All posts by mdmunk

Humanizing the Healthcare Machine: On Not Getting Lost in the Warehouse

One summer afternoon, when I was eight or nine, I impulsively chose to ride my bike down a steep hill near my childhood home.   From the top of the hill my bike accelerated at a frightening rate and I remember for brief moments somehow being airborne before landing in a pile of bent metal and bloody asphalt.  My adventure ended with ...

A Few Thoughts on “Culture” in Healthcare

The big news in Boston healthcare last week was the announcement that Tufts and Boston University Medical Centers were calling off their proposed merger.  The Boston Globe wrote:  Although they did not specify why the deal fell apart, the hospitals were apparently unable to overcome differences in culture, mission, and strategies for the future, analysts ...

Why Value Generation Doesn’t Grow Your Risk-Bearing Medical Group: On Being Foiled by the Middleman

Imagine that you are an electronics manufacturer who has figured out how to build a superb stereo system at a far lower cost (20% less) than your competitors. Over time you’ve perfected the system, created a reputation for high quality and have a machine that sounds great.  Your manufacturing efficiencies position you to sell at ...

Spending Money to Save Money? Navigating Population Health “Hard-Dollar” Investments vs. Downstream “Unicorns and Rainbows” Medical Savings.

Most medical groups considering risk contracts usually understand that they’ll need to make significant investments in population health infrastructure for capitation to work out financially.  After all, capitation can only be profitable if the risk-bearing group has the ability to manage the use of expensive downstream healthcare services and minimize unneeded care. The problem is that the relationships between ...

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Segmenting Healthcare into “Luxury” and “Value” Brands… Thoughts On Not Getting Stuck in the Middle.

A few months ago, I wrote about how healthcare is poised to segment according to cost and service levels– and that we will likely begin to see healthcare brands emerge that appeal to price-conscious consumers looking for reliable, basic care. My suspicion was that US healthcare is now facing its “Southwest Airlines” moment, where nimble and lean competitors will soon undercut inefficient legacy ...

Global Capitation: The Three Less-Obvious Vulnerabilities for Health Systems Considering Global Payments

I receive a fair number of emails and Linkedin messages from healthcare executives who are interested in global risk contracts and are looking for a some advice from the provider side. Here’s what I usually tell them: Global risk can be a very good thing for both patient care and for margins– but it’s a ...

The “Religion of Big Data” in Medicine: Will Getting More Granular Help Doctors Make Better Decisions?

I’ve been thinking a lot about “big data” and how it is going to affect the practice of medicine.  It’s not really my area of expertise– but here are  a few thoughts on the tricky intersection of data mining and medicine. First, some background: these days it’s rare to find companies that don’t use data-mining and predictive ...