Week of June 13-17, 2016


Health Care Leadership, Management and HIT
Although Ernest Shackleton’s Endurance Antarctic expedition of 1914 to 1916 is a famous epic of survival, the medical achievements of the two expedition doctors have received little formal examination.  Of Penguins, Pinnipeds, and Poisons: Anesthesia on Elephant Island, 

If the past five years of health IT can be characterized by government intervention, the next five will be characterized by innovation from the private sector. This is the prediction of John Halamka, MD, CIO of Beth Israel Deaconess Medical Center, The Five Year Plan, 

In April 2015, the IOM convened a workshop to identify how modeling could inform population health decision making based on lessons learned from models that have been, or have not been, used successfully, opportunities and barriers to incorporating models into decision making, and data needs and opportunities to leverage existing data and to collect new data for modeling. How Modeling Can Inform Strategies to Improve Population Health: Workshop Summary,  

Workers should complete the tasks that require deep focus during the hours when physical and cognitive capabilities reach their peak, Ron Friedman writes in the Harvard Business Review.  When to Schedule Your Most Important Work,  

What many leaders may not recognize is that we often need to give something up — a belief, attitude or behavior — in order to achieve a new level of performance. How is this done effectively?  To Win the Civil War, Lincoln Had to Change His Leadership,
Healthcare leaders today are expected to have the skills to create both short- and long-term strategies that anticipate and respond to the rapidly changing health care environment.  Leadership: Translating Challenge to Success, NEJM Catalyst June 2, 2016 Conference Speaker presentations,  

A study in the Journal of Medical Internet Research sought to understand millennial physicians’ perceptions about social media and professionalism, as well as determine the effects social media policy training may have on the new generation of healthcare professionals.   Millennial physicians have ‘casual approach’ to social media, 

ACA Implementation
In this second edition of our quarterly survey of the NEJM Catalyst Insights Council for the New Marketplace initiative, we posed questions designed to gauge the pace of adoption of value-based payment models, and to unpack the motivation underlying the recent consolidation wave among health care providers.  Read the survey results,

California Governor Jerry Brown signed a bill into law allowing unauthorized immigrants to buy health insurance on a state exchange created under the U.S. Affordable Care Act.  California Governor Signs Bill Letting Undocumented Immigrants Buy Insurance, 

Maryland’s health cooperative filed a lawsuit Monday seeking to block the federal government from requiring it to pay more than $22 million in fees for a program designed to cover insurance company shortfalls.  Maryland health co-op sues over ‘flawed’ Obamacare requirement,  

A Kaiser Family Foundation analysis of ACA proposed marketplace rates finds benchmark silver plan premiums are projected to increase 10 percent in 2017 on average across 14 major metropolitan areas.  Early Analysis of 14 Major Cities Finds Benchmark Silver Plan Premiums in ACA Marketplaces Estimated to Rise 10 Percent on Average in 2017,  

A new report examines what quality measures to consider when setting up value-based payment arrangements that focus on improving children’s health.  The report looks at recent examples from other states, and presents four central lessons for New York as it sets up quality measures for value-based payment for children.  You Get What You Pay for: Measuring Quality in Value-Based Payment for Children’s Health Care,


A federal judge has paved the way for Advocate Health Care and NorthShore University HealthSystem to merge and create the dominant hospital network in Illinois, a huge blow to federal antitrust regulators.  Crain’s Chicago, 

In the wake of the mass shooting in an Orlando LGBT nightclub Sunday, White House officials waived patient privacy protections to make it easier on hospitals to communicate with families of victims without getting the patient’s consent first. HHS, 

As health care consolidation accelerates nationwide, a new study shows that hospital prices in two of California’s largest health systems were 25 percent higher than at other hospitals around the state.  Hospital Prices Increase in California, Especially Among Hospitals in the Largest Multi-hospital Systems,Inquiry,
Scattered E.R.s around the country have been working to reduce opioids as a first-line treatment, but St. Joe’s, as it is known locally, has taken the efforts to a new level.  NY Times,

In U.S. drinking water, many chemicals are regulated — but many aren’t.  Washington Post, 

