Is it Time to Ditch Medicare?

Having endured the past year of the Presidential campaign — most recently the Obama v. Romney debate — in which Medicare is characterized as the program that will send the United States into bankruptcy, I realize that the question must be asked: why not end it? It is a bold notion — one discussed privately […]

Renegotiating Health Care Waste

The New York Times today cites an Institute of Medicine study with more bad news about waste in the health care system: an estimated 30% of spending was wasted in some way in 2009. That’s about $750 billion. In another study cited, three-quarters of hospitalized patients were unsure who was actually “in charge of their […]

Health Care Reform: Where Do We Go From Here?

From a post we authored for KevinMD.com, a widely read health care blog: The Supreme Court has spoken. The Affordable Care Act is upheld.  So what does this mean for those of us actually involved in health care? First, there is a lot of work to do. The Court has reached its decision with regard […]

Five ACO Pain Points…and How to Remedy Them

Barry C. Dorn, MD, Leonard J. Marcus, PhD, and Eric J. McNulty contributed to this post. Accountable Care Organizations (ACOs), the latest attempt to control health care costs while ensuring quality, are set to become reality in just a few weeks. Supporters believe that they have at last found the formula that that can deliver […]

Are Urgent Care Centers the Answer?

Primary care docs are over-booked. Emergency rooms are expensive. Are free-standing urgent care centers the answer that can deliver needed care while saving money? This is the question asked by Liz Kowalczyk of The Boston Globe as eastern Massachusetts prepares for up 19 such centers to open in the months ahead. “If they ‘are closely […]

It’s Time for a Public Health President

The discussion of health in the current U.S. presidential race has largely been limited to loud calls for the repeal of the Affordable Care and Patient Protection Act by Republicans. Each has competed to be the loudest and most strident to denounce “Obamacare.” Many on the left are afraid that Obama may have squandered his […]

Patients…and the Renegotiation of Health Care

Negotiations between Blue Cross/Blue Shield of Massachusetts and Tufts Medical Center made news this week: Tufts wants what it considers to be a modest increase in payment rates over the next three-to-five years. Blue Cross says that Tufts is already making too much. Tufts says that it gets paid at lower rates than other, larger […]

Renegotiation Brings Better Health Outcomes, Lower Costs

The November 2011 issue of The Atlantic features an article on CareMore, a health care provider serving only Medicare Advantage plan patients. Through innovative renegotiation of everything from the care model to the business model, CareMore has delivered high rates of patient satisfaction, improved health outcomes, and lower overall costs. CareMore was recently acquired by […]

Can Cost Accounting Save Health Care? Not Without Renegotiating the System

Dr. Barry Dorn contributed to this post. In the September 2011 of Harvard Business Review, Harvard Business School professors Robert Kaplan and Michael Porter argue that a better understanding of the actual cost of care patient-by-patient can have a dramatic impact in the effort to control costs. They maintain that actual costs are poorly understood, […]

The 570-Calorie Renegotiation

ABC News recently reported that the average American eats 570 more calories per day than in 1977 according to a study from the University of North Carolina at Chapel Hill. No wonder the CDC says that more than one-quarter of the nation’s population is obese. What struck us about these findings was how absent they […]