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Check out 4sight Friday email and podcast.

Dave Burda curates a weekly email and hosts a weekly podcast discussing news that impacts market-based change.

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Avoid Becoming an IT Dinosaur


Please welcome Ed Marx as 4sight Health’s newest guest columnist. Ed is among the nation’s most respected health IT leaders and an accomplished Iron Man competitor. As you’ll see in …

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 …

Looking for the Right Prescription to Regulate State Drug Markets

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 …

The Uninsured: Where We Go From Here

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 …

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 …

Safe Street for Everyone

Podcast: 4sight Friday Roundup, Pondering the Prospects of a COVID Vaccine, 09/11/20


Pondering the Prospects of a COVID Vaccine Will it be before Nov. 3 or after Nov. 3? Will it be safe? Will people take it? We talked about it on …

Pondering the Prospects of a COVID Vaccine

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 …

A Pandemic Induced Collapse of the Way We Pay for Healthcare

Should We Regulate Healthcare Chatbots?


Don’t bury the lede.  That journalism rule of thumb also applies in healthcare when you see your doctor. If you tell your doctor your throat hurts, you have a headache …

Should We Regulate Healthcare Chatbots?

Podcast: 4sight Friday Roundup, Healthcare’s Future After the Election, 08/14/2020


Healthcare’s Future After the Election What does a Biden win mean for healthcare? What does a Trump win mean for healthcare? We talked about it on this week’s 4sight Friday …

Healthcare's Future After the Election

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 …

Primary-Care Physicians versus The World (Mostly Pharmacists, Really)

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 …

Is Telemedicine Headed Left or Right?

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 …

Is There a Better Way to Bailout Providers?

Make No Big Plans: The Democratic Party’s Unity Platform for Healthcare


Key Takeaways The Democratic Party’s emerging healthcare platform, crafted by a unity task force picked by former Vice President Joe Biden and Vermont Sen. Bernie Sanders, carefully avoids controversial issues. …

Make No Big Plans: The Democratic Party’s Unity Platform for Healthcare

Pandemic Preparedness: Beyond Bioterrorism & Federalism


One week to the day following the 911 attacks, five letters containing anthrax spores were sent the offices of major media outlets, including the National Inquirer. Just over two weeks …

Pandemic Preparedness: Beyond Bioterrorism & Federalism

Pandemics Cubed: Social Injustice and Chronic Disease Amplify COVID-19’s Virulence


America’s current response to COVID-19 ranges from “no worries” to struggling episodically to acutely overwhelmed. The uneven response has led to catastrophic disease spread and death. Setting the stage and …

Pandemics Cubed: Social Injustice and Chronic Disease Amplify COVID-19’s Virulence

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 …

Don’t bail out. Bail in to value-based care.

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 …

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 …

Countering the Negative Consequences of COVID-Induced Healthcare Consolidation

Testing Snafus – Testing, Testing, 1, 2, Whoa!


Key Takeaways: Increasing scrutiny of laboratory-developed tests (LDTs) for COVID-19 casts doubts on accuracy.  Critics fear many FDA-approved tests generate an unacceptably high level of false negatives due to imperfect …

Testing Snafus

Rogue Cops and Vigilantes: COVID-19’s Best Friends


Key Takeaways Widespread civil unrest in the wake of the police and vigilante murders of two African Americans has set back the effort to control the COVID-19 pandemic. Public health …

Rogue Cops and Vigilantes: COVID-19’s Best Friends

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 …

Patients Shouldn’t Expect Their Local Merging Not-For-Profit Hospitals to be More Charitable

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 …

Why Patients Are Not Getting Their Money’s Worth on Quality Measures


When business management guru Peter Drucker uttered his famous adage, “If you can’t measure it, you can’t improve it,” he probably wasn’t thinking about the patient experience in healthcare.  But …

Why Patients Are Not Getting Their Money’s Worth on Quality Measures, 4sight Health

