All the shrugs, shock and handwringing this week over the Google-Ascension patient data-sharing deal got me wondering about what patients thought of all this. So I scrolled through a bunch …

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. …

“The most heroic word in all languages is revolution.” Eugene V. Debs           Find out more about The Customer Revolution in Healthcare in David Johnson’s book. McGraw-Hill releases …

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 …

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 …

Everyone wants patients out of the hospital, where the costliest of costly care takes place.  Government payers. Commercial health plans. Patients. Doctors. Even hospitals want patients out of the hospital. …

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 …

“There are risks and costs to action. But they are far less than the long-range risks of comfortable inaction.”  John F. Kennedy Jr.               …

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. …

“Revolution comes when human beings set out to correct decadent institutions.”  H. Rap Brown                                 …

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 …

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 …

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 …

So, how’s it going? Do you think your hospital or health system or medical practice or health plan or pharmacy or life sciences company or post-acute care facility is providing …

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 …

When people my age were kids, there was a good chance that their parents wanted them to be doctors. Some wanted their children to be lawyers. I don’t recall anyone …

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 …

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 …

Chronic disease consumes 86% of the national health expenditure and kills 7 of 10 people. President Clinton and Obama both created initiatives to cure cancer through genetic research and therapies. …

Colonoscopies are the American College of Gastroenterology’s preferred strategy to detect colon cancer. Ten million Americans annually undergo colonoscopies at a cost approximating $10 billion. Although colonoscopy prices vary, the …

In post-reform healthcare, incumbent health systems must adapt or die from the force of  innovative new companies. Incumbents are vulnerable to value-based attacks. They are asset-heavy, revenue-centric and have ineffective …

This Nov. 29 will mark the 20th anniversary of the release of the report, To Err Is Human: Building a Safer Health System, the seminal work by the Institute of …

Why is it taboo to talk about death? Too often, American families avoid confrontation with death and suffer from catastrophic emotional, medical and financial consequences. Medicare spends 26% of its …

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 …

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 …

In August 2017, Hurricanes Harvey and Irma devastated the South and Southeast regions. Florida evacuated over 7 million people, 7.4 million people lost power and almost 60 hospitals throughout the …

Jeff Dunn DO / MBA and David Johnson discuss the realities of cardiac arrest inside the hospital, for patients and clinicians, in Episode 18 of Market Corner Conversations. Survival rates are …

It seems that the Healthcare Industrial Complex (TM) is alive and well in the cardiac catheterization and electrophysiology laboratories at the top heart hospitals across the country. At least that’s …

What were you expecting, an ICU? A new study in JAMA Internal Medicine reveals that the hospitals patients rated highly for service were less likely to have the actual medical …

The home healthcare sector is dominated by “mom and pops” in a highly-fragmented and under-performing market. Fraud is rampant and customer care is inconsistent. The Department of Health and Human …

To entrepreneurs, regulation is the enemy of innovation. That’s especially true in healthcare. Experts agree that healthcare is one of the most, if not the most regulated industry in the …

Resuscitating Your Patients and Building Your Clinical Reputation The plane is in a nosedive. The sweating pilot is fighting to control the aircraft. A nervous co-pilot is furiously flipping through …

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 …

You know that moment when you “hit the wall” when you’re running a marathon? I don’t. But, I’m told that it typically happens around the 20-mile mark when your physical …

By now you know you should never order fish at a restaurant on a Monday. That’s because the fish likely has been lying around the kitchen since early Friday morning. …

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 …

I’m not sure that US millennials are going to have a happy ending when it comes to their healthcare. If I’m reading things right, in less than 30 years, when …

Knockoffs usually aren’t as good as the originals, whether they’re golf clubs, purses or pressure cookers. A new study suggests that you can add healthcare to the list, especially if …

“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 …

Like companies in any other industry, when providers misbehave, it opens the door to state regulation of their behavior. What’s interesting about a new study in JAMA Open Network is …

It’s like preparing and serving a seven-course meal that your biggest customer ordered only to have the entire menu change between the salad and the main course. That’s what it …

Hear how Dr. Zenilman’s residency at Kings College Hospital in the early 1980s, at the epicenter of the AIDS epidemic, started his career in infectious disease, through the CDC, to …

What if you walked into your doctor’s office and there was a sign hanging in the waiting room that said: “Please do not confuse your Google search with my medical …

