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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Foundational Principles for the Future of Care Delivery
Jun01

Foundational Principles for the Future of Care Delivery

How will the way we deliver care in ten years be similar to the way deliver care today and how will the future be different? One thing that is already in transition is the expectation of patients. Patients want a more “horizontal” and collaborative connection with their doctors and care team. That many patients receive care from a team of providers is itself a future oriented change. Are we ready for the the real digitalization of...

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Choices: Understanding Risk, Loss, Persuasion and Compulsion in Healthcare
May24

Choices: Understanding Risk, Loss, Persuasion and Compulsion in Healthcare

My wife had a simple mantra that she repeated each time our boys left the house to go out with their friends. She would say, “Make good choices!”. Her inference was that there was loss associated with bad choices. Never before have patients, families, doctors, other healthcare professionals and medical organizations had more important choices to make than now. Like the circumstances that potentially surrounded the choices that our...

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Anticipating the Future
May03

Anticipating the Future

I have been thinking a lot about the future lately. Years ago I concocted a quote that works for me by leaving out a few unnecessary words from a passage in The Age of Unreason by the British business guru and futurist, Charles Handy. The future we predict today is not inevitable. We can influence it, if we know what we want it to be…We can and should be in charge of our own destinies in a time of change. Our biggest problem is not...

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Money and Health; Relationships We Must Understand and Fix
Apr18

Money and Health; Relationships We Must Understand and Fix

Doctors and hospitals worry a lot about what they get paid. It surprised me several years ago to discover that a majority of the doctors and managers in our organization did not have an in depth understanding of the mechanisms and issues that really determined how we were paid. As I have traveled around the country I have discovered that our organization was not an exception. Misunderstandings about where the money comes from and the...

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Imagine a World Without Healthcare Disparities
Apr12

Imagine a World Without Healthcare Disparities

It is easy to talk about the disparities in healthcare, but making progress against the current of complex social issues that are at the root of the differences in care experience and outcomes between populations has proven to be very hard. We have preferred “military language” as we have divided the problem into smaller issues that contribute to the disparities in experience into various “wars”, “struggles”, “fights” and campaigns”....

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