Sumir Sahgal MD

Shifting the financial model alone is not sufficient for the transition - the care delivery, workforce, and many other pieces of the ecosystem with which PCPs interact also need to adjust accordingly. Funding to allow for the startup costs of transformation must be made available. A comprehensive analysis from The Commonwealth Fund: To encourage participation, practitioners say upfront payments, investment in the primary care workforce, and less emphasis on simplistic quality measures are needed, as well as more support for practices to provide accessible, comprehensive care. #primarycare #integratedcare #teambasedcare #healthcare #healthcareonlinkedin

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The Psoriatic March: PsA before PsO https://buff.ly/3CQxT2s

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Title: Bridging the Gap: Public and Private Healthcare Collaboration On June 11, we hosted a pivotal meeting with key voices from both private healthcare providers and public healthcare regulators and providers. The consensus was clear: collaboration between the public and private sectors is essential to create a robust and sustainable healthcare system. Here’s how we can achieve this: 1. Unified Vision:Establish common goals like improving patient outcomes and increasing accessibility. 2. Leverage Strengths:Public systems excel in broad coverage and preventive care, while private providers lead in innovation and efficiency. 3. Data Sharing:Integrate data to enhance diagnosis, treatment, and preventive measures. 4. Joint Investment:Collaborate on funding for advanced medical technologies and telemedicine. 5. Policy Harmonization:Align policies to reduce bureaucratic hurdles and foster innovation. 6. Public-Private Partnerships: Pool resources to tackle infrastructure and rural healthcare challenges. 7. Continuous Improvement: Regular feedback and communication to adapt to changing needs. Our meeting highlighted the potential of collaboration in transforming healthcare. By working together, we can build a more efficient, equitable, and responsive healthcare system. Let’s commit to this collaborative journey for a healthier future. #UHC #medicalai #health #PPP

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How can Patient Experience provide a pathway for better health and care? This paper presents a strategy for improving healthcare by focusing on patient experience. “The Path to Better Healthcare: A Framework for Patient Experience Excellence” (August 2024, by Boston Consulting Group (BCG). Key points include: Patient-Centered Care: Promotes using patient-reported outcome measures (PROMs) and addressing social factors to enhance care. 10-Point Framework: 🎯 Primary Concerns: Cost, care quality, and convenience. ❗ Table-Stakes Concerns: Confidentiality, communication, and collaboration. 💜 Emotional Concerns: Consideration, community, comfort, and choice. 💲 Cost Transparency: High costs delay care; AI and value-based care models can improve transparency. ⚠ Care Quality: Focus on personalized outcomes and safety. 💹 Convenience: Virtual care and flexible solutions reduce wait times and enhance accessibility. 📩 Communication & Confidentiality: Clear, private, and transparent communication builds trust. 🌏 Cultural Competence: Address disparities by improving staff diversity and training. 💙 Comfort: Tranquil healthcare environments improve patient recovery. 🔅 Patient Empowerment: Offering clear choices boosts adherence and health outcomes. Produced by: Matthew Huddle, M.D. Diego S. Bernardo Raakhi Agrawal Nick Cristea Relevant: Jennifer Clawson, #ValueBasedCare, Boston Consulting Group (BCG) ************ SIGN-UP: "Transforming Health and Care Experiences with Research and Actionable-Insights". A free monthly digest supported by The Journal of Patient Experience https://lnkd.in/eWG5XSEd ************ ATTEND: Patient Experience Symposium, Boston, Sept 16-18, 2024 https://lnkd.in/eNKSpJ8G ************ ATTEND: International Consortium for Health Outcomes Measurement (ICHOM) on Value-Based Health Care, Amsterdam, Oct 21 – 23, 2024: https://lnkd.in/ewznMk2K ************ PUBLISH: Special Collection on "Exploring the Relationship between Patient Experience, Health Outcomes, and Value-based Care" https://lnkd.in/ew4gEgz7 ************ #PatientExperience #ValueBasedHealthcare #VBHC #VBC #PatientEngagement

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"How to Live Longer" - reflecting on a fascinating discussion about the future of healthcare at the #newyorkerfest between Dr. Atul Gawande and Dr. Dhruv Khullar: A few key insights worth sharing: 💡 The future of medicine isn't just about living longer—it's about living better. We're finally recognizing that healthcare should align with patients' life priorities and values, not just survival metrics. 🔍 While maximum lifespan remains stubborn (~120 years), we're getting better at helping more people reach their 80s and 90s with quality of life. Countries like Japan and Korea are leading the way with 85-year average life expectancies. 📊 The power of accessible healthcare is striking: Thailand reduced deaths before age 50 from 60% to just 35% in 20 years by building strong primary care infrastructure and deploying community health volunteers. That's the difference good healthcare systems can make. 🌡️ Climate change is emerging as a major health crisis. From heat-related illnesses to changing disease patterns, our healthcare systems need to adapt quickly. ⚖️ The biggest challenge ahead? Healthcare equity. When our top 1% live to 89 while others barely reach 72, we have work to do. Countries succeeding in this space prioritize accessible primary care and community health workers. One measure Dr. Gawande uses in his work at USAID is % of people dying under the age of 50. This is what this measure looks like in different parts of the world: - Japan 2% - Europe -5%  - USA - 10%  - Africa - 65% #Healthcare #FutureOfMedicine #PublicHealth #HealthEquity #ClimateHealth

