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Potential Risks of Generic Therapeutic Substitution

  
  
  
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While generic drugs provide a cost-efficient means to deliver quality healthcare for a large majority of patients, mandating generic utilization for all patients through broad-brush payer policies can be problematic.

By Torsten Bernewitz

Healthcare provider incentives - do they actually work?

  
  
  
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Healthcare provider incentives have a key place in accountable care implementation, but success is not ensured unless best practices in making them work are adopted. What are key success factors?

by Torsten Bernewitz

Accountable Care model spreads – but financial return is still uncertain

  
  
  
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Paying attention to best practices in winning the buy-in of physicians and their treatment teams and aligning their behaviors with the ACO goals and success metrics will be critical to make the model successful.

by Torsten Bernewitz
 


Will physicians "fire" patients?

  
  
  
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Will physicians "fire" patients to meet pay-for-performance goals? Under poorly designed pay-for-performance programs they might!

by Torsten Bernewitz

Fixing the "doc fix"

  
  
  
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How to turn a big problem into a big opportunity

The perennial "doc fix" challenge could be an excellent opportunity to create a significant bonus pool for performance based incentives. This could go a long way in making pay-for-performance more effective and increase the chance of success for accountable care organizations (ACOs), without increasing healthcare spending. 

by Torsten Bernewitz

Love is all you need?

  
  
  
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Alternative healthcare delivery and payment models may contain costs and improve quality. What are the critical factors to make them work and a win-win for all stakeholders – and what are the challenges? 

by Torsten Bernewitz

Safety-net hospitals perform poorly on patient experience metrics

  
  
  
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A recent study suggests that safety-net hospitals (SNHs) performed more poorly than other hospitals on nearly every measure of patient experience. This result could have significant financial consequences in the future, when hospital payments will be tied to performance metrics that include patient experience considerations.

by Torsten Bernewitz

What healthcare payers should focus on now to win

  
  
  

by Torsten Bernewitz

Healthcare payers face greater profitability and growth challenges than perhaps ever before.

Spiraling costs remain an unsolved issue, while the degrees of freedom to act are limited in an industry that counts among the world’s most regulated.

Healthcare reform expands the customer base, but also constrains payers’ economics further. Competition is intense, differentiation difficult. Consumers are gaining a much more prominent role. Provider consolidation shifts power structures, while incentives throughout healthcare remain misaligned.

How can payers shape a sustainable, cost effective healthcare model that is valuable to consumers, employers and the public sector? And how can payers not only survive, but turn these challenges into new opportunities to thrive?

Oncologists restrict pharmaceutical sales rep access at accelerating rates

  
  
  

Even with expanded offerings, reps struggle to earn time with docs 

Press release

EVANSTON, Ill. — August 28, 2012 — As more pharmaceutical companies prepare to bring new oncology drugs to market, their sales representatives face a rising hurdle – oncologists are reducing the number of times they will see them.

According to the spring 2012 AccessMonitor™, a report from global sales and marketing consulting firm ZS Associates, about 61 percent of oncologists placed moderate-to-severe restrictions on visits from pharmaceutical sales reps. This makes oncology the most restrictive of the 20 most common medical specialties measured in the report. By comparison, about 47 percent of cardiologists and only 38 percent of primary care physicians restrict rep access to the same degree.

Medicare will penalize more than 2,200 hospitals for excess readmissions

  
  
  

by Torsten Bernewitz

Kaiser Health News, a nonprofit news organization reported yesterday that more than 2,200 hospitals will be penalized by the government starting in October because many of their patients are readmitted soon after discharge.

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New York City ties doctors’ income to quality of care

In a bold experiment in performance pay, patient outcomes and cost containment will be reflected in doctors’ paychecks under a plan being negotiated by the physicians and their hospitals.

Strengthening code for safer medical devices

Half the medical devices sold in the U.S. rely on software. As such technology becomes commonplace, onlookers have warned of security risks, and researchers have undertaken projects to ensure a higher standard of coding.

Medicare announces 106 new accountable care organizations

The Centers for Medicare & Medicaid Services announced the creation of 106 more accountable care organizations. The model gives doctors and hospitals a spending target for patient care and allows them to keep some of the savings if they come in under budget. Eventually, they also will be penalized if they spend too much. The organizations must meet certain health care quality standards.

Walgreens approved for 3 Medicare accountable care organizations

Drugstore chain Walgreens takes another step in its transformation into a front-line health care provider when three accountable care organizations it created were approved by the federal government. 

The future of patient experience management: post hospital follow up

In the span of just a few years, the Patient Experience has emerged as one of the strongest rallying cries for healthcare quality improvement. But with limited amount of time, resources, and budget at your disposal, how do you prioritize which patient improvement efforts should be tackled first?

California's biomedical industry still the biggest, despite tight financing

Accountable Care Organizations will grow in 2013 – and may eventually challenge the role of traditional insurance companies

Cigna and BayCare Health System join in Accountable Care initiative

Report: Measuring progress toward accountable care

How to train physicians on patient experience

Opposition stiffens to ACA's 2.3% tax on medical devices

6 state health exchanges win early approval

ACOs, already surging, poised for even more growth 

Porcupine quills inspire medical devices

MLR rule cost payers $1.45B, weakened individual market

3-D printers for medical use ahead says researcher

Many doctors don't secure medical devices from hackers, study finds

IRS tinkers with new tax on medical devices

CMS to develop survey on patient experience in the emergency department

Understanding patients’ experience and behavior through virtual reality

UnitedHealth looks at doctors' pay for medical savings

For payment innovation, which insurers do physicians prefer most?

FDA to collaborate on development of medical devices

Privacy law falls short in age of proliferating medical devices

Patient experience: New buzzword or top-priority for hospitals?