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Pay-for-performance: a dangerous health policy fad that won't die Print E-mail
Written by Kip Sullivan, Stephen Soumerai | STAT First Opinion   
Thursday, 01 February 2018 00:00

Pay-for-performance, the catchall term for policies that purport to pay doctors and hospitals based on quality and cost measures, has been taking a bashing. Last November, University of Pittsburgh and Harvard researchers published a major study in Annals of Internal Medicine showing that a Medicare pay-for-performance program did not improve quality or reduce cost and, to make matters worse, it actually penalized doctors for caring for the poorest and sickest patients because their "quality scores" suffered. In December, Ankur Gupta and colleagues reported that a Medicare program that rewards and punishes hospitals based on arbitrary limits on the number of hospital admissions of heart failure patients may have increased death rates. On New Year's Day, the New York Times reported that penalties for "inappropriate care" concocted by Veterans Affairs induced an Oregon hospital to deny acute medical care to its sickest patients, including an 81-year-old "malnourished and dehydrated" vet with skin ulcers and broken ribs.

What do you say to somebody who knows that they are about to die? Print E-mail
Written by Nathaniel Fleming, KevinMD   
Wednesday, 17 January 2018 08:47
I've had lots of practice comforting people. I've had to tell patients that their cancer is back in a busy emergency department. I've updated family members of patients who are being kept alive by machines in the intensive care unit. I've walked alongside patients as they get rolled into an operating room, and crouched down by a patient's bed as they writhe in pain. There have been moments of fear, grief, sadness, and agony. Although the context is always unique, the messages are inevitably similar: I'm sorry that this is happening. We're going to do everything we can to make this better.

Last Updated on Wednesday, 17 January 2018 08:51
Take a pill and stop aging. Really? Print E-mail
Written by FHI's Week in Review   
Monday, 08 January 2018 00:00

Stephen C. Schimpff, MD, in a KevinMD post dated January 6, 2018, writes:
"A pill to end aging. Is there or could there be such a pill? Some researchers think so."
Read more in the current issue of Week in Review>>
Last Updated on Tuesday, 09 January 2018 19:03
Drop in U.S. life expectancy is an 'indictment of the American health care system Print E-mail
Written by David Blumenthal, STAT   
Friday, 05 January 2018 19:21

First Opinion
The economy may be growing and the stock market booming, but Americans are dying younger - living shorter lives than previous generations and dying earlier than their counterparts around the world. It is easy to  place the blame squarely on our nation's opioid epidemic, but if we do that we miss seeing the abysmal new life expectancy data from the C enters for Disease Control and Prevention for what they are - an indictment of the American health care system. According to the CDC, the average life expectancy at birth in the U.S. fell by 0.1 years, to 78.6, in 2016, following a similar drop in 2015. This is the first time in 50 years that life expectancy has fallen for two years running. In 25 other developed countries, life expectancy in 2015 averaged 81.8 years.

Last Updated on Friday, 19 January 2018 18:17
ABMS/ABIM MOC Controversy: 2017 Year-in-Review Print E-mail
Written by Dr. Wes   
Tuesday, 02 January 2018 17:05
As we say goodbye to 2017, we say goodbye to a year of unprecedented exposure of the interconnected workings of the Accreditation Council for Graduate Medical Education and its member organizations, the American Board of Medical Specialties (ABMS), the American Medical Association (ABMS), the American Hospital Association (AHA), the Association of American Medical Colleges (AAMC), and the Council of Medical Subspecialty Societies (CMSS) that continue to ignore the corruption inside their walls. Money does that to people. We should not be is the wrap-up of some of the key events concerning Maintenance of Certification® (MOC®) for 2017...
Last Updated on Tuesday, 02 January 2018 17:06
Are hospital ads just unregulated false hope? Print E-mail
Written by Elina Serrano | KevinMD   
Tuesday, 26 December 2017 19:07
In a world where health care is defined by consumerism, positive health care campaigns like “Redefining Possible. The profound and unstoppable power of yes” and “Making Cancer History” have been directly targeting consumers in an effort to thrive in an increasingly competitive marketplace. Health care reform is partly responsible for the increase in hospital advertising, as customers now have a greater agency to choose where they seek care. But how common is this practice of positive health care marketing and how does it affect patients?
Last Updated on Tuesday, 26 December 2017 19:11
Do quality metrics really improve patient care? Print E-mail
Written by FHI's Week in Review   
Monday, 18 December 2017 18:35

Fred N. Pelzman, MD states, in a Dec. 13, 2017 KevinMD post, "178 measures. This is what we're up to - the collected compilation of quality and performance metrics for our ambulatory care network, across all the different divisions."

Read More

Last Updated on Wednesday, 27 December 2017 17:03
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