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 …

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 …

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 …

If you spend your Saturday afternoons watching home remodeling shows or cooking shows, you realize that having the right tools for the job makes all the difference. What you struggle …

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 …

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 …

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, …

Khosrow Shotorbani is the CEO / Founder of the Lab 2.0 Strategic Services, and a member of Project Santa Fe Clinical Laboratory 2.0. In Episode 19, Khosrow and David Johnson …

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. …

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 …

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 …

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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 …

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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. …

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 …

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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. …

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 …

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 …

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 …

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 …

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 …

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.” …

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 …

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 …

“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 …

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 …

When better customer service is a competitive threat, it really is time to rethink your business model.  That was my first thought when I read the results of a survey …

What will healthcare be like 10 years from now? Not a lot of healthcare executives toiling in our system have the luxury to think about that as they deal with …

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 …

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 …

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 …

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 …

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 …

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 …

David Johnson interviewed Tom DeRosa, CEO of Welltower, for a packed audience at MATTER on June 19th. Tom considers Welltower a “platform for innovation on scale” in the realm of …

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 …

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 …

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 …

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 …

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 …

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. …

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 …

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 …

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 …

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 …

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 …

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 …

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 …

“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 …

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 …

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 …

If you believe in the adage “follow the money,” it would lead you to telemedicine. Analyzing billions of private health insurance claims, a new report said telemedicine is the fastest …

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 …

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 …

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 …

Raghuram Rajan’s new book The Third Pillar provides an insightful framework on the relationship between the three pillars of modern society: federal governments, the marketplace and local communities. I’ll share …

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 …

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 …

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 …

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 …

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 …

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 …

“The teams were operating independently—like workers in an efficient factory—while trying to keep pace with an interdependent environment. We all knew intuitively that intelligence gathered on AQI’s [Al Qaeda in …

Dave, your article is nothing if not provocative and insightful.  What does it mean for health data to be truly free? At MultiScale, we have been thinking hard about health …

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 …

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 …

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. …

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 …

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 …

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 …

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 …

Mudit Garg, Founder & CEO of Qventus, joins David Johnson for Episode 12 of Market Corner Conversations. Mudit shares how he views the challenges clinicians push through to provide care data …

Healthcare data wants to be free, but it is oppressed. Entrenched oligarchs trap information within closed, centralized systems that prioritize revenue collection, misuse resources and tolerate medical error. Data gasps …

In the simplest terms, cloud computing means storing data and software applications on the Internet, in secure files, then accessing that data and programs over the Internet rather than from physical …

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 …

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 …

It’s like FBI profiling but for doctors—doctors who order too many unnecessary diagnostic tests. Researchers from Canada have escalated the fight against low-value healthcare services by focusing on the doctors …

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 …

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 …

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 …

August 23, 2018, Amy Compton-Phillips came to MATTER, Chicago’s healthcare incubator. She presented her perspective on platforming in the industry and at Providence St. Joseph Health. Key points included: The …

During President Richard Nixon’s historic 1972 trip to China, the press asked China’s premier Zhou Enlai to comment on the French Revolution’s impact on world affairs. Zhou famously replied, “Too early to …

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 …

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 …

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 …

Jake Crampton, CEO of MedSpeed, joins David Johnson in Episode 8 of Market Corner Conversations. Crampton shares how MedSpeed facilitates “intra-company logistics.” MedSpeed’s customers transform their transportation networks from cost …

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 …

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 …

The digitization and globalization of medical information is overwhelming traditional medical practices. Physicians confront a continuous avalanche of medical discoveries on disease origins, symptoms and treatments. By 2020, medical knowledge …

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 …

Amy Compton-Phillips, M.D., joins David Johnson in Episode 5 of Market Corner Conversations. Amy is the executive vice president and chief clinical officer for Providence St. Joseph Health. She oversees …

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 …

The news that Amazon, Berkshire Hathaway and JP Morgan Chase joined forces to create their own healthcare company rocked the industry. The ten largest health insurers and pharmacy businesses lost …

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 …

 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 …

In 1919, journalist John Reed published Ten Days that Shook the World, a first-hand account of the October 1917 Russian Revolution. During that dramatic 10-day period, Vladimir Lenin’s Bolsheviks took …

Market Corner Commentary for December 13, 2017 On the 19th of April in 1775, a ragtag Massachusetts militia confronted the mighty British army in search of Colonial munitions and rebellion …

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 …

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 …

Football is a “system” sport. Offense, defense and special teams function as distinct units with their own coaches, schemes and measures of success. The better teams bring all these components …

Sky-rocketing drug prices have captured the nation’s attention. President Trump echoes Senator Bernie Sanders when he asserts that drug companies are “getting away with murder.”[1] Republican and Democratic legislators alike assert …

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 …

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 …

It was an eventful July 4th weekend in the Land of Lincoln. The Illinois Senate over-rode Governor Bruce Rauner’s veto to pass its first state budget in over two years. …

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 …

The minute I walked into the new digs of the clinic, I knew it was very different and could get the gist of what they were trying to do. It …

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 …

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 …

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 …

Insourcing is a time-honored practice employed by market-dominant companies. Rather than contract with external experts, companies dedicate internal resources for specialized functions. While generally less efficient, insourcing enables companies to …

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 …

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 …

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 …

On Saturday evening, the Chicago Cubs won the National League pennant and the City of Chicago went crazy. The Wrigleyville celebration rocked until dawn Sunday morning. After a 71-year absence, …

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 …

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 …

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 …

“The fault, dear Brutus, is not in our stars But in ourselves.” [1]                William Shakespeare On July 27th, the Centers for Medicare and Medicaid Services (CMS) released its first-ever quality …

With pride and promise just two short years ago, Catholic Health Initiatives (CHI) introduced Prominence Health, a wholly-owned subsidiary, that would “significantly advance CHI’s ability to excel in a pay-for-value …

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, …

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 …

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 November 4, 2015- Righteous Analytics: Right Data. Right Time. Right Way Technology is on the cusp of channeling diagnosis and treatment toward best outcomes at lowest costs. …

#Leading Change-Market Corner Commentary: June 24, 2015-Welcome Back, Kotter!  Leading Health System Change A version of this commentary first appeared in “Academy 360” on June 11th In the popular 1970s …

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 …