April 2020, Volume XXXIV, No 01
A futile quest
Why “performance” measurement is not working
Over the last three decades, Minnesota’s health care policymakers have gotten into a bad habit: They recommend policies without asking whether there is sufficient evidence to implement the policy, and without spelling out how the policy is supposed to work.
April 2020, Volume XXXIV, No 01
interview
Serving pharmacists and patients
Sarah Derr, PharmD
Minnesota Pharmacists Association
A futile quest: Why “performance” measurement is not working
By Kip Sullivan, JD
Over the last three decades, Minnesota’s health care policymakers have gotten into a bad habit: They recommend policies without asking whether there is sufficient evidence to implement the policy, and without spelling out how the policy is supposed to work. Measurement and “pay for performance” (P4P) schemes illustrate the problem. Multiple Minnesota commissions, legislators, agencies, and groups have endorsed the notion that it’s possible to measure the cost and quality of doctors, clinics, and hospitals accurately enough to produce results useful to regulators, patients, providers, and insurers.
cover story two
Prior authorization: We need a better law
By Sheldon Berkowitz, MD, FAAP
Prior authorization reform is long overdue in Minnesota. It has been discussed by physicians and lawmakers for many years, but nothing has changed. In a 2017 national AMA survey on prior authorization, 51% of respondents said that their prior authorization burden had increased substantially over the previous five years. Two companion bills now before the state Legislature—House File 3398, sponsored by Rep. Kelly Morrison, MD, an OB/GYN, and Senate File SF3204, sponsored by Sen. Julie Rosen—could bring some much-needed improvement to the existing law.
2020 Community Caregivers
Recognizing Minnesota’s Volunteer Physicians
By Richard Ericson
Each year, Minnesota Physician Publishing recognizes physicians and health care providers who have volunteered their medical services. Whether volunteering at home or overseas, these caregivers help people in need and come away with a revitalized sense of their work. Their compassion, commitment, and generous spirit reflect the deeply held values in Minnesota’s medical community.
Life in a global pandemic: Helping patients cope
By Todd Archbold, LSW, MBA
On Feb. 11, the World Health Organization (WHO) announced the name of COVID-19, the novel coronavirus that had spread terror throughout Asia and Europe, and by then had already claimed the lives of thousands. Efforts to slow the spread to the United States was a topic of alarm and uncertainty. We knew little about COVID-19, which seemed shrouded in mystery, so far untreatable, and highly discriminatory to the elderly and those with weakened immune systems.
Orthopaedics
Osteonecrosis of the femoral head: Diagnosing and treating a rare condition
By Paul Hoogervorst, MD, and Edward Cheng, MD
Osteonecrosis (also known as avascular necrosis, aseptic necrosis, ischemic necrosis, and atraumatic/non-traumatic necrosis) is characterized as a bone infarct with dead osteocytes due to numerous possible etiologies. While the exact pathophysiology is unknown, etiologic risk factors most often are corticosteroids, ethanol, trauma, and diseases such as lupus erythematosus (SLE) and sickle cell disease.
Investment strategies: Assessing a volatile marketplace
By Katherine Vessenes, JD, CFP
Physicians on the front line of the COVID-19 war are faced with unprecedented stress, both on the job and with their personal finances. Many are working long hours, constantly exposed to a deadly pathogen. Others are furloughed, or working from home while home-schooling their children, all on a reduced paycheck. Life for a physician has never been more stressful.
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