New York Mayor Bill de Blasio and the City Council agreed on an $82.1 billion budget for fiscal year 2017, and the biggest new spending item is a $700 million funding boost for the city’s public hospital system.  Bloomberg,  

The Puerto Rican fiscal crisis has resulted in limited access to basic health services, an overwhelming tax burden, and widespread migration from the Island. An often unnamed contributor to the crisis is federal policy that limits Medicaid funding for the U.S. territories. Health Affairs Blog, 

The US Department of Health and Human Services and the Cuban government on Monday signed a memorandum of understanding to encourage cooperation between the two countries on health matters.  STAT,  

Location was everything when it came to treating the victims from the Pulse nightclub mass shooting.  This tragedy happened within two blocks of one of the country’s top Level 1 trauma centers, Orlando Regional Medical Center.  Orlando Sentinel,

UNOS announces technology changes to increase organ donations in U.S.  Richmond Times Dispatch, 

New York is poised to expand access to breast cancer screening under an agreement reached by top state lawmakers and Democratic Gov. Andrew Cuomo.  Under the deal, the state would order hospitals to expand hours when mammograms are offered and require insurance companies to eliminate deductibles and co-pays for the screening and some other diagnostic tests.  Washington Post,

The vast majority of hospitals need to redefine themselves from organizations that deliver care to organizations that orchestrate care.  The folks at New York-based Mount Sinai seem to get it. Last year, readers of The New York Times were treated to a Mount Sinai marketing campaign headline that read, “If our beds are filled, it means we’ve failed.”  Becker’s, 

Some studies indicate larger integrated health care systems are more likely to use evidence-based care and manage chronic conditions.  But integrated delivery systems in and of themselves may not improve outcomes.  NY Times, The Upshot,  

A new toolkit to improve the quality of care offers practical approaches and tools for home care professionals and hospital acute care providers to systematically assess the risks for and reduce the incidence of central line–associated bloodstream infections in patients receiving home health care services.  United Hospital Fund, 

Dialysis is a big, profitable, and growing business in the United States. Outcomes trail those of other countries, however.  NEJM Catalyst, 

It should come as no surprise that per-capita spending on prescription drugs grew to $9,523 in 2014 and is projected to grow by 6.3% annually through 2024, far outpacing inflation and total health expenditures nationally.  One widely discussed idea is whether to tie the price of drugs to their actual value to patients. NEJM Catalyst, 

The 1999 publication of To Err Is Human from the IOM focused attention on the need to improve the safety of medical care and spurred a variety of public and private responses. Despite this attention, progress in reducing patient harms in hospitals has been slow.  It is now clear, however, that over the past few years hospitals have made substantial progress in reducing harms.  JAMA,

In its June report to Congress, the Medicare Payment Advisory Commission warned that rising drug costs and other factors have helped drive Medicare Part D spending up nearly 60 percent from 2007 to 2014.  Kaiser,  

Many people admitted to a hospital do not go home directly after discharge; they are referred to an inpatient setting for rehabilitation (rehab services). This can be a confusing transition, and it’s one that is now addressed in a revised Next Step in Care guide for family caregivers: Short-term Rehab Services in an Inpatient Setting. United Hospital Fund,  

The 4-year, multipayer Comprehensive Primary Care Initiative was started in October 2012 to determine whether several forms of support would improve the quality and reduce the costs of care at 497 primary care practices in 7 regions across the US.  These practices have not yet shown savings in expenditures for Medicare Parts A and B after accounting for care-management fees, nor have they shown an appreciable improvement in the quality of care or patient experience.  NEJM,

The National Academies of Sciences, Engineering, and Medicine convened a committee to recommend ways to ensure that lessons learned from the military’s experiences in Afghanistan and Iraq are sustained and built on for future combat operations–and that they are translated into the civilian system.  Read the report brief,  

The Supreme Court on Thursday issued a unanimous ruling that could affect fraud charges brought against health care providers under the False Claims Act (FCA).  Boston Globe,

The following was delivered as the commencement address at the California Institute of Technology, on Friday, June 10th by Atul Gawande.  The New Yorker,


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