Incremental progress in the fight to treat heart failure
After a decade or more of relative quiescence in the 2000s, a volley of new therapies have come to the forefront in the pages of the NEJM: sacu…
A clinical vignette: the cases of Jane and Joe
Imagine if you will two individuals both at age 50. Jane is a project manager whose recent health care has focused on managing menopausal symptoms, a kn…
“My name is T-Cell…, James T-Cell”
Immune T-cells are licensed to kill other cells through a quick molecular kiss of death, and as such are potentially powerful allies in controlling a tumor. For obvi…
I am not sure how many docs continue to do this, but I still read the actual hard copy of my NEJM, and that means I flip past ad pages with smiling grandfathers playing with grandchildren thanks to su…
It is a long-standing hypothesis shared by many providers that community-based interventions that improve primary care could lead to overall healthcare savings by preventing (or delaying) the occurren…
RBRVS: an acronym we ought to think more about
RBRVS stands for the Resource Based Relative Value Scale, and codifies the time and effort involved for a comprehensive set of physician activities on wh…
Could Uber happen to healthcare?
A Perspective article that points out that the success of Uber is rooted in the flaws of an industry where customer convenience and value for money took the backseat …
Systems biology finally gets real: an unexpected use for a diabetes drug
Chronic Myelogenous Leukemia (CML) has been the poster child first for a disease with a precise genetic cause (the Philadelphia…
Summary
In this working paper, we develop the following thesis. In the not so distant future (a decade or two), medicine will be largely governed by algorithms -- highly deterministic clinical pathway…
The build-out of the Cleveland Clinic and Mayo branded networks continues apace. Most recently, the Virginia Hospital Center joined the Mayo Clinic Care Network in March and Sequoia Hospital (Dignity…
Please see update at end of post.
If value-based care broadly delivers on its promise to reduce hospital admissions by providing more timely ambulatory care, a lot of today’s bed capacity will end up …
Summary
Boeing is creating a benefit design model which sets up providers to compete for their book of lives via provider-branded narrow networks
By offering a choice among competing narrow and full …
A number of observers have noted that the Apple’s partnership with Epic on HealthKit could reinforce the role of “closed IT system” strategies in general and Epic’s leading position among EMR vendors …
Summary
Allegheny Health Network (AHN), the major delivery system in Pittsburgh owned by Highmark, and Johns Hopkins Medicine have signed a MOU to create an affiliation between Allegheny and the John…
Epic is famous for its intense focus on interoperability across its own systems coupled with its conservatism regarding interoperability with other EMRs. In 2012, KLAS said Epic has the “deepest data…
Summary
Michael Porter and Thomas Lee have articulated a strategy for fixing healthcare focused on restructuring providers and assessing them based on metrics “that matter to patients”
The most compe…
Summary
In August and early September, several Ohio provider systems have picked sides in the competition between Catholic Health Partners and Cleveland Clinic
The recently announced Health Innovatio…
A new study in JAMA (by McWilliams et al.) looks at the Medicare expenditures of patients seeing providers enrolled in the BCBS of Massachusetts version of the ACO (Alternative Quality Contract or “AQ…
Summary
Earlier this year, Catholic Health Partners, the largest provider in Ohio, signed two deals which put it on a competitive collision course with Cleveland Clinic
Cleveland Clinic has few optio…
In our last post we introduced two potential scenarios.
"Provider bastions" in which buyers of health care services select upfront the network that they will trust to deliver their care in a coordina…
It seems like every day there’s some news outlining strategic actions that various players are taking or other developments with respect to health reform. Here’s a sample of recent news:
Employer ado…
Summary
The deal locks in an option for Cleveland Clinic to grow its clinical practice transfer business 4x its current size and much larger than Cleveland Clinic’s peers
There will be significant ch…
At a TEDMED conference a couple years ago, I had to write some sample “ask me” questions on the bottom of my ID badge as conversation starters. One of them was “Ask me why PHIX+ACO=:-)” Given the p…
Summary
The case for an oncology ACO can be compelling but CMS rules for ACOs within fee-for-service (FFS) make value difficult to demonstrate
A new physician-hospital-payer partnership in Florida …
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