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by Steven Rush
Imagine traveling to a country where you don’t speak the language. Picture trying to find the right train to take you to your destination and not being able to read the signs at the station or ask anyone for directions. For many Americans, this is similar to their experience interacting with the healthcare system.
In the United States, more than 90 million adults have low health literacy or difficulty understanding and using their health information. The Department of Health and Human Services defines health literacy as the degree to which one has the ability to obtain, communicate, process and understand basic health information and services in order to make appropriate health decisions. Low rates of healthcare literacy are linked to poor outcomes, including higher rates of re-hospitalization and lower adherence to medical regimens.
Health literacy involves more than being able to read; it also includes basic math--such as figuring out medication dosages or calculating weight--and the ability to follow written and spoken directions, such as how often to take a medication. It also involves memory and the ability to make complex decisions.
by Kent Bottles
On Nov. 16, Medicare published the 2016 Medicare Physician Fee Schedule Final Rule. If physician executives and hospital leaders have not yet read all 1,358 pages of this fascinating document, there is one finding that is essential for them to understand.
Most of us applauded the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) because it finally fixed the annual sustainable growth rate (SGR) drama in which since 1998, physicians faced double-digit cuts in revenue unless Congress passed emergency legislation. The MACRA law clearly stated that there would be a 0.5 percent increase in the Medicare Physician Fee Schedule for 2016.
Martie Ross, J.D., a healthcare lawyer in Kansas City, has read the Final Rule closely and concludes that physicians will not get their 0.5 percent increase in 2016. One has to be an expert in payment reform and read the Final Rule closely, but the depressing conclusion is right there within the 1,358 pages of legal language.
by Lynn McVey
Mother Jones magazine recently published a critical piece about EHR vendor Epic. It reported: 1) "There is no interoperability." What does this mean? It means the information remains in silos. 2) "Epic focuses on Epic-to-Epic data exchanges." What does this mean? No interoperability and more silos. 3) "Is the government fed up with Epic?" What does this mean? I'll bet they wish they would have selected only one EHR vendor for all 5,000 hospitals. Sure, I understand free market and capitalism, but healthcare doesn't have the time it takes for mergers and acquisitions to end up with only a few solutions. It's ironic that we currently have hundreds of technology solutions in an industry that doesn't have technology skills.
My email's auto-signature is a quote from my healthcare hero, Dr. Atul Gawande. Dr. Gawande says "We have one opportunity to leverage technology to improve care. That opportunity is data." Fortunately, the hundreds of technology solutions that foster non-productive "silos" are not our savior. So now what?
And though organizations have made strides to transition to value-based care and better manage population health, overall the United States spends more on healthcare but ranks last in quality compared to 10 other industrialized Western nations. It's hard to imagine or dream that a perfect health system could exist--one that would meet all patients' needs at reasonable costs.
So it was with interest that I recently started to read Mark Britnell's new book, "In Search of the Perfect Health System. Britnell, the former chief executive candidate for the National Health Service (NHS) in England, now serves as the chairman and partner of the Global Health Practice at auditing firm KPMG. He's spent the last five years working in 60 countries to help governments and public and private sector organizations with operations, strategy and policy.
His travels have allowed him to witness first-hand examples of great health and healthcare. Although he hasn't found a perfect health system, he writes that if he found one it would feature 12 components that take from the best practices from around the world.
Associate Justice Ruth Bader Ginsburg's minority opinion in the 2014 Burwell v. Hobby Lobby Supreme Court case was prescient. She predicted that the majority opinion--favoring the right of closely held corporations (a corporation in which five or fewer shareholders own more than 50 percent equity of the organization) to opt out of the Patient Protection and Affordable Care Act's mandate to provide birth control coverage to employees on the basis of religious objection--would be a slippery slope. She stated that there are "thousands of closely held corporations in the United States (e.g. In-N-Out Burger and Forever 21) that could conceivably opt out of any federal law for religious reasons without any guidance from the Supreme Court as to the limitations of their objections."
Flash forward a little more than a year. The Supreme Court has agreed to take up seven cases from throughout the country that have come before appeals courts contesting the current policy that permits religious employers to opt out of their obligation to provide birth control by relegating this responsibility to either the government or private insurance companies simply by notifying their insurers, third party administrators or the government. Several religious organizations (such as Little Sisters of the Poor and the Roman Catholic Archdiocese of Washington D.C.) argue that this makes them complicit in violation of their religious beliefs.
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