Follow me
Category Archives: Bending the Cost Curve
New Recipes for Health Care Delivery
My wife is a trained chef, and by definition I guess this means she is always open to new ways to prepare food and new recipes to try. She certainly creates her share of new recipes, at the rate of about two per week, for her blog, The Wimpy Vegetarian. I was reminded of the propensity of chefs to forsake the old and adopt the new when Susan tried a new way to prepare corn … Continue reading
How Much Is the Nation Spending on ER Care? Wrong Question
Recently, Drs. Lee, Schuur, and Zink published an article in Annals of Emergency Medicine that detailed three different approaches to estimating the percentage of total national health care costs that were expended for emergency department care. The statement in this article that most health care journalists have picked up on is related to the authors’ assertion that spending on ER care could amount to as much as 10% of national health care budget. This clashes significantly with … Continue reading
‘Choosing Wisely’ Laying the Groundwork for Denial of Coverage
When the American College of Emergency Physicians (ACEP) decided not to join the Choosing Wisely campaign, I was among those who expressed disappointment with this decision, in part because I have long been a proponent of efforts to encourage more cost-effective care in the ED. In fact I had already independently done a significant amount of work in the development of such strategies. I recognized that there were legitimate concerns about participation in this campaign, … Continue reading
Compensating Emergency Physicians: If Not Fee-for-Service, What?
The push for payment reform in US health care is getting a great deal of support from every corner, and this will impact compensation for emergency physicians just as it will for nearly every specialty. Nearly everyone believes that our fee-for-service reimbursement system results in too much care for too little benefit. The perception that preventative and primary health care services are undercompensated, and procedural services to rescue failing health are overcompensated, seems to be … Continue reading
Coming Soon: the Community Paramedicine Wallet Biopsy
Recently, the California EMS Commission began to consider expanding the paramedic scope of practice in selected California counties to include ‘Community Paramedicine’ services, “an expansion of paramedic roles to support community primary care and public health delivery in both rural and urban communities”. This program is being promoted by private EMS ambulance and transport companies looking to expand the services that paramedics provide, and it is modeled after similar programs being considered in other states, … Continue reading