The COVID-19 pandemic has revealed and magnified some nonsensical elements that drive health care delivery in the U.S. One of the most glaring is the method by which primary care […]

The intersection of a novel virus, health disparities across our communities and rising health care prices presents a formidable challenge to the U.S. health care system. COVID-19 is new, but […]

Medicaid budgets are under extraordinary stress with increased enrollment, increased direct and indirect costs and declining state revenues. What can be done to mitigate these budgetary cliffs? Reducing unit prices […]

The 34th Annual Patient Classification System International (PCSI) Conference was co-hosted by the Danish Health Data Authority, Nordic Casemix Centre and the Danish Regions organization. I attended it with two […]

The “Iron Triangle” in health care refers to the concept that access, cost and quality cannot all be simultaneously improved. The premise is that an improvement in one area results […]

MedPAC is the nonpartisan advisory group that provides advice to Congress (and CMS).  Although not mandatory, MedPAC recommendations are taken seriously and may be implemented by CMS through regulation or […]

Loyalty to one’s doctor and following medical advice was rarely questioned in the 20th century.  When managed care reached its zenith in the 1990s, having an assigned primary care physician […]

The pressure to improve healthcare outcomes and reduce unnecessary use of healthcare resources weighs heavily on hospital and health system administrators working with tight margins. Success under value-based payment requires […]

How hospitals and physicians get paid is changing as the U.S. healthcare system transitions from volume-based to value-based care. Reimbursement methodologies need to allow for a plan to control costs, […]

The accountable care organization (ACO) was first proposed in 2006 as a method for reigning in the increasing costs of health care. The Medicare Shared Savings Program (MSSP) was enacted […]

The Institute of Medicine estimates that 30 percent of healthcare spending is attributed to waste. Waste in health care not only has a financial impact, but also robs patients of […]

Thanks for reading the Inside Angle blog in 2017! As 2018 approaches, revisit some of our most popular blogs of the year: 1. HCCs: A frequent factor in the value […]