Brett Sperry

Very important points about hospital consolidation. ⏺ Has led to the majority of physicians now being employed by a system. ⏺ A hospital system may have different priorities than physicians (in private practice). ⏺A system in which physicians have very little leverage to negotiate or change factors important to patients and clinical care. The real reason highlighted around 2 minutes 50 seconds. Short interview with beneficial insight. ⏺Physicians have joined unions not for wage negotiation but to focus on changes that affect clinical care. We as physicians do not have a unified voice. We have not organized ourselves well to create a unified voice. I am not sure that a union is the right path, but uniting to have a common voice, leverage, and negotiation power is needed. At 9 minutes Kevin Schulman highlights how this could be done without creation of a union (we need a system clinical strategy, not a market strategy) based on thoughts by @atul gawande. #UsingWhatWeHaveBetter https://lnkd.in/g5YTjFbD

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Thanks to David M. Wright, CDH-E and the Disruptive Innovators for the great conversation about technology, behavior change, and the future of medicine. So much of healthcare and being healthy is about behavior change. After all, simply knowing you should take medicine for diabetes doesn't make you healthy. You need to change your life to adhere to medications, change your diet, start exercising, etc. How can the technology of the future support healthcare providers and patients by supporting behavior change that results in healthy lives? #behaviorchange #healthcaretechnology

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Rural health. Is the one we’re we need to see improvement not in care, but in operational efficiency. So nice to see implementation of AI methodologies. I have been a bit of a sceptic, AI tool tries to save physican and care provider time, but than they are over burdened with administrative tasks. So glad to see AI Grand Rounds giving a realistic picture of what is happening by in the field and not just hype. If we want real victories, we need to tackle at multiple levels, AI is absolutely a yes these days, but organizations should adapt and want to make provider lives better. AI Grand Rounds Dallas AI #RuralHealth #healthequity

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Health insurance companies Medicare Advantage plans subsidy and premium based EBITDA and Profits can only be guaranteed and expanded by taking from the physicians who manufacture preventive, medical, surgical and palliative outcomes with their patients and also taking from the hospitals in which clinical outcomes are manufactured and produced. #quadrupleaim, #medicare #medicareadvantage #healthcarecosts

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On October 8th, U.S. News & World Report released its annual rankings of Children's Hospitals, called "Best Children's Hospitals". It is a 174-page report describing the methodology and data tables which I scanned through. Appendix C-10 has the data on Pediatric Pulmonology which I took a deep dive into. In the attached carousel, I have recreated two datasets that matter. If I were to shop around for a hospital for my care, what really matters to me is the outcome data for a particular condition I am seeking care for and not the reputation score. However what separates the top-ranked "Best Children's Hospitals" is their reputation scores, not the outcome scores for selected conditions as in asthma here. It's a different matter whether the outcome scores used in the rankings are good measures. We will discuss them in another post. What are your thoughts? Feel free to like, share, and comment. #healthcare #hospitals #physician

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My next Signal takes a closer look at the latest antitrust probe into large dialysis companies and the shifting role of non-competes in kidney care. A recent POLITICO article provides helpful background around topics like NCAs in dialysis and impacts on the adoption of home dialysis technologies. This is an important discussion, so I'd love to hear from you. If you have something you'd like to share, whether it's an anecdote, comment or question for other readers, please leave a comment or send me a message. H/t to Tom Mueller for sharing the article last week. https://lnkd.in/e95a23JF

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As Alex Mohseni, MD, FACEP explained elsewhere, a 2.8% physician payment cut "does *NOT* equal a 2.8% reduction in income for the typical physician, it's MUCH WORSE...." DeepScribe's focus on customization/user experience coupled with AI ambient intelligence enables industry-leading rates of physician adoption (~80%) which leads to more time savings, more accurate coding capture for physician reimbursement and more comprehensive risk-adjusted payments. These will be essential capabilities for provider groups who are challenged by physician burnout while needing to adapt to a lower reimbursement landscape. https://lnkd.in/g4vzDRdh

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100% satisfaction in birth metrics! What is the secret? Cleveland Clinic achieved 100% satisfaction across five birth metrics, a notable feat that Becker's Hospital Review highlighted. Cleveland Clinic adopted TeamBirth in October 2022. TeamBirth is a care delivery model jointly created in 2021 by Harvard Pilgrim Health Care, Ariadne Labs and UMass Memorial Health. It emphasizes routine check-ins with all patient care team members and family at key points to streamline communication about birth preferences and patient status, using a whiteboard as a key tool. Since adopting it, the health system saw the rate of C-sections for Black mothers go down from 41% to 22%. Rates also improved for white mothers, dropping from 27% to 23%, bringing the outcomes for its patient populations to a more equitable level. ▶ Satisfaction went up across five categories in 2022 to a perfect 100% for: ➡ Friendliness/courtesy of the unit — up 10% from 2022. ➡ Staff concern, information about progress and baby’s condition — up 12% from 2022. ➡ Nurse promptness in responding to patient call — up 12% from 2022. ➡ Nurse's attitude toward patient requests — up 13% from 2022. ➡ Doctor and staff working together during birth — up 15% from 2022. Patient satisfaction grew by 23% — from 72% in 2022 to 95% in 2024 — for how well they felt Cleveland Clinic managed their pain during labour. Transparent communication is important to promoting safety and reliability in high-risk organizations. ♻ How is the communication in your organization? #healthcare #communication #reliability

