Subscribe if you want to be notified of new blog posts. You will receive an email confirming your subscription.
Care Providers & Care Coordination
A Medicare Administrator’s “To Do” List: the EHR, Chronic Disease Management, Primary Care….
Let’s drop in on a top Medicare administrator as he reviews his “to do” list over a morning cup of coffee.
TO DO
1) George says everybody’s gotta have an EHR by 2014
tougher than getting a man to the moon in the 60s
stall — G will be gone by then
2) solve chronic disease crisis
chronic disease costs are killing us, 5% of seniors account for 50% of costs
baby boomers hit the fan in 2010
note to self — drop the cheeseburger at lunch
3) solve primary […]
20 Minutes of Questions Won’t Fit into a 7 Minute Doctor Visit
Greetings from Boston. I’ve been attending and speaking at the Inaugural Summit on Behavioral Telehealth: Technology for Behavior Change & Disease Management.
The conference chair is Dr. Steve Locke, Prof. of Psychiatry at Harvard. He opened the meeting yesterday with a thoughtful line of questioning to the audience.
Dr. Locke asked “How many of you audience members have participated in an ‘typical, average’ seven minute visit at one of the new retail doctor clinics?” About 75% of the people in the room raised their […]
European vs U.S. Primary Care: We Have Things Backwards
The status of primary care is dramatically different in Europe vs. the U.S.
While doing background reading, I was startled by the title of a book: “Primary care in the driver’s seat? Organisational reform in European primary care” The book was reviewed in the International Journal of Integrated Care .
Is primary care capable of taking a dominant role in running the whole health care system? This challenging question is what makes this book interesting and takes the debate one step ahead […]
A Founding Father of DM Astonishingly Declares: “My Kid is Ugly”
Al Lewis, one of the founding fathers of DM, has shaped the face of the DM industry probably more than other any single individual. (This is all fine unless you happen to be the person whose face is being shaped by Al.)
Al has been unabashedly pro-DM. Until now. Al writes in a recent article in Managed Healthcare Executive:
Disease management as we now define it may be on its last legs, though no one knows it yet. The Disease Management Purchasing Consortium has noticed that the savings in all […]
Despite Limited Penetration, Integrated Delivery Systems Have Advanced Chronic Care
The 1990’s experiment around development of integrated delivery systems (IDSs) mostly did not take root. This experiment was primarily about financial integration — doctors joining with hospitals so that they could together contract with health insurers for capitated reimbursement, hospitals starting their own health plan, or hospitals buying physician practices as a way of guaranteeing a future base of patients and revenues.
The systems and processes needed jointly to manage financial and clinical risk were an afterthought; information technology was not […]
United’s Move to Fine Physicians: The Other POV
Joe Paduda at the Managed Care Matters blog makes some great counterpoints defending United Health’s moves threatening to fine doctors for making out-of-network lab referrals. I recommend that you read his essay and his readers comments.
In my posting from a couple days ago — Doctors and Health Plans: Can Care Management Opportunities Reconcile the Hatfields and the McCoys? — I picked on United Health Care to make a point. Just to recap, my reasoning is that physicians could (and should) be important partners […]
Doctors and Health Plans: Can Care Management Opportunities Reconcile the Hatfields and the McCoys?
I’m going to try something different in this blog posting. I’d like to introduce a fairly open-ended issue that 1) is of great importance, and 2) is highly debatable. I’ll be the first to admit that my thinking about this is half baked.
Here’s the issue. Over the coming years, will health plans and doctors:
Continue to have adversarial relationship such as they’ve had over the past decades (ala Hatfields v. McCoys, cats v. dogs, oil and water), or
Is there strategic potential for […]
Healthcare Informatics Webinar — Disease Management (DM): Will Providers Seize the Opportunity to Be Back in Charge?
Next Thursday April 12, Dr. Randy Williams and I will jointly be presenting our perspectives in a webinar entitled:.
Disease Management (DM): Will Providers Seize the Opportunity to Be Back in Charge?
Click the link for details about the agenda and registration You can receive a 15% discount by entering the following Promotional Code: 0412VK
AARP On the Fence About Care Coordination Roles
Just in case this particular item hasn’t yet reached the top of your own to read pile, let me bring to your attention recent testimony to the Senate Finance Committee on Medicare Payment of Physician Services.
The testimony was presented on March 1 by Byron Thames, MD, an AARP Board member. With over 35 million members, AARP is the leading nonprofit, nonpartisan membership organization for people age 50 and over in the United States.
Here are my take-away points from Dr. Thames […]
Porter/Teisberg JAMA Article: Out-of-the-Box or Out-of-Touch?
“In theory, there is no difference between theory and reality. In reality, there is.” Yogi Bera
Out-of-the-box thinking is good; out-of-touch thinking is not. Dr. Porter and Teisberg’s (PT’s) recent article in JAMA “How Physicians Can Change the Future of Health Care” is disappointing, unrealistic and dangerous.
Disappointing: Please Answer the Challenges About Why Your Theory isn’t Workable
Unrealistic: Money Does Matter a Lot
Dangerous: Measuring Process in Health Care Does Add Value
What’s so seductive about their writing is that about 90% […]