Week of May 9-13, 2016


Health Care Leadership and Management 
The disconnect between health care in its intimate, real-world setting and the distilled information delivered in the boardroom or policy discussions is a key barrier to responsive governance and policymaking. Sometimes seeing with new eyes can lead to transformational understanding.  Immersion Day — Transforming Governance and Policy by Putting on Scrubs,

As managers, directors, and executives, we rely on our supervisors, team leaders, and charge nurses to carry critical messages of change to the front line, yet many of the leaders have never been trained in communication or leadership.  Using Shift Huddles to Empower Leaders,  

Over the last six years, nearly 1,500 breach incidents have potentially exposed the medical data of more than 155 million Americans, according to statistics reported by the Department of Health and Human Services’ Office for Civil Rights.  Hackers, phishers, and disappearing thumb drives: Lessons learned from major health care data breaches,

By pairing clinical staff with financial analysts, Yale-New Haven Health System (YNHHS) saved millions of dollars—without sacrificing care quality.  How predictive analytics helped Yale-New Haven save $150 million, 

Under the leadership of Michael J. Dowling, in 2013 New York-based Northwell Health launched its own health plan. Here, Mr. Dowling shares lessons learned from launching CareConnect.  Michael Dowling: 4 lessons learned from a CEO who oversaw the launch of a health plan, Michael Dowling: 4 lessons learned from a CEO who oversaw the launch of a health plan,

A new method described in Scientific Reports pulled treatment data from the EHR Cloud of more than 23 MM patients. Researchers combined this data with historical patterns of flu outbreaks to create an algorithm to predict potential outbreaks and the method was able to accurately predict the timing of flu season peaks, and also how many cases would crop up.  Cloud-based Electronic Health Records for Real-time, Region-specific Influenza Surveillance,

Some hospitals are teaching their resident doctors how to become more resilient as they deal daily with seriously ill and dying patients and their distraught families.  To build resiliency, some hospitals are turning to an unlikely source of inspiration: the military.  Training Doctors to Manage Their Feelings,

Hospitals that are top HCAHPS performers are seeing their revenues and net margins grow at an above-average rate, according to a recent Accenture study.  For the study, Accenture compared six years of hospital margin data with patient experience scores from HCAHPS.  Patient Engagement: Happy Patients, Healthy Margins,

Conflicts are handled best when they are approached directly and honestly, and many people would rather avoid conflict than address it. People act passive-aggressively and the problem doesn’t get resolved.  However, the reluctance to tackle confrontation head-on can be overcome with empathy and preparation. Navigating Conflict, 

A nurse leader shares how she overcame significant barriers to pursue a successful career; and strategies to recruit and graduate minority nurses, and empower those already in the field.  How to Build a More Diverse and Inclusive Nursing Workforce,

ACA Implementation
A new United Hospital Fund report examines the shifting roles of providers and payers related to the adoption of a payment model known as full-risk capitation. Capitation and the Evolving Roles of Providers and Payers in New York, 

With enrollment reaching 74 percent of all beneficiaries, it is clear that managed care has become the standard organizing mechanism for a Medicaid program.  The modern contours of a 21st century regulatory framework finally came into full view on April 25 with the release of a 1,425-page final rule that will guide the delivery of health care for tens of millions of children and adults.  Twenty-First Century Medicaid: The Final Managed Care Rule,

The Communities That Care Coalition serves a region encompassing 30 townships in Franklin County and the North Quabbin region in rural western Massachusetts. A coalition with members from many sectors of the community has been working for more than a decade to support youth well-being and reduce youth substance abuse.  The Communities That Care Coalition Model for Improving Community Health through Clinical–Community Partnerships: A Population Health Case Report, 

You might think that people enrolled in the Affordable Care Act’s marketplace plans would like their coverage more or less depending on whether they have a high or low deductible, or receive a subsidy to help them pay their premium. But by fa, the biggest difference between those in marketplace plans who say they have benefited or been negatively affected by it is whether they are a Republican or a Democrat. Partisanship’s Grip on the Affordable Care Act, 

A new data spotlight from the KFF examines the growth in the number and share of Medicare beneficiaries in Medicare Advantage. Almost one in three people on Medicare (31% or 17.6 million beneficiaries) is enrolled in a Medicare Advantage plan in 2016.  It also shows that enrollment among Medicare Advantage plans continues to be concentrated among a few insurers.  Medicare Advantage 2016 Spotlight: Enrollment Market Update,

There is “no evidence” that CMS’s Hospital Value-Based Purchasing Program has led to improvements in mortality rates for several conditions targeted by the program, according to a new study.  Association between the Value-Based Purchasing pay for performance program and patient mortality in US hospitals: observational study, 

Judge Rosemary M. Collyer sided with the House in its challenge to the administration’s funding of a program to help as many as seven million lower-income people pay deductibles, co-payments and other out-of-pocket expenses under the law.  Judge Backs House Challenge to a Key Part of Health Law, 