What if the healthcare industry could use data as efficiently as Amazon? What if physicians could know the habits of patients like Amazon knows consumers’ buying history? What is physicians …

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. …

“Dr. Knows Best” is no longer the only sell healthcare companies can make to consumers. In post-reform healthcare, successful companies need to provide quality value-based care, innovative technological solutions and …

Low-value care doesn’t just drive up healthcare costs without providing any discernable medical benefit to patients. It can kill you. That’s the takeaway and market lesson from the latest study …

There are signs that digital health—the promised cure for everything that’s wrong with healthcare—may be slipping into the trough of disillusionment.  You may want to check your heart rhythm on …

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 …

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 …

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 …

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 …

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 …

What’s going to happen in healthcare this year is anyone’s guess. Not really. What’s going to happen in healthcare this year is everyone’s guess. Like most of you, from mid-December …

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 …

What would you cut out if you suddenly had to reduce your monthly household expenses by 5 percent, 10 percent, or even 25 percent? I’m sure that some of the …

Definitions of precision medicine are anything but precise. For seriously ill patients and their families, precision medicine therapies provide a hope when all else has failed. They’re willing to risk …

American healthcare companies have a blind spot that will disrupt the growth of their organizations. The old way of American healthcare business has always been a payment battle between large …

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, …

The line between financial incentives and clinical outcomes just got a little straighter. A new study says money may have erased the difference in readmission rates between the top heart …

Expanding the scope of practice for nurse practitioners and physician assistants may be a cost-effective way to manage the health of patients with chronic illnesses. That’s the market-based reform takeaway …

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 …

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 …

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 …

Autism Spectrum Disorder (ASD) is the nation’s fastest-growing developmental disorder, one that touches each child and family in unique and complicated ways. A  lifelong condition, ASD requires individualized treatments that …

Short of making flu shots mandatory for healthcare workers, healthcare employers need to do much more to immunize their staffs from a virus that threatens their health and the health …

Unnecessary variation in patient care is a quality and cost killer. And it’s not just a problem for complex medical cases. It’s a problem for even the most routine services …

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 …

“For years I [have] thought what was good for our country was good for General Motors, and vice versa.” Charles E. Wilson Last month, General Motors signed a 5-year agreement …

Amid much fanfare, the Amazon, Berkshire Hathaway, JP Morgan health venture (ABJ) announced on June 20th that its new CEO will be acclaimed author and surgeon Atul Gawande. Gawande starts his new job …

The 21st FIFA World Cup kicked off on June 14th when host Russia trounced a weak Saudi Arabian team 5-0 at 81,000-seat Luzhniki Stadium in Moscow. It equaled the most lopsided opening …

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, …

Dr. Mike Roizen, Chief Wellness Officer and Chair of the Wellness Institute at Cleveland Clinic, joins David Johnson for Episode 9 of Market Corner Conversations. Dr. Roizen is the creator …

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 …

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, …

Most weekends in America, long lines form outside cineplexes as ardent fans of DC and Marvel Comics catch the latest iterations on the big screen. Since the dawn of motion …

Toby Cosgrove, M.D., former CEO of the Cleveland Clinic Foundation, joins David Johnson in Episode 7 of Market Corner Conversations. Dr. Cosgrove shares how he built a culture of empathy …

Rushika Fernandopulle, M.D., Co-Founder & CEO of Iora Health, joins David Johnson in Episode 6 of Market Corner Conversations. Rushika shares how he decided that the incremental change model wasn’t working …

In 1970, Marcus Welby, MD became ABC Television’s first show to top network television ratings. Dr. Welby was a cheerful family practice physician with a soothing bedside manner who was …

In Episode 4 of Market Corner Conversations, Mike Pykosz, CEO of Oak Street Health, shares the bottom-up approach Oak Street takes toward its Medicare Part B members. Oak Street creates …

Quad/Graphics, the American printing company, was founded near Milwaukee, Wisconsin in 1971 by a husband and wife team. Harry and Betty Quadracci saw advantages in a family approach to doing …

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 …

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 …

Market Corner Commentary Special Report for November 8, 2017 Earlier this year, the Choosing Wisely campaign celebrated its 5th anniversary. Choosing Wisely is a well-funded, practice-focused organization created to reduce …

