Tom Faltz
1.1K posts
Pete Hegseth's Defense Department reportedly buys $22 mil worth of LUXURY STEAK and LOBSTER The purchase was part of a larger 'end of year spending frenzy' of its 'immense budget' Unrelated footage of Hegseth DEVOURING a steak in NYC 2024
Italy goes up 5-0 on Mexico in the WBC 🇮🇹 Team USA will advance to the quarterfinals barring extra innings (via @WBCBaseball)
These two photos of the Nancy Guthrie suspect were taken on different days, sources confirm to me and @LibbeyDean_ – indicating the suspect appears to have visited Guthrie’s house before the kidnapping.
3 suspects. 125 combined arrests.
Sean Duffy got my respect when i saw this closeup! No botox or any plastics in his handsome face. He is a true gentle man🇺🇲👑🎁👏Rachel is blessed🌹
Over the past several decades, an appealing idea rapidly gained popularity: The government could advance a health care system that rewarded the quality of care rather than the volume of care. Medicare began leveraging its economic might to require physicians and hospitals to measure and improve quality. In tandem, Congress embarked on a 20-year journey to incentivize providers to report on quality and pay for good patient outcomes. Facts are out: 1️⃣ Medicare Quality Measurement Is Ineffective And Inefficient, with Distorted Incentives for Gamesmanship and aHeavy Compliance Burden 2️⃣ The Quality Industrial Complex has led to hundreds of measures that are primarily process-focused rather than patient-outcome based. This complex now drives the quality measure development process through CMS, which then is imposed on physicians either in fee-for-service or in alternative payment models. Specifically, CMS contracts with consensus-based entities (CBEs) —some of whom can count more than 400 member organizations—that get paid to endorse and steward quality measures, a cycle that creates incentives for the further expansion of measures. For example, CMS awarded Battelle Memorial Institute a five-year, $53 million contract to serve as the independent CBE for CMS. This contract, effective from March 2023 through February 2028, tasks Battelle with reviewing and endorsing clinical quality measures, guiding “national priorities for healthcare performance measurement,” and fostering stakeholder engagement to enhance the US health care system. This is an important contemporary example of industry capture; a regulatory agency is advised by industry, that creates feedback and develops measures to drive reimbursement for its constituency, while at the same time imposing significant burdens on that constituency. Despite the real-world frictions these quality measures have imposed, cross-national studies have shown no improvement of outcomes in areas ranging from hip fractures to myocardial infarction. 3️⃣ Solutions: Repeal the Medicare merit-based incentive payment system; Unburden and Empower Physicians; Engage Patients A departure from the past two decades of top-down, centralized thinking and practice, would build a virtuous, continuous quality improvement paradigm that is patient-centered, clinically focused, and clinician-engaged. Enormous resistance is expected, as the status quo has long enriched the quality and medical industrial complex. However, the potential benefits to patients and clinicians will serve as a critical counterforce. Appreicate my coauthors: @jwhite_health, Dr. Joseph Puthumana, & @PMCram.
