Bill Frist: the benefit from implementing value-based payment models has been modest, and so far has not resulted in significant savings to payers, providers, or patients. No surprise: they were all designed by the buyers of care – something that happens in no other market.
“We are now 11 years into the largest epidemic of adolescent mental illness ever recorded.”
About half of the governmental public health workforce left their jobs between 2017 and 2021.
The increase in adolescent mental illness corresponds to the increase in social media use. Once upon a time your goal was to make friends in junior high and high school. Hopefully you were in the highest ranking clique or at least had some good friends and did not become ostracized. Now the goal is to create content on TikTok, Snapchat, Instagram and YouTube and get tens of thousands of subscribers and millions of viewers. Moreover, teen girls are especially bombarded with images of what they’re supposed to look like. I wrote about teen angst in another post today.
Site neutral payments are long overdue……..but the heavy artillery of the hospital lobby will fight this tooth and nail. The financial impact of site-neutral is even larger for the under-65 population.
There are a lot of fiscal subsidies for hospitals baked into our current system….tax exemption, medical education payments, bad debt coverage (in Medicare), facility fees for hospital-owned physicians…..I am just scratching the surface here.
These subsidies have produced a hospital sector with a fantastic physical plant, a large well-paid work force, and overall excellent response times for emergency care. At some point the subsidies have to be chopped away. It will be a real challenge to maintain the strengths of our hospitals without the financial gravy.