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Last week, I had the immense privilege of interviewing Dr. Vivek Murthy, the U.S. Surgeon General under President Biden, and a long-time personal…
Last week, I had the immense privilege of interviewing Dr. Vivek Murthy, the U.S. Surgeon General under President Biden, and a long-time personal…
Liked by Vivek Murthy
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Today, Steward Health Care welcomes as many as 4,500 team members to the Steward family with the news that we are acquiring FIVE hospitals in South…
Today, Steward Health Care welcomes as many as 4,500 team members to the Steward family with the news that we are acquiring FIVE hospitals in South…
Liked by Vivek Murthy
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I'm deeply grateful to be confirmed by the Senate to serve once again as your Surgeon General. We have endured extraordinary hardship as a nation…
I'm deeply grateful to be confirmed by the Senate to serve once again as your Surgeon General. We have endured extraordinary hardship as a nation…
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What a gift to speak with Dr. Tara Narula about how to rebuild community and connection as we recover from the pandemic. If we want to address the…
What a gift to speak with Dr. Tara Narula about how to rebuild community and connection as we recover from the pandemic. If we want to address the…
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I never dreamed I’d have the honor to once again serve as Surgeon General. In this moment of crisis, I’m grateful for the opportunity to help end…
I never dreamed I’d have the honor to once again serve as Surgeon General. In this moment of crisis, I’m grateful for the opportunity to help end…
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Thinking of these words today....and hoping all of us find many more moments of being home. Home You don’t have to be each wonderful person you…
Thinking of these words today....and hoping all of us find many more moments of being home. Home You don’t have to be each wonderful person you…
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Al Bagocius
In the Age of Google, anyone can find, or provide "answers.” Asking the right question is a rare skill and reveals a more intimate comprehension of the problem and its associated issues. My friend and retired healthcare colleague from Temple University, Jay Armstrong once told me… “I don't judge intelligence or capability by the answers given, I judge them by the questions that are asked..." Jay’s comment provides me with a timely segue to a book entitled, “Critical Thinking, Logic & Problem Solving: The Complete Guide to Superior Thinking, Systematic Problem Solving, Making Outstanding Decisions, and Uncover Logical Fallacies Like a Pro” available on Amazon @ https://lnkd.in/ed6Ytz_K One reviewer, Natali, writes this about the book… This book has been a life-changing discovery for me. Packed with powerful tools, it lays out a systematic approach not just for critical thinking and problem-solving but also for effectively communicating ideas. It's rare to find a resource that tackles these areas with such depth and practicality. Initially, I bought it for personal growth, aiming to sharpen my own critical thinking, decision making and communication skills. However, as I went deeper into the chapters, I realized the immense value it holds for teaching these essential skills to my kids. The methodologies and exercises presented are so accessible and engaging that I've decided to incorporate them into our learning routine at home. What makes this book stand out is its comprehensive approach. It doesn't just focus on one aspect of critical thinking but covers a wide array, including how to articulate ideas clearly and persuasively. This is a skill set that I believe is invaluable for the future generation, preparing them not just academically but for real-world challenges. This book is a treasure trove of knowledge, but I find myself wishing for more. If there were live training sessions or a course offered by the authors, to dive even deeper into the concepts and practice them in a more interactive setting, it would be the perfect complement to the learning experience the book provides. Such a program would offer a fantastic opportunity to reinforce the book's teachings and engage with a community of like-minded learners and experts. This book has not only been a great investment for my personal development but also a resource I'm eager to share with my kids. #templeuniversity #question #google
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Jonathan Goldfinger
