Segmenting Healthcare: What’s Your Customer’s Currency?

Over the past few years, I’ve spent a lot of time speculating about the emergence of consumer segmentation in the US healthcare market. As background, here are the three main conclusions drawn from previous posts:

Hospitals are Pigging Out on Commercial Reimbursement and Starving on Medicare. What’s Next?

The Spring 2016 Medpac report on Medicare payments is out.  This annual report to Congress (put together by the 17 members of the Medicare Payments Advisory Committee) provides an assessment of the way Medicare pays for care, and offers recommendations for how to modify payments going forward. It’s a fascinating snapshot:

On Healthcare as a Complex System: Ensuring Context and The Capacity to Adapt

There is a minor brouhaha in the world of healthcare quality and process improvement.  It started with a perspective piece written by Pamela Hartzband and Jerome Groopman published in a January issue of the New England Journal.  In the essay, (and I’m paraphrasing) Groopman and Hartzband argue that process improvement tools like LEAN are “medical Taylorism” that lead to ...

How Big is too Big? On “Diseconomies” in Large Healthcare

With healthcare mergers now announced seemingly every week, I’ve been giving some thought to scale:  How big can/ should health systems be?   Anecdotally, I’m struck that the most impressive healthcare companies in America are super- regional players:  Geissinger, Cleveland Clinic, UPMC, etc.  They seem to get a lot more attention than the national players with hundreds of facilities. ...

To Reduce Physician Burnout Eliminate Garbage Time

Here’s a new chart from the AMA (reprinted from work done by Dr. Shanafelt and colleagues in Mayo proceedings) that reports the percentage of burnt out physicians sorted by specialty.  It’s a pretty horrifying report.   I’m not at all surprised to see emergency medicine at the top of the list. There are a bunch of theories on the ...

On Feedback Loops and the Selective Amplification of Random Healthcare Data

Here, within six minutes of one another, are two tweets on the subject of Amazon’s fourth quarter results, one from CNN and one from the WSJ:

Consolidating Surgery: Another Example of Balancing Population-Level Improvements with Poignant Individual Loss

In healthcare quality circles it’s become a truism that high surgical volume is linked to improved outcomes.  If you want to have the best surgical result, the thought goes, find the surgeon who has done the most cases like yours… Harvard’s Ashish Jha outlines the case in a recent JAMA Forum: We have always known that volume ...

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