By  | February 20, 2018 |  6
“We Need Creative Solutions” When I read or hear the sentence above, I think of one thing and one thing only. The solution is long in coming, involves input from multiple parties, has no obvious fix, is costly–in either money or time, and we undergird it by a whopper of a collective action problem. How […]
By  | February 1, 2018 |  0
By: Win Whitcomb, MD, MHM Hospitalist groups have been among the highest volume participants in Medicare’s Bundled Payments for Care Improvement (BPCI) demonstration project, initiating almost 200,000 episodes representing over $4.7B in spending since the model began1. On January 9, the Centers for Medicare and Medicaid Services (CMS) announced BPCI’s follow-on model, ‘BPCI Advanced’,2 which starts […]
By  | January 12, 2018 |  0
It’s that time of (every other) year! Once again, your hospital medicine group (HMG) has a unique opportunity to contribute to our collective understanding of the current state of hospital medicine in the United States. SHM’s State of Hospital Medicine Survey kicked off this week and will be open until February 16th. I strongly urge […]
By  | September 11, 2017 |  0
You all think you know hospice. You don’t, and I will tell you why. Hospice is a bastard child of the Medicare system. It went live in 1983 as a standalone entity during the Reagan administration and remains a disjointed program today. I would characterize its evolution as such: the road to hell is paved with good intentions. […]
By  | August 9, 2017 |  2
For several decades, providers working within hospitals have had incentives to reduce stay durations and keep patient flow tip-top. DRG-based and capitated payments expedited that shift. Accompanying the change, physicians became more aware of the potential repercussions of sicker and quicker discharges. They began to monitor their care and as best as possible, use what measures […]
By  | August 1, 2017 |  0
My wife and I are planning to add square footage to our house. We want more space. We are considering an office expansion, a guest room, and making the master bedroom more master and less bedroom. The kids are growing, the family is always visiting, and we have no plans to relocate. We also need […]