Congressional efforts to get low-income Black and indigenous mothers equitable care via Medicaid covering doulas & midwives, while progress, must also advance outcomes-focused, team-based pay to address low Medicaid rates. Since California led the nation putting out our Medicaid doula benefit, I have heard many concerns about how this workforce can get paid in aggregate more than OB’s. We’ve heard infighting between OB’s, midwives, and doulas shift from concerns about competency and scope of practice to a more divisive issue - is everyone getting theirs. The solution seems simple enough - recognize the value of all professionals by paying for healthy, safe births for mamas and babies, that include all team members available and coordinating. Stop simply paying for x service or y team member only. If we focus on outcomes AND who’s on the payroll, health professionals, hospitals and health systems will eventually identify the right combination of team members for a given scenario and work to improve team dynamics. Outcomes and pay rates need to be risk stratified by a transparent, data-driven system that acknowledges that OB’s are necessary for more complex cases, and the highest risk even need OB subspecialists in Maternal-Fetal Medicine. We’ve been hoping such population focused analytics and risk tiering will come from DHCS’ Population Health Management “Service” and the new ECM Birth Equity Cohort. Pay also needs to account for ALL perinatal outpatient care (and perhaps well-child care if we’re being lifecourse, dyadic, “no wrong door” care oriented) to limit overpaying for costly hospital care by comparison, which today still incentivizes c-sections over preventive services. So what keeps perinatal and obstetric care from advancing value-based, team-based pay? Is it the lobby of one group over another? Ongoing infighting that makes the teamwork needed, to prove outcomes-based, team-based pay feasible, too difficult? Or perhaps the myopic limitations of our mindsets in healthcare, where we are conditioned to seek just one solution for every problem - pay driven by either outcomes or team members. Not both. No way. Not possible?! 🧐 Would love to hear from all you experts out there on this complicated healthcare financing issue fundamentally still keeping birth equity at bay, regardless of what workforce we promote today or tomorrow. What are the most promising financial reforms ahead in this space and what makes them so special? #maternalhealthequity needs #datadriven #payparity.
102 Comments -
Chris Deacon
We know that private equity (PE) in healthcare is increasingly coming under fire, and with good reason. But vilifying PE in healthcare for the sake of villifying PE, without actually backing up criticisms with real data and concrete examples of the harm caused, is not necessarily valuable. So, here is some data as well as concrete examples. In 2023 alone, a shocking 21% of healthcare company bankruptcies were tied to these financial predators. PE bankruptcies in healthcare have exploded 112% in five years. PE firms buy healthcare companies, saddle them with unsustainable debt, strip their assets, and when these companies inevitably collapse under financial strain, they leave chaos in their wake—job losses, diminished care, and shuttered facilities. These are not victimless crimes. Envision Healthcare, owned by KKR, crumbled into bankruptcy, displacing thousands of employees and compromising crucial medical services. The Center for Autism and Related Disorders, swallowed up by Blackstone, went bankrupt, abruptly cutting off services for countless vulnerable patients. PE ownership was linked to 20,000 premature deaths in nursing homes over 12 years, according to the National Bureau of Economic Research. These are not isolated incidents but patterns of a systematic onslaught on healthcare by PEs relentless rapacity. The infuriating reality is that while healthcare companies buckle under excessive debt, PE moguls make billions by exploiting various financial strategies to maximize their profits. Dividend recapitalizations (loading companies with debt to fund dividends back to the PE firm), increases returns but also company debt. They also exploit interest deductibility to lower taxable income by deducting interest on borrowed funds. Management and monitoring fees are extracted as additional revenue streams, often prioritizing them over other company needs. PE firms asset strip, often leasing back valuable assets in order to extract cash while saddling the company with ongoing lease payments. Lastly, they use the step-up in basis tax provision to reduce capital gains taxes on assets sold, by resetting their tax value at the time of purchase. These maneuvers illustrate how PE firms legally manipulate financial and tax rules, often to the detriment of the companies they acquire. Abuse of the bankruptcy system isa the final exploit, a calculated escape hatch that allows them to walk away unscathed while the companies, employees, and patients they've burdened suffer the consequences. In many cases, and in increasing frequency, PE firms profit from their financial engineering while leaving behind a trail of human and economic devastation.