Utah holds a unique distinction among U.S. states: It has the healthiest population and the lowest per-capita health care costs, according to some measures.  Utah’s advantage in health starts with demographics.  NEJM Catalyst,

There are few things as flat out baffling as a medical bill.  On Monday morning, the U.S. Department of Health and Human Services kicks off a competition to redesign medical bills and the billing process for consumers.  Marketplace Healthcare, 

States that spend more money on social services and public health programs relative to medical care have much healthier residents than states that don’t, a prominent public health researcher found.  Health Affairs (abstract),

Shared medical appointments are still relatively rare, but they are slipping into a system rife with 15-minute doctor visits, nearly doubling in popularity in the last 10 years, according to the American Academy of Family Physicians. NY Times, 

Medicaid managers have done little to stem rampant fraud in the massive government health care program for the poor, which totaled more than $29 billion last year, according to a new Government Accountability Office (GAO) report to Congress. GAO,

Even as the digital revolution sweeps through our lives, our interactions with the U.S. health care industry have changed little. In a new blog post, The Commonwealth Fund’s authors consider how a “digital health advisor”—a comprehensive personalized set of digital health services—might help people with their health-related needs and provide guidance through the maze of the health care system.  Commonwealth Fund,

On “To the Point,” The Commonwealth Fund’s David Blumenthal, M.D., and David Squires review current approaches to prescription drug pricing—and discuss pricing changes proposed for Medicare Part B.  Commonwealth Fund,

Zoom, which serves patients in Portland, Seattle and Vancouver, Washington, is trying to buck the traditional health care system by offering what it bills as convenient, affordable care in a hip and user-friendly environment.  Kaiser,

Malpractice insurers and medical specialty groups are mining thousands of closed claims from suits that have been tried, dismissed or settled over the past few years. Their goal is to identify common reasons that doctors are sued.  WSJ,

A tool commonly used to predict a person’s chance of having a heart attack or stroke may systematically overestimate risk and lead many patients to take statins unnecessarily, according to a new study.  Journal of the American College of Cardiology,

The National Institutes of Health is overhauling the leadership of its flagship hospital after an independent review concluded that patient safety had become “subservient to research demands” on the agency’s sprawling Bethesda campus.  Washington Post,

Chicago-based telehealth startup Regroup Therapy, which provides virtual mental health consultations to treat depression and a wide range of other issues, has raised more than $1.8 million in funding.  Chicago Tribune,

A new study found that Americans spent an extra $73 billion between 2010 and 2012 on pricier brand-name drugs because physicians failed to sufficiently recommend generics. And consumers paid nearly one-third of those additional costs through out-of-pocket payments.  JAMA (abstract),

The high prices of many patented pharmaceuticals, especially chemotherapy drugs, pose substantial challenges to the budgets of public programs, private insurers, and patients and their families.  Requiring drug companies to offer drugs in multiple vial sizes, however, is unlikely to reduce the costs that matter to patients and payers.  Sherry Glied, Health Affairs Blog, 

A group of researchers at Harvard Medical School has found that medical industry payments to physicians in Massachusetts are associated with higher rates of prescribing brand-name drugs that treat high cholesterol.  JAMA (abstract), 

I had been a doctor for three months, but like most doctors had never received any training on the care of prisoners.  NY Times Well Blog,

Public debate in the 1990s over drugs’ clinical toxicity has given way to concerns about their financial toxicity. Although drug regulators aren’t supposed to be concerned with pricing, they’ve been drawn into an acrimonious debate over the cost of medicines.  NEJM Perspective, 

Lately, we’ve been contemplating a significant transformation of the Medicare program by implementing the bi-partisan MACRA legislation, legislation to make a wholesale change in the Medicare payment system to pay for quality. This has caused me to begin an obsession with the plight of independent physicians.  CMS Administrator Andy Slavitt, The Healthcare Blog,

New data on strokes paint a mixed picture. The good news: The rate of hospitalizations for acute ischemic stroke went down 18.4 percent from 2000 to 2010. The bad news: Some groups actually saw their rates go up, including younger demographics. Journal of the AHA, 

One of four Medicare beneficiaries, or 11.5 million people, were underinsured in 2013–14, meaning they spent a high share of income on medical cost.  Adding premiums to medical care expenses, the authors found that 16 percent of beneficiaries (8 million) spent 20 percent or more of their income on insurance plus care. Commonwealth Fund,  

The Economist welcomes with cautious optimism the rise of genomics in medicine, from drug development to cancer treatment, after the ‘false start’ of the early 2000s following the first sequence of the Human Genome. The Economist,

U.S. employers spend approximately $2 billion annually on workplace wellness programs. However, new research finds that when employees go home to unhealthy neighborhoods, the worksite progress is compromised.  RWJ Foundation,

For many patients with chronic illness, the majority of care is delivered not through health care institutions but in the home, by spouses, parents, adult children, and other informal caregivers.  NEJM Perspective,


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