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Dave Burda curates a weekly email and hosts a weekly podcast discussing news that impacts market-based change.
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Featured Articles
The Proof Case for Addressing the Negative Social Determinants of Health
Economics
Medicare Advantage Keeps Biting the Hand that Feeds It
When CMS released its latest national healthcare spending figures last month, they barely caused a ripple in our collective consciousness. The agency’s actuaries said national healthcare expenditures rose 4.6 percent to …
Innovation
SONG: Imagine (No JP Morgan)
Check out all the 4sight Health songs here. Imagine (No JP Morgan) To the tune of “Imagine” by John Lennon and Yoko Ono Imagine no JP Morgan It’s easy …
Burda on Healthcare
How Sticky Is Telemedicine?
Until I got into content marketing at a previous job, the word “sticky” had a negative connotation. As a child, it meant I got grape jelly on the kitchen table …
Market Corner Commentaries
The Worst and Best of Times: Perspectives from Cain Brothers’ Healthcare 2020 Virtual Conference
2020 has been a year like no other. Investors in U.S. healthcare have navigated remarkable economic and societal disruption by maintaining their focus on long-term value in healthcare businesses and …
Policy
Failing at Drug Price Reform
Exactly two months before his term expires, President Trump and the Secretary of Health and Human Services Azar announced their long-anticipated drug price reforms. This policy has been four years …
Economics
SONG: Obamacare Is Here to Stay
Check out all the 4sight Health songs here. Obamacare Is Here to Stay Sung to the tune of “Rock and Roll is Here to Stay” by Ray Henderson December 2020 …
Economics
Why We Still Need to Keep Drug Companies on a Short Leash
Drug companies may end up saving us from the pandemic, but that doesn’t mean we can take our eyes of them for a second. A new research letter in the …
Policy
A Stalled Transition: Won’t Derail Biden’s Healthcare Team
A stalled presidential transition in the midst of an unremitting pandemic sounds like a recipe for long-term damage to health policy and the health system. It probably isn’t. For a …
Consumerism
Why We Need Patient Education to Unleash Healthcare Consumerism
One of my favorite expressions on social media is “today years old.” Posters use it to tell their followers in a self-effacing way they just learned something most everyone knows …
Economics
Erasing the Hospital Community Benefit Fudge Factor
Years ago, when life was simpler, I did my own taxes. So did a good friend of mine. During tax season, we would compare notes on any changes in the …
4sight Friday
Podcast: 4sight Friday Roundup, Prospects for Post-Election Healthcare Reform, 11/06/20
Prospects for Post-Election Healthcare Reform We talked about all the possible combinations of election results and each scenario’s impact on healthcare reform in the year ahead. David Burda interviews David …
Innovation
Podcast Interview: Disruption of the Healthcare Industrial Complex™
Which strategies can drive change and lead to the rise of a consumer-centric health system in the U.S.? Vic Gatto, CEO of Jumpstart Health Investors, and David Johnson, CEO of …
Consumerism
Confirming Suspicions About Why Patients Are Crowdfunding Healthcare
In a recent commentary, David Johnson, founder and CEO of 4sight Health, pointed his finger at medical campaigns on the GoFundMe website as a sign of the growing unaffordability of medical …
Market Corner Commentaries
Stop Worrying About ACA Repeal: It’s Not Going to Happen (Part A)
The 2020 pre-election hysteria regarding the potential demise of the Affordable Care Act (ACA) resembles Chicken Little screaming to the multitudes that the sky is falling. The political theater is …
COVID-19
Why COVID’s a Win-Win-Win for Health Insurers
Every once in a while something comes along that reaffirms your belief that healthcare is an industry like any other industry and that healthcare reacts the same way to economic …
4sight Friday
Podcast: 4sight Friday Roundup, What’s Next for Health Systems?, 10/23/20
What’s Next for Health Systems? It’s been an interesting year for the executives who run the nation’s health systems. How do they see the rest of this year and 2021 …
System Dynamics
Nixon Goes to China: Why Healthcare Leaders Must Learn from History
Long before Détente, one of the boldest foreign policy moves by any president was the establishment of diplomatic relationships with the Peoples Republic of China (PRC). President Richard Nixon was …
Economics
It’s Your Move: Health Insurers Counter Provider Consolidation
Hospitals, health systems, medical practices and other providers catch a lot of grief—and rightly so—for merger after merger and acquisition after acquisition that have done virtually nothing for patients other …
Consumerism
GoFundMe Misery: Unaffordable Healthcare is Unavailable Healthcare
I spent some time this week scrolling through medical campaigns on the GoFundMe website. These campaigns seek funding to pay medical expenses for those with serious illness and injury. Their …
Economics
What’s Your State of Health?
As I watch COVID-19 cases ebb and flow around the country over the past eight months, I wonder if any place consistently is safer than another. After repeatedly watching this …
Market Corner Commentaries
America’s Frayed Safety Net Undermines Improved Primary Care
Key Takeaways Many high-cost Medicare and Medicaid patients suffer from multiple chronic conditions that have been poorly treated or left untreated, often for many decades. The healthcare system does a …
System Dynamics
What’s the Story on COVID and the Tenure of Hospital CEOs?
