Primary Cares Initiative Tests Value-Based Pay—Will It Work for You?

By Krishnan Narasimhan M.D.
May 8, 2019

The road from fee-for-service payments to value-based care has been a bumpy one for the entire health system. Current models have not found the most effective way to pay and incentivize primary care.

At an April 22, 2019 event in Washington, DC, the US Department of Health and Human Services (HHS) and Centers for Medicare & Medicaid Services (CMS) announced new payment models that aim to transform primary care through value-based options. This Primary Cares Initiative 1 will also test financial risk and performance-based payments for primary care physicians. The voluntary initiative includes five new payment models under two paths—Primary Care First (PCF) and Direct Contracting (DC). These models will be rolled out in 20 states starting in 2020. Continue reading “Primary Cares Initiative Tests Value-Based Pay—Will It Work for You?”

Best Practices for Engaging Physicians in Health Technology

By Ted James, MD, MHCM
March 28, 2019

Advances in health technology allow health care professionals and organizations to meet ever-increasing demands for performance improvement—or at least that should be the case. The problem is that the adoption of technology in health care is a slow process with many hurdles. Wearables, predictive analytics, remote medicine, EHRs, digital health, AI, diagnostic algorithms, self-care apps, and next-generation clinical decision-support all have the potential to improve patient care; however, fundamental issues with usability and implementation need to be addressed for physicians to engage with these health innovations. Continue reading “Best Practices for Engaging Physicians in Health Technology”

Dispelling Common Myths about Opioid Use Disorder in Pregnancy

By Sarah Bernstein, MD and Jessica Gray, MD
March 21, 2019

The opioid crisis and rise in overdose deaths in recent years has received a great deal of media attention. Though the media has helped to raise awareness, it has also contributed to stigmatization of individuals struggling with addiction. Pregnant and parenting women are among those who have been severely affected by the epidemic and perhaps most shamed by society for their use. Sadly, at a time when many women feel motivated to connect with the health care system and make healthy choices, women with addiction often avoid interacting with providers due to feelings of shame and mistrust. There are many misconceptions regarding the risks and benefits of medical treatment for women with substance use disorders as well as the treatment of neonatal withdrawal. We hope to dispel some of these myths and provide a better understanding of the evidence supporting the treatment of substance use disorders in the setting of pregnancy as well as neonatal withdrawal. Continue reading “Dispelling Common Myths about Opioid Use Disorder in Pregnancy”

Promoting and Implementing Size Inclusivity in Health Care

By Jamie M. Marchetti, MS, RDN, LD
March 14, 2019

Beth was obese. She had been bigger her whole life, so this was not news as she reached her late-twenties. Beth ( her name has been changed to protect her privacy) was getting married and ready to start a family, so she went to her obstetrician/gynecologist to have her intrauterine device (IUD) removed and to discuss the implications of her polycystic ovarian syndrome (PCOS) on fertility. The doctor scoffed and stated, “I don’t know how we’re going to get it out. At your size, I’m not even sure how they managed to get the IUD into you.” Further, it was discovered that Beth had grapefruit-sized cysts on both ovaries, and the doctor told her that neither he nor any doctor would do surgery to remove the cysts given her body size. Beth was desperate, so through her hurt and anger, she chose a crash diet to follow, which resulted in acute renal failure within weeks. Heartbroken and at the end of her rope, Beth found herself crying in a dietitian’s office, convinced that the well-balanced diet she was already eating must be harming her since doctors insisted she must not be nourishing herself properly if she wasn’t losing weight. Beth explained that she was content with her body, but that she was tired of seeking medical care and being treated poorly because of her size. Continue reading “Promoting and Implementing Size Inclusivity in Health Care”

The Physician Side of the Medicare-For-All Debate

By Krishnan Narasimhan M.D.
February 28, 2019

As the 2020 presidential campaign is getting into high gear with a host of candidates, health care continues to take center stage. Specifically, the Medicare-for-all proposals from Democratic candidates and members of Congress have become a key issue. These proposals could represent the biggest access change in health policy since the Affordable Care Act.

It pays for physicians to understand and be engaged in health policy as it will dictate their practice life, their patient’s health, and the future of health care. However, unraveling competing proposals is not always easy. Let’s take a deeper look. Continue reading “The Physician Side of the Medicare-For-All Debate”

Addressing the Urology Doctor Shortage: Implications For Patient Care

By Kevin R. Loughlin MD, MBA
February 14, 2018

Health care issues continue to receive extensive coverage in the lay press, however the current and future physician manpower issues which significantly impact patient care have been largely ignored. I would like to review the urologic workforce issues and their consequences. Continue reading “Addressing the Urology Doctor Shortage: Implications For Patient Care”