Julius F. Heil’s Post

Do you know what "Healthcare Economics" is? Striking a balance between patient needs and healthcare costs becomes quite necessary if you're looking to save big on hospital bills. Check out my latest guide on reducing IPD costs that I've shared on Medium. Don't miss these valuable tips! #Healthcare_management #patient_needs #utilization_management https://lnkd.in/g7KiHbGd

Earlier today, Matthew Holt published a blog post asking, "So what can we do about health care costs?" Holt proposes 4 principles: cut prices, cut overall use of services, reduce only unnecessary services, and replace higher priced services with lower priced ones. A sensible and complete list. However, ever the curmudgeon, Holt concludes that none of the principles are imminently achievable -- "And I don't see a way this changes any time soon." I disagree. In fact, I'd argue we have already achieved these four principles in MSK treatment (especially in arthritis and joint replacement care). Efforts are still fragmented and exist in mainly pockets, but that's slowly changing. Momentum is growing. Here I outline examples of how we've achieved the four principles and suggest ways to continue the momentum. (Link to Matthew's post in the first line of the article). #healthcare #medicine #health #healthcareinnovation #healthtech #healthcaretechnology #valuebasedcare Moby Parsons, MD Mahek Shah MD, MBA, MS Nick Sukay Sidney Haitoff Mike Palackdharry Nick Aubin

3 Pillars of Cost Savings Network: From the advent of managed care 40 years ago, to the bundled surgeries of today, contracting has always been a primary cost containment mechanism. By definition, networks promise aggregated demand and prompt payment in exchange for contract discounts - basic free market economics. Today, incumbent bundled surgery players sit between payers and providers acting as the new age middlemen taking a spread in exchange for a better patient experience and discounted rates against inflated billed charges. It’s traditional managed care on micro scale - carving out surgeries from TPAs and their spread game. We’ll realize the true benefits of networks and contract discounts when we eliminate spreads with complete pass through models. Navigation: New aged managed care touts ‘right care at the right time’, but revenue models are usually in conflict. Clinical appropriateness, quality and engagement are the most impactful outcomes levers to pull, but the former should be table stakes. Appropriateness used to be a primary factor in quality, but today quality is largely determined by pay-to-play metrics and incomplete claims data. Patients needing surgery should receive, patients who don’t should not, and surgery should be done in an ASC or OBS where possible. Unbiased navigation is the only way to achieve equilibrium. Administration: $1T of healthcare spend is attributed to admin waste. Plan design is predetermined and 90% of care is elective, but billing is still mostly retrospective ($200B to push paper). Employers have shifted 150M+ Americans off fully insured plans to self-funded plans, but we’re still using a 40 y.o. transaction framework. Even capitated payment models like MA still depend on claims reporting. We need new transparent infrastructure that guarantees cashflow, incentivizes collaboration, and creates informed buyers and sellers based on real-time information. Rethinking and rewiring healthcare’s transaction infrastructure is the biggest economic opportunity of our time. Ultimately, the cost problem in healthcare comes down to alignment. We’ll all win once we get patients, provider and payers on the same page. Doing so is virtually impossible without new end-to-end infrastructure. We've identified the path forward by unbundling health plans, but now it's time to rebundle the stack.

Recent moves by pathology companies to block timely access by consumers and clinicians to pathology results are unacceptable. That is the current impact of decisions being made by pathology organisations to refuse to upload to MyHealthRecord. When CHF talks to health consumers, they are always surprised to discover that health providers have not uploaded their results into MyHealthRecord. Sometimes consumers tell us that when they ask to have their results uploaded they are told no. When I spend my time and money to get a test (let alone the contribution of the tax payer) I expect to be able to in (near) real time share the results with the people who need to see them - me, my GP and other members of my care team. See my contribution to an Australian Financial Review article about this issue today. (Sadly, the article is behind a pay wall). #sharebydefault #healthcare #digitalhealth #consumerrights Australian Digital Health Agency Billy Moore Daniel McCabe https://lnkd.in/gs7-6yBe

So, let’s talk about the five biggest trends in relation to the future of healthcare… Are you concerned about the future of healthcare, especially how technological and medical advancements can affect your longevity and health? Well, you're … https://lnkd.in/eh-My3Uc #DrBerryPierreTV #MedicineMondays

Cascading failure is the idea that, in an interconnected system, failure of one part leads to downstream failure of other parts. Over time, these failures compound, and the sum becomes greater (or lesser) than the individual parts. Basically, you keep digging a deeper hole. Cascading failure is prevalent in healthcare, particularly in evaluation and management of MSK conditions. The result is low-value care, duplicated work, wasted resources, uncontrolled costs, and patient frustration. Detailed here is a fictional but representative case of how cascading failure plays out in the traditional healthcare system using knee pain as an example. Also included is purely self-indulgent fantasy detailing an evolved system meant to address these shortcomings through a forward-thinking approach. #medicine #healthcare #health #healthcareinnovation #healthtech #healthcaretechnology

In “Expert Advice on Safeguarding Your Practice When Implementing Telehealth,” published by Urology Times, Rich Cahill, JD, Vice President and Associate General Counsel, The Doctors Company, part of TDC Group, provides considerations for healthcare providers to ensure they are following the proper protocols regarding telehealth.   To access this article and more recent news from our team of healthcare experts, visit: https://lnkd.in/gbe6YM6w #telehealth #virtualcare #virtualhealth #healthcare #patientsafety #patientcare #medmal #professionalliability #medicalpractice

Are you tired of feeling like just another number in the healthcare system? Frustrated with the lack of personalized care and attention? At Delphi, we understand the importance of prioritizing your health. That's why we've developed a platform to increase access, understanding, and affordability to high-value healthcare providers. With Delphi, you can expect: Increased Access: Our platform connects you with top-notch healthcare providers when you need them most. Enhanced Understanding: We believe in empowering patients with knowledge. Delphi provides resources and support to help you make informed decisions about your health. Improved Affordability: Quality healthcare shouldn't break the bank. Delphi works to make high-value healthcare services more accessible and affordable for everyone. Visit our website and discover the Delphi difference today!

Subscribe ADVERTISEMENT FEATURE >Sponsored by EXECUTIVE SUMMARY Like many other sectors, healthcare is about to enter a period of rapid change. Longevity and the advance of new technologies and discoveries – as well as innovative combinations of existing ones – are among the many factors propelling patient empowerment, which is fundamentally changing how we prevent, diagnose and cure diseases. To understand what we should expect in the years ahead, we empaneled experts in the field of healthcare to predict which technologies and innovations we will see in the near term (the next five years) and in the long term (twenty-five years and beyond). We then surveyed 400 global business leaders in and around the healthcare sector on whether they agree with the panel's views, and what they perceive as the biggest hurdle to these technologies coming to fruition. #business #healthcare #like #change #leaders https://lnkd.in/eBSna25h

News from First Report Managed Care Volume 21, Issue 1: "Inflation and its impact across the entire health care landscape are among the main factors driving spending." This issue's insights are invaluable for managed care leaders navigating the evolving landscape. Understanding data on inpatient/outpatient volumes and formulary changes is crucial for accurate projections and cost management. Let's harness these insights to drive smarter decisions and innovative solutions in health care. #FirstReportManagedCare #FRMC #healthcarecosts #formulary #pbm #managedcare