Comments for Reward Health Sciences

Comment on To resolve conflicts, re-frame polar positions as optimization between undesirable extremes. But, sometimes there is no way to win. by Dr. Ward

Dr. Ward — Tue, 21 Feb 2012 14:48:52 +0000

You bring up an excellent point. When the parties conceptualize the issue as a zero sum game, like splitting up a pie, they won’t get agreement on an optimal point. In such cases, I would try to re-conceptualize the undesirable extremes as “keep arguing forever in hopes of getting more for yourself” vs. “give it away to the other guy immediately to get done with the unpleasant negotiation.” In zero sum games, the parties always seem to seek natural deadlines that allow both parties to feel enough urgency to be willing to compromise. If there is no natural deadline, zero sum negotiations seem to go on forever. As a facilitator, in such situations I would just focus on creating a sense of urgency.

Comment on To resolve conflicts, re-frame polar positions as optimization between undesirable extremes. But, sometimes there is no way to win. by Nancy Belmont

Nancy Belmont — Tue, 21 Feb 2012 13:15:23 +0000

What if the conflict involves two sides arguing to achieve the same outcome for only themselves? I like your ideas for conflicts involving opposition. I’m sure Ross is somewhere in CA applying similar principals as we speak. I would be curious to see how similar/if your methods would help.

Comment on Coconut oil as an Alzheimer’s treatment? Please don’t short-circuit science. by Dr. Ward

Dr. Ward — Mon, 13 Feb 2012 20:54:16 +0000

Eric, I agree that chemotherapy can have hellish side effects. I’m not familiar with the work by Max Gerson, but the Wikipedia article on his work refers to an analysis by the National Cancer Institute discrediting his work. So, although the idea of curing cancer with coffee and fruit juice is more appealing than chemotherapy, I don’t think it is wise to forego evidence-based treatment. In the words of one of my heroes, Edwards Deming, “In God we trust. All others must bring data.”

Comment on CMS Innovations Center announces new Medicare Bundled Payments Initiative. I predict it will be popular. by CBO: Bundled payments for bypass surgery saved 10%, but pay-for-performance and gain-sharing was not effective in 3 Medicare demonstrations

Mon, 13 Feb 2012 05:08:13 +0000

[...] was the Medicare Participating Heart Bypass Center Demonstration, which was used as a model for similar provisions in the health care reform law (PPACA). In this program, the hospitals negotiated their bundled payments up front, ensuring that [...]

Comment on CMS Announces 32 Pioneer ACOs, including 3 in Michigan by CBO: Bundled payments for bypass surgery saved 10%, but pay-for-performance and gain-sharing was not effective in 3 Medicare demonstrations

Mon, 13 Feb 2012 04:38:27 +0000

[...] Despite these discouraging results, the PGP demonstration was nevertheless used as the main evidence base supporting the design of the Medicare Shared Savings Program, calling for the establishment of Accountable Care Organizations (ACOs). It is also the main evidence base for the associated Pioneer ACO program, for which 32 participating provider organizations have recently been selected. [...]

Comment on Congressional Budget Office: Care management programs only work if care managers have face to face contact with patients and substantial interaction with physicians by CBO: Bundled payments for bypass surgery saved 10%, but pay-for-performance and gain-sharing was not effective in 3 Medicare demonstrations

Mon, 13 Feb 2012 04:34:30 +0000

[...] weeks ago, I commented on the results of Nelson’s review of 6 Medicare Care Management demonstration projects over the [...]

Comment on Coconut oil as an Alzheimer’s treatment? Please don’t short-circuit science. by Eric

Eric — Mon, 06 Feb 2012 23:19:52 +0000

You know medical science is losing more and more of my respect by the week, the FDA, nor medical doctors the final authority to me, and my families health. A cure for Cancer was found all the way back in the 30s, in fact a Doctor by the name of Dr. Otto Warburg showed the medical community exactly what it needed to defeat cancer. Otto discovered that Cancer can not survive in a high oxygen enviroment. Dr.Max Gerson went even further than Warberg in taking thousands of stage 4 cancer patients from death’s door step, to full recovery, with only giving them a organic coffee enema, and organic fruit juices. So, seeing that medical science still insist on putting people through the hell of Chemo theropy, and other cancer treatments that kill health cells, along with cancer cells, I have turned my back on conventional medicine.

Comment on Approach: Technology by Lanny M. Turner, M.D.

Lanny M. Turner, M.D. — Fri, 27 Jan 2012 20:01:54 +0000

Outstanding stuff! Please continue expanding on the “processes” approach to healthcare systems! L.M. Turner, MD

Comment on Approach: Care Process Improvement by The Humunculus is a metaphor for Clinical Process Improvement Frameworks

The Humunculus is a metaphor for Clinical Process Improvement Frameworks — Sat, 10 Dec 2011 17:01:34 +0000

[...] Process [...]

Comment on Telling a 46 year health care cost growth story in one graph by Dr. Ward

Dr. Ward — Mon, 14 Nov 2011 20:04:57 +0000

Charles, thanks for your great statistics and for taking the time to comment. If the question is about government expenditures for health care crowding out other government expenditures, why wouldn’t the right metric just be the proportion of government revenue dedicated to health care? Also, I feel a little uncomfortable about the underlying premise of assuming that tax payments are fixed (even though politically and empirically that might be true) since that sounds too much like accepting that the government has some intrinsic right to a certain percent of what we produce. I’ll definitely look for your upcoming blog post to learn the full explanation.