The newish specialty of palliative care struggles to win over the specialists and hospitalists who might refer patients. Some want to protect their turf. And too often, palliative care is lumped in with hospice and viewed as “giving up” on patients that oncologists, pulmonologists, and cardiologists are working so hard to save.
Demand for mental health services outstrips the supply of psychiatrists. Aggravating the situation: Many psychiatrists don’t take insurance. Nurse practitioners and physician assistants are beginning to fill the gap, but some professionals look askew at this team-based approach, wondering if care is being compromised.
For instance, in the case of Sanford Health’s acquisition of Mid Dakota Clinic in North Dakota, the agency challenged the deal, claiming that the merged entity would control 75% or more of primary care and other health services in the Bismarck–Mandan metropolitan area.
Some experts say that investors funding innovative startup companies can disrupt American health care, making it smarter and more efficient. Others warn that incentives must change if VC money is to make a real difference. It’s a trend no one in health care can ignore.
How the world looks depends on your point of view. Medical directors, some with experience as payers and providers, share their thoughts on prior authorization, value-based care, and quality measurement. One opportunity: Payers should work with specialty organizations and physician advocates to develop metrics and processes that make sense from the physician perspective.
Study results showed a modest (12%) advantage for the care management group in control of blood sugar levels, as measured by the proportion of patients whose HbA1c was under 7%. Among the obese patients, the care management group had a 16 percentage point edge (26% vs. 10%) over the usual care group in the proportion of those who lost 5% of their body weight.
A post on the Health Health Affairs blog last month offered insight into just what ACOs can bring to this process. The authors argued that while the applicability of ACOs to many areas of care delivery have been much examined, “discussions of the impact of ACOs on EOL care are conspicuously absent.”
Cutting-edge programs are sparing young people from many of the most dire IBD complications, which often occur when they are in school or starting careers and families. Most Crohn’s patients are diagnosed in their teens and 20s; ulcerative colitis is typically diagnosed when a patient is between 30 and 40 years old.