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For Shame: Government Removes Requirement for Hospitals To Disclose Their ICU Occupancy . Thousands can die as a result in next emergency : https://lnkd.in/ehPpKcJ9 The COVID-19 pandemic demonstrated that US hospital and health care systems were ill-prepared for the surge of patients who overwhelmed available health care resources. The lack of available ICU beds during the COVID-19 pandemic caused likely thousands of deaths that could have been preventable . Researchers estimate that thousands of early-pandemic deaths could have been avoided were it not for this shortage. However, ICU bed supply was not the root of the problem. Although, at the peak of the pandemic, there were many hospitals across the United States with ICU units that were overwhelmingly full, there were also ICUs in the same regions that were under capacity. Rather, load imbalance—a measure of the relationship of hospitals in hospital referral regions (HRRs) that are at or overcapacity while others are under capacity—was a problem. To prevent the needless loss of human life, we recommend that all hospitals disclose their load-balance plans—such as regional transfer agreements, regionally coordinated length-of-stay, and rapid conversion of hospital to ICU beds access—on a regular basis in a public forum, such as the SEC’s risk analysis, regularly disclosed in its EDGAR data site. Although health care agencies can promulgate the disclosure, the best agency for the collection of these disclosures is the Securities and Exchange Commission (SEC) due to its globally lauded expertise in both data collection and transparent dissemination. This disclosure should be mandated for hospitals through government legislation/rules. Sadly, the CDC recently lifted its requirement for hospitals to report their COVID-19 data—including the number of COVID patients being cared for in ICUs (https://lnkd.in/egcNGMaP). As we sift through the aftermath of the COVID-19 pandemic and return to a pre-COVID way of life, government agencies that bow to industry pressure with guidance changes, like this one, open us up to avoidable deaths in future pandemics. If we hope to avoid repeating the outcomes of the COVID pandemic in future health crises, legislation that mandates hospitals’ disclosure of their load-balance plans is a must. #COVID #CDC #SEC #healthcare #transparency#ICU #rural hospitals

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Sharing key takeaways on the CMS Hospital Inpatient Quality Reporting program for FY2025. - Seven new measures are added (which are welcome, with the caveat of let's see how they work out) -> Patient Safety Structural Measure beginning CY 2025 with payment determination in FY 2027 -> Age Friendly Hospital CY 2025/FY 2027 -> Catheter-Associated Urinary Tract Infection Standardized Infection Ratio Stratified for Oncology Locations (CAUTI- Onc) CY 2026/FY 2028 -> Central Line-Associated Bloodstream Infection Standardized Infection Ratio Stratified for Oncology Locations (CLABSI-Onc) CY 2026/FY 2028 -> Hospital Harm – Falls with Injury (eCQM) CY 2026/FY 2028 -> Hospital Harm – Postoperative Respiratory Failure (eCQM) CY 2026/FY 2028 -> Thirty-day Risk-Standardized Death Rate Among Surgical Inpatients with Complications July 1, 2023–June 30, 2025/ FY 2027 - Five existing measures are removed (which is a breath of fresh air) - the unpopular PSI-04, and measures related to 30-day episode payments for acute myocardial infarction, pneumonia, total hip/ knee arthroplasty, heart failure - Two existing measures are modified (Global malnutrition composite score expanded from seniors over 65 to anyone older than 18 - this is very positive; and Refined HCAHPS measure - will post details on this next week.)

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Health care organizations face an inflection point. With operating margins hovering at historically low levels, organizations urgently require funds not only to invest in core needs like physical plants, technology and clinical programs but also to fuel growth, to drive care transformation and to address expanding priorities around social drivers of health, access, equity and well-being. This makes it critical for all of the health care organization’s financial resources to be deployed to their most effective and best use; yet many organizations still diminish the potential impact of philanthropy by using charitable dollars for initiatives outside their strategy. Given how philanthropy deployment can significantly influence a health care organization’s ability to invest in future opportunities and outcomes, organizations should pursue alignment between strategy and philanthropy. Read more in the lastest issue of Trustee Insights from American Hospital Association in the attached or here: https://lnkd.in/dE5E8fCu This article is shared with the permission of the American Hospital Association. Thank you so much to the exceptional executive leaders who graciously shared their time and perspectives for this article. #Healthcare #Leadership #Philanthropy

