Ken Coburn MD, DrPH, FACP

If we want to see long-term investment in improving #HealthEquity, it can't only be done through short-term #grant programs from foundations. It has to be done through long-term payment policy that seeks to create lasting and durable financial flows toward specific equity-focused strategic objectives.   With this in mind, it’s great to see Boston Children's Hospital join Blue Cross Blue Shield of Massachusetts’ pay-for-equity financial payment model! https://bit.ly/3wqqDaM    Many aspects of BCBSMA’s pay-for-equity model are crucial to building sustainable improvements in equity, but one of the most notable is that it is driven by data. BCBSMA has helped set its health system partners up for success by investing in data that helps identify where equity gaps exist in key performance areas. New data collection systems gather better information from patient populations on race, ethnicity, language, sexual orientation, and gender identity.    BCBSMA team members use this information to create public health equity report cards for some of the largest health systems in Massachusetts, as well as report cards for individual health systems. Individual report cards help organizations understand how they compare on specific measures relative to their peers. With better and more refined data, providers and payers can see and tackle opportunities for improvement with greater clarity.    It’s been an honor for IHI to help BCBSMA advance its health equity journey. Congrats to them, Boston Children’s, and everyone out there that’s committing their time, talent, and resources to achieving more equitable outcomes.

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Healthcare is a complex space. Not easy to understand, design to, or operate in.

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🚨 A Hard Truth About Healthcare Innovation: Our communities aren't "hard to reach", they're hardly reached. Let me share why this matters. When I started my journey in healthcare, one truth became clear: health equity isn’t just a goal, it’s the foundation upon which everything else must be built. But here's what most people miss... True innovation demands diversity, not only in ideas but in leadership. When those developing healthcare solutions share our stories, speak our languages, and understand our communities, progress becomes inevitable. That’s why Abner Mason, Kevin Dedner, MPH, and I, along with other Black and Latino/a/x/e Healthcare Leaders, innovators, physicians, entrepreneurs, investors, and community builders, are uniting to back Vice President Kamala Harris for President. This isn’t just about who holds leadership positions, it’s about what leadership can achieve when our voices shape the future. When leadership reflects the people it serves, trust grows, technology becomes more human, and change follows naturally. Four Areas for Change: - Bridge digital divides so no one is left behind - Direct capital to visionary founders of color who understand their communities - Dismantle algorithmic biases that perpetuate inequities - Build diverse leadership pipelines that transform healthcare at every level There is power in the spaces where our histories intersect, side by side. This is where struggle transforms into strength, isolation gives way to solidarity, and innovation truly serves all. Together, we’re not just changing who leads, we’re building a healthcare future that serves everyone, block by block, breakthrough by breakthrough. - Share if you believe healthcare innovation should reflect ALL communities - Comment: What barriers have you faced in healthcare? - Tag 3 leaders who should be part of this conversation - Connect with me at HLTH this week 📄 Sign the Letter: https://lnkd.in/gUBMnUPd 📰 Read the Press Release: https://lnkd.in/guc4eFW3 📰 Review the Black Enterprise Article: https://lnkd.in/gtYSRYqM #HLTH2024 #HealthEquity #DigitalHealth #HealthcareInnovation #RepresentationMatters #LatinxInTech #BlackInTech #DiversityInTech #FutureOfHealthcare #LatinoHealth #LatinaHealth #LatinxHealth SaludConTech The Latino Health Innovation Alliance (LHIA) Color Of Change HLTH Inc. Joseph Betancourt Nana B. Afoh-Manin MD, MPH, MPA Uché Blackstock, MD Venus Ginés Ysabel Duron Rock Health Code2040 Techqueria Latinas in Tech The Commonwealth Fund RWJF Voto Latino

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The Association of Healthcare Value Analysis Professionals (AHVAP) celebrates Elizabeth Eisenberg, MSN, RN, CVAHP from Scripps Health for commitment to excellence in the specialty of healthcare value analysis! Liz has signified this commitment by signing the official Association of Healthcare Value Analysis Professionals (AHVAP) healthcare value analysis pledge. To learn more about the Association of Healthcare Value Analysis Professionals (AHVAP) Commitment pledge: https://lnkd.in/gqEWPBue. #AHVAP #valuebasedcare #excellenceincare #valueanalysis