The only reason I’m writing this blog post is so I can refer to it and link to it a year from now. The lead of next year’s post will …
4sight Friday
4sight Friday | The Future of Hospitals | Healthcare’s House Flippers | Odds on the ACA
Read 10/2/2020 Edition here. Curated by David Burda, 4sight Health’s news editor and columnist. Columns here. Find 4sight Health and industry opinions and news on market-based change, all with the 4sight …
Economics
Healthcare’s House Flippers
If you come over, there’s a decent chance that HGTV will be on. The home-improvement channel is our default TV station. It runs in the background like a radio as …
4sight Friday
Podcast: 4sight Friday Roundup, Home Is Where the Hospital Is, 09/25/20
Home Is Where the Hospital Is On today’s episode of the 4sight Friday Roundup Podcast, we talk about how the COVID-19 pandemic is expanding the definition of home care. Listen. …
Economics
Looking for the Right Prescription to Regulate State Drug Markets
Of all the sectors of the healthcare industry, the one I know the least about is the pharmaceutical sector. Journalists have made careers out of covering drug companies or even …
Innovation
Where Have All the Patients Gone? The Art and Soul of Recapturing Lost Treatment Volume
On a plane trip to Oberlin College in October 1955, singer Pete Seeger wrote the first three verses of the popular anti-war song Where Have All the Flowers Gone? With …
4sight Friday
Podcast: 4sight Friday Roundup, The Uninsured: Where We Go From Here, 09/18/20
The Uninsured: Where We Go From Here We talked about the new uninsured and unemployed numbers and what they mean for universal coverage on today’s episode of the 4sight Friday …
4sight Friday
4sight Friday | Health Is Where You Live | What Now My Uninsured | Taking Accountability for Patient Safety
Read 09/18/2020 Edition here. Curated by David Burda, 4sight Health’s news editor and columnist. Columns here. Find 4sight Health and industry opinions and news on market-based change, all with the 4sight …
Innovation
What Pandemic? Investors Love Hotspotting 2.0
Key Takeaways Investors expressed confidence in Oak Street Health’s model for caring for high-cost, low-income patients by sending its shares soaring 90% on the first day of trading after an …
Economics
How to Build Safer Streets for Everyone
Almost everyone agrees that where one lives has more influence on one’s life experience and expectancy than any other factor. Where one walks, hikes, bikes, or runs determines the safety …
4sight Friday
4sight Friday | Let’s End FFS Now | The COVID-19 Bump | Fixating on a Vaccine
Read 09/11/2020 Edition here. Curated by David Burda, 4sight Health’s news editor and columnist. Columns here. Find 4sight Health and industry opinions and news on market-based change, all with the 4sight …
Consumerism
COVID-19 Magnifies Consumers’ Love-Hate Relationship with Healthcare
We’re going to turn this week’s blog post over to consumers, who are going to tell you what they think about the healthcare system via two new opinion polls from …
Market Corner Commentaries
A Pandemic Induced Collapse of the Way We Pay for Healthcare
For many segments of the economy the long-term consequences of the pandemic remain unknown. But for healthcare, there are flashing lights that point to severe, if not fatal, damage to …
4sight Friday
4sight Friday | Healthcare Data Aggregation at Scale | Telling For-Profit and Not-For-Profit Hospitals Apart | Paying for Clinical Decision Support
Read 09/04/2020 Edition here. Curated by David Burda, 4sight Health’s news editor and columnist. Columns here. Find 4sight Health and industry opinions and news on market-based change, all with the 4sight …
Economics
Podcast: 4sight Friday Roundup, How You Can Tell For-Profit and Not-For-Profit Hospitals Apart, 09/04/20
How You Can Tell For-Profit and Not-For-Profit Hospitals Apart We talked about the differences and similarities between hospitals and systems with different ownership structures on today’s episode of our 4sight …
4sight Friday
4sight Friday | Is Healthcare Self-Aware? | An Easy Fix for Healthcare | Our Public Health Infrastructure
Read 08/28/2020 Edition here. Curated by David Burda, 4sight Health’s news editor and columnist. Columns here. Find 4sight Health and industry opinions and news on market-based change, all with the 4sight …
4sight Friday
Podcast: 4sight Friday Roundup, Reassessing Our Public Health Infrastructure, 08/28/2020
Reassessing Our Public Health Infrastructure How well do you think the public health system in the U.S. held up during the pandemic? We tell you what we think in today’s …
Innovation
High-Performing Professionals Run on Self-Awareness
Developing this self-awareness requires the courage to receive feedback from others. Martina Navratilova is one of the greatest tennis players of all time. She won a remarkable 59 Grand Slam …
Economics
Fixing Healthcare Would Be Easy If It Wasn’t So Hard
Fixing healthcare is very easy and extremely difficult at the same time. That dichotomy is what gives the status quo staying power. A few things that came out over the …
4sight Friday
4sight Friday | Healthcare’s Gray Rhinos | Regulating Chatbots | PPE Shortages Redux?
Read 08/21/2020 Edition here. Curated by David Burda, 4sight Health’s news editor and columnist. Columns here. Find 4sight Health and industry opinions and news on market-based change, all with the 4sight …
Economics
Podcast: 4sight Friday Roundup, PPE and the Healthcare Supply Chain, 08/21/2020
PPE and the Healthcare Supply Chain Did we learn our lesson or are we going to make the same mistakes again? Listen to this week’s 4sight Friday Roundup podcast to …
Economics
The Future of Hospitals in Post-COVID America (Part 1): The Market Response
Editor’s Note: This is the first of two articles on the Future of Hospitals in Post-COVID America. This article examines how market forces are consolidating, rationalizing and redistributing acute care …
Burda on Healthcare
Primary-Care Physicians versus The World (Mostly Pharmacists, Really)
Everyone loves primary care. Everyone hates primary-care physicians. Well, maybe not everyone, but certainly the healthcare market and healthcare consumerism. We’ll talk about the major takeaways from the big primary …
Economics
Bigger Isn’t Necessarily Better for Patient Care When It Comes to Health Systems
I think we all can agree now that provider integration doesn’t lower healthcare prices. When hospitals buy or merge with other hospitals, when medical practices buy or merge with other …
Policy
Op-Ed: Parochial politics killed health care transformation on Chicago’s South Side (Chicago Tribune)
Mercy Hospital and Medical Center in Bronzeville announced on July 29, 2020, it would close in 2021. It didn’t have to be this way. In January 2020, Mercy and three other …
COVID-19
Podcast: 4sight Friday Roundup, Is Telemedicine Headed Left or Right?, 08/07/2020
Is Telemedicine Headed Left or Right? Listen to this week’s 4sight Friday Roundup podcast for what we think this week’s big news means for the future of telemedicine. David Burda …
Economics
Let Doctors Be Doctors If You Want Them to Be Good Managers
I know lots of doctors having covered healthcare now for nearly 40 years. One thing’s always puzzled me. Why would a doctor not want to be a doctor anymore and …
COVID-19
Podcast: 4sight Friday Roundup, Is There a Better Way to Bailout Providers?, 07/31/2020
Is There a Better Way to Bailout Providers? Listen to this week’s 4sight Friday Roundup podcast for our thoughts on continuing COVID-19 financial relief for hospitals and health systems. David …
4sight Friday
Podcast: 4sight Friday Roundup, Reopening and Recovering the Right Way, 07/24/2020
Reopening and Recovering the Right Way Listen to this week’s 4sight Friday Roundup podcast for our take on how hospitals, health systems and medical practices should be reopening to recover …
Economics
Digging Deep (Into Your Own Pockets) to Root Out Low-Value Care
I’ve been to Oregon, and it’s beautiful. But I had no idea the state had a real problem with low-value care. I’m glad I didn’t get sick when I visited …
COVID-19
Market Lays Odds on COVID-Inspired Digital Health Tech
This is why I don’t gamble. Well, more accurately, this is why I shouldn’t gamble. In the April 10 edition of our weekly newsletter 4sight Friday, which you could read …
4sight Friday
Podcast: 4sight Friday Roundup, Walgreens, Walmart and Vertical Integration, 07/10/2020
Walgreens, Walmart and Vertical Integration Listen to this week’s 4sight Friday Roundup podcast for our take on who wins and who loses from the latest round of vertical integration in …
COVID-19
Don’t bail out. Bail in to value-based care.
Key Takeaways: Hopes for a V-shaped recovery in healthcare spending are fading fast as COVID-19 caseloads, hospitalizations and ICU bed use surge in half the U.S. Hospital and physician practices …
Economics
The Demand for Market-Driven Innovations in Medical Care Is All in the Numbers
One of the bellwethers I follow to see what direction healthcare is headed is the annual physician supply and demand reports from the Association of American Medical Colleges. If the …
4sight Friday
4sight Friday | The Folly of Furloughs | COVID-19 and the Economy | Contact Trace or Die
Read 07/03/2020 Edition here. Curated by David Burda, 4sight Health’s news editor and columnist. Columns here. Find 4sight Health and industry opinions and news on market-based change, all with the 4sight …
4sight Friday
Podcast: 4sight Friday Roundup, COVID-19 and the U.S. Economy, 07/03/2020
COVID-19 and the U.S. Economy Listen to this week’s 4sight Friday Roundup podcast for our thoughts on why the future of the economy depends on our COVID-19 response moving forward. …
COVID-19
How to Reduce Your Operating Costs When There’s No One Left to Furlough
I’m not independently wealthy, and as a journalist for nearly 40 years now, there have been times in my adult life when our family has lived check to check. Yet, …
COVID-19
Tracing: Get It Done, Make It Permanent.
