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How are urgent care centers changing the doctor-patient relationship?

August 20th, 2015

by Andrea J. Simon

As corporate anthropologists and culture change consultants, we're immersed in research on the growing appeal of urgent care centers (UCCs) and what they can teach us about the changing healthcare landscape.

While it's too early to make final conclusions based on our current sample of UCC patients at several Northeast facilities, our qualitative observations have uncovered potential trends worth sharing even at this stage.

Beyond that, these early insights are supported by other research in the field, which makes us want to dig even deeper.

UCCs and the changing doctor-patient relationship

What was once deemed the cornerstone of medicine, the doctor-patient relationship, appears to be experiencing "growing pains," and that's putting it mildly. Many observers feel that relationship is suffering on many levels--and it could get worse.

=> Read more!

Sensational reports of health insurance premium hikes misleading, incomplete

August 20th, 2015

by Joel White

At the end of July, Healthcare.gov CEO Kevin Counihan sent a letter to insurance commissioners, urging them to consider some trends in reviewing and approving rates for the coming year.

In the letter, he argues that risk pools are getting--and will get--healthier, medical cost trend is moderate, and the Center for Medicare & Medicaid Services (CMS) is stepping up by paying 100 percent of carrier reinsurance costs and risk corridor payments. The marketplace CEO also stressed that "public hearings are helpful in rate reduction."

Whether Counihan's ploy will work remains to be seen. It helps to look at each point he makes and what it might mean down the road.

Over the past month, the Obama administration has posted the initial 2016 plan rate filings for the Affordable Care Act insurance exchanges, searchable by state and insurance carrier. The initial filings posted only include plans that requested an increase of 10 percent or greater, as required under the ACA's rate review process.

These filings have produced sensational headlines about rate increases of 20 percent, 30 percent, 40 percent and even 50 percent or more. But they show an incomplete and misleading picture, as they do not include carriers that proposed either more modest rate increases or actual rate decreases.

>>Read the full commentary at FierceHealthPayer

Death in the family reveals need to respect patients' end-of-life wishes

August 13th, 2015

by Lynn McVey

It was 2:38 a.m.; the phone call I was waiting for. My Dad was 92 and lived a full life of family, fun, faith, purpose and service. He was healthy up until the day he went into heart failure. With his 30-page, attorney-prepared, Advance Directive in hand, he announced to his family and cardiologist that he planned to follow his instructions under the sub-chapter "heart failure." My 92-year-old Dad refused to have a pacemaker inserted.

For four days, we gathered family and friends to say goodbye to the man who had no enemies. Many times, there were 10 or more in his room, listening to him tell stories about each of us, as he held our hands and hugged us. It was obvious he was prepared for this moment. It was actually very beautiful to watch him acknowledge everyone individually, say an emotional goodbye, and leave each of us with some gift of advice for our future happiness.

On the fifth day, his heart rate was dipping into the 30s, which would have been his final day with us. In a surprise last-minute call, he agreed to have a pacemaker. He lived another six months at my home. I was fortunate enough to live the last chapter with my Dad. We shared meals, American Idol ("That Jennifer is one pretty girl," he'd say both Mondays and Tuesdays), my porch swing, his granddaughter, root beer floats, tennis matches, career talk and stories I had never heard before. For me, that was a priceless six months.

=> Read more!

Pharmacy integration helped BCBS of Rhode Island lower costs, improve care

August 13th, 2015

by Beth Herbert-Silvia

Although pharmaceutical costs are a key driver of healthcare costs, it's frequently assumed that's because of the high price of drugs, specialized treatments for complex diseases and unnecessary prescriptions. Yet studies have shown that medication non-adherence adds up to $290 billion per year to healthcare costs in the U.S.

One real-world solution is to more fully integrate pharmacists into the care team.

In a pilot program called the Patient Centered Pharmacist Program (PCPP), on-site pharmacists were placed in six patient-centered medical home practices across Rhode Island, reaching more than 30,000 patients. Initial patients are Blue Cross & Blue Shield of Rhode Island Medicare Advantage members of any age and members age 60 and older with other selected plans.

The program resulted in unprecedented engagement rates for complex care patients, with significant in-person counseling, modifications to prescription regimens and collaboration with the PCMH team.

>>Read the full commentary at FierceHealthPayer

What a M*A*S*H episode can teach us about patient-centered care

August 13th, 2015

by Thomas Dahlborg

Being a "typical" (is there such a thing?) New Englander, when I first saw MeTV I, of course, assumed it meant MaineTV and thus I was both intrigued and eventually hooked on watching a number of television series from my youth--M*A*S*H being one of those series.

(NOTE: The Me in MeTV actually refers to "Memorable," as in Memorable TV).

As I began to reconnect with my youth and enjoy the mix of great writing and acting and the comedic aspects and heart of M*A*S*H, I also found myself being inspired by many of the messages it shared. And today I would like to share with you one in particular that links very well to our desire to innovate healthcare by focusing on relationships and compassion in healing.

So for those old enough, take yourself back to Jan. 28, 1980, and join me in viewing from Season 8, Episode 19 of M*A*S*H ... "Morale Victory."

Much (as always) is going on in this episode, but I want to focus on Major Charles Emerson Winchester and his patient, wounded soldier David Sheridan.

=> Read more!

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