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This article from Becker's Healthcare signals to me that the term "health equity" is not fleeting or just political fodder. To me, health equity is just good, reliable healthcare for all.. and traces right back to the Triple/Quadruple Aim, and pop health. BUT it does point out some very real challenges with data, integration, and program design that will be required for entities thrive in this "future of health," which seems like it will be even more centered on equity, data, and technology than it is today, given the massive workforce and operational bottlenecks we're encountering as an industry. Becker's reported that "most providers aren't ready to meet new health equity regulatory requirements" back in March. This was based on EY's Health Equity Outlook Report (which was also excellent) and is interesting for a couple reasons. 1️⃣ One is that very soon, there will be actual concrete measures that health equity initiatives will be tied to, much like our regulatory qualiy measures etc. This means there will be clear "outcomes" to strive for, even though I've said before that "outcomes" can and should be more than just regulatory measures. Still, when something is a required measure then people pay more attention. According to Becker's, "most provider and payer respondents indicated that as of today, they could not meet health equity-related regulatory requirements introduced by CMS, the National Committee for Quality Assurance, The Joint Commission and the FDA last year." 2️⃣ Two is that the "requirements that the fewest are prepared to meet are disparity root cause assessments (21%), culturally tailored services (24%) and social needs referral pathways (27%)." ------------------------------------ My take: To me, this reads as opportunity for new data and technology methods led by people (founders, providers, CHWs, etc.) with lived experience or who are more in touch with the communities being served. This is also illuminating the need for better data and more diverse voices, something that is not new or unique to health equity initiatives in the healthcare space. I gave a TEDx talk about the latter 5 years ago. But, the difference between now and then is that we may actually have a forced catalyst by way of these new requirements. Interesting times, interested to see how things unfold. ------------------------------------ Read the Becker's article here: https://buff.ly/49hYLTw The EY report Health Equity Outlook Report here: https://buff.ly/3xeEjFW Watch the TEDx Talk here: https://buff.ly/4a6Vl77 And learn about the upcoming US regulatory changes with health equity implications, also eloquently summarized by EY: https://buff.ly/3PFZFlB

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Most viewed in the last 7 days from JAMA Health Forum: This JAMA Forum discusses the current data collection mechanisms used for Medicare and proposes ways to improve nationwide data collection efforts for Medicaid. https://ja.ma/4dJuqzJ

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"Exploring the Crisis of Primary Care Wait Times" Digging into the pressing issue of primary care access, a striking statistic caught my attention: an unprecedented national average wait time for patients to see primary care physicians. It's clear we're facing a crisis that threatens not only patient health but the foundational principles of our healthcare system. The takeaway for us as healthcare professionals, policymakers, and advocates is multifaceted. This isn't just about numbers; it's a reflection of a deeper systemic failure that requires innovative solutions, strategic policy changes, and a renewed focus on healthcare accessibility. How we respond to this challenge will shape the future of primary care and, by extension, the overall well-being of our communities. For a deeper dive into the dimensions of this crisis and the potential pathways to meaningful reform, I encourage you to read the full article: https://buff.ly/4aXNlWj #healthcare #crisis #policy #hospitals

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Indeed a turning point for women's health. I am not a political person, but this is something I can proudly support. Very proud of my friends Liz Powell, Jodi Neuhauser, and Candace McDonald for launching this Women's Health PAC who have the support of thousands of women in the healthcare industry. With more money, research, information, innovation, funding, and focus on women's health... everyone wins. Including men. This is not exclusive, this ensures inclusion of all people, especially women who have been excluded from most of the above including in healthcare. Equity ensures equality, and without a focus on women's health there will be not achievement of equity. #healthequity #healthequityforwomen #womenshealth #women #equality #womeninhealth #womenleaders #womeninleadership #womeninmedtech #PAC #womenshealthPAC

