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Study suggests how U.S. healthcare is deeply flawed

October 12, 2015by Robert Whitcomb in Uncategorized tagged ,

dollars

U.S. healthcare spending as percentage of GDP exceeds — by far —  that of other high-income countries,  says a new Commonwealth Fund study, summarized here by Becker’s Hospital Review.

Among the other findings:

  • In  out-of-pocked healthcare costs, the U.S. was  second only to Switzerland.
  • Although U.S. public spending is high, the country covers fewer citizens.

       * Americans have fewer hospital and physician visits.

       * Healthcare prices in the U.S. are higher.

       * The U.S. was the only country where healthcare spending was a greater share of the GDP than social-services spending.

        * The U.S. has poor population health despite its high spending on healthcare.

Much of the cost can be explained by the fact that U.S. physicians and healthcare executives are by far the world’s highest paid and, especially, that providers are still mostly compensated on a fee-for-service basis — an incentive to drive up costs to maximize providers’ wealth.

 

 

Expansionary Geisinger explains its success

September 28, 2015by Robert Whitcomb in Uncategorized tagged , , , ,

danville

Sleepy downtown Danville, Pa.,  where Geisinger is based.

This interview with David Feinberg, M.D.,  the chief executive of Geisinger Health System, which serves a  largely rural clientele in Pennsylvania’s coal country, gives a pretty good idea of why, as The Wall Street Journal notes, it has “become a national poster child for the kind of carefully coordinated, data-driven healthcare that experts say one day could right the nation’s troubled medical system, providing better care at lower costs.”

Among other things, the system has long been  a pioneer in the use of electronic medical records and other data, which helps it to avoid unnecessary procedures. That the company also runs an insurance company  gives it an unusual incentives to reduce the number of many procedures.

And look for Geisinger to keep expanding:

“WSJ: Geisinger has been growing in size and scope, in part through merger-and-acquisition activity such as the deal with AtlantiCare health system in New Jersey. What are your plans for future mergers and acquisitions?

“DR. FEINBERG: Our M&A activity is wild. As far as our growth goes, I’m really looking for people that are culturally aligned with where we’re going. I want people or organizations—and AtlantiCare is a great example—that may be at a different place in the journey but believe in the journey around population health, innovation.”

 

Where population health and consumerism meet

September 17, 2015by Robert Whitcomb in Uncategorized tagged , , , , ,

 

Health Forum convened a panel of healthcare executives and other experts on June 11 in New York City to discuss the intersection of population health and consumerism.

Here’s their discussion.

 

Key findings from the panel, as summarized by Hospitals & Health Networks:

• “As hospitals and health systems strive to become more consumer-friendly, they may need to rethink some common terminology, such as ‘patient-centered medical home’ and ‘discharge’ to reflect consumer sentiment.

• “Population-health management does not mean an organization needs to provide all things to all people. Instead, hospitals and health systems should focus their efforts on providing preventive care and wellness to certain populations, such as patients with co-morbidities.

• “Price and brand are top of mind for consumers. However, consumers are willing to go out of network for services if they find poor ratings among in-network physicians. Other important considerations for consumers are convenience and wait time.”

Benefits and limits of data analytics in population health

August 14, 2015by Robert Whitcomb in Uncategorized tagged , , , , , , , , , ,

data

 

“Because communities and patient populations are simultaneously diverse and interconnected, providers must take an integrated, interdisciplinary approach to care delivery to make the population health model work,” says this piece from MedPage Today.

It reported on a spirit of cross-professional collaboration as more than two dozen invited healthcare leaders gathered June 17-19 at the 2015 HealthLeaders Media Population Health Exchange at The Park Hyatt Aviara, in Carlsbad, Calif.

One of the speakers, Andrew L. Masica, M.D., noted:  “We’ve had a fair amount of success using analytics to help with readmission reduction work.” He is vice president and chief clinical effectiveness officer at Baylor Scott and White, in Dallas.

“The tool in use classifies patients as having certain risk levels.Those who are categorized as high-risk for readmission during their hospital stay get a comprehensive care coordination intervention and, in many patients greater than age 65, home visits from a nurse practitioner to help with the transitional period following discharge. Medium- and lower-risk patients receive lesser degrees of intervention, for example, phone follow-up, tailored to meet any specific identified needs.”

Data analytics has also helped to provide fiscally responsible care, Dr. Masica said.

