Empowering Patients to Self-Manage

by Super User

~ Written by Holli Masci, Director Population Health Management, Medical Group of Pennsylvania

PCMH TILES

Consumer driven care is not without its complexities. Beyond the plethora of provider choices and quality institutions exists the patients. Often, they are left to navigate the unknown waters of high deductible plans, the consequences of going to out of network providers, and the promise of price transparency. Adding to the complexity in the market is the on-demand nature of urgent health services, the often-intangible reasons patients choose providers, and the disconnect between payor reimbursement and actual cost of care. Is it any wonder why consumers can become discouraged and disengaged with their health needs? In this environment, empowering patients to become savvy consumers is an effective conduit to self-activation and self-management.

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Why Choose Independent Physicians

by Super User

~Written by Heather Gahres, Medical Group of Pennsylvania, Office Manager

It is clear with the changes to the Affordable Care Act (ACA) that now more than ever employers and patients are taking a hard look at the care they are receiving and the costs of that care.

The push from the original ACA put the buying power into Hospital Systems. About 50% of the independent practices were purchased by hospital systems. As patients became part of large health systems, centralized scheduling replaced familiar receptionists and often decreased access to their primary physician. Scott Gottlieb of The Wall Street Journal wrote, “Once they work for hospitals, physicians change their behavior in two principal ways. Often, they see fewer patients and perform fewer timely procedures. Continuity of care also declines, since a physician's responsibilities end when his shift is over.”

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Ending the Ban on Physician Owned Hospitals

by Super User


In March of 2010, Title VI of the Affordable Care Act effectively prohibited new development or expansion of existing Physician Owned Hospitals (POH). This stifled a thriving healthcare segment that had a 3-4-fold increase over the preceding decade. Shortly thereafter Centers for Medicare and Medicaid Services (CMS) began its Hospital Value Based Purchasing Program. CMS began rewarding acute care hospitals with incentive payments for quality care. Parameters measured include patient safety, patient experience, clinical care, efficiency and cost reduction. Direct comparison of hospitals became more readily available to the public.

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