New Solutions to Healthcare Delivery

A fascinating blog was recently written in a Harvard Business Review blog explaining why our efforts to change the way we delivery healthcare might not work. 

For a while now the discussion has focused around how our healthcare providers are compensated – fee for service vs. paying for patient outcomes. It’s no secret that many providers are motivated and incentivized by their payment structure, however this blog argues, rather convincingly, that we need to change much more than the payment structure if we want to change how healthcare is delivered today. This blog offers 4 ways that we might be able to achieve the kind of change we are looking for.

1. “Let doctors be doctors, not managers.” It’s true that physicians now days have so much more to do than just provide care for their patients. Perhaps if we allow physicians to just concentrate on the healthcare delivery, then we could see more efficient outcomes.

2. “Develop standard protocols for care.” Relativity is the enemy of efficiency. If we can help hospitals and providers to offer care using standardization, we will see more efficient outcomes.

3. “Hold people accountable for the little things. An endemic problem in many healthcare institutions is the unfinished task. Who is accountable for stocking the amoxicillin? For making sure the bathrooms are clean? For fixing patient beds? For paying vendors? These small tasks make a big difference to the experiences—and survival—of patients. We use simple tools like pareto analysis of drug use and reports of patient-centered outcomes to hold providers and their managers accountable to the care they deliver.”

4. “Invest in technologies that promote efficiency and transparency” Change is difficult for most of us, but it’s even more difficult for healthcare providers that have been doing things the same for decades. The average healthcare provider today is not a spring chicken, and they are not used to the technology changes that many of us are. However, this is an important step to moving healthcare into a more efficient industry.

I believe that these four suggestions are spot on. It’s amazing to know that healthcare challenges are global, and we can learn a lot about ourselves by looking abroad.

Share your Thoughts:

What do you think about the suggestions to change/solve the healthcare challenges? Do you think health policy should be involved in implementing some of these ideas?

Thank you to Baylor MBA Healthcare Program for encouraging creative solutions to complex health care and policy difficulties.

Sources:

https://hbr.org/2015/04/fixing-health-care-will-require-more-than-a-new-payment-system

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Big Data Results: Healthcare

‘Big Data’ is a buzz phrase that you hear a lot these days, but not necessarily something that you hear being associated with healthcare. Other industries like the airlines or just about any manufacturing company has used big data to analyze the hundreds of thousands and millions of flights, or used when producing a ‘widget’ that millions of Americans use. Big data has been effective for these industries for over a decade for the simple fact that these industries can use information to predict demand of their services.

Recently the Robert Wood Johnson Foundation has supported an initiative that is examining whether the ACA’s health policy coverage expansion has been as effective for patients and healthcare providers. The foundation used data from 14,300 providers caring for about 5.8 million patients. Some of the results of this initiative were fascinating.

“There was no evidence that patients with previously untreated illnesses were taxing primary care capacity during the first nine months of 2014 (though new patients may require more time to schedule and attend appointments). New patient visits to primary care doctors represented 21.8% of all visits this year through September, compared with 21.6% for the same months in 2013. And minimal changes in national rates of three major chronic diseases—diabetes, high-blood pressure and elevated cholesterol— provided no support for the concern that new patients were sicker than they have been in the past.”

This kind of data analysis can help everyone involved in healthcare from patients, physicians, hospital facilities and even health policy makers. Using this data analysis is easier said than done however. Let’s not forget that healthcare information is highly protected by HIPPA laws, and is worth millions of dollars by those trying to hack into systems and steal this information.

Be that as it may, the value for healthcare managers by leveraging this information is there, and should be used effectively in the future.

Share your Thoughts:

Do you think using healthcare data can help health policy more focused and effective? Do you think these types of analyses are important for tax payers and politicians to use in shaping American health policy? Do you think the results discussed are of interest?

Thank you to Baylor University MBA in Healthcare program for helping their students focus on real world health care practice and policy. 

Sources:

https://hbr.org/2014/12/public-health-data-should-rely-on-software-not-surveys

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Pricing Transparency: Healthcare Policy

It is absolutely amazing how difficult it is sometimes to find out how much it costs to go to a healthcare facility, either a hospital and/or a clinic and receive a procedure or treatment. If you have ever asked for the price of a procedure you know how difficult it is to get a price or even an answer. Those of us with high deductible healthcare plans, or even no healthcare have figuratively (or maybe literally) pulled out our hair trying to get an answer on ‘what is this going to cost me to come in and get something done!’

Accomplishing healthcare cost transparency is a step in the right direction if our country is ever going to get our costs under control.

