In this initial GoozNews podcast, Dr. Farzad Mostashari, CEO of Aledade, lays out how primary care can thrive -- even in the current political environment.
On the flipside to the comments, independent primary care has been running on life support and on 5% on average of the entire health care spend in this country. Isn't it time to ensure that the most cost effective locus of care isn't lost? I too am a rural family doctor seeing all insurances like the example provided, and noone besides Aledade has even considered that we might be worthy of support, or done it well enough to be worthwhile. Because of this boost as an Aledade partner practice, I hold out hope to continue independently and to have a shot at recruiting a younger generation of clinicians. We'd love to receive reimbursements sufficient to counteract decades of being severely underresourced without any of this model. Barring that, VBC is what we have...
Merrill thanks for doing this podcast. Good discussion.
We’ve spent decades working on VBC without much progress at scale. Maybe we should embrace simpler reforms that are easy to implement.
With some additional codes for high value services and a rebalancing of RVU scale we couldn’t fixed 80% of the problem. Instead we have more layers of complexity, cost, and minimal gain.
My primary care practice would still be open if we could get the simple stuff right. Yeah, simple reforms!
Many great points made as usual by Aledade. Some right on, some weaselly. I do wish you had pushed back more on some. Because when they say "Do you make more money if people are healthy, or sick?"...the real question is fundamentally different. It's "Do you make more money if people are healthier than their CMS projection, or sicker than their CMS projection?"
And that nuance muddies the calculus of which models actually save money. Including the MSSP cash cow. Hence Aledade's "alleged" upcoding practices which look very similar to Medicare Advantage tactics.
My consulting career started with helping individual practitioners understand DRGs as a good thing while at the same time being statewide Director of a statewide emergency medical services coordinator. I've helped answer the question of whether the total cost of a hospital helicopter service would provide remote access faster than an ambulance at 120 mph without the helicopter's warm-up time. I've helped a hospital hospital adjust staffing and training to pass accreditation while at the same time trying to get a rural doctor to take a cord of wood or a slaughtered pig when the patient had no insurance or money. Now I listen to your Mr. Mostahari talk about how medical care is all about private practitioners, private equity, insurance managed plans, and hospitals make more money from every visit. A well run ACA could include this service without an added fee. By the way, the rural practitioner mentioned above added more and more services and continued to fill his wall of delivered babies until one labor complication could not be resolved because the needed hospital was too far away. He went bankrupt and then, abandoning care as he dreamed, worked for a care group as a job. Just how many intermediaries have to make a buck off of a hangnail?
On the flipside to the comments, independent primary care has been running on life support and on 5% on average of the entire health care spend in this country. Isn't it time to ensure that the most cost effective locus of care isn't lost? I too am a rural family doctor seeing all insurances like the example provided, and noone besides Aledade has even considered that we might be worthy of support, or done it well enough to be worthwhile. Because of this boost as an Aledade partner practice, I hold out hope to continue independently and to have a shot at recruiting a younger generation of clinicians. We'd love to receive reimbursements sufficient to counteract decades of being severely underresourced without any of this model. Barring that, VBC is what we have...
Merrill thanks for doing this podcast. Good discussion.
We’ve spent decades working on VBC without much progress at scale. Maybe we should embrace simpler reforms that are easy to implement.
With some additional codes for high value services and a rebalancing of RVU scale we couldn’t fixed 80% of the problem. Instead we have more layers of complexity, cost, and minimal gain.
My primary care practice would still be open if we could get the simple stuff right. Yeah, simple reforms!
Jeff Brenner
Many great points made as usual by Aledade. Some right on, some weaselly. I do wish you had pushed back more on some. Because when they say "Do you make more money if people are healthy, or sick?"...the real question is fundamentally different. It's "Do you make more money if people are healthier than their CMS projection, or sicker than their CMS projection?"
And that nuance muddies the calculus of which models actually save money. Including the MSSP cash cow. Hence Aledade's "alleged" upcoding practices which look very similar to Medicare Advantage tactics.
My consulting career started with helping individual practitioners understand DRGs as a good thing while at the same time being statewide Director of a statewide emergency medical services coordinator. I've helped answer the question of whether the total cost of a hospital helicopter service would provide remote access faster than an ambulance at 120 mph without the helicopter's warm-up time. I've helped a hospital hospital adjust staffing and training to pass accreditation while at the same time trying to get a rural doctor to take a cord of wood or a slaughtered pig when the patient had no insurance or money. Now I listen to your Mr. Mostahari talk about how medical care is all about private practitioners, private equity, insurance managed plans, and hospitals make more money from every visit. A well run ACA could include this service without an added fee. By the way, the rural practitioner mentioned above added more and more services and continued to fill his wall of delivered babies until one labor complication could not be resolved because the needed hospital was too far away. He went bankrupt and then, abandoning care as he dreamed, worked for a care group as a job. Just how many intermediaries have to make a buck off of a hangnail?