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Month: October 2017

Building Better Metrics:  Immunizations and Asking the Right Question(s)

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By NIRAN AL-AGBA, MD

As policy experts cling to pay-for-performance (P4P) as an indicator of healthcare quality and shy away from fee-for-service, childhood immunization rates are being utilized as a benchmark.  At first glance, vaccinating children on time seems like a reasonable method to gauge how well a primary care physician does their job.  Unfortunately, the parental vaccine hesitancy trend is gaining in popularity.  Studies have shown when pediatricians are specifically trained to counsel parents on the value of immunizations, hesitancy does not change statistically. 

Washington State Law allows vaccine exemptions on the basis of religious, philosophical, or personal reasons; therefore, immunizations rates are considerably lower (85%) compared to states where exemptions rules are tighter.  Immunization rates are directly proportional to the narrow scope of state vaccine exemptions laws.  Immunization rates are used to rate the primary care physician despite the fact we have little influence on the outcome according to scientific studies.  Physicians practicing in states with a broad vaccine exemption laws is left with two choices:  refuse to see children who are not immunized in accordance with the CDC recommendations or accept low quality ratings when caring for children whose parents with beliefs that may differ from our own.   

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I’m 35 Years Old And I’m Realizing My Life May Be About to End. And I’m Panicking, Just a Little.

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By SCOTT RIDDLE

It’s been a while since I put a piece of writing in the public domain, but suddenly I have a lot to get off my chest, well my colon actually.

Just three weeks ago life was good. Correction. It was awesome. The newest edition to our family had arrived on Christmas Eve, joining his two sisters aged 5 and 3. A month later we were on a plane home to Sydney, having spent four great years working for Google in California. My beautiful wife had been working at a startup on NASA’s Moffett campus and was worried about finding something equally interesting in Australia, but she managed to land a very similar gig with an innovative logistics start-up in Sydney. We’d come back primarily to be closer to family, but also to pursue a dream of setting up a family farm in partnership with my parents — intended as a great place to bring up our three kids but also as a new sideline income stream. We’d spent every weekend scouring Sydney for areas that met our criteria (good schools, commutable, cost of land etc) and we were settling on Kurrajong in Sydney’s west. I was just getting into a training routine for the CitytoSurf run having done the Monteray Bay half marathon a few months prior.

I’m 35 years old.

On July 19th I went for what I thought would be a routine GP visit. In my mind it was primarily to re-establish a GP relationship in case my kids needed an urgent care visit (the practice is literally around the corner from our place). I’d also noticed a bit of unusual bleeding from, well, my back passage and very recently a change in bowel habit. I wasn’t alarmed by either of these symptoms but my GP was concerned enough to refer me for a colonoscopy. So began the roller coaster.

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AARP Caregiver Quality of Life Challenge Winners Announced!

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By CHELSEA POLANIECKI AND TIFFANY HSIUNG

Roughly one out of every three people in the United States serves as a caregiver for a chronically ill, disabled, or aging loved one at some point in their life*. Not only do most caregivers dedicate a significant amount of time to these duties, 

but they often also work full or part-time jobs to make ends meet. These stresses result in 40-70% of caregivers exhibiting clinically significant signs of depression*. Fortunately, there is an increasing focus on caregiver well being, and now, more than ever, innovation in caregiving has the opportunity to make real change and improve tens of thousands of lives.

The AARP Caregiver Quality of Life Challenge, supported by AARP, and administered by Catalyst @ Health 2.0 in partnership with Mad*Pow, aimed to find tech-enabled solutions designed to help caregivers identify as caregivers, find available resources to ease their burden, and connect with others who can build and strengthen their support systems.

The Challenge, launched at HxRefactored in June 2017, received over fifty applications, with solutions ranging from AI solutions to podcasts and mobile apps. Submitted solutions were judged by our panel of experts, and scored based on how innovative they were, their potential for scalability, the strength of their design, and the potential for impact in the caregiver community. Winners were announced live this morning at Health 2.0’s 11th Annual Fall Conference.
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CMS Should Play the Role of Virtual Group Matchmaker

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By MANU UPPAL and DAVID INTROCASO

In the 2018 proposed Medicare Access and CHIP Reauthorization Act’s (MACRA’s) rule, published earlier this year, HHS has again proposed to exclude two-thirds of physicians, or 900,000, from participation in the Merit-based Incentive Payment System (MIPS).  MIPS was created under 2015 MACRA legislation to incent financially Medicare physicians and other Medicare Part B clinicians to improve care quality and reduce Medicare spending growth.  HHS is choosing to exclude smaller-sized physician practices because, it is believed, MIPS reporting requirements place too high a burden on less resourced practices.  However, MACRA legislation includes a “virtual group” provision that allows for solo and small group practices to partner in meeting MIPS reporting requirements.  For technical reasons the Centers for Medicare and Medicaid Services (CMS) was delayed in implementing the provision.  The first year in which providers can participate in MIPS as a virtual group will be 2018.  Designed correctly, virtual groups offer substantial advantages that include greater MIPS participation, more competitiveness, higher financial reward and more opportunity for small practices to keep their independence.  

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Adapting Behavioral Health Integration to 21st Century Needs

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BY MANUEL CASTRO                       SPONSORED POST

At the start of my career, the standard of care for behavioral health integration was in-person, face-to-face interaction. As new ways to communicate have surfaced, the way we deliver care has also evolved. Today, both as a result of access but also now convenience, behavioral health treatment is often done virtually.

To keep on top of the trends, and in light of the access challenges inherent in our region, at Carolinas HealthCare System, we turned to technology to help alleviate these problems and reach more patients. Through a virtual care platform and telehealth services, patients from North and South Carolina can connect with a behavioral health provider from the comfort of home or during a visit with a primary care physician. By moving beyond the walls of the hospital and into the home and primary care setting, our dedicated team of behavioral health experts is able to help thousands of people access the quality behavioral health support they need.

I have always said that if we can save one life through this program, it is worthwhile. Two recent stories from our team prove to me that this approach is working:Continue reading…

Why Competition In the Politics Industry Is Failing America

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By DANNY STERN

Year after year, Congress fails to reach consensus on important issues, the electorate screams for change, and voters become more polarized along party lines and ideology. These struggles aren’t causes of America’s political malaise, says Michael E. Porter, co-chair of the U.S. Competitiveness Project at Harvard Business School; they’re symptoms of a much larger problem. U.S. “democracy” is a weak, uncompetitive industry controlled by a duopoly that pursues private interests at the expense of public good.

“To fix our political system, we must see politics as the major industry it has become, the major economic benefits it provides for its participants, and how today’s political competition is not serving the public interest,” as Porter explains in “Why Competition in the Politics Industry Is Failing America,” a just-released groundbreaking study co-authored with business leader and former CEO Katherine M. Gehl.

Experts in the benefits and drawbacks of competition in the private sector, Porter and Gehl describe the four fundamentals of a healthy political system:

  1. Practical and effective solutions to solve our nation’s important problems and expand opportunity
  2. Legislative action to advance those solutions
  3. A reasonably broad-based public consensus on policy
  4. Respect for the Constitution and the rights of all citizens

Measured by these success factors alone, America’s system has already failed. But Porter and Gehl are adamant in their belief that we can recover our former sense of bipartisanship and dynamism.

Read Porter’s and Gehl’s paper to learn more about their poignant perspective on our nation’s most urgent problems and how business, strategy and competition can help solve them.

Danny Stern is Managing Director of the Stern Strategy Group