Key Takeaways The U.S. needs a comprehensive tracing program to safely reopen an economy hobbled by COVID-19. State and local governments must hire between 100,000 and 300,000 workers for a …
4sight Friday
4sight Friday | Taking Revenue Management Up a Notch | Rooting Out Low-Value Care | No Care? No Problem
Read 06/26/2020 Edition here. Curated by David Burda, 4sight Health’s news editor and columnist. Columns here. Find 4sight Health and industry opinions and news on market-based change, all with the 4sight …
Economics
Collecting & Saving Pennies: Turbocharging Health System Revenue Management & Productivity
In our recent article we identified the following five margin pressures that are coalescing to drive more value into the delivery of healthcare services: Their collective impact poses an existential …
Economics
Now Is the Time to Nip Low-Value Care in the Bud
The coronavirus pandemic exposed flaws in the U.S. health system that we knew existed but weren’t in a rush to do anything about because everyone (other than patients) was profiting …
4sight Friday
Podcast: 4sight Friday Roundup, COVID-19 and Healthcare Affordability, 06/19/2020
COVID-19 and Healthcare Affordability Listen to this week’s 4sight Friday Roundup podcast for our predictions on how the outbreak will affect the affordability of medical care now and in the …
COVID-19
Countering the Negative Consequences of COVID-Induced Healthcare Consolidation
The COVID-19 outbreak in the U.S. is leaving a lot of financially struggling hospitals and medical practices in its wake. Experts predict that to recover—or perhaps as an opportunity to …
COVID-19
Consumers Counting on Private Sector to Produce Post-COVID Healthcare Market Innovations
Consumers want the private sector, not the federal government, to lead them out of this mess we call the U.S. healthcare system, which got a lot messier because of the …
Economics
Wealth and Income Inequality as a Cause of Societal Inequity
Wealth and income inequality have been defining issues in the United States. The added stress of Covid-19 has highlighted and exacerbated these imbalances not only regarding the economy and personal …
Policy
Patients Shouldn’t Expect Their Local Merging Not-For-Profit Hospitals to be More Charitable
For an old healthcare legal reporter, writing about antitrust and community benefits in the same blog post is about as good as it gets. The only thing missing is a …
COVID-19
COVID-19 Put the C Back in Healthcare Consumerism (that’s the uppercase C in Consumerism, not the lowercase c in Healthcare)
Restaurants across the country laid off workers, limited menus and closed because COVID-19 took away their customers. Hospitals and medical practices across the country furloughed workers, limited services and closed …
COVID-19
Workplace Wellness Programs and the Coronavirus Pandemic
If you think starting a workplace wellness program would be a good way to help your company recover from the COVID-19 outbreak, I’ve got a coronavirus vaccine I’d like to …
Policy
Understanding Despair, Capture and Profiteering in American Healthcare
In their recent book “Deaths of Despair,” Anne Case and Angus Deaton chronicle the rise of drug overdose, suicide and death by alcohol in the United States. Through their vivid …
COVID-19
Webinar Replay – “Uncertainty, Margin Pressure and Disruption: Forward-Looking Crisis Management During COVID-19”
Are you worried about the financial pressures inflicted on health systems due to COVID-19? Watch the replay of 4sight Health’s free webinar above. Here’s what we covered in the Before …
Economics
A Fortunate ACO Coincidence
As a skeptical journalist and amateur psychologist, I don’t believe much in coincidences. Things happen for a reason. Two new and separate studies of accountable care organizations illustrate the point. …
COVID-19
Free Webinar – “Uncertainty, Margin Pressure and Disruption: Forward-Looking Crisis Management During COVID-19”
Join us a for a live, free webinar to discuss margin pressure before, during and after COVID-19. Thursday, May 21, 2020 11AM – 11:30 AM CST We will spend 20 …
COVID-19
Forward-Looking Crisis Management for COVID-19 Recovery
Key Takeaways: Strategic partnerships, reconfiguring routine care, increasing productivity and effective revenue management are value-based strategies that help enhance competitiveness and ensure long-term market relevance. Combined with increased costs for …
COVID-19
Pandemics and Your Medication Adherence
If you suffer from asthma or chronic obstructive pulmonary disease, better known as COPD, why would you not take your medication as prescribed? You take it, you can breathe, you …
4sight Friday
4sight Friday | What COVID-19 Is Doing to Medical Practices | Coronavirus and Healthcare Spending | Healthcare’s COVID-19 Echo Chamber
Read 05/01/2020 Edition here. Curated by David Burda, 4sight Health’s news editor and columnist. Columns here. Find 4sight Health and industry opinions and news on market-based change, all with the 4sight …
COVID-19
How COVID-19 Is Accelerating the Death and Rebirth of Medical Practices
The COVID-19 outbreak in the U.S. has turned everyone’s world upside down. In healthcare, no one has had their world turned upside down more than doctors and their medical practices. …
4sight Friday
Podcast: 4sight Friday Roundup, 04/24/2020
David Burda interviews David Johnson and Gary Bisbee about the week’s biggest news around market-based change. David Johnson is CEO of 4sight Health. Gary Bisbee is Co-Founder and Executive Chairman …
Outcomes
Differential Susceptibility of Individuals and Communities to COVID-19
COVID-19 strikes with alarming inconsistency. Most recover quickly while others die. The disease devastates some communities and spares others. Understanding why and how COVID-19 preys on some and not others …
Economics
Tone-Deaf GPOs Brag About Savings While Healthcare Workers Scramble for Supplies
Sometimes, it’s better just not to say anything. If you know anything about the COVID-19 outbreak in the U.S., you know that the healthcare supply chain here has been a …
System Dynamics
Pandemic Preparedness 101: Creating Appropriate Surge Capacity
In 2014, Israel opened a parking garage that can be turned transformer-like into a 2,000-bed hospital. The architects hired by the Rambam Medical Center in Haifa designed the walls of …
Economics
COVID-19 Will Test the Ability of Healthcare CFOs to Manage Financial Risk
Chief financial officers around the world are scrambling to figure out how to manage the short-term economic impact and the long-term economic effects of the COVID-19 outbreak on their companies …
Economics
Hospitals at the Margins
Almost every hospital or health system that I’ve covered over the past 37 years as a healthcare business reporter claims to be failing financially or on the brink of financial …
Economics
The Sorry State of Hospital Interoperability
Likely overshadowed by anticipation of HHS’ final information-blocking rules, which came out earlier this week, HHS’ latest annual report on hospital interoperability didn’t get much attention. But, if you read the …
Market Corner Commentaries
Why Strategic Partnerships Are Vital To Hospital and Health Systems Success
In our January 9th, 2020, Market Corner Commentary we identified the following five forces that are coalescing to drive more value into the delivery of healthcare services: More disciplined purchasing …
Economics
How Fee-for-Service Makes Doctors Choose Poorly
It’s not complicated. If you want doctors to stop performing or ordering low-value procedures and tests, stop paying for them. The reminder that providers respond to financial incentives as much …
Policy
Status Quo vs. Revolutionary Healthcare
As the presidential elections approach this year, each candidate is still struggling to convince the American people that her or his healthcare agenda will meet consumer needs. America spends more …
Innovation
Podcast Interview: How Startups Can Create Value as They Navigate Healthcare’s Shift to Risk-Based Models w/ David Johnson
There are record amounts of investment into healthcare and provider-based services – but to get your slice of the market, you’ve got to be better, faster, and smarter than the …
Economics
Which Way Will the Private Equity Pendulum Swing for Patients?
