What if instead of incentivizing healthcare providers with complicated alternative payment models and "quality care" payments--you are a dear UnitedHealthcare--we examine the elephant in the room?
Why is high value care such a mystery? Perhaps it is because of the business of medical publications. Like it or not the pharmaceutical industry has a tight grasp on which algorithms are annointed "evidence-based" care.
Why does high-value care include more screening and more interventions? Why aren't we talking more openly about NNT, NNH, and NNS measures?
*number needed to treat, harm, or screen
"Why Most Published Research Findings are False"--John P.A. Ioannidis, MD
- The smaller the studies conducted in a scientific field, the less likely the research findings are to be true
- The smaller the effect sizes in a scientific field, the less likely the research findings are to be true
- The greater the number and the lesser the selection of tested relationships in a scientific field, the less likely the research findings are to be true
- The greater the flexibility in designs, definitions, outcomes, and analytical modes in a scientific field, the less likely the research findings are to be true
- The greater the financial and other interests and prejudices in a scientific field, the less likely the research findings are to be true
- The hotter a scientific field (with more scientific teams involved), the less likely the research findings are to be true
- Large-scale collaborative research
- Adoption of replication culture
- Registration (of studies, protocols, analysis codes, datasets, raw data, and results)
- Sharing (of data, protocols, materials, software, and other tools)
- Reproducibility practices
- Containment of conflicted sponsors and authors
- More appropriate statistical methods
- Standardization of definitions and analyses
- More stringent thresholds for claiming discoveries or ‘‘successes’’
- Improvement of study design standards
- Improvements in peer review, reporting, and dissemination of research
- Better training of scientific workforce in methods and statistical literacy
They just need a reliable and transparent network aligned with truthfullness and improving patient well-being.
Thoughtful discussions about content development and outcomes analytics that apply the principles and frameworks of health policy and economics to persistent and perplexing health and health care problems...