He notes:
And he discusses how a cost-control scheme can drive costs up:
“{T}he coding system actually punished … efficiency and effectiveness. Under this system, we got paid for our inefficiencies, and even for our mistakes: Do-overs often would drop far more to the bottom line than the original procedure did.”
See this Mayo Clinic video about shared clinician-patient decision-making.
Among the questions: How much participation and decision making do patients really want, and how can physicians tell or, at least get an idea of, how much they want?
U.S. News & World Report says:
Three of the nation’s top academic medical systems – Dartmouth-Hitchcock Medical Center, Johns Hopkins Medicine and the University of Michigan – will impose minimum-volume standards to bar their hospitals from performing certain procedures “unless both the hospitals and their surgeons do them often enough to keep their skill level up.”
The move comes after U.S. News story showing that hospitals “that do small numbers of common procedures place patients at far greater risk than those that do lots of them.”
The 5-4 majority held that such deadlines could be extended for plaintiffs who had either done their best to comply with them or had failed to obtain critical information before them, MedScape reported.
In one brief, the Paralyzed Veterans of America and other groups argued that, as an Associated Press story put it, “veterans unwittingly miss their deadlines for filing claims because the Department of Veterans Affairs has created a confusing process.”
“The long-term vision for the building will be to create a place where 90 percent of the health and wellness needs of the community can be met,” Raymond Lavoie, executive director of Blackstone Valley, told ConvergenceRI.
Humana’s booming Medicare business makes it an attractive acquisition target for Aetna, which focuses more on employer-sponsored health plans that have less unit growth potential than Medicare or Medicaid plans. And Humana has considerable experience in the fee-for-value world, Aetna less so.
“The health insurance industry deal speculation primarily focusing on Aetna’s ambitions comes just as the government plans to shift a huge amount of Medicare dollars away from the traditional fee-for-service approach to medicine that is based on volume and to medicine based on value that is tied to outcomes, performance and quality of care provided. Humana administers a large book of Medicare business Aetna may be interested in and larger amounts of capital may be needed to managed it from either insurer,” Forbes said.
He tells The St. Louis Post Dispatch that says consumers can ensure better health outcomes by applying the same research to their medical providers as for life’s other decisions.
How to connect people to the right physicians
How to educate patients about their physicians and the health system as a whole.
The role of transparency and data in healthcare.
The future of buying health insurance.
Dealing with the narrowing of provider networks.
Following these recommendations would obviously mean a considerable drop in income for some providers.
“Less frequent screening for some malignancies, as well as starting tests later in life and ending them earlier in old age, may make sense for some adults without a family history or other risk factors for cancer.”
“The notion of high-value screening is a sensible way for doctors and patients to decide whether a particular test for cancer makes sense,” Dr. Richard Schilsky, chief medical officer for the American Society of Clinical Oncology, told Reuters.
He wasn’t involved in the ACP recommendations.
“No screening test is perfect, and most people who get screened don’t have the disease. Most people who do have the disease won’t benefit from screening because the disease is so aggressive that they would have died anyway, or because it is so slow-growing they would never have symptoms,” Dr, Schilsky said.