27456 Comments -
Thomas Rocco, Jr., MD
You Can Thank Private Equity for That Enormous Doctor’s Bill Consolidation is as American as apple pie (think Walmart, Home Depot, etc) Years of dealmaking has led to sprawling hospital systems, vertically integrated health insurance companies, and highly concentrated private equity-owned practices resulting in diminished competition and even the closure of vital health facilities. As this WSJ 'Heard on the Street' series will show, the rich rewards and lax oversight ultimately create pain for both patients and the doctors who treat them. Belatedly, state and federal regulators and lawmakers are zeroing in on consolidation, creating uncertainty for the investors who have long profited from the healthcare merger boom. Consider the impact of massive private-equity investment in medical practices. When a patient with employer-based insurance goes under for surgery, the anesthesiologist’s fee is supposed to be determined by market forces. But what happens if one firm quietly buys out several anesthesiologists in the same city and then hikes the price of the procedure? Such a scheme was allegedly implemented by the private-equity firm Welsh, Carson, Anderson & Stowe and the company it created in 2012, U.S. Anesthesia Partners, according to a Federal Trade Commission lawsuit filed last year. It started by buying the largest practice in Houston and then making three further acquisitions, eventually expanding into other cities throughout the state of Texas. In each location, the lawsuit alleges, USAP pursued an aggressive strategy of eliminating competitors by either acquiring them or conspiring with them to weaken competition. As one insurance executive put it in the FTC lawsuit, USAP and Welsh Carson used acquisitions to “take the highest rate of all…and then peanut butter spread that across the entire state of Texas." Over the past decade, private equity has spent hundreds of billions of dollars acquiring healthcare businesses from emergency care to anesthesiology to nursing homes. Where private equity has gone, studies show, prices have tended to increase. In the U.S., many doctors used to work for physician-owned businesses. These days, about three-quarters work for a hospital or a corporate owner. As for your hospital, a private-equity firm or a larger medical system probably owns it. And this may not be good news for you, the patient, or your family members. The first in a three-part WSJ 'Heard on the Street' series on concentration in American healthcare
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Joseph A. Rodriguez, DNAP, CRNA
Private equity has a role, but too often, it's exploiting healthcare. The WSJ highlights how these firms inflate costs, impacting patients and providers alike. In anesthesia, we witness this daily. We must champion investments that prioritize patient care over profit margins. It's time for leadership that demands ethical practices and safeguards our profession from those looking to make a quick buck. https://lnkd.in/e_akBuWV #Leadership #Anesthesia #Healthcare #PrivateEquity #EthicalInvesting
171 Comment -
Dr. Kedar Mate
If we want to see long-term investment in improving #HealthEquity, it can't only be done through short-term #grant programs from foundations. It has to be done through long-term payment policy that seeks to create lasting and durable financial flows toward specific equity-focused strategic objectives. With this in mind, it’s great to see Boston Children's Hospital join Blue Cross Blue Shield of Massachusetts’ pay-for-equity financial payment model! https://bit.ly/3wqqDaM Many aspects of BCBSMA’s pay-for-equity model are crucial to building sustainable improvements in equity, but one of the most notable is that it is driven by data. BCBSMA has helped set its health system partners up for success by investing in data that helps identify where equity gaps exist in key performance areas. New data collection systems gather better information from patient populations on race, ethnicity, language, sexual orientation, and gender identity. BCBSMA team members use this information to create public health equity report cards for some of the largest health systems in Massachusetts, as well as report cards for individual health systems. Individual report cards help organizations understand how they compare on specific measures relative to their peers. With better and more refined data, providers and payers can see and tackle opportunities for improvement with greater clarity. It’s been an honor for IHI to help BCBSMA advance its health equity journey. Congrats to them, Boston Children’s, and everyone out there that’s committing their time, talent, and resources to achieving more equitable outcomes.
14810 Comments -
Cameron Cobb, MSW
If you're interested in learning more about U.S. healthcare prices, Marty Makary M.D., M.P.H. book, The Price We Pay: What Broke American Health Care and How to Fix It, explores the underlying issues and provides solutions for reform. A few key points I found interesting include the minimal price transparency many healthcare providers offer, the vast range of prices air transportation companies can charge, and how group purchasing organizations (GPOs) and pharmacy benefits managers (PBMs) can inflate prices and pass those on to consumers. One memorable quote: “It’s ironic that the federal government already has a mandatory disclosure rule for the real out-of-pocket costs people incur at a vulnerable time in their lives. But it’s not a rule for health care—it’s for funeral homes. The Funeral Rule, enacted by the Federal Trade Commission in 1984, requires funeral providers to offer itemized pricing information to consumers before they purchase any services. The rationale is that consumers in a distressing situation should have honest pricing information, a rule that should also apply to the living, not just the dead.”
