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33 Matching News Items |
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Radical Incrementalism or System Re-Design: Which Way Forward for U.S. Healthcare?
Paul Keckley Apr. 23, 2018
"The U.S. healthcare system is ... caught between the tyranny of the present and the possibilities of its future.... [I]ntramural conflicts, financial incentives that often reward short-term results and a structure that's flawed limit its potential.... The current state is not sustainable. We have perfected radical incrementalism. We defend it vigorously with three worn barbs: patients don't want it, physicians will resist it, and radical change is impractical, especially when the incumbents are strong and the status quo is profitable. And we fight the entry of outsiders who dare invade our turf."
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Is the Amazon, JPMorgan, Berkshire Hathaway Venture Armageddon for Healthcare as We Know It?
Paul Keckley Feb. 5, 2018
"The new venture will focus on the collective buying power as employers of healthcare for the 1.15 million employees in their organizations. Their approach features five strategies widely used by large self-insured employers to contain their employee health costs. This one is expected to leverage technology in a unique way[.]"
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The Eight C's That Will Define Healthcare in 2018 and Beyond
Paul Keckley Dec. 18, 2017
"Costs ... Capital ... Consolidation ... Consumerism ... Competition ... Compliance ... Culture ... Certainty ... Next year is pivotal to the future of our system of health.... Every board and management team in healthcare will be tested."
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Medicare for All: The Two Issues It Must Confront
Paul Keckley Sept. 18, 2017
"The U.S. debate will center on two issues: the relatively high prices we pay for the drugs, devices, technologies, services and facilities we use, and the medical necessity for many services provided for which evidence shows no benefit. What happens to innovation if the federal government uses its muscle to ratchet down what it pays for services and who decides what's necessary or not? And what's the administrative expense necessary to managing our $3.4 trillion expenditure? ... The issue will be whether and how primary and preventive health will be elevated in a U.S. single payer model and how specialty and long-term care are impacted long-term."
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5. |
Health Insurance Availability: Is Choice the Real Issue?
Paul Keckley Sept. 11, 2017
"Healthcare consolidation is the result of economic reality: the private market in healthcare is shrinking, the public market is growing and choices for consumers are fewer. And the public market is not as profitable as the private market, so access to capital and positive operating margins are increasingly achieved by fewer and bigger organizations. And that means fewer choices for consumers in choosing with whom they'll do business."
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6. |
Re-Thinking Employer-Provided Health Benefits
Paul Keckley Aug. 14, 2017
"Employer-sponsored coverage is shrinking.... What's covered and who is covered is shrinking.... Employees are paying more of the cost.... Employers blame hospitals and drug companies for excess costs.... Employers are implementing new strategies to rein in their costs.... Two issues have regulators' attention: Disparity in employee access ... Contracts with providers ... But beyond these issues, cost is the overriding employer concern that's likely to define the future for employer sponsored health benefits."
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An Open Letter to the Senate HELP Committee
Paul Keckley Aug. 7, 2017
"[T]he individual insurance market is only 4% of the 285 million who are insured.... The stability of individual insurance market is a legitimate issue but it's small relative to policies and strategies that impact every employer and household. Your charter must be bigger than reducing risks for insurers; it must be about the viability and sustainability of the entire health system."
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8. |
Changing Health Insurance Plans Again: Seriously?
Paul Keckley July 10, 2017
"Tackling the individual market for insurers is only part of the issue facing insurers: flaws in the ACA's oversight of insurance extend beyond the individual market. [1] Insurers have no obligation to provide coverage to any segment in the population if it's not profitable to their businesses.... [2] Americans want coverage but most don't trust insurers.... [3] Large Insurers have done well since passage of the ACA despite its flaws, while others have been hurt."
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9. |
Winners and Losers in the Senate Healthcare Bill, and Four Themes Not Addressed at All
Paul Keckley June 26, 2017
"Four themes have been missed in the rhetoric on both sides: [1] Access to insurance coverage is not the same as access to care.... [2] There's plenty of money in the system, but much is wasted and it's not spent in the most productive ways.... [3] The Medicaid program needs transformation: budget cuts without program re-design does nothing to fix it long-term.... [4] Affordability has not been addressed."
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10. |
The Healthcare System: 50 Years Later
Paul Keckley June 19, 2017
"In 1967, the healthcare system was an abstract concept. We paid scant attention unless we wrecked our cars or injured ourselves playing ball. We thought every physician infallible, every procedure evidence-based and every admission necessary. But today, healthcare matters and how our system operates confronts them daily. There's confusion about Repeal and Replace and dissonance about the politics: they understand healthcare is expensive but they think there's plenty of government money to cover anyone needing care."
