From an NEJM Catalyst article:
“What are some healthcare partnerships that went well? John Ayanian, director of the University of Michigan’s Institute for Healthcare Policy and Innovation, asks Joneigh Khaldun, director and health officer for the Detroit Health Department, to describe a public health and health system partnership that tackled a tough problem.”
To see the video and read the text on this, please hit this link.
In a Med Page Today article, Colin Zhu, D.O., discusses how to lure and keep Millennials in medicine to deal with the oncoming physician shortage.
Among his observations:
“Society associates Millennials with negative connotations like entitlement and selfishness, but I beg to differ. My generation is known for our tech savvy, flexibility, and eagerness to produce results. We crave constant feedback and seek out continuous opportunities to improve. We find culture to be a greater attraction than compensation, look for new experiences in life, and want to pursue passions outside of our chosen fields.
“As more doctors cut back their hours or plan to retire, practices and hospital administrators will need to look in new directions to increase retention among young doctors. Keeping talented people within the practice of medicine will ultimately benefit everyone. Organizations that build strong cultures by providing career opportunities and encouraging people to pursue outside passions will be more likely to attract and keep Millennial physicians. ”
Dr Zhu is the creator of TheChefDoc and author of Thrive Medicine: How to Cultivate Your Desires and Elevate Your Life.
To read the article, please hit this link.
An article in NEJM Catalyst touts the value of multidisciplinary teams in cancer treatment. The group of authors conclude:
“The long-term cost of care needs to be further investigated, but the treatment changes based on multidisciplinary team recommendations likely led to improved outcomes or reduced cost, including lower downstream costs from complications or poor disease outcomes, based on studies in other institutions. True cost of treatment is difficult to quantify in a retrospective fashion in our study and would require further prospective study. Though the precise value of multidisciplinary team discussions may be difficult to quantify, multidisciplinary team discussions result in improved disease outcomes and better coordination of care, and may decrease cost of cancer treatment.”
To read the article, please hit this link.
“Provider groups had plenty to say about the proposed changes to the Medicare Shared Savings Program (MSSP) that are likely to drive out a portion of Accountable Care Organizations (ACOs) if finalized.
A new survey by the National Association of ACOs (NAACOS) released this week shows that 60% of ACOs currently in the MSSP wouldn’t enter the program under the proposed structure, which includes reducing shared savings from 50% to 25% and shortening the amount of time ACOs can remain in a one-sided risk model from six years to two years.
Nearly half of the ACOs surveyed said they are likely to continue even if those changes take effect. More than one-third (36%) said they were unlikely to continue under the proposed structure, and 16% took a neutral stance.”
To read the whole article, please hit this link.
“The behavior of senior executives, and especially the CEO, is known to be directly related to an organization’s performance. In 2017, we reported on five behavioral dimensions required to build a culture of continuous improvement: willingness, humility, curiosity, perseverance, and self-discipline. Does changing leader behavior to embody these qualities lead to better patient outcomes? The leadership team at Zuckerberg San Francisco General Hospital (ZSFGH) has been studying this question over the last year and has determined the answer is yes. We will describe the outcomes ZSFGH has achieved since creating specific behavioral expectations for its leaders.”
“One step toward developing an improvement management system is defining what people should be working on. This is called True North, a handful of metrics that allow everyone to know what’s most important and whether the organization is making needed progress. ZSFGH adopted six True North goal areas — equity, safety, quality, care experience, workforce care and development, and financial stewardship — and decided how to measure each performance category. These measures are ZSFGH’s must do, can’t fail metrics for organizational performance.”
To read the entire piece, please hit this link.
Deborah Walker Keegan, Ph.D., president of Medical Practice Dimensions Inc., discusses in Medical Economics how to restructure the U.S. healthcare-delivery system. Among her observations:
”Pharmacy and retail blockbuster chains, having already embarked on retail and express clinics, are now proposing partnerships with commercial insurers to expand their reach, improve their bottom line, and reposition themselves as the new ‘front door’ of primary care.”
- “Do we want to have pharmacy/insurer monoliths wield power to steer patients to specific facilities and providers for care, services and medications? Beyond primary care, patients need access to specialty care and care coordination across the continuum of healthcare services. Except for the small number of proposed mergers that involve multispecialty provider groups … is this on the companies’ radar? If so, what are their proposals for a comprehensive delivery system of care?
- “Will we be fracturing an already dwindling provider supply? It is doubtful that economies of scale will be realized by placing one or two clinicians in a retail pharmacy and replicating this model over tens of thousands of sites as they compete on every corner. Primary care clinicians may become an even more endangered species than they already are, with many seeing only a handful of patients per day.”
She says that an innovative healthcare delivery system could look like some of the following:
- “Patients living or working within a defined region receive care from a designated healthcare delivery system.
- “Patients receive primary care services locally and specialty care services regionally. The most complex procedures are performed in a few, well-established centers of excellence located throughout the country.
- “The regional healthcare delivery system is incented to improve and/or maintain population health and wellness; financial incentives and/or subsidies are paid to the systems themselves (rather than to patients or commercial insurers).
- “Patients purchase health insurance directly from the regional healthcare delivery systems, thereby effectively integrating the financing and delivery of healthcare and thus aligning incentives.”
To read her whole essay, please hit this link.
“Proposed changes to the federal Accountable Care Organization (ACO) model—namely, a cut in the shared savings rate from 50% to 25%—would cut the knees out from under the program, board members of the National Association of ACOs said on Thursday, Oct. 4.
“Speaking with reporters at their annual conference in Washington, D.C., ACO leaders said they supported many of the proposed changes that the Centers for Medicare & Medicaid Services have brought forward regarding ACOs.
“But proposed rules that would speed their path to risk and reduce the reward they would reap in return for any savings they realize are ‘deal breakers’ for new entrants to the program, said Clif Gaus, NAACOS president and CEO.”
To read the entire article, please hit this link.
In an NEJM Catalyst piece, Poonam L. Alaigh, M.D., executive vice president for corporate development at Remedy Partners, writes about how to make Accountable Care Organizations and bundled payments work side by side. Among Dr. Alaigh’s conclusions:
“Federal policymakers have recently indicated that they expect far greater returns on their investment in payment reform and they are prepared to hold stakeholders’ feet to the fire. They’ll likely do so by eliminating Medicare value-based care participation options that lack downside risk, which fail to hold organizations accountable for negative performance.
“Provider organizations must become adept at delivering care under both of these models as we shift from volume to value-based care. This approach provides an innovative platform for primary care and specialty care integration. ACOs and bundled payment systems are an opportunity for health care providers and payers to work in unison toward improving health for patients and better managing costs. Leaders should be seeking to build on the last several years of experience and momentum by aligning these initiatives and mobilizing these complementary programs while internally leveraging economics of scale and driving increased return on investment.”
To read the whole piece, please hit this link.