Tag: Featured

Millennials Are Ditching Primary Care. What’s Next and Who Cares?

Earlier this year, our team surveyed hundreds of Millennials (men and women aged between 20 and 40) in three major East Coast cities to determine their attitudes toward primary care.  We wanted to know if these young adults had primary care doctors, whether they saw value in a primary care relationship, where they received healthcare ...

Blended FFS and Capitation: Healthcare’s “Protective Collar” Paradox

Over a couple of posts I’ve discussed how difficult risk contracts can be for healthcare systems transitioning from fee-for-service. There are three main problems for systems trying to blend FFS and capitation-payment systems.  Two have been the subjects of earlier posts: Systems growing risk capability need to make big investments in population health and have to tolerate ...

On Getting Burned by Population Health Thinking: (Why has a Decade of Intervention not Prevented More Deaths From Brain Aneurysms?)

In our house we take a lot of fizzy vitamin C to prevent colds in the winter. As doctors, my wife and I both know that science doesn’t support our decision… We take it anyway. We shouldn’t. After all, the well respected Cochrane group (which grades and distills multiple studies into a single “meta-analysis”) clearly ...

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 ...

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 ...