Before your physician asks you at your next office visit what brought you in today, you may want to ask them who owns their practice. Their answer may at least …
Market Corner Commentaries
Chadwick Annual Synthesis: A Look Inside
(from Taking Healthcare’s Pulse: 4sight Health’s 2020 J.P. Morgan Conference Report) Chadwick Annual Synthesis: A Look Inside J.P. Morgan 2020 By Edward Chadwick, Founder of Integrated Healthcare Financial Strategies LLC …
Podcasts
Podcast: Widen the Funnel and Close the Gaps: The Summit-CityMD Combo Sees “Big Apple” Opportunity through Integrated Care Delivery
Cain Brothers’ Managing Director, Carsten Beith; Warburg Pincus Managing Director, TJ Carella; and Summit Medical Group CEO, Dr. Jeffrey Le Benger joined Dave Johnson at Cain Brothers’ Annual Healthcare Conference …
Market Corner Commentaries
Widen the Funnel and Close the Gaps: The Summit-CityMD Combo Sees “Big Apple” Opportunity through Integrated Care Delivery
Private equity-funded delivery models are emerging to create more integrated care models that position well for value-based contracting. These new asset-light and consumer-oriented business models are changing healthcare’s competitive dynamics …
System Dynamics
Lessons Learned: One Health System’s Foray into Service Rationalization
An interview with OhioHealth’s Nikki Ross, System Director of Sterile Processing, on ways service rationalization works in today’s modern health system. When you pick up your dry cleaning and fill …
Market Corner Commentaries
Taking Healthcare’s Pulse: 4sight Health’s 2020 J.P. Morgan Conference Report
Each year on the second Sunday in January, the healthcare world descends on San Francisco for the J.P. Morgan conference and the circus that surrounds it. For the next week, …
Market Corner Commentaries
Healthcare Has No Clothes: J.P. Morgan 2020
(from Taking Healthcare’s Pulse: 4sight Health’s 2020 J.P. Morgan Conference Report) Each year on the second Sunday in January, the healthcare world descends on San Francisco for the J.P. Morgan …
Economics
Fun with Fraud Numbers
I’ve watched enough crime movies and TV shows to know that the law enforcement character who talks tough usually isn’t and, more often than not, is in on the crime, …
Policy
Healthcare’s Epic Problem & the Audacity of Liberating Patient Data
The gloves are off and the big guns are out. Epic Systems Corporation, the nation’s largest EHR vendor, is applying every fiber of its corporate being to dilute the government’s …
Economics
Death by a Thousand Mergers
When the Centene Corp. completed its $17.3 billion acquisition of WellCare Health Plans late last week, it created a health insurer that now operates in all 50 states with a total …
Consumerism
What’s Going to Happen in Healthcare in 2020—or Not: A Meta Review of Industry Outlooks
Maybe it’s because it’s a new decade. Maybe it’s because the year 2020 makes for easy vision analogies. Maybe it’s because CMS projects national health expenditures to break the $4 …
Economics
Why Medicare for All Can’t Work (And Here’s What Can)
America is a rich country. We spend 18% of our economy on healthcare, yet our country is plagued with poor outcomes. Everyone agrees that Americans deserve the right to quality …
Blog
7 Ways States Can Save Consumers from Rising Healthcare Prices
Competition, regulation or both? Those are the choices facing states that want to make healthcare more affordable for their residents after years of unbridled prices hikes from providers and premium …
Burda on Healthcare
Growing Pains or Warning Signs for Medicare Advantage?
The Medicare Advantage program turned 21 this month. Like all 21-year-olds with new-found freedoms and responsibilities, whether it makes 31 in the same shape will depend on how well it …
Market Corner Commentaries
Unrelenting Margin Pressures: Overcoming Healthcare’s Softening Revenues and Rising Expenses
Key Takeaways: Despite favorable rating agency outlooks, the 2020s promise to be healthcare’s most turbulent decade since the 1990s. It’s been a great 20-year run for the healthcare industry, but …
Consumerism
What Digital Health Technologies Investors Are Betting On
As a business journalist, I hang out at the corner of “follow the money” and “actions speak louder than words.” It’s the same place I go when I want to …
Blog |
Consumerism |
Economics |
Innovation |
Outcomes |
Policy |
System Dynamics |
What Revolutionary Healthcare Leaders Read This Year: The Top 5 Commentaries on 4sightHealth.com for 2019
Here at 4sight Health, we like to call it like it is. We see and throw a flag on the things that prevent the healthcare system in the U.S. from …
Market Corner Commentaries
Overcoming Collateral Damage: Healthcare Price Transparency Now and Forever
Key Takeaways: Providers and payers fight the implementation of transparent prices with all their considerable resources and influence. Monopolies and monopsonies resist transparent pricing for their services because it threatens …
House Calls
Podcast: Commercializing Breakthrough Drugs in a Value-Based Market
What does it take to bring a breakthrough drug to a value-based market? John Kerins, Director at Cain Brothers, a division of KeyBanc Capital Markets Inc., and David Johnson discuss …
Blog
Will 2020 Be the Year that Healthcare Gets More Affordable?
As 2019 draws to a close, the evidence continues to mount that healthcare affordability again will be the No. 1 challenge facing patients in 2020. What incumbent industry stakeholders, lawmakers, …
Market Corner Commentaries
Commercializing Breakthrough Drugs In a Value-Based Market
Key Takeaways: Society demands both innovation and fair pricing from drug companies that develop treatments for all diseases. Proving meaningful efficacy and value is essential for successful drug commercialization. The …
Podcasts
Cup of Joe Podcast: HFMA’s President and CEO Joe Fifer Interviews 4sight Health’s CEO Dave Johnson
HFMA’s President and CEO Joe Fifer interviews healthcare industry experts about healthcare finance on his podcast, HFMA Cup of Joe. Listen to his interview with Dave Johnson, CEO of 4sight Health. …
Blog
AHRQ Data Reveals Health System Search for Winning Formula
Pictures don’t lie. Neither do numbers. And these numbers paint of picture of U.S. hospitals and health systems remaking themselves in response to new economic forces challenging their long-term viability. …
Economics
Has Healthcare Lost Its Appetite for Value?
I get the feeling that the industry is moving on from this whole volume-to-value thing and will need to find a new analogy to replace that foot-in-two-canoes business that everyone …
Podcasts
Podcast: Mission-Critical Repurposing: Converting Aging Senior Living Properties to Affordable Housing
Bill Pomeranz, Managing Director at Cain Brothers, a division of KeyBanc Capital Markets Inc., and David Johnson dive into the plight of senior living facilities around the country that haven …
Blog |
Consumerism |
Economics |
Policy |
System Dynamics |
Patients Need More Muscle to Crush Drug Prices
Everyone complains about high drug prices. That is, when they’re not complaining about high hospital prices. So what are you going to do about it? Or, better yet, what can …
Market Corner Commentaries
Transforming the Built Environment: Unlocking Value Across the Health Care Continuum
Health care providers suffer from a unique form of institutional irony: delivering institutionalized care in centralized, high-cost facilities impedes their ability to meet their communities’ expansive health and wellness needs. …
Blog |
Economics |
Outcomes |
Policy |
How Much Will It Take To Improve Patient Safety?
