High-Deductible Health Plans: An Optical Illusion

Do you remember the first time that you ever saw a mirage? For most of us, it was the illusion of a sheet of water on blisteringly hot pavement as we gazed toward the horizon. Now we know that it was the product of refraction, of light bending in the heated air, but the first time we saw it we were sure there was a lake up ahead. From time to time, what may appear to be obvious is really our eyes playing tricks on us. More

Digging into Episode of Care Data to Improve Patient Care

It’s no secret that doctors love data. We love it because it informs which devices we use, our treatment methodologies and how we can improve patient outcomes. And, while the move to value-based care has been a challenge for physicians, I believe the data that is being generated as a result offers an incredible opportunity to advance the quality of care as well as lower costs. A great example of this is the information captured in episodes of care. More

My Conversation with a Physician about the Opioid Epidemic

Consider this statistic: In 2015, the amount of opioids prescribed was enough for every American to be medicated around the clock for three weeks. Say it aloud and your brain will have a hard time accepting what your mouth is telling it. The amount of opioids prescribed was enough for every single American to be medicated around the clock for three weeks. More

The Unintended Consequences of the Orphan Drug Act

If you look up the word “orphan” in the dictionary it is commonly used to convey loss and abandonment. However, when orphan is used in the pharmaceutical industry, it conveys dollar signs. Big dollar signs. The world’s 10 most expensive drugs are all classified as orphan drugs and the orphan drug market is expanding rapidly. Projected worldwide sales are expected to outpace conventional drugs by twofold over the next six years. Moreover, orphan drugs are projected to account... More

CMS Comes UN-bundled?

Admit it. You thought I was going somewhere else with that, didn’t you? To be fair, the agency did say it disagreed “with commenters who suggested that CMS withdraw these models altogether …” More

Improve Patient Experience to Attract and Retain Savvy Consumers

In today’s marketplace, customers increasingly utilize information from other consumers to inform decisions about where to spend their money. With the proliferation of ratings features similar to those of Yelp and Amazon, one bad experience can cost an organization loyal or potential customers and damage its reputation. This is true not only for retail stores and restaurants but for health care systems as well. Offering a superior care experience has become a foundational aspect of an... More

Forecast Calls for a Perfect Storm for Driving the Compensation Revolution

As nationally acclaimed heart and lung transplant surgeon and former Senate Majority Leader Bill Frist once said, “Our nation cannot control runaway medical spending without fundamentally changing how physicians are paid.” It’s true. And with roughly 60% of physicians employed by health systems, productivity and compensation is a top concern for many hospital executives. More

Vote-A-Rama … is a Thing on Capitol Hill

The last time yours truly tried to look into her crystal ball (March 2017) and channel nearly a decade of political and policy gut instinct, the verdict (per a previous blog post) was “that the complete overhaul or ‘repeal and replace’ of the ACA is likely off the table for the foreseeable future.” Six weeks later, on May 4, 2017, the House of Representatives passed the American Health Care Act. It then moved to the Senate.       ... More

Change Compliance Mentality from “Game Over” to “Game On”

“Game over.” It’s the angst clinicians feel as they realize it’s only a matter of time before they see the accreditation surveyors coming through the door. Adding to the angst is the fact that the Centers for Medicare & Medicaid (CMS), as the consumer advocate, is pushing for a more straightforward review by the accreditation organizations, such as CMS’ “see it-cite it” methodology. Instead of accepting 90% as an acceptable opportunity for... More

Hanging Together: Strategies and Practices for Successful Physician Partnerships

Health care reform can be as befuddling as quantum physics. But it has one aspect that’s as easy to understand as a first-grade arithmetic problem: The transition to value-based payments means that hospitals, health systems and physicians must work together as a cohesive team. Or, as Ben Franklin put it to his fellow patriots, “We must all hang together or assuredly we will hang separately.” More