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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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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The ACA, Five Years In
Jan14

The ACA, Five Years In

A recent article in the New England Journal of Medicine offers us food for thought as we contemplate the Affordable Care Act (ACA) at five years and look forward to its next challenges in 2016. If you have not read it, the article is entitled “Health Care Reform’s Unfinished Work- Remaining Barriers to Coverage and Access”, by Dr. B. D. Sommers from the Department of Health Policy and Management, Harvard T.H. Chan School of Public...

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Sustainable Universal Coverage
Sep09

Sustainable Universal Coverage

Last month CMS announced the results of the efforts of the Pioneer and MSSP (Medicare Shared Savings Program) ACOs for 2014. The headline made for compelling reading: Medicare ACOs Provide Improved Care While Slowing Cost Growth in 2014. This suggests that sustainable universal coverage is within our reach. Just in case you do not have the time to follow the link for yourself, let me help you appreciate the gist of the report. In 2014...

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Golden Age of Medicare and Medicaid
Aug05

Golden Age of Medicare and Medicaid

Medicare and Medicaid are now fifty years old. I suspect they are the two programs that much of the healthcare establishment still loves to hate the most. Lyndon Johnson’s  signing on July 30, 1965 of  the Social Security Amendments of 1965, created two landmark programs which—along with the tattered VA system—have represented the most “socialized” forms of healthcare in our society. The road to their existence was almost as long as...

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