Week of March 14 – 18, 2016


Health Care Leadership and Management
What makes an effective leader? This question is a focus of my research as an organizational scientist, executive coach, and leadership development consultant. Looking for answers, I recently completed the first round of a study of 195 leaders in 15 countries over 30 global organizations. The Most Important Leadership Competencies, According to Leaders Around the World, 

Among the challenges of moving toward improving the health of populations is the language used to describe this work. As more health systems expand their scope of accountability, from episodic patient encounters to patients’ health-related outcomes and goals over time, two terms — “population health” and “population management” — are often used interchangeably. Does it matter?   Improving the Health of Populations, 

Even the most established health organizations can struggle with change and reform. In response to the especially dynamic nature of the industry, innovation centers have been established to tackle transitions head on.  Innovation Centers in 2016.  How to Produce New and Improved Models of Care. 

To shed light on the complex and daunting challenges affecting the U.S. hospital sector, The Economist Intelligence Unit (EIU) conducted a survey in November 2015. The survey tapped the views of 301 executives at rural, urban and suburban hospitals of all sizes and across all parts of the country. Read the executive summary,

Cost–quality trade-offs pervade medicine. Studies of the relationship between cost and clinical outcomes at many hospitals, including VA facilities,5 show correlations between higher spending and better results, especially when spending variation arises from different levels of care. The myth that we can control costs without forgoing therapeutic benefit is belied by mounting evidence. Scandal as a Sentinel Event — Recognizing Hidden Cost–Quality Trade-offs,

ACA Implementation
The failures of a dozen nonprofit health insurance plans created by the Affordable Care Act could cost the government up to $1.2 billion, according to a harsh new congressional report that concludes federal officials ignored early warnings about the plans’ fragility and moved in too late as problems arose. $1.2 billion in loans to ACA health insurance co-ops may be a loss, report warns,

Federal regulators took a stab at making things a bit more straightforward for health care consumers in new rules  published Tuesday in the Federal Register.   Here are three specific changes finalized by the Department of Health and Human Services that affect consumers who buy their own health insurance in one of the 38 states using the online federal insurance exchange.   Three Changes Consumers Can Expect In Next Year’s Obamacare Coverage,

Members of the President’s Council of Economic Advisers write that the Cadillac Tax, an excise tax on high-cost employer-sponsored health insurance coverage, is a crucial tool for building on progress toward a better health care system and will benefit the U.S. economy.  The Cadillac Tax — A Crucial Tool for Delivery-System Reform

The Affordable Care Act’s cost-sharing reductions, available to low-to-moderate-income people in silver-tier marketplace plans, substantially lower deductibles, out-of-pocket spending limits, and copayments for a range of key health services, a new Commonwealth Fund brief finds. How Will the Affordable Care Act’s Cost-Sharing Reductions Affect Consumers’ Out-of-Pocket Costs in 2016?, 

House v. Burwell is far from resolution, but this case’s path through the federal courts and the threat it could pose to the Affordable Care Act show continued vulnerabilities of the health-care law as well as the stakes of the 2016 election. Obamacare Cost-Sharing Provisions and the Stakes in House v. Burwell, 

The stock market isn’t convinced that the biggest tax inversion merger on the horizon — Pfizer’s pending blockbuster deal with Allergan — will be concluded without major problems.  NY Times,

Doctors at the University Hospitals of Cleveland see an immediately recognizable symbol pop up alongside certain drugs when they sign in online these days to prescribe medications for patients: $$$$$. The dollar signs, affixed by hospital administrators, carry a not-so-subtle message.  Washington Post,

Starting on March 27, the way prescriptions are written in New York State will change. Gone will be doctors’ prescription pads and famously bad handwriting. In their place: pointing and clicking, NY Times, 

For many patients, time spent in an intensive care unit is a deeply disturbing experience, and not just because they are suffering from a serious illness. Boston Globe,

The National and State Healthcare-Associated Infections Progress Report expands upon and provides an update to previous reports detailing progress toward the ultimate goal of eliminating HAIs. Read the executive summary, 

Pablo Graiver aims to make signing up for a drug study as easy as booking a flight on the Web. The 47-year-old Argentinian entrepreneur, a former executive at the airfare search engine kayak.com, has designed a new tool that draws from the travel industry to match scientists looking to test experimental medicines with patients suffering from more than a dozen diseases. Bloomberg, 

Approximately one-quarter of readmissions are potentially preventable when assessed using multiple perspectives.  JAMA,  

One of the prime concerns about increasing telemedicine reimbursement is the possibility that it could encourage unnecessary consults, according to an article at AAFP.org. 

While millions of Americans benefit from the medical care they receive each year, this care also has the potential to harm patients. Medical care can be unsafe when it leads to adverse events, such as infections.  GAO was asked to review information on the implementation of patient safety practices in hospitals. GAO, 

Spending on prescription drugs for insured Americans rose about 5 percent last year, driven by both greater medication use and higher prices. Still, the increase was half the rate in 2014, which saw the biggest price jump since 2003.  NY Times,

Registered nurses at Kaiser Permanente Los Angeles Medical Center will begin a one-week strike today as they push for their first contract as members of the California Nurses Association union — a tactic hospital officials called a disappointing attempt to disrupt patient care in the midst of contract talks. Daily News

Today, Health and Human Services (HHS) Secretary Sylvia M. Burwell announced $94 million in Affordable Care Act funding to 271 health centers in 45 states, the District of Columbia, and Puerto Rico to improve and expand the delivery of substance abuse services in health centers, with a specific focus on treatment of opioid use disorders in underserved populations. HHS,

This JAMA Internal Medicine, study documented a dramatic increase in the number of procedures for coronary artery disease (CAD) in China. The procedures—coronary artery catheterizations and percutaneous coronary interventions—increased more than 15-fold in urban Chinese hospitals from 2001 to 2011.  Coronary Catheterization and Percutaneous Coronary Intervention in China 10-Year Results from the China PEACE-Retrospective CathPCI Study, 

On Monday, an NFL official finally truly acknowledged there is a link between playing the game and degenerative brain disease.  Washington Post, 

Health information technology (HIT) is at the center of modern health care and can facilitate health care reform. Billions have been invested in realizing the HIT promise.  While more than 80 percent of doctors report some effort to use Electronic Health Records (EHRs), 51 percent are only using basic functions, such as entering patient demographics. NYAM, 

The Medicare Payment Advisory Commission has released its March 2016 report on Medicare payment policy to Congress.  Here are eight key Medicare issues from MedPAC’s March report.  Becker’s, 

Disease-trackers from the Centers for Disease Control and Prevention arrived in Boston Wednesday to study the spread of a deadly bacterial infection among homeless people.  Boston Globe, 

Dubbed “value-based pricing,” such largely unproven ideas are the latest tactics being tried to slow growth in prescription drug spending amid rising public alarm about drug prices.  “The goal is to test whether alternative approaches will lead to better value,” said Patrick Conway, chief medical officer for CMS, in announcing the proposal March 8. Kaiser, 

Early research suggests that letting patients read their doctors’ clinical notes holds promise for engaging patients in their care, strengthening patient–provider relationships, and even improving adherence to care regimens.  Commonwealth Fund, 

When we’re notified a patient we discharged has been readmitted, it’s generally a mark of shame, generating a sense that we failed to do enough to restore our patients to good health. But discharging a patient from the hospital is among the most difficult and dangerous aspects of providing medical care.  NY Times,



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