Holly Taylor
@hollytaylorhltheco.bsky.social
Brilliant discovery!
We never learn, do we?
We never learn, do we?
November 24, 2025 at 4:33 PM
Brilliant discovery!
We never learn, do we?
We never learn, do we?
Outstanding!
And they will all be 18 by the next Presidential election.
And they will all be 18 by the next Presidential election.
November 20, 2025 at 1:55 PM
Outstanding!
And they will all be 18 by the next Presidential election.
And they will all be 18 by the next Presidential election.
I’m with you. It’s maddening.
November 16, 2025 at 5:10 PM
I’m with you. It’s maddening.
Third option is best. Would also suggest overlaying additional data visualizations (line graphs?) to represent changes in deductibles and max OOP costs for each plan offered for those categories YOY. That would also show decrease in plan offerings YOY.
November 8, 2025 at 2:10 PM
Third option is best. Would also suggest overlaying additional data visualizations (line graphs?) to represent changes in deductibles and max OOP costs for each plan offered for those categories YOY. That would also show decrease in plan offerings YOY.
Your Mother is very proud, Dr. Gupta.
November 7, 2025 at 3:30 AM
Your Mother is very proud, Dr. Gupta.
This would make a great visual
November 5, 2025 at 3:52 PM
This would make a great visual
That does nothing to solve the problem. The problem is a grossly ineffective system that drives costs up with no commensurate improvement in value.
November 5, 2025 at 12:37 AM
That does nothing to solve the problem. The problem is a grossly ineffective system that drives costs up with no commensurate improvement in value.
Summary: I recognize that our current flirtation with value based care is ineffective, largely because no one agrees on how to measure quality and everyone is gaming the system by increasing RAF scores, but it doesn’t negate the fact it’s the only possible evolution of a free market system.
November 5, 2025 at 12:34 AM
Summary: I recognize that our current flirtation with value based care is ineffective, largely because no one agrees on how to measure quality and everyone is gaming the system by increasing RAF scores, but it doesn’t negate the fact it’s the only possible evolution of a free market system.
Value Part 2: Once pricing is tied to actual value delivered, patients, and anyone who is paying for healthcare access such as employers or the govt, can then become actual healthcare consumers, driving competition, efficiencies and innovations.
November 5, 2025 at 12:30 AM
Value Part 2: Once pricing is tied to actual value delivered, patients, and anyone who is paying for healthcare access such as employers or the govt, can then become actual healthcare consumers, driving competition, efficiencies and innovations.
Value Part 1: Low/no value utilization will inherently be addressed if providers are reimbursed based on the quality of care delivered and not the volume of services provided. It will also lower costs due to the removal of administrative complexities and reduction of unnecessary services.
November 5, 2025 at 12:27 AM
Value Part 1: Low/no value utilization will inherently be addressed if providers are reimbursed based on the quality of care delivered and not the volume of services provided. It will also lower costs due to the removal of administrative complexities and reduction of unnecessary services.
Cost Part 1 cont-PreAuth/Managed Care: These approaches basically throw admin complexity into care delivery to restrict unnecessary utilization. It can result in care rationing and denial of medically necessary services. It also wastes healthcare dollars that could be applied to improving outcomes.
November 5, 2025 at 12:23 AM
Cost Part 1 cont-PreAuth/Managed Care: These approaches basically throw admin complexity into care delivery to restrict unnecessary utilization. It can result in care rationing and denial of medically necessary services. It also wastes healthcare dollars that could be applied to improving outcomes.
Cost Part 1-Fee schedule: FFS establishes fees for every service. There are reimbursement strategies w/in FFS that can help contain total cost for services. Ex: global/bundled pymnts for all services for an anchor event (surgery-pre/post care, care for complications) MPRR, coding bundles etc..
November 5, 2025 at 12:17 AM
Cost Part 1-Fee schedule: FFS establishes fees for every service. There are reimbursement strategies w/in FFS that can help contain total cost for services. Ex: global/bundled pymnts for all services for an anchor event (surgery-pre/post care, care for complications) MPRR, coding bundles etc..
Quality (cont): If we don’t measure quality we can’t determine the value of the service or a fair price. We currently determine price based on a crazy calculation of components that is really just “what can we get away with?” Dartmouth Atlas has some great data visualizations that tell this story.
November 5, 2025 at 12:09 AM
Quality (cont): If we don’t measure quality we can’t determine the value of the service or a fair price. We currently determine price based on a crazy calculation of components that is really just “what can we get away with?” Dartmouth Atlas has some great data visualizations that tell this story.
Quality: There has to be a mechanism to quantify the value of the clinical service being delivered. It should be a combination of hard clinical outcomes (surgical infection, mortality) and patient centered measures like QOL, etc.. And value should include impact beyond a one year plan term.
November 5, 2025 at 12:05 AM
Quality: There has to be a mechanism to quantify the value of the clinical service being delivered. It should be a combination of hard clinical outcomes (surgical infection, mortality) and patient centered measures like QOL, etc.. And value should include impact beyond a one year plan term.
I have always thought of it this way.
Access: Required to prevent treatable from becoming acute, or even untreatable, due to lack of basic and preventative care. This becomes a problem for everyone because patients who don’t have access to care often end up in the ER. 60% of ER care is avoidable.
Access: Required to prevent treatable from becoming acute, or even untreatable, due to lack of basic and preventative care. This becomes a problem for everyone because patients who don’t have access to care often end up in the ER. 60% of ER care is avoidable.
November 4, 2025 at 11:51 PM
I have always thought of it this way.
Access: Required to prevent treatable from becoming acute, or even untreatable, due to lack of basic and preventative care. This becomes a problem for everyone because patients who don’t have access to care often end up in the ER. 60% of ER care is avoidable.
Access: Required to prevent treatable from becoming acute, or even untreatable, due to lack of basic and preventative care. This becomes a problem for everyone because patients who don’t have access to care often end up in the ER. 60% of ER care is avoidable.
@mcuban.bsky.social if provider reimbursement is not tied to actual value delivered, we will never reign in costs. Otherwise, they will always be incentivized to perform more services, regardless of the value. This is why we’ve continued to see cost of care increase under the ACA.
November 4, 2025 at 11:45 PM
@mcuban.bsky.social if provider reimbursement is not tied to actual value delivered, we will never reign in costs. Otherwise, they will always be incentivized to perform more services, regardless of the value. This is why we’ve continued to see cost of care increase under the ACA.
Agree. I’m actually impressed.
October 29, 2025 at 12:16 PM
Agree. I’m actually impressed.
I think the South Korean President has a sense of humor….
October 29, 2025 at 12:14 PM
I think the South Korean President has a sense of humor….
Yes. Citizens United was the nail in the coffin but it started long before that.
But nothing will change until we take self governance seriously-and personally!- and stop abdicating responsibility to these corrupt political parties.
But nothing will change until we take self governance seriously-and personally!- and stop abdicating responsibility to these corrupt political parties.
October 29, 2025 at 4:23 AM
Yes. Citizens United was the nail in the coffin but it started long before that.
But nothing will change until we take self governance seriously-and personally!- and stop abdicating responsibility to these corrupt political parties.
But nothing will change until we take self governance seriously-and personally!- and stop abdicating responsibility to these corrupt political parties.
Why can’t anyone in the Democratic Party message that? It’s infuriating how inept they are.
October 28, 2025 at 9:43 PM
Why can’t anyone in the Democratic Party message that? It’s infuriating how inept they are.
