Managing Managed Care

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

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Enhancing HealthCare's Worth

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It's disheartening; the cure for the ills of U.S. health care lies within our grasp, yet it eludes us.  We cannot answer basic questions–What works?  What we are paying for? Are we getting what we need?  Are we getting the right care at the right time and place? QI and UM: Strange bedfellows, but both need data to communicate

Antibiotics, Sensible Use; Injudicious Overuse

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It's easier to prescribe antibiotics in a cold, sinsitis or bronchitis than to explain why not. (It takes less time, it's expected, it's someone else's money and diagnostic confusion from partial or inappropriate treatment will likely be someone else's problem.) Advisory

When's "Good" Quality, Good Enough?

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A payer judges a physician or a practice organization by the proportion of patients for which the physician adhered to one or more practice measures. Those in quality measurement seem to be attempting to align the clinical quality measures that are relevant to the Electronic (EHR) Incentive Program.  Isn't that artificial and once removed from the patient's care?

Autism and Autistic Behavior

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Autism Spectrum Disorders (ASDs) Understanding diseases that affect development of the brain, e.g. autism and schizophrenia is challenging because of the complexity of such diseases and the difficulty of studying developmental processes in human tissues. First, Definitions: The following provides standardized criteria to help diagnose ASD; it is from the American Psychiatric Association's Diagnostic and Statistical Manual-IV, Text Revision (DSM-IV-TR).

Cost-Share or Measure and Manage

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The modus operandi in managed care is that one cannot manage what one does not measure. Outcome Measurement will be telling; it will be the final arbiter. Managed Care is a system of health care management that is intended to reduce inappropriate and/or unnecessary health care expenditures by aligning economic incentives for both practitioners and patients so that both understand their options and select care that provides optimal value.*    

Affordable Care's in Watch Mode

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Who's not anxious to improve health care's Cost/Quality/Access, lest they be left out?  Ans: anyone but concierge practitioners, i.e.,all the rest of us–hospitals, insurance companies, health care workers and drug and medical device manufacturers. The hospital association, for instance is one of six groups that went to the White House on May 11, 2009 to announce they have made a commitment to accountable care with quality, accessibility and reasonable cost as its mainstay.

Fear of Death--A Salient Quote and Approach

Tue, 2015-07-07 15:18 -- fitdoc
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"Perhaps the best cure for the fear of death is to reflect that life has a beginning as well as an end. There was a time when you were not: that gives us no concern. Why then should it trouble us that a time will come when we shall cease to be?  To die is only to be as we were before we were born." – William Hazlitt, essayist (1778-1830) Quote from The Conversation Project by Ellen Goodman and Others