Week of February 1-5, 2016


Health Care Leadership and Management
Investing in community-based services by adding them to payment bundles can reduce readmissions and save significant expense, research suggests. Predicting 30-120 Readmission Risk among Medicare Fee for Service Patients Using Nonmedical Workers and Mobile Technology,

A team-based approach positions organizations for success in a challenging primary care environment that demands increased productivity and access, decreased costs, improved experience of care, and healthier populations. But how is this accomplished? In this Q&A with IHI Content Development Manager Jo Ann Endo, IHI Director Cindy Hupke explains how organizations can move from talking about team-based care to actually doing it. Team-Based Care: Moving from Ideas to Action,

How did one hospital add the equivalent of 75 beds without a single change to infrastructure? In this post, Frederick Ryckman, MD, Senior Vice President of Medical Operations at Cincinnati Children’s Hospital and Medical Center, shares the keys to his organization’s success with improving the movement of patients through the acute care setting (otherwise known as “flow”).  Optimizing Flow Is Everyone’s Job: How Cincinnati Children’s Improved the Efficiency of Their Hospital Operations,

There’s a lot of interest nationally in comprehensive primary care—known as the patient-centered medical home (PCMH)—and how well it works. Published with support from the Milbank Memorial Fund, the fifth annual report highlights studies of 30 primary care PCMH initiatives from around the country published last year that measured cost and utilization of service—and analyzes the findings. The Patient-Centered Primary Care Collaborative Releases 5th Annual Evidence Report,  

After decades in academic medicine and management, Harold Paz, MD, MS, left his position as chief executive officer of the Penn State Hershey Medical Center and Health System in 2014 to become chief medical officer and executive vice president at Aetna.  Read this NEJM Catalyst Interview, From Health Care Provider to Payer: One Executive’s Perspective,  

Manage Your Emotional Culture. Most leaders focus on how employees think and behave—but feelings matter just as much.

Clayton Christensen, of disruptive innovation fame, and W. Chan Kim and Renée Mauborgne, the inventors of “blue ocean strategy,” have shown that big changes in society and technology fundamentally challenge the conventional understanding of what is valuable. Those changes render obsolete whatever criteria companies are using to identify customer problems they could address. To see which ideas truly have potential, managers need new assessment criteria.  The Innovative Power of Criticism, Judgment, Not Ideation, Is The Key To Breakthroughs.

ACA Implementation
A relatively obscure category of health insurance — “critical illness” insurance — is catching on because, increasingly, conventional health plans have consumers paying a lot of out-of-pocket costs.  NPR,

In January, more than 350,000 lower income New Yorkers began paying $20 a month or less for comprehensive health insurance with no deductibles and low copayments, under a federal health law program.  N.Y., Minn. Opt For Low-Cost Plans To Help Some Residents Afford Coverage,

This report provides a five-year perspective on the impact the Affordable Care Act (ACA) has had on the U.S. economy since the law’s enactment. It discusses trends in economic growth, employment, and health care costs since 2010, as well as the national experience prior to that time, and compares the recovery in the United States with that in other high-income countries.  The Affordable Care Act and the U.S. Economy: A Five-Year Perspective,

Stung by losses under the federal health law, major insurers are seeking to sharply limit how policies are sold to individuals in ways that consumer advocates say seem to discriminate against the sickest and could hold down future enrollment.  In recent days Anthem, Aetna and Cigna, all among the top five health insurers, told brokers they will stop paying them sales commissions to sign up most customers who qualify for new coverage outside the normal enrollment period, according to the companies and broker documents.  Licking Wounds, Insurers Accelerate Moves To Limit Health-Law Enrollment, 

To realize the full potential for systemwide improvement, however, the private sector will need the right incentives to discover and deploy novel approaches to improving the health care system in addition to adopting approaches that prove successful in public programs. Unfortunately, the U.S. tax code has long undermined such incentives. Because employees pay income and payroll taxes on wages but not on compensation provided in the form of health care benefits, it is rational for employers to skew compensation packages away from wages and toward excessively costly and inefficient health benefits. The Cadillac Tax — A Crucial Tool for Delivery-System Reform,

Opponents of the Affordable Care Act (ACA) have been claiming that the law would be a job killer since its passage, and the claims have not subsided with time. Some supporters of the ACA also worry about the possibility of unintended employment consequences. In addition, the Congressional Budget Office (CBO) projected that the ACA would have negative employment effects.
However, predictions that the ACA would substantially reduce employment, and shift millions of workers from full-time to part-time work, have not been borne out.  Claims That The ACA Would Be A Job Killer Are Not Substantiated By Research,  

A new policy brief from Health Affairs and the Robert Wood Johnson Foundation looks at high-deductible health plans (HDHPs), in which the annual deductible is $1,300 for an individual and $2,600 for a family. An estimated 25 percent of Americans with employer-sponsored health coverage are enrolled in HDHPs, as compared to 4 percent a decade ago. In the Affordable Care Act (ACA) Marketplaces, almost 90 percent of individual plan enrollees select HDHPs.  This brief examines early evidence that HDHPs have reduced spending and risks they pose for some consumers, who might avoid filling prescriptions and obtaining other necessary care because of costs.  High-Deductable Health Plans,

Early indications are the individual health insurance marketplaces created by the Affordable Care Act are fostering competitive environments where insurer participation is rising and plans are competing for customers.  In a new Commonwealth Fund issue brief, Georgetown University’s David Cusano and Kevin Lucia explore the strategies used by regulators and marketplace officials in Kansas, Nevada, Rhode Island, and Washington to promote competition.  Implementing the Affordable Care Act: Promoting Competition in the Individual Marketplaces, 
About 12.7 million Americans enrolled in private health insurance through the federal and state marketplaces for 2016.  Sign-ups in the third enrollment period for the Affordable Care Act’s online marketplaces easily topped last year’s amount and also beat the administration’s modest forecast.  2016 Obamacare Enrollment Tops Expectations At 12.7 Million, 


Millions Eligible for Medicaid Go Without It, WSJ,
Biden’s cancer bid exposes rift among researchers, Politico,
State challenge to Gilead would hinge on untested legal theory,
Communication errors linked to 1,744 deaths in 5 years, Us Malpractice Study Finds, STAT, 
Discovering New Medicines And New Ways To Pay For Them, Health Affairs Blog, 
The evolution of healthcare quality measurement in the United States, JAMA, 
Hospitals Focus on Doing No Harm, NY Times Opinionater, 
Mortality Trends Among Working-Age Whites: The Untold Story, Commonwealth, 
Mobile Telephone Text Messaging for Medication Adherence in Chronic Disease, JAMA,
Aetna CEO Has `Serious Concerns’ About Obamacare Sustainability, Bloomberg, 
WHO declares international emergency over Zika virus, PBS, 
Hospitals call for $2.5 billion bailout of struggling facilities, Crain’s, 
National Cluster-Randomized Trial of Duty-Hour Flexibility in Surgical Training, NEJM, 
What New Data Tell Us About Doctor Choice, WSJ, 
CDC Sees Major Challenges Ahead In The Fight Against Zika, NPR, 
Healthcare providers weigh accountable care vs. Merit-Based Incentive Payment System, Healthcare Finance, 
Companies Form New Alliance to Target Health-Care Cost, WSJ, 
CDC’s 6|18 Initiative: Accelerating Evidence into Action, National Academy of Medicine,
The Next Phase of the OpenNotes Movement, RWJ,

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