One of the best lines in Jaws comes from Brody after he sees the 25-foot great white shark for the first time. He slowly backs into the cabin, looks at …
Blog |
Economics |
Innovation |
Outcomes |
System Dynamics |
Fireside Chat: Why You Should Join the Customer Revolution
Join us in downtown Chicago on Thursday, November 14 at 5:30PM at MATTER. Michael Allen, CFO of OSF Healthcare, will interview David Johnson about critical concepts in Dave’s new book …
Market Corner Commentaries
Mission-Critical Repurposing: Converting Aging Senior Living Properties to Affordable Housing
In 1908, the Jewish Home for the Aged of the Northwest opened in St. Paul, Minnesota, serving eight residents. As the facility deteriorated, the local Jewish community raised funds and …
Blog |
Economics |
Outcomes |
Policy |
Will Misuse of Antibiotics Respond to Regulation?
I got my flu shot on Oct. 21. (I’ll let you know how it worked out.) As I waited for my turn at our nearby immediate-care center, I explained to …
Blog |
Economics |
Innovation |
Outcomes |
Finding the Value for Healthcare Consumers in Outcomes-Based Contracting
When you buy something and it doesn’t work, you take it back to the store (or more likely send it back to Amazon via your local Kohl’s) for a refund. …
Market Corner Commentaries
A Second Coming: Medical Education’s Desperate Need for Another Flexner Revolution
On June 26th, 2019, American Academic Health Systems announced its intention to cease all medical activities at Hahnemann University Hospital by September 6th, 2019. With roughly 17,000 annual admissions, Hahnemann …
Policy
Ranking the Regulations that Bother Doctors
I love healthcare industry regulatory burden surveys. From an academic standpoint, I’m interested in the topic of competition versus regulation and how each affects how healthcare markets function—or not—for patients. …
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Economics |
Innovation |
Podcasts |
Podcast: Getting Urgent about Urgent Care: Health Systems Go Big on Retail
Wyatt Ritchie, Managing Director at Cain Brothers, a division of KeyBanc Capital Markets Inc., and David Johnson discuss the rise of urgent care clinics that are meeting market demand for …
Blog
What Revolutionary Healthcare Leaders Are Reading: The Top 5 4sight Health Commentaries Over the Past Six Months
4sight Health’s writers and authors have published 57 blog posts, commentaries, podcasts and videos on 4sighthealth.com from January through June of this year. The topics are as varied as the …
Blog
Maybe It’s the Patients, Not the Prices. Is that Stupid?
In most markets for most goods and services, you get what you pay for. The more you pay, the better the goods or the services. Hence, the expression, you get …
Market Corner Commentaries
Don’t Let Special Interests Block Pending Rules for Sharing Patient Healthcare Data
On September 23rd, the seven healthcare lobbyists listed below sent a letter to the leaders of the Senate Health, Education, Labor and Pensions Committee (HELP) and the House Committee on …
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Economics |
Policy |
System Dynamics |
Seeing Through Physician Participation in Value-Based Reimbursement Models
The more things change, the more they stay the same. I get the point of the expression. But, I didn’t fully appreciate how it applied to healthcare until I read …
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Economics |
Outcomes |
System Dynamics |
If You Scroll Down, You’ll Find Out What Employers Really Think About Healthcare
With open enrollment about a month away at most businesses that offer health insurance benefits to their workers, it’s time to look at what employers are doing and not doing …
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Economics |
Policy |
System Dynamics |
Upselling in Healthcare? It’s Just Business
As wary consumers, we’ve come to expect upselling. Need an oil change? Looks like you need a new air filter and radiator flush, too. That sports coat looks fantastic on …
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Economics |
Innovation |
Outcomes |
System Dynamics |
Platforming Health Care to Transform Care Delivery
NEJM Catalyst Article for September 19, 2019 David W. Johnson, MPP Amy Compton-Phillips, MD Hospitals used to be at the center of the health care universe. Today, new business models …
Consumerism |
Economics |
System Dynamics |
Healthcare Blocking and Tackling
Football season is upon us, and you’ll be hearing coaches at every level—high school, college and pro—talking about “getting back to basics” or “stressing the fundamentals” or “blocking and tackling.” …
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Economics |
Innovation |
Market Corner Commentaries |
Outcomes |
Policy |
An American Inquiry: Why I Wrote The Customer Revolution in Healthcare
What convinced a former Peace Corps volunteer and healthcare investment banker like me that the U.S. healthcare system (the System) requires revolutionary overhaul? It really came down to just one …
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Economics |
Outcomes |
System Dynamics |
Why Fee-for-Service Medicine is Bad for Your Health
The later in the day that you see your doctor you’re more likely to get the flu, get colon cancer and get hooked on prescription pain killers. OK, that’s a …
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Economics |
Innovation |
System Dynamics |
Higher Practice Skill Mix May Not Be What the Doctor Ordered
“Practicing at the top of your license” and “upskilling your workforce”are two popular healthcare buzz phrases right now. As account-hungry consultants breathlessly will tell you, when medical professionals spend their …
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Economics |
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System Dynamics |
Spend More. Pay More?
Everyone in healthcare is “all in” on a lot of things these days, and two things that are at or near the top of that list are social determinants of …
Economics
Should Doctors Make Less Money?
In an August 1st commentary published in the Washington Post, columnist Catherine Rampell asks an intriguing question of the Democratic presidential candidates promoting a Medicare-for-All health insurance program: “Will your …
Economics
Win-Win Partnerships: Strategics and Sponsors Increasingly Team Up
As US healthcare consolidation continues, innovative corporate buyers (strategics) and private equity investors (sponsors) are partnering to accomplish increasingly complex transactions. Such deals can create win-win arrangements that serve market …
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Economics |
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System Dynamics |
The Rising Cost of Family Coverage Is No Joke
You might have heard about this on the news. A new study is out that says employer-sponsored health insurance is getting really expensive. (How expensive is it?) Hmm. May your …
Outcomes
There’s No O (outcomes) in ACO
Medicare accountable care organizations say they’re doing a lot to manage and coordinate the care of sick beneficiaries. But a new study says the ACOs don’t have much to show …
Innovation
The Future of Liberated Data in Medicine
Digitization and globalization of medical knowledge will double every 73 days by 2020.[1] When a patient enters an exam room, they will likely encounter a “Dr. Know-it-All” or come prepared …
System Dynamics
Repositioning Temporary Staffing Services: Meeting Healthcare’s Strategic (and More Permanent) Need for Labor Flexibility
American workers increasingly wear scrubs, not overalls or store uniforms.(1) In late 2017, healthcare surpassed manufacturing and retail to become the largest employer in the U.S. economy. 19 million people …
Economics
How to Use Social Determinants of Health to Fix Reimbursements
Healthcare providers can no longer ignore the Social Determinants of Health (SDH) in the exam room. Even John Snow considered community assessment factors to identify the source of the cholera …
Economics
Should Hospitals Pay Taxes?