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11. |
Health Reform: The Tipping Points We Should Be Watching
Paul Keckley June 12, 2017
"Delegating Medicaid and insurance oversight to states is great politics for federal legislators but problematic ... if accompanied by regulations that hog-tie Governors with red-ink.... In the 57% of companies that provide coverage, employee contributions are increasing (19% for single/29% for family policies) and high deductible products are fast becoming the status quo.... Physicians are unhappy.... Hospital closures [may occur because the] ... inpatient business is increasingly unprofitable, the outpatient business is being cherry-picked by opportunistic investors, and cheaper, accessible, safe and effective alternatives are proliferating."
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12. |
It's Time for 'The Talk' About the Future of Our Health System
Paul Keckley May 30, 2017
"Public opinion is trending toward a single payer or some form of universal coverage. The majority believe healthcare coverage is a fundamental right and the federal government should play a bigger role in its provision, but most do not understand how the system operates nor believe it comprehensible. The majority think health costs are too high but rarely check prices or pursue cheaper courses of treatment. The majority believe the [ACA] is flawed but prefer it be fixed rather than replaced. And while opinions are changing, the right path forward remains unclear to most."
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13. |
Health Reform: What's Next?
Paul Keckley May 8, 2017
"As Senator Alexander's working group goes about the task of crafting its repeal and replace plan ... it might start by clarifying three concepts muddled by industry noise and partisan bickering of late:.... [1] Affordability is about more than insurance premiums.... [2] Access is about more than carrying an insurance card.... [3] Our health system is about neither health or a system."
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14. |
Health Insurance: Is It Time to Reset?
Paul Keckley Apr. 24, 2017
"[T]he fundamentals of the private insurance market are changing. Notwithstanding the political noise about what constitutes accessible, affordable coverage, two trends stand out: [1] The core market, employers, is shrinking. [2] ... consumers are disenchanted with health insurance.... Provider-sponsored health insurance plans that are part of regional, fully integrated systems of health are likely the future for private insurance."
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15. |
The Affordable Care Act: Chapter Two
Paul Keckley Mar. 27, 2017
"As we now pivot to Chapter Two for the [ACA], the realities are these: [1] The healthcare system needs improvement. Affordability is the issue one.... [2] The [ACA] has flaws. It successfully increased coverage for 20 million who were uninsured via Medicaid expansion and subsidized coverage for individuals via the marketplaces, but at a hefty price -- $1.1 trillion over 10 years -- and the rules whereby insurers are required to structure and price their plans are problematic.... [3] The strength of our economies--locally and nationally -- is closely tied to the effectiveness of our health system."
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16. |
Happy Anniversary ACA!
Paul Keckley Mar. 20, 2017
"This Thursday, March 23, marks the seventh anniversary of the passage of the [ACA]. It also marks the date the House will vote on its partial replacement, the American Health Care Act [AHCA].... Amidst the clamor of the current debate ... it's useful to harken back to the circumstances under which the ACA passed and reflect on what might be learned."
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17. |
The American Health Care Act: What You Need to Know and What You Need to Watch
Paul Keckley Mar. 13, 2017
"The calculus underscoring the AHCA is based on three fundamental beliefs held widely by its sponsors: [1] The U.S. healthcare system is best run as a private market in which the physician-patient relationship is central.... The public's interest is best served by policies that promote competition with limited regulation. [2] Reducing health costs is the primary aim for Repeal and Replace.... [3] The [ACA]'s mandate to purchase insurance is an overreach by government and unconstitutional: it should be replaced by incentives for individuals to purchase private insurance and assume greater accountability for the costs and coverage they desire."
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18. |
Healthcare is Complicated: Is it Fixable?
Paul Keckley Mar. 6, 2017
"[C]onsumers think healthcare is too complicated for them to understand. Thus, they depend on their caregivers to educate them and are predisposed to be dependent on what they're told. It hasn't changed. In this digital health age, only one in eight consider themselves well-informed and capable of navigating the system. It's too complicated for most Americans and perhaps even more for the GOP lawmakers seeking to transform it in an environment of intense media scrutiny and partisan rancor."
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19. |
The 2017 Watch list for Healthcare
Paul Keckley Jan. 3, 2017
"Watch for [1] refreshed approaches to privatizing Medicare ... [2] changes in how anti-trust issues and competition is regulated by the U.S. Department of Justice and the Federal Trade Commission ... [3] privatization to be injected into the Veterans Health and Indian Health programs ... [4] healthcare officials to relax reporting requirements for physicians and hospitals ... [5] pressures to be exerted toward drug manufacturers to reduce prices ... [6] private insurers to recover.... [7] consumer responsibility to become a key theme in health reform ... [8] employers to stay in the employee health benefits game."
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20. |
Living in Uncertainty: The New, New Normal
Paul Keckley Nov. 21, 2016
"For six years, the healthcare industry in the U.S. has been adjusting to its new normal based on the regulatory framework of the [ACA]. It became normal to discuss the volume to value transition, accountable care organizations, bundled payments, Medicaid expansion and Healthcare.gov. We adapted. We were certain they'd be around for years to come. Then came the election."
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