This paper is Part 3 in our series on payment reform. After highlighting various efforts to reign in healthcare costs over the past 50 years in Part 1, Part 2 …

By Kurt Waltenbaugh and David W. Johnson Merle Phillips is a petite 110-year old 4’9” fireball who keeps doing big things. She’s writing her twelfth book and recently created a …

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 …

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. …

In the western suburbs outside Minneapolis, two men lead average lives. Surveying them as part of the general population, no health system, insurer or policy maker would notice anything that …

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 …

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 …

In late January, I participated in an Oxford-style debate regarding whether healthcare is a commodity. The debate was the featured event at Tata Memorial Centre’s Platinum Jubilee Conference in Mumbai, …

Climbing the highest mountains requires organization, preparation and strategy. Scaling Mt. Everest is a full-scale expedition. Large teams rely on a sophisticated infrastructure of supplies, equipment and support staff. A …

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 …

by Todd Rudsenske and David W. Johnson From addiction to depression to psychosis, mental illness exacts a growing toll on individuals, families, communities and health systems. We can measure its …

Organizations fail or decline more frequently because of what they did not do than because of what they did.                                                             Russell L. Ackoff Professor of Management Science Wharton School, University …

The Cubs just finished the 2016 regular season with 103 wins and baseball’s best record by a mile. They have spectacular pitching, powerhouse hitting and solid defense. Las Vegas odds-makers …

After two-plus years of operations, clear structural flaws have emerged in the design and function of public health exchanges. Health insurance cooperatives have largely failed. Many traditional insurers have suffered …

With Labor Day weekend approaching, state fairs in full swing, and the barbeque calling, most of us have just half a mind on work. At 4sight Health we’re enjoying the …

Midway through the Rio Olympics, the prowess of the diverse, raucous and remarkably talented U.S. team is on full display. We marvel at the athletes’ dedication. Their enthusiasm is infectious. …

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 …

Market Corner Commentary for July 27, 2016 Earlier this month, President Obama took the unprecedented step of authoring an academic research article in The Journal of the American Medical Association …

Market Corner Commentary for July 20, 2016 Last month, Reed Abelson of the New York Times chronicled the challenges of Oscar Health, the venture-funded health insurance company. Despite massive investment, …

The tango is a beautiful, complex, fast-paced dance that gets the heart racing for participants and spectators alike. The intimacy of two partners moving in coordinated lockstep leaves no doubt: …

Health companies experience excessive variation in clinical outcomes, quality metrics, procedure pricing and customer satisfaction. This frustrates providers, payors, employers and patients alike. All Americans want the healthcare system to …

Gold’s glitter and the lure of quick riches led 90,000 unruly prospectors to California in 1849. The gold rush was on and it had rules. Prospectors had to actively work …

Coming into 2015, Ozzie Delgado confronted a thorny problem. Cleveland Clinic Florida was experiencing expansive demand for surgical services. Occupancy was already at 92% and there would be no capacity …

Wisconsin may never be the same. Green Bay Packers star quarterback announced this month that he has stopped eating dairy products to “get healthier.” As Bart Simpson might observe, the …

At Jeff Shield’s memorial service, Genie Shields proclaimed that her husband’s death has been a “gift,” one that enriches all who receive it. When it became clear that lymphoma would …

Rethinking Healthcare.Gov: As Covered California Goes, So Goes Nation? The 17 state-run healthcare exchanges are real-life “laboratories” for the federally-run exchanges that operate in 34 states. No state exchange has …

For over a decade I’ve plodded up and down the Chicago lakefront with the same group of idiotic runners. Through wind, sun, snow and rain we babble about anything that …

Market Corner Commentary for March 2, 2016: Misdirected Fury: The Boston Globe “Spotlights” Concurrent Surgeries At Sunday night’s 88th Academy Awards, Spotlight won the Oscar for best picture. The movie chronicles …

Market Corner Commentary for February 17, 2016-Healthcare’s Productivity Paradox: Ferocious Exploitation of Reimbursed Payment Las Vegas is a strange place to attend a medical conference. In June 2014, the Healthcare …

Market Corner Commentary for February 10, 2016-Big Data’s Ups and Downs: The Good, The Scary and The Creepy Big data analytics are essential for understanding consumer preferences. Collecting, measuring and …

