Senator Richard Burr: Thirteen Months (And Counting) In Medical Whistle-blower Hell - Courtesy Of Private Equity/For-Profit Healthcare And Cruelly-Indifferent/Morally-Bankrupt State & Federal Oversight
Author ' s Note: I cannot " sound-bite " the last year - and perhaps it ' s time to write the book. Scroll about half-way down to read the letter to Senator Burr. The bottom line is that for thethird time in 23 years, as a Pediatrician staffing a community hospital, I was fired " with-out cause " immediately after intervening in a neonatal ( " bad baby " ) case, rescuing the situation/ " saving " the baby, and reporting it INTERNALLY to Peer Review. NO discussion. NO recourse. NO review. A total cover-up. And EVERY SINGLE TIME I ' ve asked the state/Federal government to enfor...
Source: Dr.J's HouseCalls - February 28, 2021 Category: American Health Tags: ACA Apollo Global Management ApolloMD Ballad Heath Central Carolina Hospital CMS Duke Lifepoint ETSU Medicaid Medical Whistleblower NCDHHS Pandemic Quality Assruance Randolph Health Richard Burr Trump Source Type: blogs
Quality in Healthcare: Cultural Competence, Diagnostic Accuracy or Patronizing Insensitivity?
By HANS DUVEFELT
I sometimes tell patients “I work for the government”, but sometimes I say the opposite, “I work for you”.
Herein lies a dichotomy that is eating away at primary care in this country, like a slow growing cancer. I suspect everybody is aware of it, but it seems nobody has the inclination to deal with it.
2020 exposed how differently Americans view and prioritize things like personal freedom and public safety. We have also seen how vastly different perceptions of reality suddenly exist about what constitutes medical facts. Alternative facts and fake news are suddenly household concepts.
F...
Source: The Health Care Blog - January 4, 2021 Category: Consumer Health News Authors: Christina Liu Tags: Medical Practice Physicians Primary Care Source Type: blogs
CRAZY AMERICA: Health Insurance Covers Testing When You Are Well But Not When You Are Sick
By HANS DUVEFELT
Insurance is the wrong word for what we have here. Our private health insurance system’s prioritization of sometimes frivolous screenings but non-coverage for common illnesses and emergencies is a travesty and an insult to typical American middle class families.
State Medicaid insurance for the underemployed has minimal copays of just a few dollars for doctor visits and medications. From my vantage point as a physician, it is the best insurance a patient can have. They cover almost everything and it is clear to me how to apply for exceptions or follow their step care requirements. I cannot...
Source: The Health Care Blog - December 9, 2020 Category: Consumer Health News Authors: Christina Liu Tags: Medical Practice Physicians Source Type: blogs
What Will Shape Joe Biden ’s Health Care Agenda?
I’m thrilled to have health futurist Jeff Goldsmith back on THCB, and given Biden was only confirmed as President-elect this morning, his article on what to expect is extremely timely!–Matthew Holt
By JEFF GOLDSMITH
The Trump administration’s health care journey began with a trillion dollar near miss–the failed Repeal and Replacement of ObamaCare- and ended with a full-on train wreck, the catastrophically mismanaged COVID epidemic that will have claimed 300,000 lives by the time he leaves office. After four years of posturing and lethal incompetence, it will be a relief to see caring and pr...
Source: The Health Care Blog - November 7, 2020 Category: Consumer Health News Authors: matthew holt Tags: Health Policy OP-ED Politics THCB ACA Biden Jeff Goldsmith States Unions Source Type: blogs
Election Issue Spotlight: “Junk” Insurance Makes a Pandemic Even Worse
By ROSEMARIE DAY and NIKO LEHMAN-WHITE
One of the most important responsibilities of the American government is to protect its citizens from harmful industry practices, from lead poisoning to dangerous pharmaceuticals to financial meltdowns. Its record is far from perfect, but government regulators usually act in good faith and in turn earn the trust of those they protect. As we head into Tuesday’s election, it’s important to shine a spotlight on the fact that the Trump administration has betrayed that trust yet again. They have allowed low-quality, unregulated forms of insurance called Short-Term Limited Du...
Source: The Health Care Blog - October 30, 2020 Category: Consumer Health News Authors: Christina Liu Tags: Health Policy Politics election 2020 Health insurance niko lehman-white rosemarie day Source Type: blogs
