“Physician Alignment” Payments Won’t Fix Broken Healthcare Delivery Systems. Considering a New Path Forward.

A colleague at a hospital-based health system recently told me about “physician alignment” initiatives his employer was introducing. These included “co-management” deals (where doctors get per-patient incentives for on-time discharges, and high quality scores) and new salary models that adjusted based on various metrics. At the same time, he noted, his hospital was laying off ...

Is The Proliferation of Urgent Care Clinics an Evolutionary Step Towards Primary Care 2.0? Thoughts on Not Betting the Farm When it Comes to Urgent Care Mania…

About seven years ago, the California Healthcare Roundtable and HealthAffairs sat down to prepare a white paper on the emerging “phenomenon” of urgent care centers, and what it might mean for primary care. At the time the group couldn’t agree that urgent care was a “disruptive” innovation, but it seemed clear to all participants that it represented ...

Distinguishing Products from Solutions in Healthcare: Remembering the “Job to be Done”

I recently sat down with a surgeon colleague to lament what he described as a “surge” of new patients who had come to his practice with well-defined and specific demands for surgery. Many of these patients had various painful ailments, and all had spent time online researching options. Each one was quite convinced that surgery ...

Asking Patients To Advocate for Their Own Safety is Not Patient-Centered Care.

Last year the New York Times reported that the aviation industry had become so safe that one could fly every day for 123,000 years before dying in an aviation crash. I wish we could say the same for the US healthcare system. Nationally, problems with healthcare quality (doing too much, doing the wrong things, and doing ...

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The Growth of Doctor Networks: Will “Healthcare Islands” Appeal to Value-Seeking Millennials?

Around the country, doctors are leaving independent practice and joining large groups owned by healthcare systems. It’s a trend: the recruiting firm Merritt Hawkins predicts that if current growth continues, over 75 percent of newly hired physicians will be hospital employees within two years. There seem to be a number of reasons for this consolidation of ...

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Academic Medical Centers Are Under Siege. Is the Best Strategy to Go Small or to Go Big and Own the Continuum?

The university hospital at my alma mater recently announced an intriguing deal. Jefferson University Hospital, around since 1825, signed a deal with an upstart company called American Well to provide “virtual ED” visits to patients who would otherwise have come to the hospital’s emergency department. A recent article in Becker’s noted: The American Well technology will ...

HMOs Are Back on the Table. And “Cheap” Isn’t Good Enough This Time Around.

If you’re a fan of 1990’s movies, you will likely remember a scene in the Academy Award winning film, As Good as It Gets. The Washington Post described the ruckus in theatres: Audiences in the Washington area have been erupting in whoops, whistles and applause when actress Helen Hunt, playing the single mother of a ...

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