Week of January 4-10, 2016


Health Care Leadership and Management
Health care has made tremendous strides in recent years, improving the quality and lowering the costs of the services it delivers to patients. And yet, there’s still a long way to go, rooting out the variation and opaqueness that still plague the field. Don Berwick, M.D. — former head of the Centers for Medicare & Medicaid Services and senior fellow with the Institute of Healthcare Improvement — illustrated the wide gap between what health care is and what it could be.
Don Berwick Offers Health Care 9 Steps to End Era of ‘Complex Incentives’ and ‘Excessive Measurement’,

The authors note that simultaneously delivering better care and better health at lower per capita costs cannot be done without the courage and commitment of leaders in health care. Leaders must ensure their organizations are able to adapt promising practices and innovations to local contexts, engage in authentic dialogue with policy makers and civic leaders, and garner greater trust from the public.
Change From the Inside Out Health Care Leaders Taking the Helm, 

We’ve gotten in the habit of using Medicare data to comment about spending across the entire U.S. health care system. But as private health insurance data have become available to researchers, we’re finding that using Medicare data this way is likely a mistake.
The Limits of Using Medicare Data to Evaluate U.S. Health Care Spending,

Health systems the world over list a strikingly similar set of ambitions: moving to value-based care that improves outcomes, reduces costs, and increases patients’ satisfaction; turning hospitals into health systems; focusing more on preventing ill health rather than treating it; implementing technology to make care more efficient; and empowering patients. But no country is delivering these transformational changes. Instead of rewarding leaders for transforming health care, our systems reward leaders for making narrow improvements within them.
Transforming Health Care takes Continuity and Consistency,

No business survives over the long term without reinventing itself. But knowing when to undertake deliberate strategic transformation—when to change a company’s core products or business model—may be the hardest decision a leader faces. So how can a leader know that it’s time to transform a company? We have identified five interrelated “fault lines” that suggest the ground beneath a company is more unstable than it may appear.
Knowing When to Re-Invent,

ACA Implementation
Late in the day on December 15, 2015, House Republicans released the $1.1 trillion Consolidated Appropriations Act for 2016 and a $650 billion tax extenders package. The legislation embodies an agreement among Congressional leaders that will keep the government open through September 2016.
How does the Budget Agreement Affect the ACA?

With Commonwealth Fund support, health economist Sherry Glied sought to determine how close the CBO’s estimates of enrollment in marketplace plans and in the newly expanded Medicaid program were to actual experience. They also looked at the agency’s projections of spending on marketplace plan subsidies and compared the results with projections made by four other forecasters. Given that the ACA is “unlikely to be the last national health policy reform considered by Congress,” Glied finds it reassuring that the CBO was able to provide fairly reliable estimates.
The CBO’s Crystal Ball: How Well Did It Forecast the Effects of the Affordable Care Act? 

This issue brief investigates several key changes to the qualified health plans, with a focus on increased transparency and consumer protections. A new out-of-pocket costs calculator, requirements regarding provider networks, and prescription drug cost-sharing requirements should serve to better inform and improve consumer selection.
Increased Transparency and Consumer Protections for 2016 Marketplace Plans,

A new Commonwealth Fund–supported study published in Health Affairs finds that in states that expanded Medicaid coverage, 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. Both the ‘Private Option’ and Traditional Medicaid Expansions Improved Access to Care for Low-Income Adults

Since the implementation of Medicare’s Hospital Readmissions Reduction Program in 2012, concerns have been raised about the effect its payment penalties for excess readmissions may have on safety-net hospitals. This analysis from Health Affairs authors suggest that patient socioeconomic status can explain some of the difference in readmission rates but that unmeasured factors such as hospitals’ performance may also play a role. We also found that  Understanding Medicare Hospital Readmission
Rates And Differing Penalties Between Safety-Net And Other Hospitals, 


The Hidden Financial Incentives Behind Your Shorter Hospital Stay, The New York Times 
The Burden of Medical Debt: Results from the Kaiser Family Foundation/New York Times Medical Bills Survey, Kaiser/New York Times,
Recent Trends in Employer-Sponsored Health Insurance Premiums, JAMA
How Health-Care Bills Hinder Millions of Americans, The Wall Street Journal
Feds Funding Effort To Tie Medical Services To Social Needs, Kaiser, 
What researchers found when they went looking for the jobs Obamacare killed, The Washington Post,
NorthShore CEO: FTC gerrymandered hospital market to oppose merger, Becker’s, 
A bid to make Mass. hub of digital health world, The Boston Globe,
Saving Corporate Cash by Hiring a Chief Health Officer,  WSJ, 
The Hidden Patient Experience, Health Leaders Media,  


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