Many health systems and hospitals operate as Not-for-Profit (NFP), mission-oriented organizations that do not pay sales, excise, property or other taxes. In exchange, NFPs must publicly report the level of …
Economics
Pets versus Babies: Who Offers More Health Benefits at Work?
Everyone, including me, is always on employers to do more to improve the healthcare system in the U.S. We’re on them to use their healthcare purchasing power and insured-lives market …
Consumerism
Surprise! Surprise! The Surprise Billing Legislation Could Usher in Government Price Controls. Nathan Bays, Guest Columnist
As the Senate Committee on Health, Education, Labor, and Pensions (HELP) prepares to vote on the Lowering Health Care Costs Act, the issue of surprise medical bills will take center …
Economics
What Are Healthcare Executives Thinking? – Burda on Healthcare
I write a lot about what healthcare organizations and companies do, and I make educated guesses on why they do what they do based on my experiences, industry knowledge and …
Policy
States Foul-Tipping Regulatory Approaches to Control Healthcare Prices
A new Viewpoint in the Journal of the American Medical Association said states are trying, but largely failing, to control through various regulatory tactics the prices paid by private health …
Economics
More on Why Employers Should Pay Attention to Behavioral Health
More on the what and the why of employers and behavioral health, and what both mean for remaking the nation’s healthcare system into one where outcomes matter, customers count and …
System Dynamics
Doctors and the Laws of Supply and Demand – Burda on Healthcare
It’s a great time to go to medical school and become a doctor. Ignore all the manufactured angst from organized medicine and opinion polls of aging physicians who say they …
Economics
Getting Urgent about Urgent Care: Health Systems Go Big on Retail
Historically, health systems have delivered acute care services in hospitals and ambulatory facilities. Their business models centralize care delivery in expensive settings to optimize their operations and revenue. In avoiding …
Outcomes
What Businesses Say They’re Doing About Their Employees’ Mental Health
The National Institute of Mental Health says 46.6 million adults suffered from some form of mental illness in 2017. Of those, 57.4 percent didn’t receive any mental health treatment for …
System Dynamics
The Deep State of Physician Prescribing Patterns
And you thought changing patients’ health behaviors was going to be hard. Try changing physicians’ drug prescribing patterns. That’s the lesson from a new study in Health Affairs that reported …
Consumerism
An Unbearable Burden (Part 2): Wide Variations in State Health Insurance Costs
The Healthcare Affordability Index (Index) is a simple and powerful metric for assessing the impact of rising healthcare cost on American living standards. The Index measures the relationship between the total …
Policy
Let’s Get Real: Medicare for All Can’t Work, but Affordable Health Insurance for All Can
As it has in the last three presidential elections, healthcare is emerging as a decisive political issue in the 2020 election. Unlike in those previous elections, however, universal health insurance …
Policy
This Is a Story About Where Healthcare Regulations Come From – Burda on Healthcare
Healthcare is one of the most if not the most regulated industry in the U.S. While its businesses like to blame overzealous bureaucrats for all the red tape, the current …
System Dynamics
Culture Change Isn’t a Natural for Healthcare Organizations
“We must begin by asking it, ‘What is losing?’ Losing is a disease. As contagious as polio. Losing is a disease. As contagious as syphilis. Losing is a disease. As …
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Consumerism |
Economics |
Innovation |
How to Improve Patient Satisfaction with Transparent Payment Systems
American healthcare patients are demanding more price transparency, affordable services and quality care. Why are they not receiving it? How can healthcare organizations listen to consumers and set themselves up …
Economics
The Universal Patient Experience of Debilitating Healthcare Costs
The lack of affordable medical care isn’t just a U.S. phenomenon. It’s a serious problem across Europe, according to a new report from the World Health Organization. WHO’s report identified …
Economics
Consolidating Retail Medicine: Positioning Single-Specialty Practices for Acquisition
Single-specialty medical practices are the front door of American medicine. Dentists, Dermatologists, Ophthalmologists, GI doctors, ENT doctors, Internists, Gynecologists, Obstetricians, Urologists and their “retail medicine” counterparts provide high volumes of …
System Dynamics
Interoperability Battle Lines: Data Freedom Fighters vs. Entrenched Data Blockers
On a cold Minnesota morning in January 2018, Fairview Health Services CEO James Hereford addressed Twin Cities business executives regarding healthcare IT and innovation. (1) With an advanced degree in …
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Economics |
Policy |
How Crony Capitalism in Healthcare Hurts Communities and Markets
Does “pro-business” equate to “pro-market”? Or is crony capitalism blurring the line in the healthcare industry? How can consumers tell if they are being treated fairly? There are two types …
Economics
Why Proponents Are Finding Innovative Health Plan Designs a Hard Sell
When your phone company or your cable provider offers you a new and innovative service plan, your immediate thought is that you’re going to end up paying more for less. …
Economics
When Pillars Crumble: A Warning for Healthcare?
Raghuram Rajan’s new book The Third Pillar provides an insightful framework for understanding the interconnected relationships between the three pillars of modern society: governments, the markets and local communities. An …
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Consumerism |
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Market Corner Conversations |
Podcasts |
MARKET CORNER CONVERSATIONS: Tomer Shoval, CEO & Founder, Simplee
Tomer Shoval, CEO & Founder of Simplee, discusses how his relentless focus on the customer created a payment platform for health systems that actually increases customer satisfaction and improves financial …
Consumerism
When Hospitals Merge, Patient Satisfaction Gets Squeezed
When two competing companies merge and get bigger, a common worry of their customers is whether the quality of service will suffer as a result. Should patients worry about the …
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Economics |
Outcomes |
Policy |
Price Controls Take Root in Rhode Island. Will They Spread to Your State?
