David Johnson: Academic medicine, where privilege compounds dysfunction
Academic medicine combines healthcare with higher education, the two U.S. economic sectors that have exhibited outsized cost growth over the past 50 years. The result is a stunning disconnection between academic medical center (AMC) business practices and the supply-demand dynamics reshaping healthcare delivery. Market, technological and regulatory forces are pushing the healthcare industry to deliver…
AI and the rise of human-machine collaboration in healthcare
Commentators, researchers and academics can’t stop finding applications for ChatGPT.a Two of its recent claims to fame include passing all three medical licensing exams and the final exam for a core MBA class at Wharton.b ChatGPT, short for Chat Generative Pre-Trained Transformer, is a form of conversational artificial intelligence (AI). The concept is not new.…
David Johnson: Rewiring healthcare’s smartest professionals (Hint: It’s not physicians)
I won’t keep you in suspense. Healthcare’s smartest professionals are the tens of thousands of individuals who populate its revenue cycle operations. Revenue cycle professionals determine how much payers fork out and how much providers receive for healthcare treatments. They constitute the beating heart of the nation’s transactional healthcare system. Their ingenuity knows no bounds.…
David Johnson: Cracks in the foundation (Part 4): Overcoming a brittle business model
U.S. health systems’ rely on centralized, high-cost platforms (e.g., hospitals) to deliver routine care in an approach focused on optimizing revenues under fee-for-service payment. Yet this approach is inefficient and asset-heavy. To build less brittle, more consumer-centric delivery platforms, health systems must decant procedures to more convenient, lower-cost locations as they pursue full-risk contracting.
David Johnson: Cracks in the Foundation (Part 3): Overcoming healthcare’s services-need mismatch
Clinical care only accounts for 20% of health outcomes, yet this area is where America disproportionately invests its healthcare resources. To overcome U.S. healthcare’s services-need mismatch, there should be a greater investment in healthy multipliers that help to address the social and economic factors, health behaviors and the physical environment that drive the remaining 80% of health outcomes.
David Johnson: Cracks in the foundation, Part 2: Overcoming healthcare’s artificial economics
In normal markets, demand for services at given prices drives supply. Healthcare reverses the equation so demand for services is driven by the supply of healthcare facilities and practitioners, says hfm columnist David Johnson. In this second column in his series examining structural defects of the U.S. healthcare system, Johnson challenges these “artificial economics” and describes how cutting-edge health systems will apply new, more customer-focused economics to become the future market leaders.
David Johnson: Cracks in the foundation — 5 structural defects are undermining nonprofit healthcare
The relentless organizational imperative under which nonprofit healthcare providers operate to optimize revenues under fee-for-service medicine has led to fragmented care delivery, unsustainable cost growth and severed connections with American consumers. Nonprofits should address five structural defects to their modus operandi that stand in the way of their delivering care empathetically and cost effectively to their patients.