9210 Comments -
Jonah Feldman MD, FACP
Thanks to Becker's Healthcare for covering our recent NEJM Catalyst paper on using #AI and #GPT4 to scale quality improvement for physician notes across a large healthcare organization. 👉 Check out the link to the NEJM paper in the comments below! Some key reflections: 🔆 We are about to enter a time when the way we write physician notes is going to undergo a drastic change. 🔍 Our findings suggest that AI can play a role not only in reducing documentation burden but also in measuring the impact of large scale changes to documentation processes. 📊 Peter Drucker once said, “What gets measured gets managed.” The truth is that doctors’ notes have never really been measured or managed outside of billing and coding concerns. 🚀 As a #healthtech community, we are privileged to be living in an amazing age of innovation. 💡 Generative AI has the potential to not only change the way we provision care but also change the way we measure care quality and give feedback to drive improvement. 🛠️ Let’s make sure that for this wave of change we develop and implement tools to reduce the burden of documentation while at the same time measuring improvement for care quality. 👀 See the comments for the direct link to read our full article and offer your own reflections!!! - Feldman, J., Hochman, K., Guzman, B. V., Goodman, A., Weisstuch, J., & Testa, P. (2024). Scaling Note Quality Assessment Across an Academic Medical Center with AI and GPT-4. NEJM Catalyst Innovations in Care Delivery, 5(5), CAT-23.
8512 Comments -
Edwin F. Estévez
Health equity doesn’t exist in any state in the Union. Disparities are often manifested by non-medical drivers fueled by political determinants. Systemically, value-based care is meant to address these. Inherently, VBC frameworks are architecturally designed to close these gaps. Sadly, we are far from it as economic and payment models still incentivize services for isolated fees. It’s time for change! How? What do you think it’s needed? While progress is underway, what changes are still missing?
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Al Bagocius
Bruce Fischer writes a good thread to thwart off what I call “BRT” Broken Record Thinking in his thread entitled, “How to Generate Ideas” @ https://lnkd.in/eupBNiTd Here’s a snippet… We all are born with curiosity. It’s essential in helping us adapt to the world. Then it is subtly discouraged by a “system” that promotes the status quo. That needs to be resisted. Be observant and ask questions. Listen to others with different perspectives. Experiment and test your ideas. Be persistent. Why is it that some people seem to have lots of ideas and others don’t? If you feel like you struggle to generate ideas, there are a few simple techniques that can help transform you into an “idea person.” We call the process of coming up with new concepts “ideation.” Ideation is the generation of ideas. Ideas become innovations when they are successfully implemented. Innovations improve our quality of life and entrepreneurs create jobs by commercializing them. Here are some ways to ideate: Ask questions Write Your Ideas Down: Think Associatively: Put Ideas to the Test: Persistence is a key attribute of a creative person. Creativity propels innovation and offers great rewards. Societies and organizations need to encourage innovation. That is the reason for a historic abundance of innovation in the United States. Our patent laws and economic system draw innovators from abroad. The US continues to be a place where ideas are supported more than in other parts of the world. You Generated an Idea. Now What? Most serial innovators and other creative people have a technique for monitoring their progress. They have goals for certain innovative output. My recommendation is to set a quantitative goal that is challenging but attainable. The more ideas you come up with the more likely you are to get some that are useful. Very few significant ideas are ready to be implemented at first blush. They invariably need to be modified, even during implementation. Ideation should be an ongoing process. Often the best goal is to expect continuous improvement. A certain amount of time set aside daily for ideation will help to maintain your focus on innovation. What motivates most creative people is the joy of discovery in the pursuit of something they are passionate about. Know the difference between a setback and a failure. Ideation rarely fails. When an idea is not sufficient it almost always is a link to a new possibility. Stay on the trail. Approach the idea from another angle for a different perspective. Appreciate simplicity. And always observe. The only way you can fail is if you quit! Try Something New Set goals for your creative efforts. What idea(s) did you have last week? When you keep track of your progress, it will be evident if you are getting results. Then act. Ideas are just dreams until you implement them. Make your dreams come true!