A recent opinion article written by a healthcare executive, Douglas Ghertner, criticized an attempt by CMS to release information about how we might become better healthcare consumers in an article published by CNBC. In the article Ghertner points out that while CMS’ intentions may have been sincere, the attempt neglected to capture what costs are truly conveyed to the actual patients. In point, CMS uses hospital charges and did not actually take into account what the reimbursements were after Medicare, Medicaid and insurers have negotiated what they would actually pay the hospital.

In the noted study, CMS also neglected to take into account quality of care measures that hospitals monitor. Certainly they don’t believe that all healthcare is created equal, and could probably agree that some measure should be in place for consumers to judge the quality of care they receive.

Ghertner also mentions in his article the increase need for this healthcare cost transparency, noting a study that showed the rise in high deductible healthcare plans.

Finally, Ghertner talks about the increasing need from a national perspective to increase this transparency.

“A recent analysis by West Health Policy Institute suggests that transparency initiatives could cut $100 billion over 10 years from health spending. This may be a small step towards reducing the trillions of dollars we spend each year on health care in this country, but it is a step in the right direction. Additionally, as we improve our ability to make public provider level outcomes from a quality perspective, the patient can assess the value of health-care services, forcing providers to compete on quality as well as cost.”

Hopefully those of us who manage healthcare today will be able to take additional steps to assist patients healthcare cost decisions. 

Share your Thoughts:

Have you ever tried to find out the price of a procedure before having the procedure? Was it difficult? Do you think transparency in healthcare costs is important? Do you think that health care policy should be transparent? What types of improvements would  you like to see in your healthcare?

Thank you to Baylor University MBA Healthcare for an education that encourages critical and creative thinking to solve complex healthcare and business problems. 

Sources:

http://www.cnbc.com/id/101880007

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American's Don't Feel Impacted from the ACA

Interesting poll results came out last week concerning American’s attitudes towards the Affordable Care Act. According to the latest Kaiser Health Tracking Poll 

"More than four years after passage of the Affordable Care Act (ACA) and several months into the first year of its coverage expansions, most Americans do not feel personally impacted by the law. Among the minority who say they have felt an impact, more feel they have been harmed than helped by the law, with Republicans more likely to say they have been hurt and Democrats more likely to say they have been helped."

However most would like politicians to stop talking about it. 51% of registered voters say they are tired of hearing candidates for Congress talk about health care law and want them to focus more on other issues like jobs. These results were also found similarly within Gallop poll findings. 

The Gallop poll results reiterated the same results regarding the health policy with more detail,

"About one month after the new healthcare exchanges closed with over 8 million new enrollees, there has been little substantial change in Americans' perception that the healthcare law has helped them. Most Americans say the law has had no impact on their healthcare situation, while those who do perceive an effect are more likely to say it has hurt them rather than helped them. The majority of Americans have reported that the Affordable Care Act has had little effect on their personal situations since Gallup first asked this question in early 2012. In more recent months, after the exchange-based enrollment opened up, Americans have gradually become more likely to indicate that the law has had an effect -- both positive and negative. The current 24% who say the law has hurt them is by one percentage point the highest measured, while the 14% who say the law has helped them is also within one point of being the highest measured on that dimension. In all instances, across seven different surveys, Americans have been at least marginally more likely to say the law has hurt them and their families than to say it has helped them.Americans' views on how the healthcare law has affected them personally are predictably partisan, as are almost all attitudes about Obamacare."

Share Your Thoughts:
Do you feel impacted by the Health Policy of the Affordable Care Act? If you were impacted by the change in health policy was it positive or negative? Do you feel this political debate about health policy is overdone or still of concern?



Thank you to Baylor MBA in Healthcare Program for helping it's students understand the impact of health policy in America.

Sources:
http://www.huffingtonpost.com/2014/05/30/aca-poll_n_5420425.html
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Healthcare Fraud Uncovered

Something those of us who are learning to become leaders in the healthcare industry are being taught is that we have to keep our eyes out for those who might be taking advantage of the system. Many of my posts have been about the significant costs of healthcare, totaling hundreds of millions of dollars on an annual basis. 

We have also discussed the causes of this cost, and why it continues to increase. But every once in a while, we are reminded about one of the causes of rising healthcare costs, and it may not be what you think.

Today it is being reported that one of the biggest scams in healthcare history is coming to a verdict. 

"Between 2006 and 2012, federal law enforcement authorities allege more than 230 Dallas-area home health care agencies funneled patients to an Arlington physician, Joseph Megwa to approve $100.5 million in care they did not need. The owner of the largest home care agency in the case, Nigerian-American Ferguson Ikhile of Irving, has pleaded guilty."

