Dr. Grace Terrell, President and CEO of Cornerstone Health Care, recently visited LDI and shared her experience of directing a physician-led health system through health care reform. Terrell, a primary care physician and a good Southern storyteller, told us about ‘Julia’, her patient of more than 20 years:
[cross-posted with the Toward Health blog]
Much of what we hear about Accountable Care Organizations (ACOs) has to do with how well, or poorly, they’re serving the Medicare population. Medicare ACOs have received a great deal of attention, but less discussed is the application of this new health care delivery model to the Medicaid population.
About 10 years ago, my primary care physician decided that she would no longer take insurance, and left the practice. Patients could pay directly to continue in her care in her new practice, or see another physician in the existing practice. I chose to stay in the practice with another physician.
“How do we close the gap between the care we actually provide and what ought to be provided?” This was the question posed by Dr. Martin Roland to open a recent seminar at Penn. Roland’s research focuses on the implementation of pay-for-performance schemes in the United Kingdom’s National Health System (NHS). He has found that the evidence of impact on quality of care is modest and mixed.
Social impact bonds (SIBs), also known as "pay for success financing," are a relatively new way to attract private investment in public goods and social programs. The potential to draw new revenue streams that can fund programs with significant upfront costs but long-term savings has made these bonds attractive in the health care sector.
How can we redesign physician incentives to improve their impact on behavior and performance? Recently, the Commonwealth Fund published a round-up of expert views on reforming physician incentives, and one of the experts was LDI Senior Fellow Amol Navathe, MD, PhD. Navathe, a physician, health economist, and engineer, studies how to apply behavioral economic principles to physician financial and non-financial incentives.
[cross-posted with US News]
Twitter has been abuzz with commentary about ProPublica’s Surgeon Scorecard, which reports on how individual surgeons perform on in-hospital mortality and readmission (complication) rates for eight common elective procedures. Amidst the pointed criticisms of the Scorecard, there exists moderate agreement that it provides some value in helping consumers select a surgeon.
In a new NEJM Perspective, LDI Fellow Ari Friedman, Brendan Saloner, and Renee Hsia analyze different policies to reduce emergency department (ED) use in Medicaid patients. They advocate strongly for providing Medicaid patients with better alternatives to the ED, rather than discouraging nonemergency ED use by imposing steep copayments.
Cross-posted with the Philadelphia Inquirer
Imagine a woman in labor who goes to the hospital with a delivery plan she made in consultation with her obstetrician: yes to antibiotics in labor; no to an epidural for pain control; yes to neonatal circumcision; and yes to having an intrauterine device (IUD) placed immediately after childbirth.
Cross-posted with US News
Cross-posted with the Field Clinic blog
Over the past two years, one of the top health care priorities in Philadelphia has been getting people signed up for health insurance. That is still a huge, unfinished task, but alongside it we need to make sure we have enough doctors in the right places to deliver care. For health care reform to deliver on its promise, people need good access to primary care.