How to Make the Most of MACRA Programs in 2018

Many clinicians, myself included, recall CMS’ Sustainable Growth Rate (SGR) formula and Congress’ two decades of intervention to stop reimbursement decreases. In 2015, the Medicare Access and CHIP Reauthorization Act (MACRA) replaced the SGR formula with two tracks to choose from in CMS’ Quality Payment Program: the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs). More

Clinician Communication is Key to Patient Safety

It's 6:45 p.m., near the end of your third 12-hour shift in a row. The night shift will be arriving any second, and then you are off for four days. You decide to round on your patients one final time before report.  More

Malnutrition: 3 Steps to Improving Care in Contemporary Hospitals

In 1974, a groundbreaking article by Dr. Charles E. Butterworth, Jr. described malnutrition as “the skeleton in the hospital closet” because it so often went undetected and untreated. Sadly, more than 40 years later, contemporary authors similarly describe malnutrition as a silent epidemic. Reports today show that 20 to 50% of hospitalized patients are malnourished upon admission. More

Safety Across the Board: An Idea Whose Time Has Come

Patients expect hospitals to be safe places; places of healing, not harm. But those of us in health care know that’s not always the case. Patients experience harm in the course of their care from hospital-acquired conditions (HACs), such as central-line blood stream infections or ventilator-associated pneumonia. The rate of patient harm has been quantified by the Agency for Healthcare Research and Quality as 115 HACs per 1,000 discharges, according to the 2015 Annual Hospital-... More

Solving the MACRA Puzzle: Short-term Tactics and Long-term Strategies

Editor’s note: This post is adapted from an Expert Insight, originally featured on on Feb. 26, 2018. More

Transparency: A Critical Component in Advancing Health Care Improvement

Depending on context, the word transparency has different meanings. Outside the scope of medicine, it conveys a sense of invisibility. In health care – which is built on the scientific method requiring evidence for decision-making – it bespeaks the ability to see into areas that were previously obscured. For administrators and physicians to make change to improve outcomes, they not only need data, but they also need the ability to have transparent compare groups to ensure apples-to... More