Cartoon – Management Today
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7 THINGS DRIFT TAUGHT ME ABOUT COMMITMENT
https://leadershipfreak.wordpress.com/2016/07/18/7-things-drift-taught-me-about-commitment/
I’m reflecting on a young man who doesn’t care much for making commitments. I’ll call him Drift. He’s easygoing, generous, kind, carefree, and transparent. I like him. Drift doesn’t demand much from life. He takes things as they come. In his role, you might be surprised to know that Drift is committed, dedicated, flexible, helpful, and reliable. He doesn’t make commitments because it’s the right thing to do. He makes commitments for his reasons, not someone else’s. Frankly, Drift makes a bigger contribution than many who fit more traditional patterns.
Association Between Medicare Accountable Care Organization Implementation and Spending Among Clinically Vulnerable Beneficiaries
“Medicare ACO programs are associated with modest savings on average across all beneficiaries, with savings concentrated in clinically vulnerable beneficiaries and use of institutional settings.”
INTERIM HEALTHCARE CHIEF RESTRUCTURING OFFICER (CRO) – A CEO’S MOST POWERFUL ALLY DURING TRANSFORMATION
http://www.jacksonexecutives.com/2016/07/19/interim-healthcare-chief-restructuring-officer-cro/
When the survival of the organization is at stake and things have reached crisis proportions, traditional chief restructuring officers are a solid option and best fit. A CRO immediately brings credibility and objectivity to the restructuring process, while stabilizing the ranks and quickly devising a plan to lead the turnaround.
Confidence builders and skilled communicators, they bring deep financial and industry-specific experience. This allows them to identify the root cause(s) of under-performing organizations, and to work in concert with CEOs to transform organizations from the inside out using strong strategic and negotiation skills.
Anthem-Cigna Deal: Seeking Merger Approval, Anthem Makes Major Donations To State Political Groups
Seeking regulatory approval for a controversial merger proposal, health insurer Anthem recently pumped $460,000 into groups supporting the election campaigns of governors and state attorneys general. The money was disclosed in second-quarter campaign finance reports reviewed by International Business Times.
Those federal filings, which were released by the Internal Revenue Service late Friday, show Anthem gave $210,000 to the Republican Governors Association, $200,000 to the Democratic Governors Association in the last three months. In many states, the insurance commissioners reviewing the proposed Anthem-Cigna mega-merger are appointed by governors. The cash to state officials is on top of $50,000 Anthem gave to a Democratic-affiliated political group called “Unity Convention 2016.”
The money to the DGA is particularly notable because the group is headed by Connecticut Gov. Dannel Malloy, whose insurance commissioner, Katharine Wade, runs the agency leading the national multistate review of the deal. Anthem money flowed to the DGA in June amid an ethics probe prompted by IBT’s investigative series documenting Wade’s personal and familial ties to Cigna.
Malloy has refused to force Wade to recuse herself from the merger review, at a time when Anthem and Cigna have increased their donations to the DGA, which backed his campaigns and which he has chaired since late 2015. In all, the DGA has raised a total of $1.1 million from Anthem and Cigna since Malloy began the process of nominating Wade to the insurance post in 2015. That sum is 37 percent more than the group raised in the entire 2014 election cycle, and almost half of the total campaign contributions the companies have given the group in the last decade.
iFHP cost report highlights cause for concern over lack of provider competition
The International Federation of Health Plans (iFHP) today released its2015 Comparative Price Report, detailing its annual survey of medical prices per unit. Designed to showcase the variation in healthcare prices around the world, the report examines the price of medical procedures, tests, scans and treatments in seven countries.
The report undercuts the idea of what’s being played out in the recent Sutter Health case which alleges the health system is overcharging insurers causing medical costs to be pushed downstream to patients. Last Friday, the suit was allowed to seek class-action status. Matthew Cantor, partner and attorney at Constantine Cannon and lead lawyer for the plaintiffs, told Healthcare Dive the plaintiffs allege to have contracts which require health plans to purchase all the hospital services that Sutter provides in Northern California.
Sutter is “leveraging its larger power in those markets to say to these health plans that they have to also purchase Sutter Health hospital services elsewhere and not only do they have to purchase them but they have to purchase those Sutter services at higher, super competitive prices,” Cantor said, adding that this, in turn, raises the costs of medical services to health plans. These higher costs, Cantor said, are then sent downstream to insurance policyholders.
“Competition is not working,” Sackville told Healthcare Dive. “The market’s not working because if it was, no one would get away with charging $17,000 [for a day of hospital care].”
The report put a focus on the lack of provider competition and consolidation. There’s been a fair amount of consolidation in various states and more systems are pursuing the idea of mergers or partnerships. Such activity, in theory, could bring down competition in an area and tick up costs for consumers as hospitals’ market power grows. “Powerful hospital systems have the ability to raise the prices of medical care. Health plans have no alternative but to take these forced, higher costs upon them because [if they refused] then no one would buy their insurance,” Cantor told Healthcare Dive.
Cartoon – The Company’s New Motto
Fraud Concerns Emerge As Compounding Drug Sales Skyrocket
Government spending on “compounded” drugs that are handmade by retail pharmacists has skyrocketed, drawing the attention of federal investigators who are raising fraud and overbilling concerns.
Spending on these medications in Medicare’s Part D program, for example, rose 56 percent last year, with some of the costliest products, including topical pain creams, priced at hundreds or thousands of dollars per tube. The federal workers’ compensation program has also seen a recent spike in spending.
The spending jump, along with a sharp increase in the number of patients getting the compounded drugs “may indicate an emerging fraud trend,” said Miriam Anderson, who helped oversee a June report on the Medicare spending by the inspector general’s office at the Department of Health and Human Services.
Some of the prescriptions may not have been medically necessary — or even dispensed at all, notes the report, which also details recent fraud cases brought by U.S. attorneys in several states.
How ‘digitizing you and me’ could revolutionize medicine. At least in theory
How ‘digitizing you and me’ could revolutionize medicine. At least in theory
There’s a whole lot of hype around precision medicine.
Proponents — up to and including President Barack Obama — predict a revolution that will bring us medical treatments as precisely tailored as a bespoke suit: Drug doses adjusted to your genome. Chemotherapy customized to your tumor’s DNA. Diets adapted perfectly to your risk for diabetes.
To propel research, Obama has proposed spending a $215 million on a Precision Medicine Initiative. The first step: Rally 1 million volunteers (or even more) to give up a slew of intimate details about their health, medical history, diet, lifestyle, genetics — and even the granular details of the bacteria that line their guts.
