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Tag: Michael Millenson

THCB Gang Episode 89, Thursday April 28, 1pm PT 4pm ET

Joining Matthew Holt (@boltyboy) on #THCBGang on April 28 for an hour of topical and sometime combative conversation on what’s happening in health care were: THCB regular writer and ponderer of odd juxtapositions Kim Bellard (@kimbbellard); medical historian Mike Magee (@drmikemagee); patient safety expert and all around wit Michael Millenson (@mlmillenson) & Principal of Worksite Health Advisors Brian Klepper (@bklepper1). Matthew had COVID so didn’t do much & Kim ran the show. Lots of discussion on telehealth, primary care, private equity and much more…

You can see the video below & if you’d rather listen than watch, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels.

THCB Gang Episode 88, Thursday April 21st, 1pm PT 4pm ET

Joining Matthew Holt (@boltyboy) on #THCBGang on April 21 for an hour of topical and sometime combative conversation on what’s happening in health care are: patient safety expert and all around wit Michael Millenson (@MLMillenson); digital health guru Fard Johnmar (@fardj); delivery & platform expert Vince Kuraitis (@VinceKuraitis); and a special guest – Alexandra Drane (@adrane) the queen of caregivers everywhere.

You can see the video below live (and later archived) & if you’d rather listen than watch, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels.

THCB Gang Episode 86, Thursday March 24th, 1pm PT 4pm ET

Joining Matthew Holt (@boltyboy) on #THCBGang on March 24 for an hour of topical and sometime combative conversation on what’s happening in health care and beyond were fierce patient activist Casey Quinlan (@MightyCasey); patient safety expert and all around wit Michael Millenson (@MLMillenson); THCB regular writer and ponderer of odd juxtapositions Kim Bellard (@kimbbellard); and back from his travels in Mexico and medical historian Mike Magee (@drmikemagee).

Special guest this week was population health and primary care expert Ines Vigil, who developed that program at Johns Hopkins but now hangs her hat at Clarify Health &is the author of Population Health Analytics. We dived deep into what populations health means. What we need to do to make it work and whether it’s real or not!

You can see the video below live (and later archived) & if you’d rather listen than watch, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels.

THCB Gang Episode 84, Thursday March 3rd, 1pm PT 4pm ET

Joining Matthew Holt (@boltyboy) on #THCBGang at 1pm PT 4pm ET Thursday for an hour of topical and sometime combative conversation on what’s happening in health care and beyond will be:  fierce patient activist Casey Quinlan (@MightyCasey); patient safety expert and all around wit Michael Millenson (@MLMillenson); THCB regular writer and ponderer of odd juxtapositions Kim Bellard (@kimbbellard); and policy consultant/author Rosemarie Day (@Rosemarie_Day1).

The video will be below. If you’d rather listen to the episode, the audio is preserved from Friday as a weekly podcast available on our iTunes & Spotify channels

What Would Newt Do? Making Value-Based Care Victorious

By MICHAEL MILLENSON

Health care’s much-trumpeted transition “from volume to value” care remains more tepid than transformational, according to a new study. Looking at 22 health systems nationwide, RAND researchers found that compensation continues to be “dominated by volume-based incentives designed to maximize health systems revenue.”

Although confusing payment schemes bear part of the blame, there are deeper problems that appeared in sharp relief when I chanced upon a long-ago PowerPoint from a prominent political strategist and early advocate of “data-driven reimbursement.” 

I refer, of course, to Newt Gingrich. His recommendations from 2007 about designing transformational change in health care provide a perspective that remains useful today in addressing what is ultimately a political problem. Frankly, value-based care (VBC) advocates perform dismally.

Going Along the Gingrich Roadmap

Back in 2004, Gingrich and I both served on a commission seeking to improve the quality of long-term care. This was during a period when a neutered Newt, out of power, was undergoing a political makeover by championing bipartisan health reform ideas such as electronic health records (EHRs) and evidence-based care. He even shared an award from NCQA with then-New York Sen. Hillary Clinton. 

What Gingrich also shared, often, were his thoughts about what was necessary to drive the kind of sweeping alteration of the status quo represented by his leading Republicans to their first House majority in decades. Reviewing that roadmap, it’s not surprising that VBC advocates remain far from their destination.

