How To Think About ACOs
Sep27

How To Think About ACOs

Elliott Fisher first described the concept of the ACO in an article in Health Affairs in December 2006. As of January 2016 there were over 800 ACOs, but there is huge variation in form and execution of an idea that looked simple at the start. Since 2011 the number of people getting their care from a CMS, Medicaid or Commercial ACO has grown from zero to over 28 million. That means that close to 10% of Americans get their care from an...

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Is It Time For ACA 2.0?
Sep20

Is It Time For ACA 2.0?

Back in April when we were not absolutely sure who the nominees for president would be. Michael Cohen wrote “Obamacare: an unheralded success” in the Boston Globe. He  commented then that healthcare was not getting much discussion by Republicans beyond a flat out assurance that the ACA would be abandoned on the first day of a Republican presidency. Over in the Democratic Primary Bernie and Hillary were in a confusing debate about the...

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Old Fashioned Values Applied to Complex Times in Healthcare
Sep13

Old Fashioned Values Applied to Complex Times in Healthcare

  An “Interested Reader “ and friend recently sent me a eulogy that he delivered at his father-in-law’s funeral. Let me give it to you to read, and then invite you to think with me about Don Berwick’s recent call for Era 3, the “Moral Era” of healthcare.   I have been thinking about my nearly 50-year long relationship with Granddad, …Charlie to work colleagues, friends and neighbors. He brings to mind Churchill’s...

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Patient and Family Centered Care and Lean in Healthcare Transformation
Sep06

Patient and Family Centered Care and Lean in Healthcare Transformation

Patient and Family Centered Care and Lean in Healthcare Transformation Lately, I have been thinking a lot about the power of combining patient centeredness and Lean in healthcare transformation. These ideas became more focused after a recent call that worried me from the moment I saw the identification of the caller on my screen. Emails and texts are the usual forms of communication for this person whom I have known for many years. My...

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