Archive for November, 2012

Election Impact on Integration Strategies

Similar to the marketplace right before the passage of the Patient Protection and Affordable Care Act (“Healthcare Reform”) there seemed to be a pause in healthcare providers making any strategic moves as providers waited to see what would happen with the Election. In the second quarter of 2010, following the signing of the Healthcare Reform Act, billions of dollars of acquisitions and transactions occurred. Now that the Election has been decided, healthcare providers are slowly, but surely changing strategic plans and establishing clinical integration models. Because the Healthcare Reform Act will likely be implemented quickly, healthcare providers must evaluate how they deliver care. In 2013 reimbursement models will change and in 2014 the insurance payor sources will transform. Therefore, providers can no longer wait and see what will actually happen, but must act now to be ready for the changes on the near horizon.

One main focus for providers is the redesign of …

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Holidays . . . and Healthcare

It’s that time of the year again – leftover turkey and stuffing for lunch at the office, crowded streets around the malls which make afternoon commutes even worse, and the constant bombardment of messages about the latest technology products (on sale). It is also a reminder about the time we get to spend together as families as well as the joyous celebrations of the holidays and their traditions.

Holidays also suggest that there are healthcare related implications too – let’s call it “end-of-the-year planning for healthcare”. Perhaps you might have already gone through your insurance coverage election period known as “Open Enrollment” at work already (these typically occur in the mid-Fall, prior to the holidays).

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The Irrelevance of Non-existent Alternatives

A basic tenet of economics (and logic) is that an individual will make a choice based all the possible alternatives for them, ignoring alternatives that are not available. If a person decides to drive to work rather than take a bus, that decision doesn’t change if they see people transported instantly from place to place on old episode of Star Trek. As attractive as the transporter might seem the fact that it doesn’t exist means that it doesn’t change the calculus that led the person to opt for driving.

The logic that many of the states used to justify their decision not set up exchanges or expand Medicaid under the Affordable Care Act (ACA) suggests that their choices are between implementing the ACA and some more attractive alternative. The problem is the more attractive choices either don’t exist or sound exactly like the ACA.

Under the ACA states have the option of setting up health insurance exchanges for individuals and small business. If they don’t set …

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Healthcare Technology Bridges the Gap between Providers and Patients

Guest blogger Patrice Wolfe from RelayHealth writes, “There is so much discussion around health care reform, and it can often be hard for the general public to keep up with all the angles on this complex topic. Ultimately, the business of healthcare should be about the business of creating healthier patients.”

One of the buzz concepts in healthcare is “patient engagement.” Patient engagement is different than patient satisfaction in that it is defined as actions that individuals must take to obtain the greatest benefit from the healthcare services they receive. So, patient engagement means an active and responsible patient, not a passive patient. This engagement spans across both a patient’s care and financial responsibility.

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The Affordable Care Act is solidified with the election – Healthcare providers will need to accelerate their plans for payment reform

The recent reelection of President Obama solidifies the future of the Patient Protection and Affordable Care Act (PPACA). A number of healthcare providers (hospitals, physicians, post-acute services, etc.) sat on the sidelines awaiting the outcome of the Presidential election to determine if they needed to start rethinking their business model and what changes are required. Now that we have the answer the PPACA is here to stay, healthcare providers are starting to reassess how they need to redefine their businesses and strategic business relationships.

An underlying principle that all healthcare providers will base their strategic planning against is that the demand for healthcare will rise and the level of reimbursement will decline.  Various payment models are being tested by CMS, and we can expect more variations over the next year or two. With the power of the PPACA, CMS can rapidly adopt a payment model that demonstrates effective results reducing costs and make it a …

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Needed Resources and Health Information for the Patient Centered Medical Home

 The Patient Centered Medical Home (PCMH) model may be the hottest topic in health care especially among healthcare providers. This model will not be the savior of the health care market but if implemented properly, it may solve some of our problems. It is believed that PCMHs can improve the quality of medicine that we practice and cut cost therefore allowing for savings that will help cover the medical operation. Pilot projects across the country have shown good success in validating this theory.

The practices that have been the most successful at becoming PCMHs are those who have the human and financial resources to support the workflow changes, purchases, and new employees that are often required. These are often larger practices and hospital systems which have resources that are leveraged across the clinical operations. Many of the successful practices have seen a return of investment through more efficient clinical and business practices along with better care …

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What should a Charitable Hospital do about 501r?

There is much confusion in the industry about the status of the IRS 501r regulations for 501c3 charitable hospitals. While the regulations from the IRS have not been finalized, the creation of 501r and its four requirements are currently law, and have been since the signing of PPACA in 2010. At this time, until the regulations are finalized, hospitals are subject to a Good Faith interpretation of the Law. While there exists much confusion regarding the proposed regulations issued in June, there are core requirements of the provision that are not likely to change much when the regulations do become final.

In anticipation of the regulations becoming finalized in the next year, it is suggested that Hospitals should begin to take the following actions to substantially implement these regulations now, and therefore, also bring themselves into good faith compliance with the law. If a hospital begins work now, when the regulations become finalized, hopefully only tweaking of …

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We Need More Mentors in America Today

mentorGiving back. Paying it forward. We’ve all heard these expressions when talking about those who have experienced random acts of kindness like paying for the next driver’s toll or buying a stranger a cup of coffee. They are always appreciated and always bring an immediate smile to the face of the benefactor.

But, when someone has had such a profound influence over the way you critically think, over the way you process information and over the way you respond to life’s daily opportunities, that person is a mentor. We need more mentors in America today.

People walk into and out of our lives on a daily, weekly, monthly basis. But, mentors and their lessons last a lifetime. We should not discount the importance of mentors and of mentoring.

My first mentor, Larry Braden, was recently recognized by the National Community Pharmacists Association (NCPA) Foundation for his lifelong dedication to advancing pharmacists and, more specifically, to helping to reshape independent …

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Is Retail Healthcare Technology’s Next Frontier?

I’ll be speaking this week at the Customer Engagement Technology World (CETW) show taking place in New York. As expected, the show’s news and information should be heavy on technologies, advancements and customer-centric tactics. No real surprise as we know that’s where today’s marketing landscape is heading. We live in a world where consumers are global, connected, engaged, mobile and constantly moving between their offline and online worlds. Today’s consumer is empowered and in-control.

But, despite the rise of digital, another familiar theme rings true across the industry: Retail matters. Despite today’s technologies and gadgets we are still frequenting retail, brick-n-mortar locations.

I whole heartedly believe in technology and its ability to empower today’s consumer. But there is no disputing the facts: Consumers still frequent retail locations and they matter in a consumer’s “offline” and “online” world. Don’t believe me? Ask Apple. Their …

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