July 2nd, 2011 by Happy Hospitalist in Health Policy, Opinion
No Comments »
Over the last few years, you may have heard a lot about the value of checklists in ICU medicine and their ability to reduce mortality, reduce cost and reduce length of stay. But a recent study took the concept one step further and suggested that checklists by themselves may not be effective unless physicians are prompted to act on the checklist.
As reported in the American Journal of Respiratory and Critical Care Journal, a single site cohort study performed at Northwestern University Feinberg School of Medicine’s medical intensive care unit compared two rounding groups of physicians. One group was prompted to use the checklist. The other group of physicians had access to the checklist but were not prompted to use it.
What they found was shocking. Both groups had access to the checklist. However, patients followed by physicians who were prompted to use the checklist had Read more »
*This blog post was originally published at The Happy Hospitalist*
May 3rd, 2011 by Stanley Feld, M.D. in Health Policy, Opinion
1 Comment »
Thousands of articles have been written about forming ACOs. Millions of dollars have been spent by hospital systems to try to form an ACO. Healthcare policy consultants have discovered a new cash cow.
Hospitals systems are wasting their money. They think the return from owning salaried physicians’ intellectual property will be more than worth the cost.
- Thousands of physicians have been confused by the concept of ACO.
- Many have felt ACOs are an attack on their freedom to practice medicine the best they can.
- Many have rejected the concept because they feel they will have to be salaried by hospital systems.
- Many physicians do not trust President Obama or Dr. Don Berwick.
- The Stage 2 ACO regulations are not easy to understand. They are more ominous than the stage 1 regulations.
The two core stated objectives for ACOs are:
(1) Reducing healthcare costs.
(2) Preserving and improving quality.
The stated objectives are laudable. The government regulations and controls are confusing. Read more »
*This blog post was originally published at Repairing the Healthcare System*
July 21st, 2010 by AlanDappenMD in Better Health Network, Health Policy, Opinion, Primary Care Wednesdays, Research, True Stories
No Comments »
After seven years, my wife has finally stopped asking me for “The Power of DocTalker” story of the day. Now when I start with the details of the latest case report justifying the model, she stops me with “I get it, I get it! Go write the case report up and post it on your website for others to ‘get it,’ too.”
Case reports center on the mission of our medical practice, with points regarding care that include quality, accessibility, convenience, affordability, empowerment, trust, and price transparency. Because our patients pay us directly for the service and don’t necessarily expect any insurance “reimbursement,” we are a very unique practice. We adhere to the points in our mission and also outperform all our local competition — i.e. medical offices that accept insurance payment for service in order to survive as a business.
To the patient, our services cost a lot less than services available via the insurance model. About 40 percent of our clientele have no insurance, and the other 60 percent have insurance yet chose to use our services because they believe it’s worth paying directly in order to assume control of their care. (As a quick aside — my favorite clients in this group are health insurance executives and CEOs of large companies, who have the best health insurance in the country.) Read more »
March 19th, 2010 by EvanFalchukJD in Better Health Network, Health Policy, Opinion
No Comments »
The Jobbing Doctor, a primary care doctor in the UK, writes about the British version of what Americans call “Pay for Performance,” or “P4P.”
He says something I’ve said many times before (like here, here, and here). Which is this: incentives fail because they try to treat medicine as an assembly line process, when it’s not.
But what’s most interesting about his post is that it could have been written by a doctor from anyplace on the planet Earth.
The Jobbing Doctor talks about a UK program that started in 2004 called the Quality and Outcomes Framework, or “QoF.” Now, the American “P4P” is a much more catchy name, so score one for American marketing. But it doesn’t matter what you call it – that which we call a rose would, by any other name smell as sweet. Read more »
*This blog post was originally published at See First Blog*
March 12th, 2010 by StaceyButterfield in Better Health Network, News
No Comments »
As one would expect from such a diverse group, comparisons were a common topic at the co-located National Medical Home Summit, National Retail Clinic Summit, and Population Health and Disease Management Colloquium this week.
During an opening session, Carolyn Clancy, head of the AHRQ, updated us on some of the comparison work her agency has been doing. Last year’s stimulus bill dedicated a lot of funds ($300 mill directly, more through the Secretary of HHS) to the agency’s work on comparative effectiveness. Read more »
*This blog post was originally published at ACP Internist*
