Dr. Brian Casull’s Blog
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American Healthcare in Transition.
No one system escapes criticism. It appears that there is good, bad, and ugly to be found in any system you choose. For sure there would be winners and losers. THE PRIME DIRECTIVE: -ELIMINATE VARIABILITY One Operations Manual One Policy Manual One Reimbursement Manual USE THE HEIRARCHY OF EVIDENCE GRADING 1A-Strong recommendation. High quality evidence. Strong recommendation can apply to most patients in most circumstances without reservation 1B - Strong recommendation. Moderate quality evidence. Strong recommendation, likely to apply [...]
Return on Investment (ROI) is, basically, what you are getting in return for what you are spending. Or ... "How much bang for the buck." In the current American Healthcare "System," unlike traditional return-on-investment models, benefits are frequently gained from cost avoidance, rather than from revenue enhancement activities.
When comparing data from all the major healthcare models in other countries, how do these models rank? If you crunch the numbers obtained from the number crunchers, simply stated: All the other models of health care have a greater ROI than our current model. If we use the data from a very complete and thorough comparison of existing health plan models not being practiced in the United States, here is what that data shows us. The numbers represent where [...]
If competition may not be the best way to approach our American healthcare in transition, what would? Perhaps we need to take a look at other healthcare delivery models besides our current Multi-Payer model? And what type of scorecard should we use? Perhaps RETURN ON INVESTMENT (ROI) might be a better way to approach our choices. ROI has four main basis of competition discussed previously: PRICE (COST) CONSUMER CHOICE ACCESS AND STYLE OF CARE QUALITY OF CARE It also [...]
As you have already learned in my first 2 vlogs, our current healthcare model is broken, driven by profit rather than the health and care of the patients. At the end of the day -- it all comes down to cost. And currently this cost comes out of your pocket. How can we fix the healthcare model in our country? Listen on ...
Let us address a common “wisdom” being espoused by decision makers of the Republican persuasion in Congress. Greater transparency More choice for consumers Competition to decrease cost WHAT BASIS COMPETITION? What do these product lines look like? 1: PRICE-The primary consideration Why are we concerned about competition based on PRICE? The raising cost of health care, currently $3.65 trillion dollars in 2018 or roughly $11,212 per capita. And how does that impact the SECOND PARTY or Health care Consumer? 2: [...]
The Democrats have revealed their “Medicare for All” Proposal. WILL IT WORK? Health coverage for all Americans to include premiums, copays and deductibles Expansion of Medicare to younger Americans essentially replacing both Medicaid (low income/disabled) and employer-paid (workers) healthcare coverage The current for-profit healthcare insurance model would be reduced to supplying supplemental coverage only, which will not go unnoticed by the FOURTH PARTY decision makers whose job it is to maintain profit or the current THIRD PARTY PAYORS; Benefits [...]
One Administration END RUN has been struck down. A federal judge ruled against the Trump administration's highly touted small-business health insurance plan, calling it an "end run" around consumer protections provided by the Affordable Care Act. At issue in the latest ruling are so-called "association health plans," in which businesses and sole proprietors can band together to offer lower-cost coverage that doesn't provide all the benefits required under the Affordable Care Act.That said, STILL IN PLAY:The Trump administration has reversed [...]