One state’s attempt to control healthcare costs by using “affordability standards” ended up limiting increases in commercial health insurance payments to hospitals and doctors without any changes in utilization or …
System Dynamics
Forced Resignations at NCH Healthcare System Expose Medicine’s Dark Side
An ongoing feud between independent physicians and hospital administrators in Naples, Florida, exploded last month, damaging the trust between the community, providers and the health system. (1) The furor centered …
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Economics |
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System Dynamics |
When Blue is the New Green
I mean, what did you think was going to happen? A new study says big Blues plans that went for-profit dramatically raised their premiums right after their ownership conversions. The …
Economics
An Unbearable Burden: Paying for Commercial Health Insurance
The Healthcare Affordability Index (the Index) is a simple and powerful metric for assessing the impact of rising healthcare cost on American living standards. The Index measures the relationship between …
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Economics |
Outcomes |
System Dynamics |
Wither the Traditional Physician Office Visit
It’s not your imagination or the self-serving forecast of a healthcare consultant angling for your business. Fewer people are seeing their doctors in person in a physical office. It’s a …
System Dynamics
After the Breakups: Big Payers Find Vertical Love in New Faces
In rapid succession at the end of 2018, CVS closed its $70 billion acquisition of Aetna and Cigna closed its $67 billion acquisition of Express Scripts. The consolidated companies are …
Policy
The Immovable Force That Is Employer-Sponsored Health Insurance
Death, taxes and employer-sponsored health insurance. We know the first two are certainties in life, and new research again confirms the assurance of the third. Researchers from the School of …
Outcomes
Everything in Healthcare is Changing—Except One Thing
Much has changed in healthcare over the past 25 years. A lot has changed in healthcare over the past 25 minutes. But one thing hasn’t changed, and that’s the public’s …
Consumerism
When the Price Is Right: Aligning Payment with Health System Transformation
In 1952 at the tender age of 25, Elizabeth became the Queen of England upon the death of her father King George V. The popular Netflix series “The Crown” depicts the …
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Economics |
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System Dynamics |
Medicare Advantage Bends Cost Curve the Wrong Way
Everyone sees what they want to see in the latest figures on national health expenditures released by the Centers for Medicare and Medicaid Services earlier this month. Most people see …
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Burda on Healthcare |
Economics |
Innovation |
Policy |
System Dynamics |
HHS Goes All In on Competition as the Way to Fix Healthcare Woes – Burda on Healthcare
Competition good. Regulation bad. That’s my caveman summary of HHS’ manifesto released on Dec. 3 on how to improve the quality and safety of patient care while simultaneously lowering healthcare …
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Economics |
Outcomes |
How to Create Pro-Market Healthcare Reform in an Opioid Crisis
Over 200,000 Americans have died since 2000 due to opioid overdoses.[1] That’s equivalent to all of Salt Lake City[2] disappearing from our country. The epidemic is destroying communities throughout America, …
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Consumerism |
Economics |
Innovation |
Med Tech Bets on Value as Its Future Business Model
If you’re looking for a sign that we’re truly approaching a watershed moment in healthcare innovation, look no further than the people whose job is creating new medical technologies that …
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Economics |
Innovation |
Market Corner Conversations |
Podcasts |
System Dynamics |
MARKET CORNER CONVERSATIONS: JIM HARDING, FOUNDER & CEO, MULTISCALE HEALTH NETWORKS
Jim Harding, Founder & CEO of MultiScale Health Networks, joins David Johnson for Episode 13 of Market Corner Conversations. Jim discusses how he applied his experience as a serial tech entrepreneur …
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Burda on Healthcare |
Consumerism |
Economics |
Innovation |
Man or Corporate Culture: Who Has More Power to Disrupt Healthcare? – Burda on Healthcare
We’re at a branch point in healthcare’s evolution. We’ll learn soon whether disruptive innovation is the product of individuals or organizations. When we find out, we’ll know the best path …
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Consumerism |
Economics |
Policy |
New Primary-Care Provider, Same Old Price
Patient office visits to primary care physicians are down. Patient office visits to nurse practitioners and physician assistants are up. But switching to NPs and PAs from doctors isn’t saving …
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Economics |
Market Corner Commentaries |
System Dynamics |
Brand-Heavy and Asset-Light: Moving Beyond the Acute-Care Mindset
For health systems, the day of reckoning is near. A recent Morgan Stanley report states that over 1,000 of the nation’s 5,000+ hospitals are currently weak or at risk of closing. …
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Economics |
Outcomes |
System Dynamics |
Few On The Same Page When It Comes To The Value of Value-Based Reimbursement
Yet another report shows that fee-for-service medicine is hard to kill. This time the culprits are a lack of faith in value-based reimbursement by clinicians and a lack of trust …
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Economics |
Policy |
System Dynamics |
Amplifying Transformation: Addressing Medicare Advantage’s Disadvantages
The U.S. healthcare system will not change the way it delivers care until it changes the way it pays for care. Perverse incentives riddle fee-for-service payment (FFS) and lead to …
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Economics |
Outcomes |
System Dynamics |
Pointing the Finger at Health Plans for Providers’ Price Variations
Wide variations in what providers charge for the same medical services are notorious. But providers are not acting alone. They’re aided and abetted—and some would say coerced—by health plans whose …
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Economics |
Policy |
System Dynamics |
It’s Commercial Health Plans That Are Keeping Fee-for-Service Alive
Far from pulling the plug on fee-for-service medicine, commercial health plans continue to give it CPR. A new report says well over half of commercial health plan payments to providers …
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Economics |
Policy |
System Dynamics |
Study Refocuses ER Coverage Debate on Patients
A new study reminds us that the squabble between providers and payers over coverage of unnecessary emergency room visits should be more about patients and less about who pays who …
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Burda on Healthcare |
Consumerism |
Economics |
System Dynamics |
Employees’ Premiums Actually Dropped This Year and Nine Other Untold Employer Health Benefits Stories – Burda on Healthcare
Every picture tells a story. So does every chart in the Kaiser Family Foundation’s annual employer health benefits survey. Here are 10 small stories from Kaiser’s latest survey that collectively …
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Consumerism |
Economics |
Outcomes |
TOP HOSPITALS MAKE IT TOUGH ON PATIENTS WHO WANT TO SEE THEIR OWN MEDICAL RECORDS
All hospitals say that they want to engage patients in their own medical care. But even the best hospitals are making it difficult for patients to access their own medical …
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Economics |
Market Corner Conversations |
Podcasts |
MARKET CORNER CONVERSATIONS: Luigi Zingales, University of Chicago
Luigi Zingales, University of Chicago economist, joins David Johnson to discuss the key components of capitalism that encourage innovation rather than creating paralysis in markets. Listen to his thoughts on …
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Consumerism |
Economics |
System Dynamics |
An Urgent Message for Those Who Want Care on Demand
The news cycle in healthcare seems to be following the news cycle in politics. Twenty-four hours is now 24 minutes if not 24 seconds. With that in mind, let’s hit …
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Economics |
Outcomes |
System Dynamics |
A Lesson in Value-Based Payments from Across the Pond
If you paid your kids to clean their rooms and keep them clean, would they? If you stopped paying them, would they keep cleaning their rooms because they realized that …
Policy
Kentucky HEALTH and Medicaid Work Requirements: A Behavioral Economics Lens Sheds Light
On Friday, June 29, near the zero hour, a federal judge ruled [1] that Kentucky’s Medicaid waiver approved by the CMS could not go forward on Sunday, July 1 as …
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Market Corner Conversations |
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MARKET CORNER CONVERSATIONS: Amitabh Chandra, Harvard Business School
