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 throughoutContinue reading “The inflection point in the healthcare value chain”

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, whatContinue reading “Healthcare technology, please don’t revert to the mean”

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 advisorContinue reading “Fiduciaries for Health Insurance Brokers”

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 beContinue reading “To capitate or nah, that is the question!”

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 toContinue reading “The pharmacy benefit manager and private equity firm will see you now”

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 contextContinue reading “Why are self-pay charges still a black box?”

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 theContinue reading “Blockchain and ADEIT”

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 SystemContinue reading “Why can’t all health plans pick us up and take us to the gym?”

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 expectContinue reading “Quality, With a Dash of Affordability”