In a separate case, more than 500 home health agencies were accused of sending their patients for unnecessary care to a man, who gave 347 million dollars worth of unnecessary treatments. In both cases it was reported that most of the elderly patients who participated in the schemes did not even know what was going on. 

With this information, it’s important to realize that most individuals just simply don’t understand all the healthcare jargon like those of us training to become healthcare administrators. It’s always a good idea to take a step back and remember the entire scope of our responsibility going forward.

SHARE YOUR THOUGHTS:

Do you think there is enough health policy preventing healthcare fraud? How would you feel if your elderly loved one had been taken advantage of? Who do you think is the biggest victim in these types of fraudulent cases?

Special thank you to Baylor University Healthcare MBA program for the education to encourage honest, efficient healthcare policy and leadership. 

Sources:

http://www.dallasnews.com/business/health-care/20140215-dallas-area-home-to-huge-health-care-frauds.ece

London's Calling....to Help America's Healthcare System.

With the current healthcare policy and system in constant debate, one element remains inevitable, healthcare services are becoming more in demand on a daily basis. 

As we have discussed in other posts there are many contributing factors to the increased demand in healthcare, not to mention the obvious increase in insurance that will be offered as a result of the healthcare policy of the Affordable Care Act.

Occasionally it might be a good idea to listen to our good friends ‘across the pond’ when it comes to how hospitals might handle the challenge of potentially providing services to so many new and returning patients. American’s situation of a higher demand to supply (access to doctors) is not unique. Great Britain is also feeling the pressure of dealing with an increased population demanding healthcare services. However, Great Britain does not seem to disagree with where to focus their efforts in confronting this potential crisis as a recent article in the UK’s Guardian points out.

“Ultimately, in order to increase efficiency in the National Health System and meet the public's top priorities of waiting and access, General Practitioners need to be resourced and equipped to do more. They also need to build teams to perform and complete more episodes of care in their primary care setting in modern, purpose-built 21st-century facilities. It is extremely difficult to change the expectations of the general population, but what we can do is ensure that healthcare practitioners are working in the right environment to respond to the demands effectively.”

Unfortunately Americans appear to be reacting to increased healthcare policy pressure and are not incentivized to see their primary care physicians before an issue becomes a crisis. Ultimately, if we want to find ways to take care of the healthcare system, we have to let them, the physicians, take care of us, early, so that it is not too late.

Thank you to Baylor Healthcare MBA for helping their students see how to prioritize healthcare needs in America.

Sources:

http://www.theguardian.com/healthcare-network/2013/sep/09/primary-care-ease-pressure-hospitals

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White House Delays Affordable Care Act for Big Business

Just a week ago President Obama and the White House Administration announced that one of the most essential elements of the Affordable Care Act, or ‘Obamacare’ which states that businesses with 50 or more full-time employees must provide healthcare benefits to their workers was delayed one year. Because the employer mandate deems a 30 hour work week as ‘full-time,’ this provision has affected thousands of businesses in America. One such business, Fatburger, claims that this news has simply come too late since they have been in “slash” mode to cut additional employees now for more than 6 months.

Mike Johnson, the owner of a Buffalo’s Café franchise has said that the mandate has made his life particularly difficult. "I've been worried nearly sick about it," Johnson said. "This gives me another year to look at all the options, and lets the politicians talk about what the best course of action would be. The employer mandate never made any sense to anybody, especially to struggling small businesses," he said.

Still, the White House claims that these changes will make very little difference considering that according to their facts, 96% of businesses already offer their employees some kind of healthcare benefits. What these statistics don’t consider however, is that the Affordable Care Act also mandates that these health plans contain 10 ‘essential health benefits’ which typically expands what current business health plans offer. Many are continually questioning the Presidents healthcare policies.

In a closed meeting to Republicans, Speaker of the House John Boehnor said “Is it fair for the president of the United States to give American businesses an exemption from his health care law’s mandates, without giving the same exemption to the rest of America? Hell no, it’s not fair.” With the Affordable Care Act still lacking favorability, and Americans getting even more nervous about its implementation, comments like this are certain to continue to political bonfire. 

Share your Thoughts:

Do you think the Affordable Care Act Health Policy will benefit or hurt small businesses? Do you think Health Policy should be mandated to all people or should certain groups be except? What do you think the best plan of action would be for Health Policy in America?

Thank you to Baylor MBA in Healthcare Program for continuing to challenge their students’ thoughts on Health Policy.

Sources:

http://money.cnn.com/2013/07/08/smallbusiness/obamacare-fatburger/?hpt=hp_t3

http://www.newsmax.com/politics/boehner-obamacare-business-exemptions/2013/07/09/id/514200

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