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by Kent Bottles
The implementation of the Affordable Care Act (ACA), with its payment reform components that champion the transition from fee-for-service to global, value-based payments, continues to stir up the healthcare insurance industry. Insurers, recognizing that the ACA outlaws traditional industry practices, attempt to reinvent their business models.
Three recent news articles highlight the difficulty of this reinvention process. Emphasizing the national nature of this challenge, two of the developments came out of the Pittsburgh region and one out of Los Angeles.
The bitter battle between the University of Pittsburgh Medical Center (UPMC) and Highmark has captured the attention of health policy analysts from all over the country. Both organizations have their own insurance products, and the decision by Highmark to create a competing health system, Allegheny Health Network, resulted in UPMC failing to renew contracts with Highmark. Many Pittsburgh citizens with Highmark insurance want to be able to visit specialists at UPMC and complained about the inability of the two large organizations to cooperate.
Why do people fear failure in business? I mean, what's the worst they could happen? You get fired.
It was around 1999 when my boss Sue called me into her office. Someone brought a concern to her and she wanted me to know. She let me know there were a few people in my department who felt I was out to get them. These were all employees who were out on a performance improvement plan for their work. She was aware of these plans. We spoke some more and she saw I was clearly shaken up. Here I was, holding people accountable, staying focused on our organizations goals, my intentions in the right place and wham--I was suddenly the bad guy.
My boss provided a good lesson: She asked if I was out to get these employees and I immediately said no. She asked if she's ever accused me or expressed concern that I wasn't treating people fairly while holding the department team accountable. I said no.
She said, what's the worst thing that could happen to you? I shared the fact that she could fire me. She agreed and went on to ask, "Don't you think you would have some warning if this was going to happen, or if I had concern with your performance?" Yes, that certainly made sense.
Patient-centered care, patient engagement, patient activation--all terms many of us healthcare leaders use to describe a key output of improving the healthcare system.
I write a lot about these topics and recently made note of misconceptions and lessons learned specific to these very important focal points:
Like the healthcare industry as a whole, the nursing profession constantly evolves and adapts to meet new demands and changes.
Amid debates about the nursing shortage, changes to nurses' scope of practice and educational requirements, only one thing is certain--the future of nursing remains in flux.
In this special report, FierceHealthcare talks exclusively with Beverly Malone, Ph.D., R.N., CEO of the National League for Nursing (pictured), about the issues, expectations and challenges nurses of the future will face, from an aging workforce to a shortage of nurse educators to overcoming a lack of diversity in the field.
"This is the most exciting time to be a nurse," Malone says.
In my most recent Hospital Impact blog, I reinforced the simple, but significant need to focus on 3 Ps of Patient Experience, offering that at the core of this idea is the central purpose on which an organization builds its experience effort.
I closed with, "I see one consistent action in those organizations achieving success. They are clear on who they are, what they want achieve and where they are going. This is the idea of definition I often speak to and reinforce." Yet with this fundamental importance, defining patient experience remains an elusive idea for many. In fact, it's a question people ask me frequently: How do we define patient experience for our organization?
I'm not surprised, as recent benchmarking research discovered only 45 percent of U.S. hospitals had a formal definition of patient experience for their organization. While people may have clear personal purpose in healthcare, the foundation on which organizations build their patient experience efforts in many cases is shaky at best.
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