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Laura Cooley, PhD
How can we improve patient experience in primary care in the midst of immense constraints? Recent conversations highlight the extreme need to transform our primary care model, which is a critical pathway to enable better experiences and outcomes for primary care patients, families, and providers. For example see: 💡 Zeev Neuwirth, MD https://lnkd.in/eBiZ6Ewm and a featured editorial posted by 💡💡Barbra Rabson https://lnkd.in/ehD-iKCE While the immense constraints in primary care delivery models are far from "simple", the featured article below offers "14 Simple Tips" on Patient Experience (published by The Journal of The American Academy of Family Physicians ). Article Highlights: 👉 A positive patient experience is the result of multiple factors and interactions throughout the patient journey. 👉Physicians and their teams can improve the patient experience through practical steps, such as expanding visit options, using pre-visit planning to keep visits organized, and involving patients in their care decisions. 👉To improve visits, try simple strategies such as sitting down, avoiding medical jargon, providing visit summaries, and using the “teachback” technique. Morcomb EF, Schlecht KA, Malone E 3rd. Improving the Patient Experience: 14 Tips. Fam Pract Manag. 2022 Mar-Apr;29(2):27-31. PMID: 35290007. **** The Patient Experience Symposium will feature a robust #PrimaryCare track in Boston Sept 16-18, 2024. www.PatientSymposium.com Learn from Susan Edgman-Levitan , Zeev Neuwirth, MD and Barbra Rabson and many other primary care experts advocating for improved primary care experiences for all. See the lastest post about the track here: https://lnkd.in/etb7rk8M The Journal of Patient Experience is a proud partner of the event. #PatientExperience #PrimaryCare #HealthcareExperience #ValueBasedHealthCare
655 Comments -
Sandy Scott, FACHE, MPA
Physicians have some of the best knowledge, experience and perspective to actually fix our broken healthcare system. Here's Dr. Jason Johnson describing his experience leading clinicians on the Horn of Africa, which includes themes I hear from physician leaders every day. I believe part of his success is predicated on his ability to embody the following: - Oscillating between visionary thinking and gritty execution - Focusing on his sphere of influence - Making decisions in alignment with his core values and personal "why" - Appreciating his own natural creativity and resourcefulness - Mastering his inner world as the missing key to success Which is why I believe stagnant healthcare systems will be revolutionized not by traditionalists, but by adaptive clinical leaders. #healthcare #medicine #leadership
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Jonathan Goldfinger
It's wild to think in 2024 we're FIRST seeing the DOJ accuse telemedicine conglomerates of criminal drug distribution. How long have we known about these practices in brick and mortar care...? Answer: decades! Take it from someone who prescribed stimulants and other psychotropics to kids over the years - painstakingly measuring and documenting the need and impact - these appalling abuses by Done and Cerebral mean we need more calls for thoughtful pause when it comes to working with startups. Particularly about funding's role - my favorite topic! 🤑 How did we end up with venture capital and PE financing in healthcare that risk the safety of kids in the name of exorbitant returns? Not that all VC or PE dollars are bad, of course, but they're certainly key drivers who shouldn't be in that seat. Did we underestimate these funders as 'barbarians at the gate', much like the pharma reps of the 90's and early 2000's heyday? Have we not learned from Purdue Pharma's aggressive and deadly Oxoycontin marketing? Purdue pleaded guilty to criminal charges and paid $600 million in fines in 2007. Or TAP Pharmaceutical Products's Lupron kickback scheme for the prostate cancer drug? TAP also pleaded guilty to criminal charges and paid $875 million in fines in 2001. Or Pfizer marketing Neurontin, an anti-seizure drug, for off-label uses, such as treating pain and bipolar disorder, even though the drug was not approved for these purposes, and paying physicians kickbacks. In 2004, Pfizer pleaded guilty to criminal charges and paid $430 million in fines. Cerebral and Done's playbooks were practically the same thing, just with a modern mid-pandemic, low-regulatory scrutiny, digital-platform twist. Will appropriate regulation ever outpace American venture greed? Is it even possible to ensure patient safety AHEAD of tragedies driven by the intersection of innovation and venture funding? If you're keeping score, healthcare regulatory reactivity: 1 million. Healthcare ounces of smartly preventive policy: 3. Blech. 😖 When will we finally own that prevention in-house? #healthcare #overdoseprevention #suicideprevention