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I'm delighted to be visiting Kansas City this week to speak at the University of Missouri-Kansas City on Planetary Health. It will be my first time visiting under the phenomenal leadership of Alexander Norbash, Dean of the School of Medicine. My talk will cover the important links between climate change, human health, & planetary health. I will also focus on actionable next steps for health systems, such as the following: 1. Education: for health science schools, join the Planetary Health Report Card. These students provide actionable ways to incorporate planetary health into curricula, and for health professional schools to track change. Amongst the highly competitive folks in medicine, there's nothing like an open report card to inspire change! #FOMO 2. Operations: Discover, learn, & share insights through the National Academy of Medicine climate movement. https://lnkd.in/g3FaMmHx At the hospital level, consider joining Practice Greenhealth. #SaveMoney 3. Quality: seek Sustainable Healthcare Certification from the Joint Commission. https://lnkd.in/g-psJjxU #ImproveQuality 4. Research: One guaranteed way for labs to improve their science, reduce environmental impact, and to attract top student talent is to join My Green Lab. #Opportunity 5. Planetary Health: the Planetary Health Alliance is at the forefront of this movement. 450 universities, non-governmental organizations, and research institutes from 75+ countries can't be wrong! #ThePlanetAsPatient Medicine's role in climate change is too large to be tackled by universities, hospitals, governments, or medical societies alone. It's easier & faster to join existing groups rather than to start from scratch. Of many paths forward, only one will be successful: working together. Marie Studer Shanda Demorest Jonathan Perlin Toni Laracuente RN, BSN, MHA, MS, CPHIMS Julia Polk David J. Calkins Borden Lacy Michael Vandenbergh Kyle Tafuri Carolyn Meltzer Summer Decker Jessica Marx Urvashi Bhatnagar, DPT, MBA Mark Schuster Titus Schleyer Agata Exner Komal Bajaj Hardeep Singh

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5 yr outcomes of 150 difficult-to-treat RA (D2T RA) pts - D2T RA resolved in 45%, persisted in 50%, & 5% died. Resolved D2T RA was signif younger, had more Rx changes, & more IL-6i use. Mortality predicted by comorbidity index, steroid escalation (OR 3.50; & 32) https://buff.ly/4bG7aRQ

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CarePoint Health System's most recent bankruptcy reflects years of financial struggles, legal disputes, and attempts to salvage its healthcare operations. Ironically, it was formed in 2013 when three hospitals—Bayonne Medical Center (BMC), Hoboken University Medical Center (HUMC), and Christ Hospital— were purchased out of bankruptcy. Financial strain and management controversies plagued the network, particularly after reports surfaced in 2019 that former CEO Vivek Garipalli and other leaders funneled millions through shell companies, casting a shadow over CarePoint’s financial integrity. In recent years, CarePoint’s financial troubles deepened, with operating losses reaching 14% and significant debt accumulation, prompting the state to appoint a fiscal monitor. CarePoint repeatedly requested state subsidies to maintain operations, cut employee hours, and faced over $11 million in lawsuits from unpaid vendors. An intense rivalry with Secaucus-based Hudson Regional Hospital and its owner, Yan Moshe further complicated CarePoint’s stability. Moshe acquired the land beneath BMC in 2019, spurring legal battles over property control. Bayonne’s city council attempted to safeguard BMC’s future as a hospital through zoning protections, leading to a prolonged court dispute that recently concluded with a ruling in favor of preserving the hospital's function. Despite their adversarial history, CarePoint and HRH recently forged a tentative partnership to create a unified healthcare network, a deal brokered by Jersey City Mayor Steven Fulop. However, just weeks after this announcement, newly appointed CarePoint CEO Dr. Jawad Shah abruptly resigned, leaving CarePoint without a clear leader and triggering renewed uncertainty. Following Shah’s departure, HRH promptly offered $25 million in interim funding to help CarePoint avoid liquidation. HRH proposed to integrate HUMC, Christ Hospital, and BMC into its network, which includes its existing facility in Secaucus, with hopes of forming a stable, regional healthcare system. The Hudson County community and union representatives have since called for a state investigation into CarePoint’s financial management. To keep this story very "New Jersey" its also worth noting that HRH’s recent public image suffered a blow due to the arrest of its marketing director, Reuven Alonalayoff, who was found with an arsenal of weapons and ammunition in an unlocked hospital office. This prolonged crisis raises a pressing question for New Jersey’s state leadership: why wasn’t more done to prevent this unfolding catastrophe? For years, warning signs were not only apparent—they were glaring. Mismanagement, spiraling debt, and questionable practices were well-documented. As a critical safety-net system, CarePoint’s facilities serve some of the most vulnerable populations in Hudson County. When we have a crisis in leadership, patients and communities suffer. Full stop. Kevin Lyonsjeff lestonJohn TozziAnna Mathews