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Who knew that both our country's organ donation system AND our health data exchange networks needed more transparency to stop corruption? The Health Tech Talk Show's special guests Jennifer Blumenthal and Jennifer Erickson did. And perhaps in addition to live documenting Lisa B.'s journey through menopause when that great time will come, we will also live document my mammogram. You are welcome in advance, loyal followers. Jennifer Erickson, senior fellow at the Federation of American Scientists, pretty much blew our minds about the US organ donation system. 17 people die each day waiting for an organ, but worse, we recover on one out of every five organ donors across the country. On top of that, the organ procurement organizations, controlled by the national monopoly, UNOS, are 15x more likely to lose an organ in transit than an airline is to lose your luggage. Listen to the show for more jaw dropping stats, but the good news is that Jennifer and a strong coalition have, after more than 8 years of fighting, have reached a major milestone--an RFP for Health Resources and Services Administration (HRSAgov), HHS's Organ Procurement and Transplantation Network has just been released, and incumbents will have to compete against innovators in a competitive and transparent process. What can you do to help? See the RFP links in comments and if you're a hot shit tech company that knows how to do stuff, please respond to the RFP! If you're a regular person, WRITE TO YOUR CONGRESSPEOPLE! Everyone's favorite and fiercest advocate Jennifer Blumenthal, co-founder of OneRecord (a part of Milliman), joined us to talk about problems with patient access to health data. Despite the big talk about patient access, neither the national networks nor organizations participating in TEFCA are required to respond to IAS requests. Well, that's dumb. Jenny thinks we might see the states and their HIEs get to patient access before the national networks and #TEFCA. You know what Lisa and I always say: GOD BLESS THE STATES. What is Jenny excited about with the states? They're standing up FHIR APIs and investing in their data infrastructure, and hey, it's not so hard to maintain 50 - 70 APIs. And dear national networks and those overseeing TEFCA - you can fix IAS if you listen to Jenny. Is this a policy problem or a technology problem? Kind of neither. What can we individually do to improve patient access? Everybody go through remote identity proofing events and tell Jenny if you made it through! What else? No, #telehealth is not dead. Yes, Change Healthcare screwed up. Zorya Foundation will be providing its first full-year childcare grants to moms working in clinical roles. Listen to Shannon Sartin West's new Datavant sponsored podcast "Longitudinal." Check out the comments from yesterday's LinkedIn live for Brendan Keeler's thoughts on making TEFCA more transparent and thus, effective. https://lnkd.in/eeP4yYEu

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It's become common "wisdom" in the US that modern healthcare requires huge well-capitalized corporations. I say baloney. Massive health systems, group practices, etc. are a consequence of the way the US health insurance industry works, but they doesn't make business sense from any other perspective. Check out Kevin Pho's latest interview with me my thoughts on why healthcare ought to be locally run, and how America might be able to get there. #ethicalhealthcare #healthsystems #hippocraticcapitalism #physicians

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Please help the Association of Healthcare Value Analysis Professionals (AHVAP) in welcoming the newest member, Robin Lundrigan, MS, RN, CVAHP to the Association of Healthcare Value Analysis Professionals (AHVAP) family. Welcome Robin! To learn more about Association of Healthcare Value Analysis Professionals (AHVAP) membership, visit: www.ahvap.org. #AHVAP #membershipmatters #valueanalysis #valuebasedcare

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Tune in to this podcast featuring Eric Alper, UMass Memorial Health Senior Vice President, Chief Clinical Informatics Officer, and Chief Quality Officer, to learn more about Hospital at Home and its future growth, and the potential AI brings to improve safety and quality while enhancing the patient and caregiver experience. In addition, Dr. Alper shares his career journey and how combining informatics, technology and expertise enhance care. Listen now!

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"The distortions were thought to discourage physicians from practicing in primary care specialties and in rural areas and to encourage a procedurally oriented style of care." This is the usual revelation - too little, too late, costing the nation too much, and resulting in little possible change in outcomes But there is much much worse damage via CMS and RBRVS in the 2621 counties most behind 1. Primary care 2. Mental health 3. Basic women's health 4. Geriatrics 5. Basic surgical 6. 40% of the pop in 2621 counties (37 million rural, 90 million urban) with 75% of services (above) suppressed not only by RBRVS but by 15% less for office payments documented in Medicare 2011 data 7. Prevention of integration, coordination due to insufficient/lesser delivery team members 8. Acceleration of turnover and costs of turnover at 10 - 15% of the revenue that a primary care physician can produce 9. Countless losses of locally focused leaders 50,000 primary care physicians short x 4 employees per physician x 2 because their spouses are also contributing to health, education, and other most needed civic leadership for about 1 million fewer local leaders Now multiply this times 3 for other basics Even 1 million more for local leadership in this 130 million could be a substantial force. Some of us did health fairs, weight control groups, STD clinics, work with law enforcement, Kiwanis, chamber of commerce, economic development, work with schools and programs, work with extension and farm bureau Now calculate the health insurance and leadership losses from the CMS killing of 400 plus hospitals x 40 - 70 employees x 2 for spouse plus losses of general specialists and their practices Not all of these administrators, professionals, managers, techs, and other delivery team members will contribute as leaders, but most will have impacts. Nearly all likely have have better jobs in these communities with better benefits and better insurance - much better than public plans paying less than cost of delivery. https://lnkd.in/gZshJNCz

