Welcome to Healthcare Big Ideas
Thank you for visiting our website and we hope that you find the information and commentary here useful as you engage with the healthcare industry in whatever capacity. During the past three years since we launched healthcarebigideas.com, the healthcare industry has experienced more disruption and chaos than in the previous four decades. At Healthcare Big Ideas, we are here to empower you to understand the chaos and how it affects daily life.
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If Mr. Becerra is confirmed as the next Secretary of Health and Human Services, it is likely that the issue of healthcare pricing regulation will be high on his agenda. Healthcare leaders could be viewed by the public as “heroes” instead of “villains” by addressing this issue before that occurs.
Read MoreIn this day and age, my account in their system includes all of my insurance information. I don’t understand 1) how they could not have already known about this problem; 2) when they are inputting the test into their system, why it doesn’t alert them to an out-of-network laboratory; and 3) why they didn’t provide me with that information, so I could decide whether or not to go ahead with the tests.
Read MoreThe healthcare industry needs us just as much as we need them. As healthcare consumers have more control than we ever thought possible. We can take back control and demand the transparency of healthcare prices.
Read MoreHowever, to borrow from Ruth Bader Ginsberg’s last communication with her granddaughter, it is our “fervent wish” that the Supreme Court will apply basic common sense and will take into account the stated intent of Congress when they make their decision regarding the ACA’s fate. In our view, although it is far from perfect, the ACA has played a central role over the past decade.
Read MoreValue-based pricing and vertical integration of insurers and providers may be the models of the future. But the bridge to getting there is long and needs to provide a “soft landing” for the healthcare industry. The first step in building that bridge is fee-for-service price redesign and transparency. The technology exists to provide better fee-for-service price transparency, simpler pricing models and more alignment of price to the cost of service.
Read MoreIf ever there was a time for a new healthcare payment paradigm, the time is now. Healthcare providers can no longer rely upon an outdated fee-for-service payment model to provide long term financial health for their organizations. They need to consider an immediate redesign their operating revenue portfolios to (1) better align their fee-for-service prices with actual cost; (2) convert more of their physician services to managed risk and value-based care arrangements; and (3) consider strategic alignments or potential mergers with health insurers of scale in their markets.
Read MoreAll this likely points to renewed arguments that a Medicare-for-All single payer government healthcare system would be a potential solution to this new normal scenario. We do not support that plan for all the reasons described above. However, we are convinced that the current crisis will require some type of public option alternative going forward. We believe that the New Normal Medicaid program we described last month could be utilized as one model for this type of public option alternative.
Read MoreOur practical solution and rationale, outlined below, proposes to mirror the Medicare funding model by transferring all Medicaid funding responsibility to the federal government. This bold action, which is in keeping with much of the government’s virus response, better positions the U.S. healthcare safety net to perform its critical task in this crisis and its aftermath. If it is to care for us, we must first care for it.
Read MoreI have spent the past four decades as a healthcare executive and consultant – the last 20 of those years working with academic medical centers. It made it especially difficult to watch over the past three months as the COVID-19 pandemic wreaked havoc on the U.S. healthcare provider community.
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