When Health Care Organizations Are Fundamentally Dishonest

Brian Klepper A class action legal ruling this month, on a case originally filed in 2014, found that UnitedHealthCare’s (UHC) mental health subsidiary, United Behavioral Health (UBH), established internal policies that discriminated against patients with behavioral health or substance abuse conditions. While an appeal is expected, patients with legitimate claims were systematically denied coverage, and […]

HIMSS19 Recap: Disruption, Innovation, and the Growing Need for Validation

  RD Whitney   The Validation Institute was out in force at HIMSS19 (Healthcare Information and Management Society) in Orlando, FL where disruption of the healthcare status quo was a major theme. From the miles of exhibit floor to speakers on the main stage, there was a resounding call for innovation as a means of […]

The Continuing Abject Failure of US Healthcare

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 […]

Chronic Disease by the Numbers: We are Fighting the Wrong Battle

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”:  “Chronic diseases cause seven in 10 deaths each year in the U.S.”   “About […]

Health Care's Most Needed Next Step

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 previously been available. To manage risk and drive performance, […]

North Carolina's Battle for Health Care Value

“Lobbying? We’ve got 9 million taxpayers and 720,000 participants in this plan who understand that they aren’t consuming health care, it’s consuming them.” North Carolina State Treasurer Dale Folwell In North Carolina, a storm is brewing that highlights the health care industry’s influence and stranglehold over public dollars. An experienced civic-minded reformer with clout has […]

High Performance Health Care and the Shift to Higher Value

Brian Klepper “How many businesses do you know that want to cut their revenue in half? That’s why the health care system won’t change the health care system.” Current Florida Governor and Former Columbia/HCA CEO Rick Scott at a 2012 Investor conference Health care management expert Fred Goldstein recently related an encounter with health system […]