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There were many presentations at the March conference of the American College of Healthcare Executives regarding population health management. With value-based purchasing heating up, accountable care organizations forming fast, and readmissions a big hot button, it's only natural that keeping people well and out of the hospital would be a part of the conversation.
I am not a clinician, but I know enough to understand that population health management has been focused on the chronic conditions that eat up cost, challenge access and could be controlled--heart disease, diabetes or cancer, for example.
But is dementia, including Alzheimer's, really being addressed in current population health management models? I would contend no.
I have contended that hospitals are going kicking and screaming into value-based purchasing and have surmised that when the Centers for Medicare & Medicaid Services moves, private insurers will follow. That's why I find it utterly fascinating that one of our local health systems is in a heated battle with a large insurer that wants to introduce pay-for-performance into future pricing scenarios. The insurer took out multiple full-page ads in the daily newspaper. It's currently a he-said, she-said debate. Stay tuned.
As we move into bundled-payment scenarios and accountable care organizations (ACOs), I think one of the biggest hurdles we face is changing our mindset. Believe me, most of my clients are still in a fee-for-service mentality, knowing, but not quite acting on, the shift in healthcare. It's a juggling act, and real money is involved. But guess what: It is the inevitable future and all payers will follow.
Superficially, many people look at the intense focus on patient experience as an effort to keep patients satisfied (however that is defined) and worse, making them happy. Happy people do not always make for happy outcomes even if your Hospital Consumer Assessment of Healthcare Providers scores mislead you otherwise.
Patient experience is about four things in this priority order: patient safety, clinical quality, patient satisfaction and value received. Get the first two right and chances are you will achieve the third, while scoring where you want in retrospective data.
Let's face it: As people make New Year's resolutions, they may be including bucket-list items to accomplish in 2015. Being a patient in a hospital will not be one of them. I had a bucket-list item happen to me in December, and what I learned from it might just contain a lesson or two for healthcare professionals.
Many of you know that in addition to being a healthcare professional, I have been a life-long performer, musician and singer. Thanks to a music-loving mother and father, I grew up like most of my south Philly Italian brethren on the Great American Songbook, the classics sang by Sinatra, Martin, Crosby and so many more. I sang those songs in my house and now sing them for assisted living and nursing home residents.
In bands however, I was a rock and roller, and when I gear up as a solo act outside the long-term care settings, I still am. But I have always dreamed of singing the great songs with a big band. My wish came true Dec. 15.
I discovered the Lake Norman Big Band last September when I took my wife and mom to see them for mom's 93rd birthday. Wow, who knew this 27-piece orchestra existed, let alone played every third Monday in a bowling alley in Mooresville, North Carolina. I saw that they had two female vocalists and at the time no male vocalist. So after the concert I sent the band president a few of my vocal tracks and imposed myself on them so to speak by suggesting that just maybe I could sing with them in the future.
Well, next thing I knew I was rehearsing with them in early December and performed with them twice, singing four songs in their holiday program. Major bucket-list item and honor. Here is what I learned.
By now we're used to and numb to airlines adding fee after fee to drive as much revenue as possible. Booking fees, change fees, premium seat fees, bag fees. Flying used to be a great experience. Now it's a cattle herd. Oh, and don't dare recline that seat!
It seems the hospital industry is following the trend. Witness two articles in The New York Times in the space of a month that essentially amount to cataloging the price gauging taking place in the industry. While the industry talks about cost cutting and the need for it, hospitals not so subtly try to make up reimbursement cuts by creatively finding ways to charge extra and often hidden fees.
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