Can health plan value be distilled down to a single score? Would it reveal anything meaningful and if so, how could that information be used? While working for Texas Medicaid, […]

The shift of the U.S. health care system from fee for service (FFS) to value-based care and payment now seems inevitable. To date, the transition has been relatively slow, as […]

Paying for value makes sense. It incents health care providers to maximize patient outcomes relative to price rather than the number of office visits, lab tests or medical procedures they […]

I sat down with 3M Health Information Systems Business Director of Grouper Applications and Payer Services Susan Salek to discuss 2022 trends for payers and how 3M methodologies were created […]

Gestalt is defined as: “Something that is made of many parts and yet is somehow more than or different from the combination of its parts.”  Long ago, I remember attempting […]

SCOTUS ruling The Supreme Court of the United States (SCOTUS) recently dealt a blow to the American Hospital Association (AHA). What was the bone of contention? The AHA contended that […]

The three-legged stool that supports primary care in a successful value-based practice includes data analytics, care coordination and patient outreach. The primary care provider (PCP) cannot perform all these roles, […]

When I was a young primary care physician, all I wanted was more time to spend with my patients. Each day felt rushed, prodded by the fee-for-service system that incentivized […]

As a mom of four growing (and constantly eating) boys, I’m always trying to find ways to manage our grocery bill.  Occasionally, I try the generic brands to see if […]

Health care outcomes improve and unnecessary spending declines when we can get ahead of problems rather than reacting to them after they have spiraled out of control. For a woman […]

Some state Medicaid agencies leverage the enrollment process  to drive health plan improvement.  Within states that operate Medicaid managed care, there are typically high percentages of individuals newly enrolled in […]

State budgets have been pushed to extremes driven in part by ballooning Medicaid costs and ballooning Medicaid rolls. According to the Kaiser Family Foundation:  “Early estimates indicate that states are […]