Heed the FTC’s Warnings on Your Use of Healthcare AI


I’m not sure how many times data scientists and marcom people are in the same room at a hospital, health system or medical practice. But if you’re looking for a …

Then and Now: What Woodrow Wilson’s 1918 Pandemic Failure Can Teach Us Today


Key Takeaways: There are eerie parallels between the 1918 and current viral pandemics. Woodrow Wilson’s decision to pursue the war irrespective of the pandemic accelerated the disease spread and increased …

Oh, hey. About that Accreditation Survey


Hospitals, health systems, medical practices, health plans, licensed clinicians and virtually every type of healthcare setting imaginable not only have to comply with countless state and federal regulations, they also …

The FDA’s Vast, Uncontrolled, COVID-19 Science Experiment


Add the Food and Drug Administration to the lengthening list of federal agencies abandoning best scientific practices as it caters to the ill-informed whims of the president of the United …

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 …

How the COVID-19 Pandemic Is Dulling the Point of All Those Healthcare Regulations


So, it took a deadly pandemic to expose how utterly useless most healthcare regulations are in ensuring that patients get the best possible care at the lowest possible cost when …

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 …

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 …

The Next Moonshot: Moving to Reverse America’s Declining Life Expectancy


Meet Dr. Allen Weiss, veteran health system administrator, former AHA Board member, thought leader, healthcare revolutionary, and Chief Medical Officer for the Blue Zone Project. While Allen was President & CEO …

The State of Our HLTH 2019: Hard Truths and Hope. A Post-Conference Report from HLTH 2019.


HLTH engaged 4sight Health to produce this exclusive post-conference report of the HLTH 2019 conference. HLTH gave 4sight Health and its five-member writing team carte blanche to attend all theme …

How Can Healthcare Avoid Screwing Up AI’s Potential?


“Just what do you think you’re doing, Dave? Dave, I really think I’m entitled to an answer to that question.”—HAL 9000 in 2001: A Space Odyssey I get that a …

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 …

Advancing Advance Care Plans through Medicare: It’s Time to Move


American culture and politics make little room for honest discussions about death and dying. Healthcare thought leader Ian Morrison is fond of saying, “In Scotland, death is imminent. In Canada, …

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 …

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 …

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, …

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 …

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 …

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 …

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 …

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 …

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 …

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 …

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 …

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, …

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. …

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. …

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 …

drug prices, patients, hospitals, drugs, healthcare

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 …

The Rush to Move Patient Care Out of the Hospital


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. …

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 …

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. …

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 …

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 …

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 …

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 …

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 …

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 …

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 …

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 …

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 …

Desperately Seeking Market-Based Patient Safety Solutions – Burda on Healthcare


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 …

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 …

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 …

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 …

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 …

Regulatory Chess: Positioning for Competitive Advantage


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 …

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 …

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 …

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 …

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 …

Opioid Variations and State Interventions


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 …

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 …

Why Healthcare is Spinning Its VBR Wheels


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 …

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 …

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 …

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 …

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 …

Everyone Knows What’s Going to Happen in Healthcare in 2019. Do You?


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 …

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 …

Eisenhower’s Prophecy: The Healthcare Industrial Complex (TM)


On January 17, 1961, three days before leaving office, Dwight D. Eisenhower spoke to the nation one last time as its president. Eisenhower’s observations about war, peace and democracy are …

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 …

Sponsored by Cain Brothers

Want Better Cardiac Outcomes? Just Follow the Money


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 …

New Primary Care Provider, Same or Better Outcomes


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 …

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 …

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 …

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 …

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 …

Healthcare Worker Flu Vaccine Rates Offer a Lesson in Self-Policing


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 …

Against the Wind: Hospitals Challenge CMS’s Pro-Market Payment Reforms


Over the past month, the Centers for Medicare and Medicaid Services (CMS) announced several pro-market policies that will enhance pricing transparency, stimulate competition (and fair prices) for routine procedures and eliminate burdensome reporting requirements. …

