Leaping Barriers to the Triple Aim
Feb17

Leaping Barriers to the Triple Aim

In  “The Triple Aim: Care, Health, And Costs” Berwick, Nolan and Whittington describe American healthcare as the most fragmented, most expensive and least effective care delivery system among all of the advanced economies of the world, and they identify the barriers to improvement. Their assertion remains a triple surprise for me. First, it was a true statement. Second, it did not disturb more people. Third, it is still true. The...

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Looking to Vermont’s Future
Nov16

Looking to Vermont’s Future

Last week I attended a unique healthcare meeting in Stowe, Vermont. I was there to get a better feel for the mind of clinical leadership at a moment of great transition in the state. The subject that was at the core of the conference was the future of care in Vermont. I think that someone had a stroke of genius when they decided to weave a program from threads of traditional clinical discussions with a chance to talk about concerns...

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Fostering Healthcare Innovation in Vermont
May05

Fostering Healthcare Innovation in Vermont

In my recent encounters with leaders who are fostering healthcare innovation in Vermont, I have observed that leadership within the ACOs, The Vermont Medical Society, forward-looking and socially oriented members of Faculty at the UVM Medical School, the leadership of state health agencies, members of the legislature, the governor and the local leadership of the regional health areas all have a high degree of understanding of the...

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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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