Susan Dentzer, MS

The word accountable in accountable care organization (ACO) means being vigilant in monitoring healthcare’s costs and quality. And lately, many ACOs participating in the Medicare Shared Savings Program (MSSP) have been vigilant in spades.  First, some ACOs tipped CMS off about a $2 billion urinary catheter fraud when that spending hit their bottom lines in…

The phrase “only in America” usually refers to the upside of national exceptionalism, but in the context of healthcare, the meaning is often negative. That’s the case with current efforts to cut Medicaid — now the nation’s largest healthcare program in terms of enrollment — to pay for large tax cuts that will primarily benefit…

Zoe Chance, who teaches at Yale’s School of Management, tells students that they should ask a “magic question” when they are faced with a difficult situation: “What would it take?” That question can open their thinking “to ditch conventional ideas and consider a new approach,” Chance writes in her book, Influence is your superpower.a I…

The healthcare sector is facing a perfect storm of aging patients, rising costs, aging providers, and a shortage of primary care physicians, creating a need to a shift toward preventive care, increased use of technology, more virtual and home care and sustainable care teams.

Amid the complexities of U.S. healthcare, there is probably no construct that’s more byzantine than the Medicare Physician Fee Schedule (MPFS) — the program’s elaborate system of paying physicians and other clinicians (including nurse practitioners, physician assistants and clinical psychologists) for more than 10,000 medical services.a In 2022, the schedule drove about $71.2 billion in…

Author Malcolm Gladwell famously wrote in a 2000 book about the phenomenon of tipping points — those moments when “critical mass, the threshold, [or] the boiling point” is reached and change occurs “not gradually but at one dramatic moment.”a One historical case in point: the collapse of the former Soviet Union, which, though building for years,…

Signs that the United States is in the midst of a healthcare workforce crisis are everywhere: A mounting national problem While exacerbated by the pandemic, the crunch has built for decades. The biggest driver is demographics: By 2029, one in four Americans will be 65 or older, translating into declining labor force participation, including in…

The most successful industrialists of America’s Gilded Age were often skewered by contemporary critics as being robber barons. A new generation of naysayers wants to recycle the old rhetoric, this time targeting organizations focused on healthcare: The critics’ clear message: Big money is helping healthcare get bigger, and it’s a bad deal all around. Many…

he most successful industrialists of America’s Gilded Age were often skewered by contemporary critics as being robber barons. A new generation of naysayers wants to recycle the old rhetoric, this time targeting organizations focused on healthcare: The critics’ clear message: Big money is helping healthcare get bigger, and it’s a bad deal all around. Many…

Drive through rural New England and you’ll see them: “connected farms,” cobbling together houses, sheds, barns and outbuildings in disjointed structures. Often centuries old, they are at once unlovely, yet exude charm. To me, they’re a perfect metaphor for the jumble of Medicare. How else does one describe a program that baffles new enrollees as…