High Performance

Brian Klepper

A year ago, 92 primary care physicians (PCPs) in Charlotte, NC broke away from the region’s largest health system, Atrium Health, forming Tryon Medical Partners, an independent, physician-owned group. Then, a couple weeks ago, another 41 PCPs left the area’s second largest health system, Novant, to join Holston Medical Group, a large multispecialty physician practice with more than 80 PCPs headquartered in nearby Kingsport, TN.

In these and most primary care breakaways from large health systems, the complaints are generally the same. Within a fee-for-service, volume-driven environment, primary care’s role, at least in part, is to capture patients and feed the machine. Health systems pressure PCPs to refer patients internally as often as possible for lucrative diagnostics and procedures.Read More

William Bestermann, MD

No matter how far up the food chain you are, the failure to reform US healthcare puts you and those you care about squarely in the crosshairs of physical and financial catastrophe. Almost everything that you love about life depends on your health. You may have the wherewithal to have a vacation home and a yacht. You may have access to the best interventional cardiologist, but almost no one has access to optimal medical therapy to treat and prevent chronic conditions.  

No one has access to the best new science and systems because of an abject failure of leadership at multiple levels. If you don’t get best practice medical treatment and develop a heart attack with congestive heart failure, your endurance and enjoyment of life will be diminished. The failure to improve health and lower costs creates a medical financial bubble that puts every segment of our economy at risk. Men will frequently ignore their own health for a dollar, but are you really ready to throw your spouses, parents, and best friends under the bus? Are you ready to put national security at risk? Really?

Moneyball tells the story of a team manager who turned baseball on it’s ear by using data, evidence, and systems to do more with less. Money medicine isn’t like that. Money medicine defends old expensive treatments that are proven ineffective, while failing to apply new data, evidence, and systems.

We know how to do this. We know how to develop a system that serves patients and voters. The way forward has been spelled out in detail years ago. The Institute of Medicine (IOM) brings together the best and brightest in American healthcare to provide advice on health policy. In 2001, the IOM called for drastic change and provided a roadmap for reform that has been entirely ignored. Nothing has changed 18 years later.Read More

Al Lewis

The wellness withhold provision in the Affordable Care Act codifies the CDC’s  2009 “Call to Action” about chronic disease: The Power to Prevent, the Call to Control. On the summary page, we learn some of what the CDC calls “arresting facts”:

  1.  “Chronic diseases cause seven in 10 deaths each year in the U.S.”
  2.   “About 133 million Americans — nearly one in two adults — live with at least one chronic illness.”
  3.   “75% of our healthcare spending is on people with chronic conditions.”

More recently, they decided that 75% was not a high enough statistic to get people’s attention, so they changed it to 86%. Most recently, they’ve upped the third statistic to 90%. More on that later.

The most “arresting fact” is how head-scratching these CDC claims are…and of how they created the wellness legend.

Take the first statement — “chronic diseases cause seven in 10 deaths.” We have to die of something. Would it be better to die of suicides and homicides? Mercury poisoning? Barbecuing rattlesnakes?

The CDC’s second statistic is also a head-scratcher. Only 223 million Americans were old enough to drink in 2009; divide 133 million into that number, and you see that a whopping 60% of adults, not “nearly one in two,” live with at least one chronic illness. So they got that part wrong but…Read More

Brian Klepper It seems inevitable that, in the near future, an innovative health care organization is going to seize the market opportunity, gradually cobble all the pieces together, and demonstrate to organizational purchasers that it consistently delivers better health outcomes at significantly lower cost than has...

Dave Chase Originally posted 9/04/2018 on LinkedIn. I'm often asked why my life's work has become helping build a new health ecosystem that restores humanity to patients and clinicians while achieving the Quadruple Aim. I give my most personal explanation why in the Preface to my book...