Black-white Tornado

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 …

Pool Balls Break

CMS Misdirection: Two Troubling Decisions Damage Market Competitiveness


In well-functioning healthcare markets, governmental regulatory policies ensure access, safety, quality and privacy. The government’s most important role is creating level-field competition through balanced regulation, targeted enforcement actions and price/outcomes …

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 …

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 …

Honey vs. Vinegar: Value-Based Pricing Wins Customers and Market-Share


Common wisdom holds that “it’s easier to catch flies with honey than vinegar.” That aphorism also applies to payers seeking lower prices for routine healthcare procedures. It “tastes” better when …

Taxing Consequences: House Republicans Target Tax-Exempt Hospital Bonds


Market Corner Commentary for November 21, 2017 Having failed to “repeal and replace” the Affordable Care Act, House and Senate Republicans have set their sights on reforming the U.S. tax …

Crony Capitalism Has Consequences: Opioid Distribution, Destruction and Death


Market Corner Commentary for October 25, 2017 – Special Edition Talk about bombshells. On October 15th, the Washington Post and 60 Minutes released a detailed and damning investigative report titled …

Senate Republicans Confront Their Healthcare Waterloo: Now What?


Last weekend Senators Jerry Moran of Kansas and Mike Lee of Utah announced they could not support Speaker Mitch McConnell’s Better Care Reconciliation Act of 2017 (BCRA). Their defections put …

Forming a More Perfect Health System: Senate Republicans Confront Their Policy Demons


Senator Mitch McConnell is the most effective Senate Majority Leader since Lyndon Johnson. A tactical maestro, McConnell faces the seeming impossible task of uniting the Republican party’s divergent conservative and …

“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 …

best health policy

Trumpian Healthcare Reform: A “Silver Linings” Legislative Playbook


Special Edition: Market Corner Commentary for March 29, 2017 Last Friday was supposed to be the shootout at the healthcare corral where Republican gunslingers were going to take the first …

venture capital fund 

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 …

Healthcare’s Gettysburg Moment


Seven score and thirteen years ago this month (November 19, 1863), Abraham Lincoln delivered his renowned Gettysburg Address at the dedication for the Soldiers National Cemetery. With the ravages of …

Overturning Obamacare: A 5-Point Plan for President-Elect Donald Trump


Two weeks ago, I distributed a 5-Point healthcare plan for presumed President-elect Hillary Clinton. That was then. In a remarkable and unprecedented election surprise, Donald Trump defeated Hillary Clinton and …

HealthCare.Gov’s Death-Defying 2013 Launch: Implications for Government-Led Payment Reform


Enrollment for purchasing health insurance on public health exchanges began November 1st. Headlines for this fourth enrollment period include: 22% average price increases; major health insurers dropping coverage; and single …

Overhauling Obamacare: A 5-Point Plan for President-Elect Hillary Clinton


Absent a cataclysmic surprise next Tuesday, Hillary Clinton will become the 45th President of the United States. She will govern a divided electorate with highly-polarized elected officials. It’s no longer …

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 …

health care system

Market Evolution: Addressing Structural Flaws on Public Health Exchanges


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 …

health care services

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 …

Healthcare Advisory Services

Obama Speaks: A Presidential Assessment of Obamacare


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 …

4sight Health

Now You See It…. The Unreliability of Government Student Loan Forgiveness


Each October, the Association of American Medical Colleges (AAMC) publishes its “Debt, Costs and Loan Repayment Fact Card”. It surveys recent medical school graduates and details the amount and composition …

Dynamic Tension: Rethinking Health System Governance


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-based health care system

Of Metrics and Meaning: Making Sense of Healthcare Quality Ratings


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 …

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 …

Supreme Court vs. Obamacare II: Decision Time


This article first appeared in Huron Perspectives on June 2, 2015-Supreme Court vs. Obamacare II: Decision Time The “Thrilla in Manila” in 1975 was Mohammad Ali and Joe Frazier’s second …

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, …