Market Corner Commentary for February 3, 2016-Pursuing What Works: Genetics, Epigenetics and Chronic Disease Genetics-based therapies represent the pinnacle of medical science. Billions of dollars have poured into research to …

Market Corner Commentary for January 27, 2016- U.S. Healthcare in 2016: Enjoy the Sideshow; Watch the Main Event For the sixty-second time, the U.S. House of Representatives passed legislation repealing Obamacare …

Market Corner Commentary for January 20, 2016 During an investor call in November, the nation’s largest health insurance company (UnitedHealth Group) delivered a body blow to the Affordable Care Act’s …

Market Corner Commentary- Health System Governance- for January 6, 2015 John Koster MD and David Johnson The winds of post-reform transformation are blowing through healthcare. Long-established health systems confront existential …

Market Corner Commentary for November 11, 2015-Getting Right with Consumers: Right Businesses. Right Places. Right Prices. Consumerism has the force and precision of heat-seeking missiles. Customers flocked to Walmart because it …

“Amazoning” Healthcare’s High Prices A recent Kaiser Health News article reports that prices for basic women’s health services vary dramatically within and across markets. The cost for mammograms in Dallas …

Market Corner Commentary for October 21, 2015-Value Rules: Playbook for Post-Reform Healthcare Warren Buffett famously noted that “price is what you pay and value is what you get.”  In fee-for-service …

Market Corner Commentary for October 14, 2015-“The Cubs Way”: Lessons in Leadership, Cultural Change and Performance Improvement Any team can have a bad century!  The Chicago Cubs define ineptitude.  They …

David Johnson and Nathan Bays-Doc-Fix Legislation: Medicare Makes Physicians an “Offer They Can’t Refuse” After years of temporary fixes and short-term extensions, the U.S. Congress repealed Medicare’s Sustainable Growth Rate …

Market Corner Commentary for September 23rd-The Tyranny of Average Costing: Profit and COST in Value-Based Delivery Michael Porter, the eminent Harvard Business School professor, defines “value” in healthcare as “achieving the best …

Market Corner Commentary for September 16, 2015-Mind and Medicine: Amplified Healing Through Behavioral Science In announcing his Precision Medicine Initiative, President Obama articulated a medical future where genetic discovery shapes tailored …

Market Corner Commentary for September 9, 2015-Of Metrics and Meaning: Making Sense of Healthcare Quality Ratings As healthcare becomes more consumer-focused, hospital and physician rating systems are proliferating.  Yelp is …

Market Corner Commentary for August 26, 2015-Kinky Boots, Swedish Dialysis and Demanding Customers The oldest and best advice in business is “give customers what they want.”  From Broadway to Sweden, …

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 …

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, …

Market Corner Commentary: August 5, 2015-Medicare at Fifty: More Yesterdays than Tomorrows? A version of this commentary appeared in Huron Healthcare’s “Perspectives” on July 30th With Harry Truman watching, Lyndon …

Market Corner Commentary: July 28, 2015-Reimbursement Roulette: Health Companies “Double Down” on Revenue A version of this commentary appeared in “Academy 360” on July 23, 2015 Let the good times …

Market Corner Commentary: July 22, 2015-David Jones’ Locker: Humana and the Perils of Vertical Integration American healthcare is losing the iconic Humana brand.  Aetna has announced it will acquire Humana …

Crossing the Technology Chasm: Tele-ICUs Save Lives and Money The Leapfrog Group’s[1] fact sheet on ICU Physician Staffing estimates that preventable ICU deaths exceed 54,000 each year. This figure excludes …

Market Corner Commentary: July 1, 2015-No One is an Island: Meaningful Second Opinions A good friend (let’s call him John Donne) in his mid-fifties recently wrote describing his treatment for …

Market Corner Commentary: June 17, 2015-Chasing Colonoscopies: It’s the Customer, Stupid! Who knew a routine colonoscopy could illuminate the wild world of healthcare consumerism? Before getting to my story, let’s …

A version of this commentary first appeared April 30th in “Academy 360”-Deep Web Rising: Healthcare’s Looming Cyber Threat Healthcare is a “target-rich” environment for cyber criminals. Cyber attacks on health …

Holy Sheets! Fast-Tracking Delivery Innovation Hospitals have used cotton linens since the early 1900s.  Crisp, white sheets touch all patients and epitomize healing.  “Hospital corners” describe the proper way to …