Week of January 18-22, 2016


Health Care Leadership and Management
The problem at the core of the volume-to-value movement — the shoals it is running aground on — is this: How do you make it work economically? How does your organization make a living at it?  To put a finer point on it: How do you know that you can make it work? How can you guide your strategy with the maximum safety and opportunity for your organization? Follow this primer for tactical decision-making in times of significant change.  A Four-Dimensional Strategy for Thriving in Value-based Reimbursement, 

Health care organizations are increasingly entering into contracts that reward them for improved outcomes and reduced spending. But many struggle to develop effective incentive programs for physicians, who are the ones making key decisions that affect quality and cost.  The University of Pennsylvania’s Ezekiel Emanuel, M.D., and colleagues examined how the principles of behavioral economics can be used to create incentives that encourage doctors to follow evidence-based guidelines and deliver better-coordinated care to patients.  Using Behavioral Economics to Design Physician Incentives That Deliver High-Value Care, 

Despite the huge impact executives can have on their organizations, failure rates remain high. Prescriptions for what to do continue to fall short. So we wondered: If we closely studied the executives who succeed in top jobs once appointed, could we identify distinguishing features that set them apart and defined their success?  A Ten Year Study Reveals  What Great Executives Know and Do, 

Leadership in healthcare requires a different skill set than it does in other types of businesses, Robert Pearl, M.D., CEO of the Permanente Medical Group, wrote in a recent commentary for Forbes.  What Healthcare Leaders Should Do To Step Up: Part 1, 

ACA Implementation
Researchers reported in Health Affairs that in states that have expanded Medicaid, either by traditional means or through the so-called private option, low-income adults are better able to get insurance coverage, afford needed health services, and obtain regular care for chronic conditions. According to researchers, the results “suggest that deciding whether or not to expand matters much more than deciding how to expand.” Both the ‘Private Option’ and Traditional Medicaid Expansions Improved Access to Care for Low-Income Adults,

As we embark on the new year, it’s the perfect time to take stock of which major issues remain outstanding from years past and which are coming down the pike.  Four Key Issues In Health Law That Are As Relevant As Ever In 2016, 

Integrating specialty care can be key for high performance and financial success for ACOs, as the most complicated and costly patient care usually is managed by specialists.  Integrating Specialty Care Into Accountable Care Organizations: Perspectives From The Field,

Despite the struggles of many CO-OP plans and other ongoing challenges, most of the Affordable Care Act’s state-based marketplaces have an equal or greater number of insurers competing for business in 2016 relative to 2015.  The authors explain that some states have managed to foster competition by establishing ground rules, such as Maryland’s prohibition against most insurers offering health plans outside the marketplace unless they also offer plans in it.  Insurer Participation in State-Based Marketplaces in 2016: A Closer Look, 

In the past two years, 31 states and the District of Columbia have expanded eligibility for Medicaid under the Affordable Care Act, but even more have simplified sign-ups and renewals, according to a 50-state survey released Thursday.  For example, 49 states this year take applications for Medicaid by telephone, up from 15 in 2013, reports the Kaiser Family Foundation.  States Simplify Medicaid Sign-Ups, 


New Guidelines Nudge Doctors to Give Patients Access to Medical Records, The New York Times, 
Is an Annual Physical Necessary?, The Wall Street Journal, 
Cleveland Clinic wants to bring its brand to fitness, furniture and more food products, Cleveland Plain Dealer, 
State acts on simultaneous surgeries, The Boston Globe, 
U.S. Toughens Rules for Latecomers Trying to Enroll in Health Care Act, NY Times
Obamacare Left Intact as U.S. Supreme Court Rejects Appeal, Bloomberg
Gov. Chris Christie pocket vetoes bill to tax New Jersey nonprofit hospitals, Healthcare Finance,
To Fight ‘Superbugs,’ Drug Makers Call for Incentives to Develop Antibiotic, NY Times, 



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