Week of November 9-13, 2015

HEALTH POLICY RESEARCH REPORTS AND KEY TAKEAWAYS

Strategy and the Health Care Marketplace
In today’s healthcare environment, hospitals and health systems must be diligent in developing and keeping a positive relationship with their community and consumers, which includes gaining their trust. Patients openly share their satisfaction and dissatisfaction with healthcare facilities, so if trust is lost, word gets out.
Beckers, Community perception: How does a hospital regain trust?

On January 1, 2014, the Centers for Medicare and Medicaid Services (CMS) Innovation Center and the state of Maryland launched the Maryland All-Payer Model, under which CMS and Maryland agreed that all health care payers, including Medicare, would pay the same rates for inpatient and outpatient hospital services.  As part of the agreement, Maryland pledged to achieve substantial cost savings and quality improvements by moving its hospital-reimbursement system away from traditional fee-for-service payments.
NPR, Budget Switch For Maryland Hospitals Is Starting To Pay Off, 

The promise of bundled payments is real. We’ve seen that by aligning incentives, providers and payers will work together collaborate to both lower costs and improve quality. So where can this partnership have the greatest impact?
Advisory Board, Bundled payments: Not just a cost-reduction strategy, 

Geisinger Health System President and CEO David Feinberg, MD, said the Danville, Pa.-based health system is going to start offering a money-back guarantee to patients who receive care at its facilities.  According to Dr. Feinberg, after patients receive care at a Geisinger facility, they will be able to use a smartphone app to tell the system about their experience and then request a refund if they are unhappy with the care they received.
Becker’s, Geisinger to begin offering refunds to unsatisfied patients, 

In addition to treating what ails you, a number of health care systems aim to sell you a health insurance plan to pay for it.
Kaiser, Health Systems Dipping Into The Business Of Selling Insurance,

“In health care, the days of business as usual are over.” So began an essay, published two years ago in the Harvard Business Review, by Michael Porter, a professor at Harvard Business School, and Thomas Lee, a physician. The two were proposing a new strategy centered on value-based health care—the concept of linking payment to the outcomes achieved, relative to costs, rather than to the volume of services provided. The New Yorker,
Can Providers and Insurers Team Up to Fix Health Insurance? 

In 2000, AG Lafley became CEO of the Procter and Gamble Companies. In assuming the role of CEO, he quickly grew frustrated that he and his fellow executives were spending too much time in corporate headquarters divorced from the people who really mattered: the consumer.  So he instituted the practice of meeting with consumers to better understand their experience with Procter and Gamble’s products.
What Procter & Gamble Can Teach the Health Care Industry: Assume Nothing About Patients, 

Poor customer service is out. We’ve known that for many years. Now in health care, even mediocre customer service is out. CMS said so last year when it eliminated financial bonuses for Medicare Advantage health plans that didn’t have star ratings of four or five (on a five-point scale).
Managed Care Magazine, Chief Experience Officers Push Patients to Forefront, 

Health care systems are competing in the market around both price and quality. Nonprofit health co-ops are struggling to provide affordable insurance coverage, while for-profits are also trying to keep business afloat under new federal laws. In Oregon, health insurers will be raising premiums next year. But one for-profit company, recently launched in Portland, is going lower.
Marketplace Healthcare, Neighborhood competition in the health care market, 

ACA Implementation
In a new Commonwealth Fund multimedia article, read about the financial and other barriers to implementing new approaches to care for complex patients.
Improving Care for Those Who Need It Most, 

As Congress considers year-end legislative options, one small change in the Affordable Care Act could make a big difference in access to quality health care for millions of Americans: Lifting the ban on creation and expansion of physician-owned hospitals.
Forbes, Lift The Ban On Physician-Owned Hospitals, 

As we look at the evolution of the Affordable Care Act there are clearly some positives and some negatives. By and large, we believe the ACA is not going away after the next election or for a long time. Thus, we thought we would take a moment to reflect on a few observations on the ACA. Some of the observations are new, some are not.
Becker’s, 17 winners and losers under the ACA and 10 more thoughts and observations on the ACA so far, 

A new report, “State Actions to Promote and Restrain Commercial Accountable Care Organizations,” written by researchers at the Nicholas C. Petris Center on Health Care Markets and Consumer Welfare, School of Public Health, University of California, Berkeley, draws on evidence from the literature and four case studies to outline tools that state governments can use to promote the potential benefits of ACOs while mitigating their potential risks.
Milbank Organization, State Actions to Promote and Restrain Commercial Accountable Care Organizations, 

In most states, consumers with HIV or AIDS who buy silver-level plans on the insurance marketplaces find limited coverage of common drug regimens they may need and high out-of-pocket costs, according to a new analysis.
Kaiser, Study Finds Marketplace Silver Plans Offer Poor Access to HIV Drugs

ELSEWHERE IN THE NEWS

Supreme Court to Hear New Case on Contraception and Religion, NY Times
Regulators Urge Broader Health Networks, NY Times
The controversial part of Obamacare that even GOP-led states are keeping, WSJ 
Blast from the past: doctor house calls. An app, Heal, facilitates them. LA Times
Will The Obamacare Cadillac Tax Increase Worker Wages?  Forbes
Hillary Clinton Vows to Fight VA Privatization,  WSJ
White House Seeks to Ease Veterans’ Access to Care, NY Times
10 of the most interesting healthcare transactions of 2015, Becker’s
Electronic Health Record Adoption In US Hospitals: Progress Continues, But Challenges Persist, Health Affairs
SPRINT Would Cut BP Target to Less Than 120 mm Hg in High-CV-Risk Patients with HTN, No Diabetes, Medscape
AMA to DOJ: Block the insurer mergers, or doctors will pay the price, Advisory Board

 

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