Wishing everyone a restful Thanksgiving, however you’re spending it.

“Gratitude turns what we have into enough.” — Aesop

#HappyThanksgiving #Grateful #Community

In a year that’s been full of movement, projects, and decisions, I’m especially thankful for the people who make the work worth doing…and the people who make life outside of work full, too.

-- It’s time with family: biological, chosen, or the people who simply make life feel lighter.
-- And it’s one of the few days where eating a little too much and taking a nap in the middle of the day are completely acceptable, even encouraged.

-- It’s a moment to pause and actually feel grateful, not in a performative way, but in a real, grounding way.
-- There’s no pressure to buy anything. Decorations are optional; being present is not.

I mean, paired with better headphones I might be game.

I have exactly one CD and it would be great to be able to listen to it

We cannot achieve systemic cost sustainability if the majority of providers operate outside clear financial accountability mechanisms.

buff.ly/5dD0tij

#ValueBasedCare #Medicare #HealthcareFinance #ACOs #HealthPolicy

• Risk Shift: While two-sided ACO participation grew substantially (from 7.3% to 22.2%), the overall increase in QPP exemption means that nearly two-thirds of clinicians did not participate in an Alternative Payment Model (APM) as of 2022.

• Specialty Gap: Specialists were more likely to be QPP exempt and less likely to participate in two-sided ACOs compared with primary care providers, potentially hindering effective management of complex chronic conditions.

• Impacted Spend: Clinicians who were QPP exempt or in traditional MIPS (which has been criticized for weak incentives) accounted for over 60 percent of Part B services and allowed charges during the study period, limiting total cost control.

Executives need to understand the financial scope of this fragmentation, as these non-participating groups account for the majority of Medicare Part B volume.

The operational and financial implications are severe:

that the share of clinicians entirely exempt from the Quality Payment Program (QPP) grew from 27.5 percent in 2017 to 38.1 percent in 2022. This rapidly growing cohort of non-participants threatens CMS's ability to drive population-level financial and quality improvements.

Research indicates that with UBI, under or unemployed people don't have to take 3 part-time jobs, and are therefore able to focus on a better job search. Results show that UBI is a path to a better job.