Geisinger takes ‘radical’ approach to improve population health

http://www.fiercehealthcare.com/population-health/geisinger-launches-new-population-health-initiative

Geisinger Health System faciliity

Geisinger Health System will unveil a new “radical” population health initiative this week that aims to transform the health of an entire community.

“When it comes to the social determinants of health, we know there are many more causes impacting the health of a population than access to quality medical care,” said Geisinger CEO David Feinberg, M.D., in an announcement. “We want to transform healthcare at its core by focusing on preventive care, behavioral health and economic growth.”

The Danville, Pennsylvania-based system’s new program, called Springboard Health, will kick off in Scranton, Pennsylvania, and targets both patients’ chronic conditions and the community’s overall socioeconomic health, Geisinger said.

The organization will partner with several local stakeholders to implement the program, which features broad goals. The program’s website says it will test several approaches to tackle large-scale socioeconomic issues like hunger and housing insecurity. Potential projects that make it through testing will also be cost-effective, sustainable and designed so that they can be replicated in other regions, according to the website.

“We are going to introduce innovative programs and foster robust community collaborations and back it all up with data to make sure Scranton is the healthiest place to be in the country,” Feinberg said in the announcement. “Once we successfully implement Springboard Healthy Scranton, we’ll take the program on the road to communities with similar socioeconomic health challenges.”

The program’s first project (PDF), titled Fresh Food Pharmacy, aims to provide more healthy eating options to people in the Scranton area. Chronic conditions like diabetes are a significant driver of healthcare costs, research has shown, so the program will identify patients at risk for the disease and enroll them in the project.

The project will ensure that participants have access to at least 10 healthy meals per week and will connect them with local farmers and farmers’ markets to provide them with fresh options they may have had no access to otherwise. Geisinger is already eyeing other Pennsylvania communities for the project.

 

A new public health crisis: Preventable harm in healthcare

http://www.fiercehealthcare.com/healthcare/a-new-public-health-crisis-preventable-harm-healthcare?utm_medium=nl&utm_source=internal&mrkid=959610&mkt_tok=eyJpIjoiTlRrd09UVTNNMlEyWlRkayIsInQiOiJNUWd0R2JcL0hydzN1TUp5N3I3eFpjaGtST1wvNzk5bWdBU1JmdWl1WFwvSzNWYk1XUmdoOWhBaHBpRE0xMzFLdGFUaUljcWVwNjdjVE80N3RVWkZnckFucVVzeDhpdk9GazBsXC9SXC9GSmI1bUtuRGdnd3AwazBQRWNlY1NQcERvcEF6In0%3D

Doctor and nurses wheeling patient in gurney through hospital corridor

CBO: Republican healthcare bill would cover millions fewer than ACA but reduce federal deficit

http://www.fiercehealthcare.com/aca/cbo-republican-healthcare-bill-would-cover-millions-fewer-than-aca-but-reduce-federal-deficit?mkt_tok=eyJpIjoiTW1OaFl6TXlZVFF6WldKayIsInQiOiI3eHNMN1ZraGpJWHJ0eUFFRmdzaDRjVFVsOXBpV0VKVzdtWlU1UmxTbVZWRkpnMDhEN0Rrb3cyZlwvM0NmZnFJMXZTOG1KYXlLRHc0YWNUQzA3MmhpOVNQRFN4WmNsNUZVQmNQTGdPWE5UNUczUGppRUFGZ2dwelltaldGXC9IM3pWIn0%3D&mrkid=959610&utm_medium=nl&utm_source=internal

capitol

The Congressional Budget Office on Monday released its highly anticipated score of House Republicans’ healthcare bill, finding that it would increase the number of uninsured individuals by millions, but also lower individual market premiums in the long run and decrease the federal deficit.

Congress uses the CBO’s cost estimates to evaluate the effects of any major legislation, and policymakers were particularly eager to get its estimate for the American Health Care Act given the high political stakes associated with the bill.

Here’s a brief rundown of the CBO’s estimates (PDF):

  • In 2018, 14 million more people would be uninsured under the GOP bill than under the Affordable Care Act—mostly due to the repeal of the individual mandate penalties. By 2026, that number would swell to 24 million because of changes to subsidies in the individual market and in the Medicaid program.
  • Relative to projections for the ACA, the Republicans’ bill would lead to higher average premiums in the individual market before 2020—15% in 2018 and 20% in 2019—and lower average premiums after that. The CBO notes, though, that premium changes under the new proposal would differ “significantly” for people of different ages, given the bill’s provision that allows insurers to charge older customers up to five times more for coverage.
  • Enacting the legislation would reduce federal deficits by $337 billion from 2017 to 2026, with the largest savings coming from reductions in Medicaid spending and eliminating the ACA’s subsidies for individual market customers. The largest costs, on the other hand, would come from the bill’s elimination of many of the ACA’s taxes and its creation of a new tax credit for health insurance.
  • The CBO estimates that the individual market would probably be stable in most areas under either the ACA or the AHCA. While tax credits under the newly proposed bill would be less generous than the ACA’s subsidies, other changes such as grants to states from the Patient and State Stability Fund would lower average premiums enough “to attract a sufficient number of relatively healthy people to stabilize the market,” the agency said.