66 Comments -
Ann Kempski
More #Medicaid hospital provider taxes and state directed payments to hospitals are coming, confirming my concern that CMS has let this get way out of hand. #Delaware (my home state), one of the few states that doesn't yet have a hospital tax, is enacting legislation (SB 13) to levy a 3.58% tax on acute care hospitals. #NorthCarolina, which raised its hospital provider tax last year to near 6% and now pays hospitals commercial level rates, is considering a bill that would extend the tax to psychiatric hospitals. It seems like a no-brainer--"free" federal matching dollars--but it inflates hospital and health system costs, feeds bloated bureaucracies and increases market power. Worst of all, it overpays hospitals relative to other more important Medicaid services, reinforcing inequities and leaving primary care and community long-term care and behavioral health underfunded and communities underserved. It's a kind of re-institutionalization, with facility-based services favored over community-based ones. In fact, the increase in hospital reimbursements financed by the tax will be paid on a per diem basis--the antithesis of value-based payment. Physicians employed by Christiana Care, Delaware's dominant health system, are seeking to form a union. Christiana Care has acquired or hired many of Delaware's physicians and other clinicians and seems to have bought up all the urgent care. It calls the shots and its working conditions and culture are apparently not good. It ranks quite low in The Leapfrog Group quality ratings. The DE hospital provider tax legislation calls for "72% of the federal funds raised by the tax to be used to increase payments to hospitals." If health care workers want a raise, they have to go where all the money goes. If they want real change, they (along with DE patients and employers) will need to go to Delaware's elected officials. Christiana Care has been expanding outside of Delaware in recent years, and the legislature is writing them checks to finance it. At the same time, DE is not welcoming new providers, care models or physician practices that could offer competitive alternatives to hospital system care. Strict licensure, CON laws, and a natural tendency to favor home grown entities hold DE back and fuel price increases. Delaware leaders have been grappling with high health care costs (well above national averages), driven by hospital costs. I worry they are throwing in the towel. Christiana Care generates 56% of the revenue that would be subject to the provider tax. My rough estimate (thank you NASHP | National Academy for State Health Policy) is the tax could draw down well over $260 million in federal funds and most of it will, of course, go to the dominant health system. #consolidation https://lnkd.in/eab5m4cG Chris Deacon Claire Brockbank Ge Bai Hannah Edelman Leah Binder Amy Abdnor Farzad Mostashari Sean Cavanaugh Joshua Gordon Brian Miller Steven Costantino Chris Koller
61 Comment -
Christine Santiago, MD, MPH
Excited to share our insights on recent research uncovering racial disparities in readmission rates from Medicare data! From hospital segregation to community-level disparities, there's much to unpack. Let's work towards targeted interventions and policy changes for a more equitable healthcare system. #HealthcareDisparities #StructuralFactors #ResearchInsights https://lnkd.in/gMT-dFDk
191 Comment -
Kristi Wells
🏥 Extending Hospital at Home: A Bipartisan Initiative 🏥 Senators Tom Carper (D-Del.) and Tim Scott (R-S.C.) have introduced the Hospital Inpatient Services Modernization Act of 2024. This pivotal legislation aims to extend the CMS Acute Hospital Care at Home waiver program for five additional years. Here's what this means: - **Continued Success**: The program has shown to reduce healthcare costs, improve patient outcomes, and alleviate hospital burdens. - **National Reach**: Currently active in 37 states, including Delaware and South Carolina, with the program set to expire on December 31, 2024. - **Home Care Benefits**: Enables Medicare beneficiaries to receive hospital-level care in the comfort of their own homes. - **Bipartisan Support**: This extension builds on prior successes and bipartisan efforts to innovate healthcare delivery. - **Healthcare Evolution**: ChristianaCare has successfully admitted over 1,000 patients, showcasing the effectiveness and patient satisfaction with home-based care. 🗨️ "Our efforts aim to revolutionize healthcare by allowing vulnerable Americans to receive high-quality care at home, reducing traditional hospital risks," said Senator Scott. Take a look a the bill here: https://lnkd.in/ge4CMpx8 #HospitalAtHome #HealthcareInnovation #BipartisanHealthcare #Medicare #HomeCare #PatientCare #HealthPolicy #ModernMedicine #SeniorCare #CMS 👩⚕️🏡 Let's support the future of healthcare, where home is where the healing happens!
