The 35-year-old medical director of the plan’s office of medical policy and technology assessment has broad interests, but he’s particularly keen on wellness because it “ties into the evidentiary component of my position—evaluating the scientific literature to support evidence-based medicine.” His take: Rely less on active patient participation.
The move to a value-based payment system was supposed to end perverse incentives that pay doctors more for delivering often unnecessary services. But things are changing slowly and the market is still 95% fee for service. There’s talk of reworking the Medicare fee schedule so docs are paid more for the things that work, and less for those that don’t.
Direct primary care (DPC) occupies only a small niche in the health care payment system. But proponents say that federal legislation that would allow people to pay the monthly fee with health savings account dollars would help DCP take off.
Oscar Health, a small insurer with big ambitions, has been enlisted to assist the storied Cleveland Clinic launch its own health plan. Each member of the plan will be matched with a care team made up of primary care provider, physician assistants, and other health care professionals.
Accurate prognostic estimates can predict and document expected response to treatment, avoid ineffective and costly overtreatment, and facilitate meaningful discussions with lung cancer patients about the timing of best supportive care and hospice care when appropriate, thereby improving cancer care planning and quality scores.