Week of April 24 – 29, 2016


Health Care Leadership and Management 
Introverts can struggle in meetings—but they don’t have to. The right strategies can help introverts contribute and feel more comfortable, Dana Rousmaniere writes for Harvard Business Review.  How to Talk in Meetings When You Hate Talking in Meetings,

Compared with the national average of 16.8 percent, Nebraska Methodist’s 30-day coronary artery bypass grafting readmission rate is only 4.5 percent. Learn how the hospital implemented a comprehensive—and effective—cardiac surgery readmission reduction initiative. How Nebraska Methodist beats the national CABG readmission rate, 

Many avenues to changing physician behavior exist: regulation and oversight; education and training; professional standards and rewards; peer pressure and review; community standards; the threat of malpractice; performance/quality measurement; financial incentives; and competition, to name the most important.  This Health Affairs post reflects on the last three of those avenues — performance/quality measurement, financial incentives, and competition.  What Does A New Era Of Physician Accountability Mean For Patients?

The Leapfrog Group in its latest Hospital Safety Scores awarded nearly 800 hospitals an “A” grade for safety—but gave more than 1,100 organizations a grade of “C” or below.  ‘A’ to ‘F’: Leapfrog grades 2,571 hospitals on safety,

In the next decade, 3.5 million new U.S. jobs will be created in the healthcare sector, while today hundreds of thousands of entry-level and middle-skilled roles in healthcare are sitting unfilled. Today, over 50 organizations are coming together to launch the Health Careers Pathways initiative (HCP), a new privately-led effort that builds on a career pathways framework developed with a $19.6 million Job-Driven Training Community College Department of Labor grant to better match up training with employer needs at a more national scale. Expanding Career Pathways and Connecting Americans to Healthcare Jobs,

The modern era of healthcare heavily emphasizes rapid evolution and the need for innovation and reform, but this emphasis has come at the expense of reinforcing several universal values.  Healthcare’s 4 Forgotten Virtues, 

Although health systems and holding companies have their fair share of differences, Mr. Buffett’s remarks and management philosophy may ring true for system executives overseeing large teams. Here are 10 pieces of management advice from Mr. Buffett, pulled from Berkshire Hathaway’s annual shareholder letters, which he pens himself.  11 universal management truths from Warren Buffett,

ACA Implementation
ACOs have become the programmatic and conceptual framework that is the centerpiece of moving our health care system from volume to value. Yet, with significant organizational, economic, legal, political, cultural, and conceptual challenges facing the formation and sustainable success of ACOs, the task remains formidable.  Sustainable Success in Accountable Care, 

The Obama administration outlined a new way to pay nursing homes, the latest in its ongoing efforts to transition Medicare payments away from fee-for-service medicine.  Commonwealth Fund, 

The Obama administration tightened rules Monday for private insurance plans that administer most Medicaid benefits for the poor, limiting profits, easing enrollment and requiring minimum levels of participating doctors. Administration Says New Rules For Medicaid Plans Will Improve Service For Enrollees, 

There are two key practical issues with the tax: the indexing problem and the adaptation question. In our opinion, these are serious enough issues to warrant continued caution before implementing the Cadillac tax. About That Cadillac Tax,

While the ACA contains several tools designed to control health care costs, the current political environment makes it unlikely that reforms will be achieved at the federal level in the near future.  Zeke Emanuel, State Options To Control Health Care Costs And Improve Quality,

On April 27, CMS released the highly anticipated proposed rule that would establish key parameters for the new Quality Payment Program, a framework that includes the Merit-based Incentive Payment System (MIPS) and Alternative Payment Models (APMs).  Breaking Down The MACRA Proposed Rule ,


A new Commonwealth Fund report by Deborah Bachrach and colleagues at Manatt Health takes a close look at New York State’s DSRIP program, whose stated goal is to reduce avoidable hospital use by 25 percent.  Read the report, 

The WHO is marking one year today since it announced a plan to eliminate malaria by 2030, and a report this morning from the organization suggests doing so will be quite difficult.  WHO, 

A new study out this morning says the highly touted, healthy Mediterranean diet — chock full of veggies, fish, and other unprocessed foods — could lower the risk of heart attack and stroke for people who already have heart disease.  European Heart Journal,

