Where We Should Focus
Apr18

Where We Should Focus

In a recent essay Michael Dowling, the CEO of Northwell, the massive health system with 21 hospitals in metropolitan New York and Long Island, points out that the most frustrating aspect of the current healthcare debate is that “it is ideological and not practical.” He describes the debate as “…contentious, tumultuous and exhausting to keep up with.” These comments set the stage for his central contention that through it all and...

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Good Strategy in a Fog of Uncertainty
Feb07

Good Strategy in a Fog of Uncertainty

There is no challenge like the challenge of creating a strategic plan in uncertain times. What do you do when you do not know what to do? That is a question that frequently challenges leaders. Over eight years ago, after Lehman Brothers had failed and the value of the stock market had fallen by almost fifty percent and we did not know if we were facing a deep recession or the second coming of the Great Depression, I was asking myself...

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Thinking About ACOs Again For the First Time
Jan10

Thinking About ACOs Again For the First Time

I am proud to be a member of Whittier Street Health Centers Foundation Board and was delighted when our very able CEO, Frederica Williams, recently asked me to talk to the organization about ACOs at their Grand Rounds. Whittier Street is an exceptional example of a practice that will be sorely tested by the chaos that Jonathan Oberlander describes in his “Perspective” article, “The End of Obamacare”, in the January 5, 2017 issue of...

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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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