Week of December 7 -13, 2015


Strategy and the Health Care Marketplace
In 2007, Institute for Healthcare Improvement began recruiting organizations from around the world to participate in a collaborative to implement what became known as the Triple Aim. The 141 participating organizations included health care systems, hospitals, health care insurance companies, and others closely tied to health care. In addition, key groups outside the health care system were represented, such as public health agencies, social services groups, and community coalitions. This collaborative provided a structure for observational research. By noting the contrasts between the contexts and structures of those sites in the collaborative that progressed and those that did not, we were able to develop an ex post theory of what is needed for an organization or community to successfully pursue the Triple Aim.
Pursuing the Triple Aim: The First 7 Years, 

David T. Feinberg, MD, was named president and CEO of Geisinger in February 2015. In the almost year since he took over leadership of Geisinger from Glenn Steele, MD, PhD, Dr. Feinberg has redefined what customer service looks like in healthcare. In an unprecedented move, he spearheaded the evolution of the healthcare “warranty.”
The corner office: Dr. David Feinberg on raising the patient experience to a whole new level, 

2016 will be a year of firsts for healthcare consumers, organizations and new entrants as innovative tools and services enter the New Health Economy. PwC’s Health Research Institute  annual Top health industry issues report highlights the forces that are expected to have the most impact on the industry in the coming year, with a glance back at key trends from the past decade.
Top health industry issues of 2016,

Efforts to reduce low-value care can decrease spending while helping patients avoid potentially harmful treatments. … The current approach focuses on 2 strategies to reduce low-value care. First, professional societies are exhorting physicians to consider costs and value when deciding among alternative treatments. … These initiatives appeal to a sense of professionalism by promoting the idea that physicians are stewards of societal resources. Second, payers are promoting health care system innovation and implementing payment reforms to reduce the incentives to provide ineffective treatments. Unfortunately, discussions about how to reduce low-value care often gloss over a crucial third strategy: a sustained effort to generate evidence that will distinguish between high- and low-value care.
Producing Evidence to Reduce Low-Value Care,

Large employers, aiming to reduce the health costs for their employees, are forming tighter relationships directly with large provider networks, tying the contracts to the Triple Aim. Will Boeing Change Health Care?

ACA Implementation
A group of doctors is pushing to bring house calls to the nation’s 2 million oldest, frailest and costliest patients, saying it has the potential to save the government billions of dollars. Working with the American Academy of Home Care Medicine (AAHCM), the doctors developed a program through which Medicare would share the money saved via home care with the doctors who provided it.  A three-year pilot program in 17 practices around the country was included in the Affordable Care Act and implemented in 2012. The initial results were promising, and this summer Congress voted to extend it another two years for 14 of the practices.
Doctors prescribe old-fashioned house calls when treating the old and frail, 

Health insurance premiums for plans offered through the Affordable Care Act’s marketplaces remained steady or increased only modestly from 2014 to 2015, according to a new Commonwealth Fund–supported study in Health Affairs.
In Second Year Of Marketplaces, New Entrants, ACA ‘Co-Ops,’ And Medicaid Plans Restrain Average Premium Growth Rates,

A new analysis from the Kaiser Family Foundation finds that among uninsured people who are eligible for an Affordable Care Act marketplace plan, the average penalty for remaining without coverage in 2016 would be $969 per household – 47 percent higher than the 2015 estimated average of $661.
The Cost of the Individual Mandate Penalty for the Remaining Uninsured,

States’ health care systems improved more than they declined, and access to care expanded across the nation, The Commonwealth Fund’s latest Scorecard on State Health System Performance finds.  The 2015 edition of the state scorecard—the first one in the series to reflect a full year of the Affordable Care Act’s health insurance expansions—finds that the uninsured rate for working-age adults declined in nearly all states and dropped by at least three points in 39 states. However, stark differences persisted among states on many other health system performance indicators.
Latest Scorecard on Health System Performance Shows More Improvement Than Decline Across States,  

The Affordable Care Act created the Consumer Operated and Oriented Plan (CO-OP) Program to give consumers the option to choose a nonprofit insurer with a strong consumer focus. But of the 23 CO-OPs launched, all but two have fallen short of enrollment or profitability projections, and 12 have, or soon will, shut down.  A new Commonwealth Fund report by Georgetown University’s Sabrina Corlette and colleagues examines the many challenges CO-OPs contend with and the ways in which these insurers have responded. The researchers focus on the experiences of six CO-OPs located in Iowa/Nebraska, Kentucky, Maine, Maryland, Montana, and Tennessee.  Why Are Many CO-OPs Failing?
How New Nonprofit Health Plans Have Responded to Market Competition,

At the moment, the proponents of the ACA believe the new law is working, and initiatives are being readied to build upon what was enacted in 2010 by further bolstering the federal government’s power to control costs through additional regulation. We are among those who opposed the ACA because of its heavy emphasis on federal control. W e propose major reforms to the tax treatment of employer-sponsored health care, Medicaid, Medicare, Health Savings Accounts, and other areas of existing policy.
Improving Health And Health Care: An Agenda For Reform


Jobs For Medical Scribes Are Rising Rapidly But Standards Lag, Kaiser
HMO giant Kaiser eyes expansion and agrees to buy Washington state insurer, Los Angeles Times
As Aging Population Grows, So Do Robotic Health Aides, The New York Times
How to Create Exceptional Patient Experiences — Without Exception, Health and Hospitals
A ‘Netflix-like’ predictive model: Hospital systems could pinpoint which patients are most likely to code on their watch, The Washington Post
Primary Care Physicians in Ten Countries Report Challenges Caring for Patients with Complex Health Needs, Commonwealth Fund
Jon Stewart Returns to ‘The Daily Show’ as a Guest to discuss the Zadroga Act, The New York Times
SAP Unveils Software for Doctor Data-Sharing After CEO Accident, Bloomberg
Your New Medical Team: Algorithms and Physicians, The New York Times
IHI Forum: New Surgeon General Offers Hospitals Advice for Tackling Population Health.  Health and Hospitals
State Obamacare Exchanges ‘Sustainable’ Without Federal Aid, Official Tells Congress, Kaiser 
Marco Rubio Quietly Undermines Affordable Care Act, The New York Times
Merging the Health System and Education Silos to Better Educate Future Physicians,JAMA
How Our Community Designed a Better Hospital,  Harvard Business Review
Policy Options to Expand Medicare’s Low-Income Provisions to Improve Access and Affordability, Commonwealth Fund
One in 4 HealthCare.gov customers renew coverage so far, HHS says, The Washington Pos
Moody’s: High rate of physician employment linked to lower profitability, Becker’s
Medicare Penalizes 758 Hospitals For Safety Incidents, Kaiser



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