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Transition from Medicaid to Commercial Insurance Reduces Major Amputation Risk in Diabetic Foot Ulcer Patients, Study Finds https://lnkd.in/gAiB8Y9v

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Are you positioned for success in rural medicine? Kevin Post, DO, CMO of Avera Health and a longtime rural family medicine physician, shares his recipe for effective rural medicine. "Physicians, advanced practice providers, and nurses are all key, but the patient is the most essential component of the care team," Post says. "They need to be engaged in their care and involved in decision-making with their caregivers." In rural medicine, physicians should lead care teams, according to Post. "Then you must leverage the team around the physician, which includes APPs, nurses, care coordinators, and patient service representatives," he says. "All of these other professionals are key to having a team that has a mindset of how you can take care of the patient and the patient's family." Read the full HealthLeaders story at https://lnkd.in/exB_cht9

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Somewhat counter to the narrative that you have heard: that Private Equity investment in physician groups increases costs, etc. This study by Avalere comparing what happens when independent specialists join a private equity backed MSO platform vs. acquired by a hospital/foundation or a large corporate entity (Optum) demonstrates the reality: 1. The study found that Medicare patients of private equity-affiliated private practices had Medicare expenditures in line, and sometimes lower, than patients of unaffiliated private practice physicians or those in hospital or corporate settings.  2. Per-beneficiary Medicare expenditures were an average of $963 lower for beneficiaries whose physicians moved from an unaffiliated model to a private equity affiliation in the 12 months following the transition, compared to an average of $1,140 higher for beneficiaries whose physicians moved from an unaffiliated model to corporate affiliation in the year following the transition. 3. Additionally, patients in hospital and corporate settings had greater numbers of inpatient days and emergency department visits.  4. Medicare expenditures for patients attributed to hospital-affiliated physicians had the highest percentage of expenditures in the facility setting (64% to 69%) compared to other practice affiliation models.  5. The analysis shows that hospitals — rather than practices supported by private equity groups — are more likely driving Medicare spending growth, https://lnkd.in/ghGVwuDi

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Great meeting today and more work planned over the coming weeks to bring some interesting research insights as to what makes PNS effective and how we can design future systems that are consistently effective for our patients in order to drive greater payor coverage and improve patient access. Looking forward to crafting a really interesting presentation for this interactive presentation at NANS and cuing up Dr. Evan Peskin to share data on functional outcomes with PNS #innovation #PNS #neuromodulation #research #patientoutcomes #understandhowitworks #NANS

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KH's most recent Flash Report unveils promising signs of financial performance, with a notable slowing of margin decline. The widening gap between lower and higher performing organizations highlights the focus on long-term investment and innovation in high-performing orgs. Lower performing organizations must focus on enhancing efficiencies and reworking key elements like their operating model and portfolio management. Explore the insights in the report here: [National Hospital Flash Report May 2024 Metrics](https://lnkd.in/ggUcyDPh). For resources to boost performance, visit us at https://lnkd.in/enBa3Tp

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Sharing key takeaways on the CMS Hospital Inpatient Quality Reporting program for FY2025. - Seven new measures are added (which are welcome, with the caveat of let's see how they work out) -> Patient Safety Structural Measure beginning CY 2025 with payment determination in FY 2027 -> Age Friendly Hospital CY 2025/FY 2027 -> Catheter-Associated Urinary Tract Infection Standardized Infection Ratio Stratified for Oncology Locations (CAUTI- Onc) CY 2026/FY 2028 -> Central Line-Associated Bloodstream Infection Standardized Infection Ratio Stratified for Oncology Locations (CLABSI-Onc) CY 2026/FY 2028 -> Hospital Harm – Falls with Injury (eCQM) CY 2026/FY 2028 -> Hospital Harm – Postoperative Respiratory Failure (eCQM) CY 2026/FY 2028 -> Thirty-day Risk-Standardized Death Rate Among Surgical Inpatients with Complications July 1, 2023–June 30, 2025/ FY 2027 - Five existing measures are removed (which is a breath of fresh air) - the unpopular PSI-04, and measures related to 30-day episode payments for acute myocardial infarction, pneumonia, total hip/ knee arthroplasty, heart failure - Two existing measures are modified (Global malnutrition composite score expanded from seniors over 65 to anyone older than 18 - this is very positive; and Refined HCAHPS measure - will post details on this next week.)

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