Overtesting: Where Do We Go From Here?
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I heard recently about a case of over-testing that seems so typical nowadays that it makes me wonder not just how we got here, but how we go back.   A 9-year-old child comes to the ED with abdominal pain and … Continue reading

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Reconciling Patient Satisfaction, Drug Seeking Behavior, and Cost-effective Care in the ED
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  The first step to reconciling the seeming conflicting objectives of improving patient satisfaction, restricting the inappropriate prescribing of abused drugs, and providing cost-effective care in the face of rising patient expectations regarding testing and treatment in the ED, is … Continue reading

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Why Healthcare Regulators Fail to Regulate
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Why do healthcare regulators so often fail to enforce their own regulations?  Let’s look at some examples for an answer.  In 2015, the Department of Managed Health Care in California did a survey of plans and risk bearing organizations (RBOs) … Continue reading

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When Hospitals Have One Foot in FFS and the Other in VBP
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Most hospitals these days have one foot firmly planted in Fee For Service (FFS) Reimbursement and the other foot in Value Based Payment (VBP); and though this somewhat schizophrenic business model complicates life for the C suite, it poses an … Continue reading

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The Transition to Single Payer: What Would Medicare Look Like?
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What if Bernie Sanders were elected President, and what if that was just the beginning of a Social Democratic revolution in America? Improbable, to be sure, but if we went to a single payer health care system, what might Medicare … Continue reading

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