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Paul Keckley

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The Cures Act and hospitals

 

Paul Keckley, the healthcare-sector analyst, looks at the implications of the  21st Century Cures Act for hospitals.

Among his recommendations for hospital executes for living in the Cures Act world:

  • “Formulary design and medication management policies and procedures need constant review so that competing compounds can find their way readily into a hospital’s prescribing patterns. And the hospital’s interaction with retail pharmacies should enable shared knowledge about new and emerging classes and compounds that offer the same efficacy and effectiveness at a lower rate.”
  • “Medical device utilization, purchasing, and measures of effectiveness and safety need closer scrutiny. Of particular note are two areas where compliance risk is quite strong: the financial relationships between physicians and hospitals and manufacturers, and the safety associated with devices.”
  • “Medical directors must be proactive. Pharmacists should be included in care coordination teams across the organization.”
  • ”Mental health professionals should be recruited to the clinical community.”
  • The diagnostic tests inclusive of mental and physical health signs, symptoms, risk factors, and co-morbidities should be updated and hardwired into clinical decision support systems that prompt, alert and remind clinicians to make definitive diagnoses.”

To read his article, please hit this link.

 


‘Proven care at known prices’

bigewave

Healthcare economist Paul Keckley looks at the wave of big health insurance company mergers and what they might mean for providers.

“At this juncture, everything has to be on the table for hospitals and health systems. There can be no sacred cows. Maybe instead of owning, sharing is key. Maybe instead of patients, it’s about consumers as individuals. Maybe instead of capital for bricks and sticks, it’s clicks and tools for care coordination. Maybe instead of physicians as customers, it’s physicians as partners. And maybe instead of a value proposition premised on convenience and access, it’s about proven care at known prices.”

 

 


A fresh look at physician employment by hospitals

 

doctor

“The Doctor,” by Luke Fildes 

With health-insurance companies and hospital systems getting fewer and bigger, more physicians are seeking to work in hospitals, which have more price-power than  do  physician groups.

Paul Keckley, of Navigant Healthcare, takes a fresh look at physician employment by hospitals. He poses some big questions and at least implies some answers.

“Here’s the challenge for hospitals: employing physicians is not a slam dunk, even if the market is benign about shared risk arrangements with payers. Physicians want clinical autonomy whether employed or not. Physicians want the technologies and tools that are required to ply their trade and they expect them to help, not hinder their work. Physicians want to be heard on matters of consequence to the entire organization, not just clinical issues de jour. Physicians want to be  ‘in the room,’not outside looking in. Physicians want to be compensated for their experience and aptitude, not just their production. And they want to be aligned with a winning organization that’s recognized for quality and well-positioned long term.”

“In tandem with the Healthcare Financial Management Association, we gathered impressions from the administrators of 44 hospital-sponsored group practices to see how their marriage with the hospital is working. They’re losing sleep over three concerns:

Operations: “We worry about how to operate the group efficiently as payments shift from volume to value, margins shrink, and costs for information technology and labor increase. It’s a tough job, and it’s a different job than running the hospital.”

Compensation: “We worry about how to compensate doctors as the change from production to performance accelerates. Doctors like to ‘eat what they kill’ and they expect to get paid well. Something’s gotta give.”

Recruitment: “We worry about how we will recruit new physicians to join the group and sustain its growth.”    

 

 

 


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