The journey starts off in the right direction, with VBC advocates following Gingrich’s advice to “focus on large changes.” Trying to upend the way physicians have been paid since Hippocrates made his first house call certainly qualifies. But ambition has to be articulated as part of an organizing and attractive vision.

In 1997, in a book called Demanding Medical Excellence, I summarized the urgency of what we now call value-based care this way: 

Tens of thousands of patients have died or been injured years after year because readily available information was not used – and is not being used today – to guide their care….(The health care delivery system) must be restructured according to evidence-based medical practice, regular assessment of the quality of care, and accountability.

In a similar vein, Gingrich in 2007 emphasized “a clear and compelling vision for quality” that would appeal to patients and medical professionals by promising safe care (no preventable deaths or injuries); consistent clinical excellence (appropriate and effective evidence-based care); and clinicians and staff partnering with patients.

Language That’s Bureaucratic, Not Bold

In contrast, the coalition sponsoring last month’s Health Care Value Week positioned transformation as a series of “models” addressing a bureaucratic checklist of health care “challenges.” The same type of language is used by the Centers for Medicare & Medicaid Services.

Continue reading…

THCB Gang Episode 83, Thursday Feb 17th, 1pm PT 4pm ET

Joining Matthew Holt (@boltyboy) on #THCBGang at 1pm PT 4pm ET Thursday for an hour of topical and sometime combative conversation on what’s happening in health care and beyond will be: futurist Ian Morrison (@seccurve); Queen of all employer benefits Jennifer Benz (@Jenbenz);  fierce patient activist Casey Quinlan (@MightyCasey); and & patient safety expert and all around wit Michael Millenson (@MLMillenson)

The video will be below. If you’d rather listen to the episode, the audio is preserved from Friday as a weekly podcast available on our iTunes & Spotify channels

THCB Gang Episode 77, Jan 6 1pm PT – 4pm ET

After our Christmas break THCB Gang is back! Joining Matthew Holt (@boltyboy) on #THCBGang at 1pm PT 4pm ET Thursday for an hour of topical and sometime combative conversation on what’s happening in health care and beyond will be THCB regular writer Kim Bellard (@kimbbellard);  fierce patient activist Casey Quinlan (@MightyCasey);  futurist Ian Morrison (@seccurve) & patient safety expert and all around wit Michael Millenson (@MLMillenson)

You can see the video below live at 1pm/4pm or it’s kept here for posterity. If you’d rather listen than watch, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels

THCB Gang Episode 75, Dec 16

Joining Matthew Holt (@boltyboy) for an hour of topical and sometime combative conversation on what’s happening in health care and beyond were — medical historian Mike Magee (@drmikemagee); futurist Jeff Goldsmith; fierce patient activist Casey Quinlan (@MightyCasey); and policy consultant/author Rosemarie Day (@Rosemarie_Day1).

Plenty of talk about voting rights, the future of American “democracy” and much more, and we did get back to health care eventually. A great & fun, while important, conversation!

You can see the video below where it’s kept for posterity. If you’d rather listen than watch, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels

THCB Gang Episode 73, Dec 2 1pm PT – 4pm ET

#THCBGang is back from its Turkey day snooze! Joining Matthew Holt (@boltyboy) at 1pm PT 4pm ET Thursday for an hour of topical and sometime combative conversation on what’s happening in health care and beyond will be patient activist, author & entrepreneur Robin Farmanfarmaian (@Robinff3);  Queen of all employer benefits related issues Jennifer Benz (@Jenbenz); medical historian Mike Magee (@drmikemagee); and patient safety expert and all around wit Michael Millenson (@MLMillenson)

You can see the video below live at 1pm/4pm or it’s kept here for posterity. If you’d rather listen than watch, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels

THCB Gang Episode 67 – Thurs October 14

Joining Matthew Holt (@boltyboy) on THCBGang today were THCB regular writer Kim Bellard (@kimbbellard); patient safety expert and all around wit Michael Millenson (@MLMillenson); and privacy expert and entrepreneur Deven McGraw (@HealthPrivacy).

We heard a good bit from Deven about Ciitizen’s acquisition by genomic testing company Invitae, and got into it about the Texas abortion law, Walgreens moving into health care delivery in a big way–and whether the Giants can beat the Dodgers despite spending only 55% of their payroll! At least one of those questions will be answered tonight!

You can see the video below & if you’d rather listen than watch, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels.

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