Before the score emerged, the Trump administration had already cast doubt on the merits of the CBO’s projections. White House Press Secretary Sean Spicer pointed out during a press briefing Monday that the agency had originally projected 24 million people would be enrolled through the Affordable Care Act exchanges as of 2016, but the number ended up being only about 10.4 million.

“The CBO was off by more than half last time,” he said.

Later, he acknowledged that some senators are likely to look at the CBO’s score when evaluating the American Health Care Act, and it’s important to remind them of the agency’s past track record.

Previously, The Commonwealth Fund issued an analysis that sought to dispel such criticism of the agency’s estimates about the ACA. It concluded that while the CBO overestimated marketplace enrollment and costs and underestimated Medicaid enrollment, overall its projections were “reasonably accurate,” and closer to realized experience than the estimates of many other prominent forecasters.

 

CBO report predicts 24 million would lose coverage by 2026 under American Health Care Act

http://www.healthcarefinancenews.com/news/cbo-report-predicts-24-million-would-lose-coverage-2026-under-american-health-care-act

Image result for CBO report predicts 24 million would lose coverage by 2026 under American Health Care Act

An estimated 14 million people would lose coverage under the American Health Care Act, a number that would rise to 24 million by 2026, according to a Congressional Budget Officer report released Monday afternoon.

Most of the initial loss would be due to repeal of the federal mandate for individuals to buy coverage, due to lack of a financial penalty and higher premiums.

Uninsured numbers would rise due to the bill’s repeal of Medicaid expansion. Some states would discontinue the expansion. Also per beneficiary spending caps would affect coverage, the CBO said.

Due to a lack of subsidies for insurance purchased in the nongroup market and to the Medicaid program, the increase in the number of uninsured people relative would rise to 21 million in 2020 and then to 24 million in 2026, the CBO said.

“In 2026, an estimated 52 million people would be uninsured, compared with 28 million who would lack insurance that year under current law,” the CBO said.

Premiums are expected to rise 15 to 20 percent in 2018 and 2019.

Older Americans would pay five times the amount on their premiums as compared to younger enrollees.

 

CBO ignites firestorm with ObamaCare repeal score

http://thehill.com/policy/healthcare/323652-cbo-millions-would-lose-coverage-under-gop-healthcare-plan

Image result for congressional budget office

The Congressional Budget Office (CBO) on Monday projected that the number of people without health insurance would grow by 14 million in 2018 under the Republican ­ObamaCare replacement bill, with that number rising to 24 million in a decade.

The bombshell estimate was larger than even many analysts had predicted, stirring fresh doubts about whether the legislation can pass ahead of a possible vote in the House next week.

Democrats highlighted President Trump’s campaign promises to provide “insurance for everybody,” saying the bill falls woefully short.

“The CBO’s estimate makes clear that TrumpCare will cause serious harm to millions of American families,” Senate Democratic Leader Charles Schumer (N.Y.) said in a statement.

“Tens of millions will lose their coverage, and millions more, particularly seniors, will have to pay more for health care. The CBO score shows just how empty the president’s promises, that everyone will be covered and costs will go down, have been.”

The CBO estimated that 24 million people would become uninsured by 2026 under the bill, largely due to the proposed changes to Medicaid. Seven million fewer people would be insured through their employers over that same time frame because some people would choose not to get coverage and some employers would decline to offer it.

The CBO calculated that premiums would decrease an average of 10 percent by 2026 after an initial increase of 15 percent to 20 percent due to the repeal of ­ObamaCare’s requirement that everyone buy coverage. Costs would rise for older people but fall for younger people, it said.

Out-of-pocket costs, including deductibles, “would tend to be higher” under the GOP plan than under ­ObamaCare because of looser requirements on insurers. High deductibles have been one of the GOP’s main lines of attack against ­ObamaCare.

 

Root Out Bias from Your Decision-Making Process

https://hbr.org/2017/03/root-out-bias-from-your-decision-making-process?utm_campaign=hbr&utm_source=facebook&utm_medium=social

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We’ve all experienced the disappointment of an important decision not going our way. The feeling is far worse when you feel that the decision was somehow “rigged” against you — that you never had a chance, that your input wasn’t given its fair due, or that only some of the data was considered. You can accept a fair decision that goes the other way, but a rigged decision feels much worse. And the ill will festers.

Poor decision making happens in our business, civic, and personal lives. But often we are perpetrators, participating in or making rigged decisions, even if we may not realize it.

Rigged decisions are all too frequent, and while they come in many forms, the most virulent feature the following steps:

  1. Make the decision based on some or all of the following: ego, ideology, experience, fear, or consultation with like-minded advisers.
  2. Find data that justifies your decision.
  3. Announce and execute the decision, and defend it to the minimum degree necessary.
  4. Take credit if the decision proves beneficial, and assign blame if not.