Wednesday, September 22, 2021

Kip Piper's Health Care Blog
Medicare, Medicaid, Health Reform

A South Carolina surgeon has asked the American Medical Association to approve a national policy permitting physicians to deny medical treatment to malpractice attorneys, according to NPR's Morning Edition. This is the latest in a series of controversial steps by some physicians to blacklist patients and trial lawyers. It's unclear what...
In Consumer-Driven Health Care, Regina E. Herzlinger, a leading health care thought leader and a professor at the Harvard Business School, provides a thought-provoking look inside a new, powerful force transforming America's dysfunctional health care industry. Consumer-Driven Health Care builds on her popular 1997 book Market-Driven Health Care: Who...
To address the enormous deficiencies in quality of health care, health care organizations need to make a business care for improvement. That is, they need to demonstrate a compelling rationale for the significant financial investments necessary to improve quality and reduce medical errors. To make decisions, businesses traditionally look at...
Health insurers, whether commercial health plans or public programs like Medicaid and Medicare, only wish to pay for care that is necessary. Every day they make decisions on what is and is not "medically necessary." Gov. Phil Bredesen has proposed a new definition of medical necessity for TennCare, Tennessee's long-troubled...
In the typical hospital, nurses spend only about 30 percent of their time on patient care. The remaining 70 percent of their long days are spent largely on paperwork. This lopsided situation is seen as a major cause of poor quality, patient dissatisfaction, nurse turnover, and operating inefficiency. Thanks to...
Escape Fire is collection of compelling speeches by one of America's leading crusaders for health care quality and patient safety - Don Berwick, MD, founder and president of the Boston-based Institute for Healthcare Improvement. Each year, IHI hosts the National Forum on Quality Improvement in Health Care. The influential annual...
There is ample evidence America has a serious problem with poor quality health care and high rates of preventable medical mistakes. Thankfully, there is no shortage of caring professionals motivated to improve care and the problems are solvable. As with any effort to improve performance, measurement is the first step...
In an excellent new piece for HealthLeaders, E. Preston Gee asks an fascinating question with wide ranging implications for health care: "What if the mass merchandising giants like Wal-Mart or Target got into the healthcare delivery business in a big way?" Highly efficient, consumer friendly, and tech-savvy companies like Wal-Mart...
Under the new Medicare prescription drug benefit, drug plans will have a fair amount of discretion in setting formularies. The idea is to encourage competition among drug plans and offer Medicare beneficiaries choice. The Centers for Medicare & Medicaid Services (CMS) will review the benefit designs of drug plan...
The pay-for-performance (P4P) movement continues to grow: 1. The Medicare Payment Assessment Commission (MedPAC) is calling on Congress to incorporate quality incentives in Medicare payments to hospitals, physicians, and home health agencies. In 2003, MedPAC released similar P4P recommendations for Medicare managed care plans and dialysis facilities. MedPAC says the...

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