Blog

Newtown, CT - June 30, 2017

Maybe it’s time we move from “no margin, no mission” to “no mission, no mission” – With those words, Dr. Harlan Krumholz made one of the more important points in his talk at HFMA’s annual meeting. The running mantra in most hospitals and health systems has been to ensure margins in order to ensure the continuation of the mission, but when margins come first and missions...

Newtown, CT - June 23, 2017

As debates in Congress and the country rage over mechanisms to finance commercial insurance coverage and Medicaid, let’s not forget that financing coverage is easier when costs of care are sustainable – In a recent analysis of a sample Medicaid managed care dataset, less than 1% of the plan membership was deemed super-utilizer (3 or more inpatient stays and...

Newtown, CT - June 9, 2017

A young woman having a baby should never have to hesitate about getting health insurance if it’s available – And yet on some state exchanges the combination of premium, deductible, and co-insurance is so high that it’s almost higher than the total cost of a routine vaginal delivery and newborn. I’m not suggesting that the expecting mother shouldn’t get insurance, in...

Newtown, CT - June 2, 2017

I knew there was an opioid epidemic when the ads for Movantik first came out – And now, in the midst of this crisis, which builds on the base problem of substance use disorders in America, everyone is scrambling for solutions, even those that caused it at the onset. Treatment of pain with opioids was, for long, considered a last resort because of the potential for addiction....

Newtown, CT - May 13, 2017

Every year, for the past nine years, I’ve had the privilege of spending a week with children and adults who, although they are very sick, shine with the light of internal peace – Reinsertion after such a week is difficult given the jolting...

Newtown, CT - April 21, 2017

Why is it so difficult for health care policy experts – and many others – to grasp the fundamental concept that form should follow function – In a recent...

Newtown, CT - April 14, 2017

This is the week of hope, and beyond what our faiths make us hopeful for, the PTAC delivered a whopper for the country – It was touch and go for several hours, but when the vote was tallied, it was unanimous. Soon the Secretary will have an official recommendation to test one of the most ambitious, most hopeful alternative payment model for the hundreds of thousands of...

Newtown, CT - April 7, 2017

Repent, for the day of judgment is at hand - There is, for many of us, a deeply rooted belief that those who thirst for justice, will hear their prayers answered. “For the eyes of the Lord are on the righteous, and his ears are attentive to their cry; the face of the Lord is against those who do evil, to cut off the memory of them from the earth.” Like all beliefs,...

Newtown, CT - April 1, 2017

Beyond the rhetoric of value-based payment and value-based insurance design, is the simple concept of financial risk transference – While many understand that the goal of VBP and VBID is to affect the way in which the financial risk associated with bad outcomes is distributed, the rhetoric gets in the way of addressing the underlying issues inherent to financial risk...

Newtown, CT - March 25, 2017

We’ve long known that social inequities are immoral, but now we also know it’s also bad for business – Earlier this week...