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primary care

Hope for Primary Care … from a Payer? A White Paper on the Collaborative Payer Model

by Tom Doerr, MD and Randy Bak, MD, JD

What if the health care payer were re-imagined as a service to the primary care doctor – supplying the tools, information and funding primary care physicians needed to meet the call to reform health delivery?

The structure of physician payment is considered one of the most problematic aspects of our health care system.  Driven by volume instead of coordinated, proactive care and favoring procedures over cognitive work, the payment system has driven primary […]

Stunning Announcement: AMA Goes to the Dogs in Deal With Physician Web Portal Company

What’s stunning about this deal is who its NOT with.  The AMA chose NOT to partner with any of the incumbent electronic medical record (EMR) companies, e.g., Allscripts, GE, Epic, NextGen, or many others.

For those of you who have not seen earlier posts in this series, please understand that the reference to “goes to the dogs” is a great compliment.

In a joint press release, the American Medical Association and Covisint unveiled an agreement yesterday:

Compuware Corporation (NASDAQ: CPWR) announced today that its Covisint subsidiary signed […]

Stand for Quality Group: “Link HIT Investment to Quality Improvement”

On March 24, Stand for Quality — a new group representing 165 diverse health care organizations — called for a new era of quality in health care. Their white paper is titled Building a Foundation for High Quality, Affordable Health Care: Linking Performance Measurement to Health Reform .

The perspectives of Stand for Quality are a remarkable break from the past and have significant implications for future […]

Landmark Report: “The Promise of Care Coordination” in Medicare

Download a copy here .  Excerpts from the Executive Summary:

Effective Interventions

Three types of interventions have been demonstrated to be effective in reducing hospitalizations for Medicare beneficiaries with multiple chronic conditions who in general are not cognitively impaired:

Transitional care interventions in which patients are first engaged while in the hospital and then followed intensively over the 4 – 6 weeks after discharge
Self-management education interventions that engage patients for 4 -7 weeks in community-based programs designed to “activate” them in […]

Will HITECH Lead to Innovation? The Continuing Cat/Dog Dialogue

Will the recently passed HITECH legislation — the federal stimulus funding for health IT — encourage innovation?  or will it lock in outdated electronic health record (EHR) technology?

It’s a mixed bag — HITECH legislation  is both dog-like (innovative) and catlike (protecting incumbents).  I’ll refresh your memory below on more specific definitions of cats and dogs.

Among many other reasons, HITECH is dog-like primarily because it has ended the question of WHETHER the U.S. is really serious about health IT reform.  HITECH spells out […]

Medical Home “Model” Transmogrifies to: The Medical Home Movement

Part Medical Home 101,  part strategy session to rescue primary care, part revival meeting — the National Medical Home Summit held earlier this week in Philadelphia was an amazing event.

The optimism, energy, and dogged persistence of attendees and presenters was pervasive. The event was standing room only with another 200 people tuning in to a live Internet video cast.

Dr. Joseph Scherger captured the mood of the day when he proclaimed:

The Medical Home “model” has […]

Spider Webs of Care Coordination Networks

We have learned that coordinating care of patients — particular care of Medicare patients — is complex and time consuming for physicians.

A breakthrough study quantifies just how complex and challenging care coordination really is.  The study is reported in the February 17 issue of Annals of Internal Medicine and is entitled Primary Care Physicians’ Links to Other Physicians Through Medicare Patients: The Scope of Care Coordination :

We found that in a single year for just fee-for-service Medicare patients, the typical primary care physician needs […]

How Should Fed HIT Dollars Be Spent? Cat vs. Dog POV.

“Where’s the single best place to get up to speed on how the Feds should  spend $20 billion to advance health information technology (HIT)?”

A colleague asked me this question a couple of days ago, and at first I hesitated.  Then it struck me — Matthew Holt’s The Health Care Blog has become the focal point for discussion of this critical topic.

Matthew’s very recent article — Cats & dogs: Can we find unity on health care IT change? — summarizes the two […]

JAMA Article Asks: What About “The Other Medical Home”?

Dr. Steven H. Landers writes a thoughtful article in today’s JAMA .  He asks why the term Medical Home doesn’t include the patient’s home:

“…the Medical Home initiative, as currently articulated, ironically fails to emphasize the complex chronically ill patient’s actual home. This represents a failure to recognize the profile of the highest-risk beneficiaries driving much of the high Medicare costs—that is those with or more chronic conditions and activity limitations…

“A promising way to strengthen and broaden the Medical Home initiative […]

“The Innovator’s Prescription”: Christensen’s Book Offers Insightful Dx, Unrealistic Rx

by Vince Kuraitis and David C. Kibbe MD, MBA

Being big fans of Clay Christensen and his theory of disruptive innovation (DI), we have been awaiting his just-released book The Innovator’s Prescription: A Disruptive Solution for Healthcare .  The book is co-authored by Dr. Jerome Grossman and Dr. Jason Hwang.

We have mixed reactions.

The book is mistitled. It should have been titled "The Innovator’s Diagnosis". The book does a fantastic job at diagnosis (Dx) of problems in the U.S. health care […]