Managing Managed Care

Our inequitable, inefficient, oftentimes uncaring health care "system," revealed. -- Jeffrey G. Kaplan, M.D., M.S.

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Cost is the Big Item in the Value Equation of Health Care and Here's Why

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The main tension about healthcare centers around medical need, quality, access and cost-efficiency, i.e., affordability.To increase "value," one must raise quality, improve access and/or lower the cost of care. The latter, however, is an elusive goal; it is the elephant in the room. 

Prevention's Underinvested

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Medical research has largely been focused on curative medicine–"medicine yielding better drugs, medical devices, and clinical procedures. [Where as] Prevention science—the systematic application of scientific methods to the causes and prevention of diseases in populations—has yet to receive the necessary investment and support required to reduce the growing burden of largely preventable noncommunicable diseases (NCDs)."1

"But, My Patients Are Sicker!"

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The Commonwealth Fund contends that: reforms physicians could champion to eliminate waste and duplication (inefficiency) include, but are not limited to: "integrated systems of care,""shared savings, bundled payments, or global fees" and "performance measures that promote care coordination." I say that docs aren't happy about any of that.  I can hear them now.... Here's what i hear docs saying with regard to Affordable, Accountable, or Managed Care:   I'm too expensive?

Health Care Reform at the Office

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Francis J. Crosson, MD seeks "a rationale designed to influence the physician microenvironment so as to support physicians in developing patterns of clinical decision making that result in better health outcomes and lower costs."