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A New Tier in Healthcare Services: "TransCare" The traditional framework of healthcare delivery has long been structured around three primary tiers: primary care, secondary care, and tertiary care. These tiers are defined by the complexity of care and the level of specialization required, forming the backbone of healthcare systems worldwide. However, with rapid advancements in technology, we are witnessing a transformation that challenges and extends beyond these conventional boundaries. "TransCare" emerges as a revolutionary new tier in healthcare services, designed to bridge the gaps between these traditional levels and provide a more integrated, accessible, and patient-centered approach to care. Leveraging cutting-edge technologies such as telemedicine, teleconsultation, wearable devices, and robotic surgery, TransCare offers a flexible and seamless healthcare delivery model that caters to the evolving needs of modern patients. Unlike traditional tiers, which often function in silos, TransCare creates a continuous flow of care that follows the patient across different stages of treatment. Whether it's remote monitoring of chronic conditions via wearable technology or conducting complex surgeries with the aid of robotic systems, TransCare ensures that patients receive high-quality care, regardless of their location or the complexity of their medical needs. As healthcare continues to evolve, the introduction of TransCare represents a significant shift towards a more dynamic and adaptable healthcare system. This new tier is not just an addition to the existing framework but a reimagining of how healthcare can be delivered in a way that is more responsive to the demands of the 21st century. TransCare is poised to become a cornerstone of future healthcare, offering a model that is as versatile as it is essential, ensuring that every patient receives the right care at the right time, without the traditional constraints of location or access. As we move forward, the adoption and integration of TransCare into global healthcare systems will likely redefine how we think about and deliver health services, making it an exciting development to watch. SanalBee Pudena Health Consulting Co. Mustafa Köroğlu World Health Organization #TransCare #Telemedicine #HealthInnovation Eric Topol, MD Vivian S. Lee, MD, PhD, MBA John Halamka, M.D., M.S. Ferhan Ö. Alper Utku

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Consolidation is a reaction to the forces at work. Declining reimbursement, increasing administrative complexity, rising overhead. To remain independent, there are a couple options. One approach is to be very small, nimble, and able to keep overhead down. This often involves exiting the traditional system altogether. Doing so is risky, challenging, and difficult as a specialist. Not easy, but possible. Alternatively, you can find strength in numbers without resorting to the typical consolidation tactics. Things like supergroups or physician-led MSOs that have economies of scale and negotiating power. Full marks if you're able to improve quality, value, and access at the same time. Also no easy, but possible. Of course, reversing the forces that led to consolidation in the first place is also a possibility. Unfortunately, it seems like the least likely one. #medicine #healthcare #health #healthcarepolicy

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It's wild to think in 2024 we're FIRST seeing the DOJ accuse telemedicine conglomerates of criminal drug distribution. How long have we known about these practices in brick and mortar care...? Answer: decades! Take it from someone who prescribed stimulants and other psychotropics to kids over the years - painstakingly measuring and documenting the need and impact - these appalling abuses by Done and Cerebral mean we need more calls for thoughtful pause when it comes to working with startups. Particularly about funding's role - my favorite topic! 🤑 How did we end up with venture capital and PE financing in healthcare that risk the safety of kids in the name of exorbitant returns? Not that all VC or PE dollars are bad, of course, but they're certainly key drivers who shouldn't be in that seat. Did we underestimate these funders as 'barbarians at the gate', much like the pharma reps of the 90's and early 2000's heyday? Have we not learned from Purdue Pharma's aggressive and deadly Oxoycontin marketing? Purdue pleaded guilty to criminal charges and paid $600 million in fines in 2007. Or TAP Pharmaceutical Products's Lupron kickback scheme for the prostate cancer drug? TAP also pleaded guilty to criminal charges and paid $875 million in fines in 2001. Or Pfizer marketing Neurontin, an anti-seizure drug, for off-label uses, such as treating pain and bipolar disorder, even though the drug was not approved for these purposes, and paying physicians kickbacks. In 2004, Pfizer pleaded guilty to criminal charges and paid $430 million in fines. Cerebral and Done's playbooks were practically the same thing, just with a modern mid-pandemic, low-regulatory scrutiny, digital-platform twist. Will appropriate regulation ever outpace American venture greed? Is it even possible to ensure patient safety AHEAD of tragedies driven by the intersection of innovation and venture funding? If you're keeping score, healthcare regulatory reactivity: 1 million. Healthcare ounces of smartly preventive policy: 3. Blech. 😖 When will we finally own that prevention in-house? #healthcare #overdoseprevention #suicideprevention