Senate Assistant Minority Leader Richard J. Durbin stands apart on a key point from the crowd of Democrats with bills to allow direct Medicare negotiations on drug prices. He wants the federal health program to have the right to decline or limit coverage of certain medicines through the creation of a so-called formulary.  Commonwealth Fund, 

In his latest column for The Wall Street Journal’s Think Tank, Drew Altman analyzes the Kaiser Health Policy News Index to determine which health stories in the news have broken through to the public the most in the last year. One conclusion: It wasn’t the Affordable Care Act.  NY Times, 

Public health authorities have issued new guidelines to protect workers who treat patients exposed to the Zika virus.  CDC,

For 15 of the 17 measures assessed, Hispanic Medicare Advantage enrollees in Puerto Rico received worse care compared with Hispanics in the United States. JAMA Internal Medicine,

Contract provisions allowing most health plans to reimburse themselves if a member receives a personal injury settlement or jury award are routine and often assert that the plan should be first in line for settlement or award money.  But a recent Supreme Court decision gives consumers ammunition to push back.  Commonwealth Fund, 

Mayor Bill de Blasio’s administration will propose an overhaul of the cash-strapped public-hospital system.  The overhaul is expected to turn inpatient centers into outpatient centers and focus less on ERs.   NY Times,

In April 2015, the IOM convened a public workshop to explore recent shifts in the health and health care industry and their implications for health professional education (HPE) and workforce learning. This study serves as a follow-up to the 2009 Lancet Commission report on health professions education for the 21st century and seeks to expand the report’s messages beyond medicine, nursing, and public health. National Academies Press, 

Patients often find it daunting to make the right healthcare choices while in the fast-paced emergency department, but new apps and other tools may help make those tough choices a bit easier. WSJ,

A new study in the European Heart Journal finds that fasting isn’t necessary before getting your cholesterol checked.  European Heart Journal,

Recently the surgical case volume battle was reignited when a trio of prominent health systems — Johns Hopkins, Dartmouth-Hitchcock and the University of Michigan — pledged that they will require their surgeons and 20 affiliated hospitals to meet minimum annual thresholds for 10 high-risk procedures.  Kaiser, 

The current conventional wisdom holds that higher volume hospitals produce better outcomes in a number of surgical procedures and have lower rates of patient mortality. But a new study calls that idea into question. Applied Health Economics and Health Policy,  

The U.S. is generally prepared to manage public health emergencies like the Houston floods, a Zika virus outbreak or a potential bioterrorist attack, but health protections aren’t distributed evenly across the country, according to a new state-by-state analysis.  Forbes,

It was first developed in a Canadian lab more than three decades ago, promising and potent — and intended to relieve pain in a less addictive way and patented in the U.S. and Canada in 1984. But no pharmaceutical company would pick it up.  Then a Chinese chemist found it, and started developing the drug that experts say is 100 times more potent than fentanyl and 10,000 stronger than morphine.  Washington Post,

What will New York’s health care system look like in 2021? What should it look like?  United Hospital Fund, 

A new study examined the variations in the prices for 242 common medical services in 41 states and the District of Columbia, using a national multipayer commercial claims database for the years 2012 and 2013.  Health Affairs Blog,

Just seven procedures make up 80 percent of all hospital admissions, deaths, complications, and inpatient costs from emergency general surgery.  JAMA,

New York medical schools and their competitors offshore are clashing over a precious resource: the opportunity for students to watch and learn from doctors in hospitals.  WSJ,

Colorectal-cancer incidence has dropped by almost 40% since 1975 and by more than 45% since its peak in the mid-1980s.These trends are often attributed to screening. But the magnitude of the changes alone suggests that other factors must be involved. NEJM Perspective,

Medicine is in an era of necessary process improvement and cost cutting.  In academic medical centers, there is a third goal that is equally critical: preserving and enhancing the academic mission in this challenging context. The Washington Post,

As a tidal wave of new health-related gadgets, apps and tests hits the market, government agencies like the FDA, Federal Trade Commission and others are showing up in Silicon Valley like they’ve never done before. The Washington Post,


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