“That’s been a very efficient way to manage resources. The nurse practitioner model for transitional care has been shown to be effective but can be resource-intensive from a hospital operational standpoint.”

While there is value in numbers, however, Masica explains that the benefits of analytics can only be had if the numbers are strong. “Too much information, particularly if delivered in the wrong fashion, isn’t helpful and can sometimes be harmful.”

“When you talk about population health and you limit the conversation to data analytics — that’s just the tiniest sliver of that solution,” says Alan Pitt, M.D., professor of neuroradiology at Dignity Healthcare in Phoenix. “I think there’s a big role for the objective EHR data, but also [for] the subjective data … that would be more relevant to something of a solution.”

 

 

Heart Assn. focuses on social determinants of heart health

August 4, 2015by Robert Whitcomb in Uncategorized tagged , , , , , , ,

 

heart

The American Heart Association  is urging public- and private-sector healthcare policymakers to pay  more attention to the social factors that influence heart health, such as race, education and location.

This all comes under what we at Cambridge Management Group have long worked to understand  and address — the social determinants of health.

“What we’re discovering is that this is a very complicated space and there may be a number of variables beyond people’s control that have an impact on their health,” Dr. Clyde Yancy, an author of the report, told Reuters. Dr. Yancy  is chief of cardiology at Northwestern University’s Feinberg School of Medicine, in Chicago.

He gave as an example  new research suggesting that local pollution levels are tied to the risk of high blood pressure, among an area’s population.

The AHA group  notes that deaths from cardiovascular disease have declined since the 1970s thanks to advances in prevention and treatment.

But the group noted  that not all groups have benefited equally across economic, racial and ethnic groups. “Overall population health cannot improve if parts of the population do not benefit from improvements in prevention and treatment,” it wrote.

They cited social and economic status, race, ethnicity, social support, culture and language, access to care and place of residence as determining factors of health.

 

 

 

Cambridge Management Group at 30

July 7, 2015by Robert Whitcomb in Uncategorized tagged , , , , ,

 

Cambridge Management Group is (quietly) celebrating its 30th anniversary this month. Since 1985, our firm, composed of senior professionals with many years of business and clinical experience from across America — has been privileged to help organizations adapt to healthcare-sector-wide changes while addressing individual organizations’ often unique challenges.

The sector has seen vast changes since 1985! Consider the arrival of various forms of managed care, the rise of big hospital chains and the surge in hospital employment of once-independent physicians. Then there are the stunning new technologies that can turn patients into amateur doctors and new government insurance programs aimed at expanding coverage while controlling costs. The Affordable Care Act has, of course, accelerated the sector’s transformation in the past several years.

During the past three decades, CMG has expanded from consulting at hospitals to also work for a wide range of other healthcare organizations, such as Federally Qualified Health Centers and statewide Medicaid programs as “population health’’ becomes a mantra.

Whatever the challenges along the way, we’re always energized by our mission, as summarized in our motto “Cooperating for Better Care’’. To us at CMG, healthcare remains the most exciting – and, arguably, the most important — place to work. We’re grateful to have had the opportunity to do so for three decades, and look forward to continuing for years to come.

What does ‘population health’ mean?

June 22, 2015by Robert Whitcomb in Uncategorized tagged

 

Healthcare executives give varying definitions of “population health.”

 

 

Partnerships in population health

June 22, 2015by Robert Whitcomb in Uncategorized tagged

 

Thought leaders discuss the importance of partnerships in population health.

Guidance for move into population health

May 18, 2015by Robert Whitcomb in Uncategorized tagged ,

 

This American Hospital Association-Leavitt Partners document offers guidance for hospitals trying to get into population health, including case studies from three different kinds of hospitals with Accountable Care Organizations and a look at different payment models.

It discusses physician-alignment problems, finding seeking the right mix of payers, how to distribute shared savings, finding the right physician leaders and integrating with physician practices.

 

 

How public-health officials, hospitals should team up

April 14, 2015by Robert Whitcomb in Uncategorized tagged ,

 

“Driven by the increasingly shared vision of managing population health, officials for hospitals and public health departments are working together more closely,” notes Hospitals & Health Networks.

“These two types of health organizations do not have a tradition of working as true partners, but resources are available to aid in the process from such organizations as the Institute of Medicine, the Institute for Healthcare Improvement and the Robert Wood Johnson Foundation.”

This article also takes you to  11 recommendations stemming from 12 successful hospital-public health collaborations.

 

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