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"Where do we start to transform healthcare?" Healthcare leaders and professionals face a profound challenge: managing complexity while addressing the evolving needs of individual patients. True transformation requires us to move beyond isolated, acute medical events and embrace the longitudinal whole-person health journey — a path that is rarely linear. Care evolves over time, shaped by the person’s life context, environment, and ongoing interactions with the healthcare system. To meet this challenge, we must design adaptable, responsive, and human-centered systems. I had the pleasure of discussing these ideas and more on the Physician Accelerator Podcast with Zed Williamson. It was a dynamic conversation about the future of healthcare and the strategies we need to support both patients and providers. 🎧 Tune in and join the conversation. I'd love to hear your thoughts! https://lnkd.in/d4vsaZRs #HealthcareTransformation #WholePersonCare #Innovation #PhysicianAcceleratorPodcast Ed Magee Anderson Spickard Thomas F. Frist, Jr. College of Medicine Azfar I Mir Ron Loeppke MD Bruce Brandes David Nace Katherine A. Meese, Ph.D Katie Kaney

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It’s Sepsis Awareness Month! Are you looking for peer inspiration to get started on improving Sepsis practices? Check out our 2023 Sepsis Honor Roll hospital journey posterboards, compiled in this Excellence in Practice Hospital Journey virtual booklet. https://hubs.ly/Q02MWxGn0 #SepsisAwarenessMonth

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Are you ready to stay the course, even when the finish line keeps moving? I want to share a story about a journey that took nearly two decades to complete. I represented a group of New York hospitals facing a complex Medicare payment issue. Our strategy required us to pivot between regulatory and legislative avenues multiple times, highlighting the importance of adaptability in any long-term plan. It took: ✅Patience ✅Tenacity ✅And unwavering confidence In our evolving strategy to ultimately succeed after 20 years. Remember, real change takes time. But with a resilient mindset, you can navigate any challenge and achieve your objectives. Stay confident and adaptable in your pursuits! #PersistencePays #LeadershipLessons #StrategicPlanning #AdaptAndOvercome

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Looking forward to sharing recent KLAS Research insights at the upcoming The Millennium Alliance Assembly and learning from attendees their expectations in #digitalhealth for 2025. 🔎 What are the investment priorities of 100 healthcare provider executives and 50 payer executives over the next 2 years? 🔎 How do provider priorities compare to patient expectations? 🔎 What are the current digital health problems that you are trying to solve? 🔎 What digital tools do you plan to add, consolidate, or eliminate? 📢 CHALLENGE FOR THE LINKEDIN COMMUNITY Using 5 words 'What digital health trends do you expect to see in 2025? ' Fun fact: we are about to be 40 years since Marty McFly got in the DeLorean.

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Feeling overwhelmed by all of the new generative AI options available? 🚀 Breaking Ground in Healthcare AI: Mass General Brigham Launches Initiative to Evaluate AI Solutions. With FDA-approved AI tools flooding healthcare, Mass General Brigham is taking a collaborative approach to evaluate these new tools. They've just launched the Healthcare AI Challenge - bringing together leading institutions like Emory Healthcare, University of Washington, and the American College of Radiology to evaluate AI solutions from Microsoft, Google, and OpenAI in real clinical settings. What makes this meaningful? • First-of-its-kind interactive virtual testing environment • Starting with radiology, expanding to pathology and genomics • Public sharing of clinician feedback and insights • Real-world validation at the point of care Since 75% of leading healthcare companies explore generative AI (Deloitte), this collaborative approach to testing and validation is timely. This is a good step towards setting practical standards for safe, effective AI implementation in healthcare. #HealthcareInnovation #AI #DigitalHealth #Radiology #FutureOfHealthcare

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Our new study shares how an innovative Medicaid health plan used Peers to reduce HbA1c levels by 1.3 points (vs. 0.16 for the waitlist control)! KEY INSIGHTS: ▶️ Hyper-focus on the member's needs. SDoH, literacy, diet, etc. (which led to...) ▶️ High engagement. 16 calls & 146 min of coaching PER participant. (which led to...) ▶️ 1.3+ point HbA1c drop. This is statistically & clinically significant. --- An elevated HbA1c is just a signal that something is wrong. NOT a signal of what exactly is wrong. Trust, empathy, and time are needed to understand ROOT causes. Solving for the member's problems FIRST is the key to solving the health plan's problems. #CAHPS, #HOS, #HEDIS --- Link to the full paper in the comments.

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Did you know that your organization has probably already committed to spend budget every year with Microsoft Azure? And that’s a good thing, bc you can also purchase tech through the Azure Marketplace that 1) earns you discounts and 2) expedites purchasing!! Yes, that means instead of months spent in supply chain, you can transact in a matter of days. Amenities Health is proud to be a part of the Azure Marketplace and “MACC Eligible” (Minimum Azure Consumption Commitment) for health systems with such an agreement in place. Check out my HIStalk article to learn more. #DigitalFrontDoor #PatientAcquisition #ROI #BrandLoyalty #PatientLoyalty

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