23 Comments -
Tommy Barletta
👀 Been saying this for a while...the scrutiny around consolidation and mergers in healthcare is becoming increasingly #bipartisan and will be on full display at this week's @House Budget Committee hearing (h/t POLITICO's Ben Leonard and Chelsea Cirruzzo). This trend will continue to impact #privateequity in healthcare on both the state and federal levels and will be an overhang regardless of who wins in November. #healthcare #mergers #antitrust https://lnkd.in/eFAHSuNQ
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Howard Haft MD, MMM
Health Policy and Muscle Memory What is muscle memory and what does it have to do with health policy? I had the enlightening pleasure of attending the Duke Margolis Annual Health Policy Conference in Washington, DC. The presenters were an all-star cast including, but not limited to, the Directors of the CDC, NIH, CMS and past HHS and state Health Secretary’s. The overall outlook they presented, particularly for primary care, was very optimistic. The discussion that really caught my attention was about the need for the healthcare industry to develop muscle memory for value-based strategies in order for sustainability. Their premise and corresponding concern were that the industry has had a lot of value-based programs introduced over the past decade but there has not been the degree of sustainable and broad-based value delivery cemented into the day-to-day delivery of care. This is a really intriguing point. Edward Deming proposed that “Every system is perfectly designed to get the result that it does” Webster defines muscle memory as “the ability to repeat a specific muscular movement with improved efficiency and accuracy that is acquired through practice and repetition”. With these definitions in mind, has the past decade of innovation in healthcare payment and delivery been designed to train that muscle memory that allows healthcare organizations and providers to function at peak performance in value-based care? I think the results, so far, provide a somewhat disappointing answer. As noted in the conference, there have been a lot of amazing innovations, but they have not yet been incorporated into muscle memory. In the early days of healthcare transformation, it was necessary to experiment with a variety of innovative models in order to get the basic elements of value-based care nailed down. The confounding issue over the past decade may have been the continued changes and tinkering at the policy and program level and the lack of consistency across payers that continually shifted the implementers and healthcare providers from settling into patterns that would allow that muscle memory to develop. As was said many times; “That was then, and this is now”. I heard a strong commitment from many of the important policy makers, leaders and influencers at this important gathering, to restrain the pace of new modeling (there was a recent bevy of models from CMMI, many of which are promising) over the next decade and allow the industry to settle into stable patterns. The innovation will not stop, but it will come from the training of that healthcare industry muscle to perform at a peak level, always improving and always competitive in the best sense of the word. More about the conference here: https://lnkd.in/eSyUVEVx Yours in Health Howard
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Sophie Zhou
With the advancement of remote, virtual and AI technology, access to certain care becomes increasingly important for many patients who live in rural areas. It also helps to bridge the gaps of lowering operating cost, staff shortages, and providing timely quality care. But the existing model and care delivery ecosystem for rural areas are still challenged, especially if operating in a lower patient volume area. What can we learn from those systems and adjust to a better model? #accesstocare #telemedicine #newbusinessmodel
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W. Brian Byrd
Why are we allowing 5 non-elected individuals to significantly affect the lives of 30,000+ people who work under a non-compete, and thousands of business whose models depend on non-profits? This administration that touts itself as "protecting consumers" has again undercut entrepreneurs and corporate businesses, the people who create all the wealth in our country. Prediction: the forthcoming legal challenge will be successful.
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