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How 4 institutions moved toward value-based care

This piece by Thomas H. Lee, M.D., in NEJM Catalyst discusses how four very different institutions have worked to move to value-based care to volume-based care.

It looks at:

Intermountain Medical Group clinics, where mental-health care is integrated with primary-care as a default practice.

Mayo Clinic,  where surgeons who perform lumpectomies or partial mastectomies for breast cancer work during the operation with the Frozen Section Pathology Lab to determine whether all the cancer has been removed.

The American College of Radiology (ACR),  which in 1993, developed clinical-practice guidelines for radiologic services.

Intermountain Healthcare, which initiated a care-process model for febrile infants in 2008, including guidelines for the use of physical exams, lab tests, antibiotics, and discharge criteria.


Rough road for provider-led insurance

A new McKinsey & Co. report looks at the dainting challenges  of provider-led health-insurance plans and asks whether they will just repeat the mistakes of the 1990’s.

Thirteen percent of all U.S. health systems now  offer insurance in one or more market.

The report says that special circumstances explain the success of the few health systems that have succeeded — such as Intermountain Healthcare, Geisinger and the University of Pittsburgh Medical Center.


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