The inflection point in the healthcare value chain
In 1965 there were 4.6 workers for every beneficiary on Medicare. In 2030 that number is slated to be 2.3 workers, and 10,000 baby boomers will be retiring every single day through that same period. The healthcare value chain is the system of resources an organization uses to drive its outputs and the inputs throughout…
Healthcare technology, please don’t revert to the mean
Cognitive dissonance, Stockholm’s syndrome, and poor incentive structure havecognitive dissonance, Stockholm’s syndrome, and poor incentive structure has burdened the consumer healthcare experience until healthcare data’s democratization. The decision-making power that patients now possess with access to “their data” creates an environment that is not your father’s healthcare system. Information is the only demarcation. So, what…
Fiduciaries for Health Insurance Brokers
Employers spent an estimated $738B on health benefits covering roughly 170 million Americans in 2018. Half of US employers use a health insurance broker to assemble a health benefits package that best suits their employees. Tony Robbins does an Unshakeable job of analyzing how individual American consumers should shop for fiduciaries in the financial advisor…
To capitate or nah, that is the question!
One look behind the curtain of organizations like ChenMed, Iora Health, and Oak Street Health and the signs of disruption in how healthcare is delivered permeate. To start, they don’t employ billing staff, and every patient has a multi-disciplinary care team assigned to them. Appropriateness of care and waste are two concepts that can be…
The pharmacy benefit manager and private equity firm will see you now
The #1 cause of personal bankruptcy in the United States is medical debt, and healthcare is officially the largest employer in the United States of America. Bubbles happen when anyone with a heartbeat can take on a mortgage or apply for a college loan. Similar to the principles that underlie The Giving Pledge trying to…
Why are self-pay charges still a black box?
Recently, my significant other got into a grappling match with my power drill. Let’s say, drill bit-1 and wife-0. This piece is a bit more opinionated and much more personal than usual (I hope). With both HIPAA and current employment in mind, let’s tap dance into describing an emergent healthcare experience and offer some context…
Blockchain and ADEIT
Why are black hats happy to hand over our healthcare data in exchange for Bitcoin? There is probably utility in understanding why people stealing our healthcare data leverage blockchain technology to capture revenue for their “services.” And if data breaches don’t justify the means, how about our ability to make quality healthcare decisions? As the…
Healthcare Blockchains, What’s the Deal?
In 2008, 9% of US Hospitals had an electronic health record system (EHR, EMR); today, over 96% of US Hospitals have an EHR system. The arms race in healthcare information technology adoption since The HITECH Act has created a patchwork quilt of systems to communicate our nation’s healthcare data. The double edge sword of a…
Why can’t all health plans pick us up and take us to the gym?
If we look at the bell curve of adopting healthcare delivery models in the United States, we are still early adopters of the quality variety in 2019. Take the Medicare Access and Chip Re-Authorization Act (MACRA) which has been the flavor for Medicare Part B’s quality reimbursement programs since 2015. The Merit-Based Incentive Payment System…
Patient Experience is a real thing, finally
The HITECH Act created an immense opportunity for healthcare providers with the appropriate tools and culture to thrive by engaging with patient. There are example after example where organizations are skating quickly towards who the payor is becoming, the patient. Couple the rise of mobile devices with the advent of organizations like The Leapfrog Group,…
Navigating the existential impacts of dementia, Part 2:
In 9 out of 10 cases of Alzheimer’s disease, there is no inheritance or familial component. To be sure, the compounding incidence of this manifestation is too damning for Generation X, millennials, Generation Z, and those that will proceed us not to pay attention. While the jury is still out on the many factors that…
Navigating the existential impacts of dementia, Part 1:
“Up to 47 million Americans have preclinical Alzheimer’s Dementia (AD), meaning they have AD in the brain, but no symptoms.” Assuming that roughly 1 in 6 Americans have preclinical AD, how does one navigate all the systems and processes available if you are faced with the prospect of sustaining a loved one’s activities of daily…
Quality, With a Dash of Affordability
Healthcare is unlike any other business model, so it isn’t easy to manage or evaluate for innovation. Innovation is occurring but happening in a framework that is difficult to modify in short periods (generations). Moreover, the Medical Loss Ratio should not abdicate health insurance companies from providing quality and pricing transparency that patients can expect…
Digitizing American Healthcare
The American Recovery and Reinvestment Act (ARRA) of 2009 was intended to be a boon to the economy on the heels of a tumultuous 2008. The Health Information Technology for Economic and Clinical Health Act (HITECH) is a lesser-known stimulus program within ARRA that propelled the United States of America toward digitizing personal health records. The benefits of having…
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