going beyond SES adjustment in Hospital readmissions penalties

Source: JHM 2018.

Lost in transition: how physicians perceive the actionability of tests pending at discharge

Time for a New Business Focus in Medicine

When we reduce low value care, who benefits?

Joshua M. Liao, Lee A. Fleisher & Amol S. Navathe | JAMA

Social comparisons are increasingly used to influence physicians' behavior. However, instead of simply ranking doctors against each other, professional "norms" are needed to ensure comparisons are appropriate.​ READ MORE


discussions between patients and providers about PSA testing

6 Trends that will reshape the patient-provider dynamic

Joshua M. Liao & Amol S. Navathe | The Lancet

Health systems are encouraging value through pay-for-performance (P4P) programs that link payment to high quality actions and results. However, P4P should not undermine the quality of patient–physician relationships. READ MORE


Amol S. Navathe, Joshua M. Liao & Ezekiel J. Emanuel | Annals of Surgery

Volume increases are not inherently signals that joint replacement bundles are a policy failure. READ MORE

Commentary

Source: JAMA IM. 2016

Succeeding in bundled payments through behavioral principles

Data analysis

Studying how providers can make HIGH Value clinical and care delivery decisions

Data analysis

Source: JHM 2018.

VIewpoint

Joshua M. Liao, et al | Journal of Hospital Medicine

As policymakers consider financially penalizing physicians to deter low-value care, support among hospitalists for such penalties are unknown. READ MORE

Joshua M. Liao | Boston Globe

Numbers are indeed important. Our increasingly interconnected societies and sophisticated technologies generate massive amounts of data that can revolutionize disease management. It should not, however, become our philosophy along the way. READ MORE

cost & Quality of orthopedic joint replacement bundles

motivation & uncertainty in P4p

Joshua M. Liao & Krisda Chaiyachati | Harvard Public Health Review

Despite laudable intentions, readmissions penalties have produced continued debates. SES adjustment is an important consideration, but hospitals should also adopt public health-minded organizational strategies.  READ MORE


Data analysis

VOlume and value of orthopedic joint replacement bundles

Joshua M. Liao, Mark J. Ommerborn & Cheryl R. Clark | PLoS One

While discussions about advantages and disadvantages of PSA testing are a feature of patient-centered care, it is unclear how provider recommendations and the presence of a personal doctor influence testing in the presence of such discussions. READ MORE

Selecting a Specialist

DATA ANALYSIS

PERSPECTIVE

how can doctors balance Value to patients & society?

Joshua M. Liao, et al | Journal of Hospital Medicine

Effective communication between hospitalists & PCPs is essential for safe, high-quality transitions of care. Unfortunately, discrepancies in the actionability of tests pending at discharge exist, even when awareness of TPAD results is improved by electronic systems. READ MORE

norms & social comparisons of physician performance 

Joshua M. Liao, Ezekiel J. Emanuel & Amol S. Navathe | Healthcare

Six trends are driving the US health care system towards a future defined by quality- and patient-centric care. Several organizational strategies can create positive system redesign while guarding against unintended consequences for the patient-provider dynamic.​ READ MORE


Niteesh K. Choudhry, Joshua M. Liao, Allan S. Detsky | JAMA

This Viewpoint discusses data about consultants becoming available to referring physicians and patients in an effort to improve the selection of specialists.. READ MORE

penalties for Low value care in Hospital medicine 

reframing the value of CABG bundles 

Joshua M. Liao | Huffington Post

Medicine is undergoing a pretty significant makeover, and one of the most fascinating aspects of this transformation is the effort by some groups to reexamine their business focus. READ MORE


Viewpoint

penalties for inappropriate antibiotic prescribing

Amol S Navathe, Andrea B. Troxel, Joshua M. Liao, et al | JAMA Internal Medicine

Medicare has accelerated its commitment to orthopedic bundled payment, but hospitals need guidance on how to succeed under new programs. We describe how bundled payment at one institution was associated with hospital savings and reduced Medicare payments. READ MORE

PERSPECTIVE

Commentary

When Patients Are more than their data

COMMENTARY

Joshua M. Liao, Amol S. Navathe & Danny Chu | JAMA Surgery

Alternative perspectives can help reframe the value of CABG bundles as a case example of mandatory bundled payment programs.​ READ MORE


Joshua M. Liao, et al | Healthcare: The Journal of Delivery Science & Innovation

Amid rapid movement towards value-based reimbursement, bundled payment represents a promising alternative to traditional fee-for-service (FFS) payments. However, not all bundled payment programs gain lasting traction.  READ MORE

DATA ANALYSIS

Commentary

Joshua M. Liao, et al | Annals of Internal Medicine

To deter low-value services, policymakers have proposed financial penalties for physicians who prescribe them. It is unclear if physician support of financial penalties targeting inappropriate antibiotic prescribing is influenced by emphasis on patient, societal, or institutional harms of such prescribing. READ MORE

Can crowdsourcing find the right diagnosis?

DATA ANALYSIS

VIEWPOINT

Joshua M. Liao, et al | Journal of Hospital Medicine

Physicians’ willingness to reduce low value care may depend on whether they perceive that benefits accrue to patients or insurers and hospitals. READ MORE

Joshua M. Liao | KevinMD
Clinicians will increasingly face the tension of providing care that is high value to both patients and society, but these commitments can sometimes conflict in clinical decision making. READ MORE

Data analysis

VIEWPOINT

VIEWPOINT

Joshua M. Liao | Boston Globe

Can we eventually harness the power of the masses to meaningfully improve diagnosis? Medicine has changed so unimaginably fast no one can rule it out. For now, however, I still have considerable doubts. READ MORE