Commentary | Integrated delivery networks: Is the whole less than sum of the parts?
Is it inevitable that most care in the US will be delivered by so-called Integrated Delivery Networks, that span hospital, physician and post-acute services and offer these services through their own health plans? This model of care organization was felt to offer less expensive care at higher quality than less integrated enterprises. In a comprehensive review of the economics literature as well as a preliminary look at new data, Jeff Goldsmith and Rob Burns of the Wharton School of Finance at the University of Pennsylvania found no evidence either of savings or improved quality from these complex care models. Read Integrated Delivery Networks: Is the Whole Less than the Sum of the Parts?
An Interview With George Halvorson: The Kaiser Permanente Renaissance, And Health Reform’s Unfinished Business
In this interview, Jeff Goldsmith talks with the recently retired CEO of the $60 billion Kaiser Permanente Health Plan about his turnaround strategy at Kaiser, his activism during the 2008-2010 health reform debate, the health system’s unfinished business and his future plans as an advocate for reducing healthcare disparities. Interview with George Halvorson
How Much Market Power Do Hospital Systems Have?
Hospital systems like Boston’s Partners Healthcare and Northern California’s Sutter Health are supposed to exert virtually unchecked economic power in their local health insurance markets. Many health policy experts believe they have enough clout with health insurers to charge what they wish for their own services. So why did these and other high quality health systems suffer sharp economic reversals at the end of 2013? See How Much Market Power Do Hospital Systems Have:
A Modest Proposal: Charting Day
Physicians are spending more than a day a week on paperwork, and nearly $85 thousand a year on administrative costs related to billing and “quality reporting”. Administrative costs are drowning independent physicians and driving them to sell their practices. Jeff Goldsmith proposes a solution: Charting Day
Can Hospitals Survive? Part II
Hospitals all over the United States are seeing fewer inpatients and their revenues have basically ceased growing, despite five years of economic recovery. Traditional strategies such as merging to get market power with health insurers and acquiring physician practices don’t seem to be working. What is happening to the nation’s hospital industry and what do boards and managements need to do to cope with a rapidly worsening economic outlook? Can Hospitals Survive, Part II
Primum Non Nocere: Congress’s Inadequate Medicare Physician Payment Fix
As Congress wrestles with how to end the Sustainable Growth Rate Fiasco, a bipartisan proposal has emerged which will probably make things worse than they are now. Read about Congress’ Inadequate SGR Solution.
Pioneer ACOs’ Disappointing First Year
The most controversial and heavily hyped healthcare payment reform idea in the Affordable Care Act has been the Accountable Care Organization. Thirty two high performing health systems participated in the Pioneer ACO demonstration, which reported its first year results in the summer of 2013. The blizzard of hype and press releases concealed a lot of problems. Read about the Pioneer ACO’s Disappointing First Year.
Health Industry Price Inflation At Historical Low
Health costs are slowed to a near standstill. What caused it? What does it mean? Is the pause durable or transient? Read: Health Cost Inflation at Historic Low.
Hospitals’ Twenty First Century Time Warp
The US hospital of 2013 is remarkably similar in technology and services to the US hospital of 1998. Have hospitals entered a 21st Century Time Warp?
Practice Redesign Isn’t Going To Erase The Primary Care Shortage
The largest problem the health system faces in the next decade is the retirement of the baby boom primary care physicians, just in time for boomers enrolling in Medicare and millions of newly covered by health reform. Younger physicians are not entering primary care because it pays so poorly. Can we design new primary care models to alleviate the impending shortage, or is something more fundamental required?