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As a CMO, if true, this was definitely a blind spot for me. If nearly 60% of physicians feel "peer review" may be used improperly and in a "sham" manner to punish them, every hospital CMO and CEO must make certain the entire medical staff understands the purpose of "peer review" and that the facility and medical staff leadership are committed to the peer review process never being used other than to improve patient safety and the quality of care. As the saying goes, "actions speak louder than words." All the assurances of fairness and good intentions will quickly evaporate the first time the "peer review" process is used improperly. Having a functional and robust peer review process is critical to ensuring physicians are practicing to the standard of care and to ferret out the, albeit, very rare, "bad physician" none of us would want caring for our loved ones. The process must remain free of any taint of unfairness or misuse, if it is to serve that critical function.

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Recently right before National Health Center Week (August 4-10), I had the privilege to talk with TechTarget's Sara Heath about the recent growth of Community Health Centers (CHCs) of over 1 million more lives to now serving over 32.5 million people or 1 in 10 across our nation. Please read the article and excerpts below: "Community Health Centers serve as the provider of choice for primary care for 32.5 million or 1 in 10 people across our nation," said Kyu Rhee, MD, MPP, president and CEO of National Association of Community Health Centers (NACHC). "They deliver high-quality, team-based, comprehensive health services that integrate medical, mental, oral, pharmacy, social, and specialty care within and beyond our exam room walls in rural, frontier, urban, suburban, and island communities in over 15K locations." ... In a statement about National Health Center Week, President Joe Biden affirmed the calls for greater CHC funding. "Community health centers play a key role in making sure health care is a right in this country, not a privilege -- that is why my Administration is investing in them at a historic rate," Biden said in a public statement. "My Budget would put the Health Center Program on a pathway to double in size. We have also delivered funding for community health centers to expand critical services, including substance use disorder treatments, behavioral health care, pregnancy-related care, and preventative cancer screenings." ... "As a primary care physician and former National Health Service Corps Scholar, I have witnessed firsthand how they prevent acute and chronic disease, deliver essential jobs, reduce overall healthcare costs, save our nation billions of dollars, and advance health equity for families and communities in need," Rhee said. "During this annual National Health Center Week and with gratitude to The White House and bipartisan members of the US Congress for their recognition of health centers' critical value, we celebrate health centers as not only the largest primary care network across our country, but also the best, most innovative, most diverse, and most resilient part of our health system." NACHC believes that CHCs are the best, most innovative, most resilient, and most diverse part of our health system. We stand united with CHCs for and with the people we have served and will serve as “the best is yet to come.” Please learn more and support the CHC movement at: https://www.nachc.org. #HealthCenters #ValueCHCs #FundCHCs #WeAreNACHC https://lnkd.in/eDbMDB2t

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What's Your Solution For the Key Issue in Healthcare Today? I was happy to be in DC on Wednesday 9/18  at one of the most vibrant hearings I have ever attended (as staff or not). The US House Ways and Means Health Subcommittee held a hearing to discuss ways to invest in a healthier America through chronic disease prevention. Overall, the hearing was strongly bipartisan as member after member agreed on the need to invest in health and nutrition in America to reduce overall healthcare spending and chronic disease prevalence. Subcommittee Chair Vern Buchanan (R-FL), in his opening statement, highlighted the need to invest in a healthier America due to the increasing prevalence of obesity and chronic diseases like cancer, heart disease, and Alzheimer’s. He outlined that the obesity epidemic threatens to increase our healthcare expenditures and national security. Chair Buchanan recommended that medical providers educate patients about the importance of nutrition. One of the witnesses, Dr. Mark Hyman said: The statistics are chilling. Today, 60% of American adults have at least one chronic disease, and 40% have two or more. In Medicare, the numbers are even higher, with at least 59% of Medicare beneficiaries suffering from two or more chronic conditions. Overall, 93% of Americans are metabolically unhealthy, meaning they are at heightened risk of a health crisis. In addition, more than half of our population has pre-diabetes or diabetes, and 26% of Medicare FFS enrollees had a diabetes diagnosis in 2022. I believe we can't possibly hope to dampen costs without addressing this issue. Whats your policy ideas? #rootcause #foodismedicine https://lnkd.in/eB67pGSK

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