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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Overkill Can Be Deadly
Jun18

Overkill Can Be Deadly

Dr. Doug Beer, my former colleague and longtime friend, told me a story about the way healthcare overkill can actually kill a patient. Doug, who practices internal medicine at Emanuel Hospital in Portland, Oregon, and I were talking about cancer treatment during a recent visit he and his wife, Leslie, paid to my wife Nancy and me in New Hampshire. Doug confused me when he said he had a patient who died because he was treated too soon...

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Medical Practice & the 8 Wastes
May14

Medical Practice & the 8 Wastes

As I reflect in early retirement on my years of practice, I am a little surprised that I am losing the names of many of my patients. I saw thousands of patients in more than a hundred thousand office visits and stood at the bedsides of thousands more in hundreds of tours of duty as the hospital-based cardiologist on call for my practice; but now, without the refresher of a recent visit, even some of the most active patients are...

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ACO Leaders Need Focus, Commitment
Feb03

ACO Leaders Need Focus, Commitment

ACO leaders are going to need to acquire a new set of competencies.  Recently I attended a conference in Boston on access, innovation and Accountable Care Organizations. I was scheduled to be on a panel at the end of the day talking about ACOs with a physician from Steward Health, who was standing in for their CEO and David Cutler, the economist from Harvard who helped construct Chapter 224 and advised the Obama administration on the...

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