Two Sides of the Same Health Care Coin

Fred Goldstein Recently two articles were sent to me by Cliff Frank, a colleague and friend. If you know anything about Cliff, you’ll know that 1) if he’s sending something, it’s worth reading, and 2) he doesn’t mince words. In this case, with regard to the first article, it was one short line: “Fascinating article […]

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 […]

To Understand Value’s Market Progress, Watch Primary Care

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 […]

The Validation Institute’s Certified Health Value Professional Designation

For Benefits Advisors and Purchasers, Knowledge Really Is Power! Health care is vast and complicated, and filled with nooks and crannies that are more nuanced than most of us understand. Every day we read about, hear about and even sell important services – say, drug cost management, health care analytics, episodic case rates, medical claims […]

CORA Pro Certification in Action!

Al Lewis A few months ago, the American Cancer Society (ACS) published data showing an “alarming” increase in colon cancer among younger people. This “finding” generated some major headlines, like the one below. Consequently, major health plans decided to cover more screening for more young people: This is a very instructive decision, but not because […]

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 […]

Validating Health Care Performance

Brian Klepper Posted 8/20/18 in Valid Points, the Newsletter of The Validation Institute The beginning of wisdom is calling things by their true names. – Confucius For purchasers, health care is the Wild West. Vendors of all types – disease managers, wellness companies, care navigation firms, ambulatory surgery centers, benefits advisors, worksite clinic firms, and on […]