Looking Forward with the Triple Aim
Feb25

Looking Forward with the Triple Aim

It is surprising that we have no good metrics to track our progress toward the Triple Aim. We have lagging numbers on what we spend as a nation and debatable public health indicators of gross population metrics. No one knows how many healthcare organizations have incorporated the Triple Aim into their strategic plans. We have very little to help us judge what organizations are accomplishing and no way of comparing their results to...

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D. F. Wallace, Burnout, and Healthcare
Aug26

D. F. Wallace, Burnout, and Healthcare

What does David Foster Wallace have to tell us about burnout? More than most healthcare professionals might think. The publicity for The End of the Tour, a new film starring Jason Segel as Wallace, has reminded me of the message I took away from the first Wallace book I ever read, This Is Water: Some Thoughts, Delivered on a Significant Occasion, about Living a Compassionate Life (2009). Before 2009 I had missed out on David Foster...

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Healthcare Innovation in Vermont
Apr28

Healthcare Innovation in Vermont

I am now involved in a small way with the Vermont Healthcare Innovation Project that is the latest of several efforts in Vermont to move away from healthcare that is fragmented, inefficient and expensive. Despite efforts to move toward value-based reimbursement and the presence of three ACOs in the state (the largest, OneCare Vermont, sees about one hundred thousand Medicare, Medicaid, and commercial patients), the current system of...

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Lean Leadership for ACOs
Jan10

Lean Leadership for ACOs

Last week I traveled from my new home in New London, New Hampshire to Farmington, Connecticut to participate in a leadership conference for a large physician group there. This group, like many physician groups across the country, is making that transition from the current reality of their total dependence on fee-for-service income to a future where they expect to be paid for quality and value. They know that to be successful in the...

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