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Unite care continuum with a common vision

July 26th, 2012

by Anthony Cirillo

I have attended many hospital and long-term care conferences in the last few months and it has become clear: There is confusion and fear in the industry. And while every part of the continuum has a vision for their particular segment, no one has a clear vision for how the continuum will work together. Or even if it will work together.

Everyone seems to be hunkered down in their foxholes waiting for the next shoe to drop. And at the same time, industries are sneaking out of those holes encroaching on one another.


Consider the American Health Care Association (AHCA) urging for-profit nursing home members to go deep vertically by developing businesses outside but related to their core, such as home health and hospice.

Meanwhile, at the Assisted Living Federation of America (ALFA) conference, providers debated aging in place in assisted living, in which a higher acuity resident would stay at a facility and not be transferred to a nursing home. The nursing home industry should be worried because Harvard University researchers found that a 10 percent increase in assisted living occupancy rates was associated with a 1.4 percent decline in private-pay nursing home occupancy.

There is a bigger vision needed for the continuum of healthcare. And buying up the pieces of the continuum so you don't have to play nice in a bundled-payment ACO is not a long-term solution. We need a CEO Visioning Retreat for every major segment of the healthcare industry. While it was nice to see AHCA, ALFA, Leading Age and ACHCA on the same panel discussing long-term care industry issues, we need more than a panel. We need all the major players in one room.

It's amazing how all the bankers got together during the bailout when they were in crisis. Healthcare is in a crisis too. Maybe despite it all, the industry does not think it is in a crisis. After all, when asked in a Health Leaders survey if healthcare was moving in the right direction, 56 percent of leaders said the industry was on the wrong track while 74 percent said their organization was on the right track.

This, in an industry experiencing 16 percent to 20 percent CEO turnover. Is healthcare too big to fail? Will my fellow boomers who have let their bodies go to pieces seek care in record numbers causing record profits? Or will an empowered patient change the equation?

Guest author Aanand D. Naik in a Mind the Gap blog post adds some further perception.

"Transparency occurs when patients understand 'in their gut' the meaning of the health problem and how health care will impact their daily lives. Patients have control when they choose not to pursue a course of action the doctor might recommend because those outcomes are not consistent with their values or the desired course of their lives. In the non-transparent form of PCMH, access to health care improves but health costs will continue to skyrocket.

What we need now is real discussion of patient control and transparency rather than platitudes about Patient-Centered Care."

And Tom Dahlborg put some of this in perspective with his May 18 Hospital Impact blog post. From Dalhborg:

"It still amazes me how important time, relationship, caring, continuity, trust and empathy are to healing AND how consistently the healthcare 'system' considers these items as afterthoughts and/or positions them as unimportant, or worse, sets them aside to ensure productivity and revenue generation."

Perhaps it is the patient we fear in the end, and their ability to become truly empowered and vote with their feet. The stalwarts--relationship, caring, continuity, trust and empathy seem to be lost among the disparate healthcare players in their actions toward each other. The platitudes come when the movers and shakers appear on panels as if united only to go and pursue their own agendas after the show is over.

As summer is here, perhaps this is an appropriate analogy:

Healthcare is like a child on the beach. The shifting sands and the tides of healthcare reform swirl around.

He/she still builds a sandcastle only to see it knocked down by the waves of reform.
The child could get mad and throw sand in people's faces or maybe they build something different.

They take the sand and the water and mix it with the cement of new relationships to build a concrete, solid healthcare condo where all the players live and interact and where all patients need only one place to go for their needs.

Sounds childish right. Even if two disparate players got together and did this it would be a great start. A child on the beach is not afraid to make new friends. Healthcare shouldn't be afraid either.

Is anyone really willing to come together, set down their agendas and truly put the patient at the center?

Anthony Cirillo, FACHE, ABC, is president of Fast Forward Consulting, which specializes in experience management and strategic marketing for healthcare facilities. He also is the expert guide in Assisted Living for and Healthcare Channel Partner for CEO².


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