Co-wrote with Dr. Harold Picken, Huron Consulting.

Definitions of precision medicine are anything but precise. For seriously ill patients and their families, precision medicine therapies provide a hope when all else has failed. They’re willing to risk long odds for the chance to improve or extend life, but they want health insurers to cover the costs.

I know some people abhor social media.  The sector has certainly taken a beating lately in the markets, but I really love Twitter. It gives me the ability to hear the (curated) voices of people I know, don’t know, and in some cases hope I never know, but who make me think.  I follow the newspapers and journals I used to have to login to separately, read other media from all around the world I didn’t even know existed, and get into impromptu conversations with real experts. 

FMI’s commentary on the use of state & local incentives in the Amazon headquarters deals.

Amazon HQ Flawed But Still Good Deals for Winning States

When Socialist flavor-of-the-month Representative-elect Alexandra Ocasio-Cortez and conservative Fox host Sean Hannity both denounce a policy as an outrage, it must be truly outrageous. Or they must both be very confused. In the case of the incentives given Amazon for its new headquarters, it is the latter.

For health systems, the day of reckoning is near. A recent Morgan Stanley report states that over 1,000 of the nation’s 5,000+ hospitals are currently weak or at risk of closing. (1) This is the beginning of a larger wave.

The pressure is top down and bottom up. Payers are unwilling to continue unadulterated fee-for-service (FFS) payment formularies. Consumers increasingly expect convenience, lower costs, better outcomes and improved customer experience.

The U.S. healthcare system will not change the way it delivers care until it changes the way it pays for care. Perverse incentives riddle fee-for-service payment (FFS) and lead to overtreatment, fragmented delivery and runaway medical inflation. Incremental attempts to reform care delivery through value-based payment reform and provider education (e.g. the “Choosing Wisely” initiative) have not changed practice patterns in meaningful ways.

As everyone knows, October has been a terrible month for equity markets. Some market participants feel that this did not just coincide with higher interest rates, but was caused by flawed Fed monetary policy and comments on overshooting. Like the humming chorus in Madama Butterfly, there has been a steady rise in the number of voices supporting a Fed pause in December. These include members of the Federal Reserve Open Market Committee itself, such as Neel Kashkari, and leading economists such as Jason Furman. 

Healthcare data wants to be free, but it is oppressed. Entrenched oligarchs trap information within closed, centralized systems that prioritize revenue collection, misuse resources and tolerate medical error. Data gasps for breath as it fights to break into curated systems that produce insight.
 

Co-authored with Todd Rudsenske & Daniel A. Gofman*.

Autism Spectrum Disorder (ASD) is the nation’s fastest-growing developmental disorder, one that touches each child and family in unique and complicated ways. A lifelong condition, ASD requires individualized treatments that are now increasingly available in communities across the United States.

This essay was originally published by The Washington Post, October 1, 2018

Despite robust economic numbers during the Trump presidency, the American public has seemed curiously unmoved by good news such as the lowest U.S. unemployment level in nearly half a century. Its enthusiasm might have been dampened by this underappreciated economic reality: The typical working American’s earnings, when properly measured, have declined during the Trump administration.

Healthcare has experienced a parade of surprising megamergers and acquisitions during the last year. At first glance, Best Buy’s August acquisition of GreatCall may be the most startling. At a deeper level, however, Best Buy’s movement into healthcare reflects a nuanced understanding of consumerism, retail market dynamics and America’s need for more connected, holistic care services.