- Operations & Quality
Reading the CMS Tea Leaves: What to Watch For in the Future
Acting Centers for Medicare & Medicaid Services (CMS) administrator Andy Slavitt said earlier this year that CMS often can be viewed as a “black box with opaque regulations and limited back and forth about our policy reasoning or our implementati...
- Operations & Quality
New Episode Payment Model Furthers CMS’ Goal for Provider Alignment
Continuing with the effort to build on value-based payments, the recent announcement by the Centers for Medicare & Medicaid Services (CMS) regarding the new Episode Payment Models (EPM) for acute myocardial infarction (AMI) and coronary artery bypass g...
- Operations & Quality
As Your Mother Might Say ... Elections Have Consequences
Consider this your public service announcement for the day: VOTE!
Given the current political climate, I would not presume to enter the debate over which of our presidential candidates should be in the White House come 2017; we could certainly discuss t...
- Operations & Quality
A Hammer, a Chisel and a Bus Token
The news of Dartmouth’s withdrawal from the accountable care organization (ACO) program, as reported in a recent article in The New York Times, caught many by surprise since the ACO model can be traced back to concepts initially proposed by Dartmouth...
- Operations & Quality
Unraveling of the Public Health Insurance Exchange Markets: Now What?
In the early spring, we smelled smoke in the public health insurance exchange markets. There were accounts of consumers stopping payments on their premiums and a few notable insurers were reporting financial losses. Those early signs of smoke have given wa...
- Operations & Quality
Election 2016: The Only Thing Certain is the Uncertainty Ahead
On January 20, 2017, Donald J. Trump will be sworn in as the 45th president of the United States of America. He comes into this role after what many consider to be the greatest political upset in modern day history. The uncertainty ahead that many speak of...
- Operations & Quality
Guns and Butter: Health Care Approaching an Economic Crossroads
Economics is fundamentally about choices. Some choices are relatively easy and others are agonizingly difficult, but in the end, we are faced with making choices. At the root of economic theory is the culprit that forces choices: scarcity.
- Operations & Quality
Ready, Fire, Aim: The Risk of Unintended Consequences
The rapid increase in health insurance deductibles over the last several years is rooted in traditional microeconomic theory: raise the price of a good or service and demand will go down. The price elasticity of demand – that is, the rate at which de...
- Operations & Quality
The “Cures” for What Ails You
The 21st Century Cures Act was signed into law on Dec. 13, 2016. It will, in all likelihood, be the final piece of health care legislation that President Obama will ever sign into law. It will bring to a close the legislative components ofa presidency that...
- Operations & Quality
Penguins and Policy: Listening through the Noise
Emperor penguins congregate on desolate stretches of packed ice in colonies comprised of tens of thousands of birds – some colonies are estimated to reach 50,000 breeding adults. Before an egg hatches, a mating pair alternates between searching for f...
- Operations & Quality
The Difficult Reality of Repealing the ACA
Repealing and replacing the Affordable Care Act (ACA) has been a unifying, and politically potent talking point for Republicans on the campaign trail, since the law was passed nearly seven years ago. Beyond the campaign, opposition to the law in Congress b...
- Operations & Quality
Hamburgers and Health Care: The Power of a Brand
It’s interesting to think about the industrial engineering and almost fanatical insistence on consistency that goes into the production of something as inconsequential as a hamburger or a can of soda, and to contrast that with our tolerance for varia...
- Operations & Quality
The Dust Has Yet to Settle on Health Care Reform
It’s the end of the world as we know it. Buckle up, this is only the beginning. Who knew health care could be so complicated?
- Operations & Quality
Kicking the Can down the Road: Musings from a Farmer’s Market
A few years ago, I ran into an old high school classmate at a Sunday farmer’s market. We were in our mid-50s at the time and he excitedly told me that he was retiring from his teaching job, adding that 30 years was long enough to work and it was time...
- Operations & Quality
Cost Shifting and the Desert Island Paradox
In 1964, an eclectic group of seven strangers set out on what was to be a three-hour sightseeing excursion, only to become shipwrecked on a seemingly deserted island.Through syndication and reruns, the seven hapless castaways of Gilligan’s Island app...
- Operations & Quality
On the Concept of a Good Death
Martin Luther once said, “Every man must do two things alone: he must do his own believing and his own dying.” A number of profound concepts are embedded in that statement, starting with the unavoidable entanglement between beliefs and the proc...
- Operations & Quality
“Free Soloing” Health Care Reform
A few weeks ago, Alex Honnold, the groundbreaking 31-year-old rock climber scaled Yosemite National Park’s El Capitan wall without using ropes or any other safety gear. The astounding, and beyond dangerous, “free solo” climb was viewed by...
- Operations & Quality
Taking It to the Top: Talking to Your Board about Cyber Liability
It’s Thursday afternoon and when you return to your office after lunch, the head of IT is waiting for you. He notifies you the organization has been targeted by a sophisticated foreign phishing attack and over the last two days employees have been cl...
- Operations & Quality
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 t...
- Operations & Quality
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 ...