Amitabh Chandra, economist and the McCance Family Professor of Business Administration at Harvard Business School, joins David Johnson for Episode 10 of Market Corner Conversations. Chandra shares his path form labor economist …
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Consumerism |
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Market Corner Commentaries |
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Destination Medicare Advantage: Lonnie & Cathy’s Quest for Great Health Insurance
In 1993, the health insurance industry funded the legendary “Harry and Louise” campaign to mobilize public opinion against the Clinton healthcare reform proposal. The strategy worked. Despite enormous investment of political capital, …
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Market Corner Commentaries |
Outcomes |
Policy |
System Dynamics |
Pro-Market and Pro-Business: Not Always the Same, Particularly in Healthcare
Shortly after publishing Market vs. Medicine: America’s Epic Fight for Better, Affordable Healthcare in June 2016, I met with my former investment banking colleague, Jullia Quazi. Jullia arrived with a very funny story …
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Economics |
Market Corner Commentaries |
Outcomes |
System Dynamics |
Superhero Healthcare (Part 2): Already Here; Growing Fast; Payment-Driven
Part I of Superhero Healthcare identified several bright spots within American healthcare where liberated caregivers deliver appropriate, efficient care to engaged patients; where the interests of health companies and their customers align; and where compassion, …
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Economics |
Market Corner Commentaries |
System Dynamics |
Mission First: Mission Health’s Surprising Sale to HCA
On March 22nd, Mission Health in Asheville, North Carolina announced its intention to sell its seven-hospital not-for-profit (NFP) health system to HCA Healthcare, the nation’s largest for-profit healthcare system. The …
Outcomes
Reimbursement Follows Respect: Leading States Pay to Address Social Determinants of Health
For too long, the “Social Determinants of Health” (SDH) have been the big elephant in the exam room. While no one denies that a diabetic living alone in a food …
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Economics |
Market Corner Commentaries |
Outcomes |
System Dynamics |
Fortress Healthcare Meanders Toward Value
There are more “suits” in downtown San Francisco each January for JP Morgan’s annual healthcare conference than the rest of the year combined. Heavy rain drenched San Francisco on January …
Economics |
Innovation |
Market Corner Commentaries |
Policy |
System Dynamics |
Is Tax-Exemption Necessary? Enlightened Health Systems Should Consider the Unthinkable
In the mid-1800s, English philosopher and political economist John Stuart Mill developed “Utilitarianism,” a framework for making moral decisions. In Mill’s formulation, an action achieves optimal social utility when it …
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Consumerism |
Economics |
Market Corner Commentaries |
Introducing the Healthcare Affordability Index: High-Cost Private Health Insurance Reduces Family Incomes
Today, Dr. Ezekiel Emanuel and I along with Aaron Glickman published Measuring the Burden of Health Care Costs on U.S. Families in the Journal of the American Medical Association (JAMA). …
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Consumerism |
Economics |
Market Corner Commentaries |
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System Dynamics |
Advantage Medicare Advantage: Delivering Healthcare’s Triple Aim to America’s Seniors
Hitting the Sweet Spot for Patients and Providers The United States is experiencing a demographic tidal wave. Baby Boomers are turning 65 in record numbers and that trend will accelerate …
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Economics |
Innovation |
Market Corner Conversations |
Outcomes |
Podcasts |
Market Corner Conversations: Paul Walczak, NuVista
4sight Health’s inaugural episode with Paul Walczak, the CEO from NuVista, a remarkably innovative post-acute care company coordinating value-based delivery in southern Florida that achieves superior outcomes at very low costs. …
Economics |
Market Corner Commentaries |
Outcomes |
System Dynamics |
Symbiotic Disruption: Skilled-Nursing-REIT Ecosystem Adapts to Market Dynamics
Nature thrives on symbiosis. Its many ecosystems would not exist without important relationships between sometimes strange bedfellows. The oceans’ most colorful coral reefs, for example, are often found in clear …
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Market Corner Commentaries |
Outcomes |
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“Indumbent” Healthcare Thinking: Prices Don’t Matter
In a March 29th New York Times article, author Elizabeth Rosenthal chronicles America’s dystopian system for coding and billing medical treatments. Rosenthal concludes that the medical-billing system itself is a …
Consumerism |
Economics |
Innovation |
Market Corner Commentaries |
System Dynamics |
Darwinian Outsourcing: Big Pharma Adapts to Market Realities
by Kristin Carey and David W. Johnson Competitive markets drive innovations in business efficiency and strategy. Twenty-five years ago, Big Pharma companies did little outsourcing. Fortified by robust cash flows …
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Letting Go: Steward Sells Its Hospitals and Embraces Patient-Centric Care
Last September, Massachusetts-based Steward Health Care System announced that it would sell its 9 hospitals to Alabama-based Medical Properties Trust (MPT) for $1.2 billion in a 15-year sale-leaseback transaction with …
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Market Corner Commentaries |
Policy |
System Dynamics |
The Rise and Fall of Academic Medicine: AMC Competitiveness in Post-Reform Healthcare
Rome wasn’t built in a day and didn’t collapse overnight. After centuries of growth, prosperity and domination, the Roman Empire began a long slow decline at the peak of its …
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Value Quest: Capital Formation Challenges for Non-Profit Health Systems
by David W. Johnson, James Moloney and Carsten Beith There’s a battle outside and it’s ragin’ It’ll soon shake your windows and rattle your walls For the times they …
Consumerism |
Economics |
Market Corner Commentaries |
Policy |
System Dynamics |
Epi(c) Pharmaceutical Market Failure
It was hard not to feel sorry for Mylan CEO Heather Bresch as she sat for an extended CNBC interview on the morning of August 25th. Clearly on the hot …
Economics |
Market Corner Commentaries |
The Big Lift: Improving Public Health Exchanges
Bring out the Xanax. Anxiety among Obamacare supporters is skyrocketing. The bad news just keeps coming. Aetna has joined UnitedHealthcare and Humana in announcing plans to exit almost all public …
Consumerism |
Economics |
Market Corner Commentaries |
Outcomes |
Where’s the Beef? Employers Question the Value of Hospital Mergers
In an iconic 1984 commercial for Wendy’s hamburgers, the diminutive octogenarian Clara Peller and two friends are eating hamburgers at the fictional “Home of the Big Bun.” Disappointed by their …
Consumerism |
Economics |
Market Corner Commentaries |
Healthcare’s Dysfunctional Pricing: Be Afraid. Be Very Afraid.
The Health Care Cost Institute (HCCI) released its annual report of healthcare prices last month. To no-one’s surprise, HCCI found huge variation in commercial prices for 240 common medical services …
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Economics |
Market Corner Commentaries |
System Dynamics |
Asset-Light and Ready: Physician Groups Embrace Accountable Care
Hockey superstar Wayne Gretzky gave the business world its most over-used strategic metaphor, “I skate to where the puck is going to be, not where it has been.” In healthcare, …
Economics |
Market Corner Commentaries |
Manipulating Demand: Paying Patients for Lower-Cost Care
Market Corner Commentary for January 13, 2016-Manipulating Demand: Paying Patients for Lower-Cost Care In October, Planet Money aired a podcast with the intriguing title “Pay Patients, Save Money.” Their report …
Economics |
Market Corner Commentaries |
Outcomes |
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Individual Mandate: Are You Up for N=1 Healthcare?
Market Corner Commentary for August 19, 2015 (disruption)-Individual Mandate: Are You Up for N=1 Healthcare? Yogi Berra famously observed, “The future just ain’t like it used to be.” In N=1: How …
Consumerism |
Economics |
Innovation |
Market Corner Commentaries |
Outcomes |
King for a Day: Winning Strategies in Post-Reform Healthcare
Market Corner Commentary for August 12, 2015 -King for a Day: Winning Strategies in Post-Reform Healthcare-(#Quality Outcomes) Great leaders ask great questions. Banner Health’s CEO recently wrote and asked me, …
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Market Corner Commentaries |
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Supreme Court vs. Obamacare II: High Drama; Not the “Main Event”
The “Thrilla in Manila” in 1975 was Mohammad Ali and Joe Frazier’s second championship fight. In 1967, Ali refused conscription as a conscientious objector. He was convicted of draft evasion, …