Cooperating for better care.

Robert Whitcomb

Author Archives

Global lessons for U.S. primary care

An article in NEJM Catalyst uses a global survey of innovative health-delivery to imagine the future of primary care.

It looks at provider organizations in Mexico, sub-Saharan Africa, Nepal and Rwanda as examples of approaches/programs that can be used to improve primary and preventive care in the United States.

To read the article, please hit this link.


He’s upbeat about post-COVID health-care sector

Graphic by K. Aainsqatsi

An article in Physicians Practice by John Nantz looks at the future of the health-care business after COVID-19.

Among his observations:

“Now, the business of healthcare seems to be well on the road to recovery. Recent research conducted by my firm, Redwood Advisors, and Evolve Healthcare Marketing indicates that practice volumes have been steadily returning. Roughly 25% of practices have already seen patient volume return to a pre-COVID level, and another nearly 25% expect it to return by the end of Q1 2021. In contrast, less than 10% believe practice volume will return after Q2 of next year, and only 18% remain “uncertain” as to when volume will return.”

The article concludes: “In light of the November {and after} surge in cases, it is possible that businesses, including physician practices, may be heading to another slow-down. However, with PPE, staff bonuses, and telemedicine structures now in place, practices will be well-equipped to weather COVID-19 and stay-at-home orders.

To read the article, please hit this link.


Nurturing trust in pandemic

  • Ghazala Q. Sharieff, M.D., chief medical officer at Scripps Health, writes in NEJM Catalyst about senior management’s engendering of, and maintaining, trust among physicians, other staff and patients during the COVID-19 pandemic, and implementing several mechanisms for ensuring that communication is regular and transparent and addresses the needs of the community.

To read the article, please hit this link.


The future of the CMO

In a NEJM Catalyst conversation with Thomas H. Lee, M.D., Andrew Masica, M.D., chief medical officer of Texas Health Resources, discusses how the new generation of CMOs will need to be comfortable being innovative change agents as the market heads toward value-based care.

He describes three different kinds of CMO’s.

To read the dialogue, please hit this link.


Partly scary predictions for hospitals in 2021

Robert King of Fierce Healthcare has come up with five predictions for the hospital business in 2021. They are:

“Hospital consolidation likely to increase at a rapid pace.”

“Patient volumes will continue to be disrupted.”

“An unstable payer mix could roil finances.”

“Telehealth visits will continue to skyrocket.”

“Don’t expect a major new round of relief funding.”

To read the article, please hit this link.


How huge Providence Health chain got back to pre-pandemic volumes

NEJM Catalyst editor-in-chief Tom Lee, M.D., talked with Amy Compton-Phillips, M.D., executive vice president and chief clinical officer of Providence Health & Services, the huge Seattle-based chain, with 51 hospitals and more than 800 clinics in western states, about clinical leadership as the company navigated the health crises of the past year, including COVID-19, hurricanes and massive wildfires, and got back to pre-pandemic volumes.

Among her remarks:

“….{W}e have this large-scale change infrastructure of vision, trust, data, capacity, and alignment. In COVID, the vision was very clear: survive COVID… so everybody knew exactly where we were going — we were trying to get to the other side of a pandemic. Trust. We had all worked together and trusted that each was doing their own job and not try to manage it but allow it to happen. Data. We built an amazing data architecture that has allowed us to have not only insight into what the outcomes are that we’re seeing, but also predictive analytics, and now we can see with pretty good fidelity about 2 weeks into the future….  Capacity. We were very creative in creating capacity, and now that capacity generation is going to serve us well into the future. Alignment has been really essential for us to be able to flex people into the roles that we need [in order for us] to [provide] care in a new way. [In terms of] the platforming article, I’m really glad we had that model before COVID hit because it allowed us to go from 0 to 60 very rapidly when we needed it.

To read the whole interview, please hit this link.


Cross-hospital collaboration in response to pandemic in New York City

An article in NEJM Catalyst looks at lessons learned from hospital collaborations in response to the COVID-19 pandemic in New York City.

The authors conclude:

“As NYC became the epicenter for the COVID-19 pandemic, the hospitals of the Department of Medicine at NYU — BH, NYU-Tisch, NYU-Brooklyn, and the VA — developed multiple strategies for communication, surge capacity, clinical guidelines, and staff wellness. Despite these four hospitals being distinct, there were many uniform approaches that can be adapted by hospitals of any affiliation or size. Collaboration within academic affiliations and, more globally, across the country will be beneficial to leadership, staff, and patients. This overview can be used for diverse hospital systems that are currently facing, or are likely to experience, a surge of patients with Covid-19 or future disaster planning of any kind.”

To read the article, please hit this link:


Growing economic stress for many physicians

An article in Physician’s Practice looks at how “instability in compensation and the massive move of physicians from private practice to employed models could be indicators of trouble ahead for physician compensation.”

Actually, a lot of physicians, especially those in private practice, are already under growing financial stress. COVID-19, of course, has made everything worse.

To read the article, please hit this link.


Comparing value-based care in four countries

An article in NEJM Catalyst compares and contrasts value-based health-care systems in Massachusetts, the Netherlands, Norway and England, revealing structural differences and variation in programs’ emphasis. This provides insights on how policymakers and providers can speed up implementation of value-based care.

The authors conclude:

“There is a general drive across all of the studied systems toward a more value-based health care, although there is a considerable variation in VBHC implementation status among the systems. Our study shows that strengthening government involvement in driving change, focusing on continuous IT improvements to ensure the availability of outcome data across the full care cycle, and instituting a VBHC culture among providers may prove to be pivotal in accelerating the implementation of VBHC across different health care systems.”

To read the article, please hit this link.


From alone to partner

This PhysiciansPractice article provides guidance on the opportunities and pitfalls of transitioning from a solo practice to a partnership. To read it, please hit this link.


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