Guest Commentaries

We have done it. We have decreased the increase in the cost of healthcare. Let us explain. For three decades (1980–2009), the cost of healthcare has been increasing each year at an average rate of 7.4%—double the rate of inflation. However, over the past three years, the increase in healthcare expenditures has remained at a low 3.1%.Is this decline the desperately needed bend in the healthcare cost curve or just the impact of the depressed economy?
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One of the most disturbing challenges faced by American healthcare is the enormous geographic variability in both access and quality. We are one nation, and no matter which state we live in, we are all Americans. But (to paraphrase Bono) where we live actually determines if we live.A poor person living in Massachusetts is more likely to have access to health insurance and healthcare than one who lives in Texas. Given what we know about the relationship of healthcare and health, this means that a poor resident of Texas faces the possibility of a less healthy, shorter life.
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Democrats and Republicans are sharply divided over how best to improve Medicare, a program that covers nearly 50 million Americans and that will spend almost $600 billion this year.
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Springtime in Washington brings the annual federal budget ritual. This year, President Barack Obama's budget for 2014 included a proposal to increase Medicare premiums for higher-income seniors. Other ideas to sustain Medicare are cross-pollinating across the political aisle. Both Republicans and Democrats have discussed raising the Medicare eligibility age from 65 to 67. Whatever the White House and Congress decide, Americans need to be prepared for sticker shock when they enroll in Medicare.
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"Of all the transformations reshaping American healthcare, none is more profound than the shift toward value.”
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Every hospital and healthcare facility has some variation of this sign: “It's the law. Be careful not to discuss patients in public.” Like World War II posters warning that “Loose lips sink ships,” these notices stress that information falling into the wrong hands can lead to disaster. Staff training that emphasizes the punitive consequences of improper disclosures of protected health information reinforces this caution.
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People's lives today are full of choices. They know what they like. They know what matters to them. They trust their judgment and check with their gut. But when it comes to choices related to their health, they could use a little help. There's nothing quite as personal and important to patients as their health. However, they are not experts in navigating the healthcare maze. While there is no shortage of ideas and advice, it's often confusing. They are looking for the best care possible, and need help with the questions as much as the answers.
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Half of all adult Americans are expected to be obese by 2030, and already more than 40 million adults do not meet appropriate physical activity levels. The challenge of addressing obesity and physical inactivity requires new thinking and monitoring by healthcare providers.Intermountain Healthcare in Utah and Idaho has recently implemented both. It added a new “Physical Activity Vital Sign” to its electronic medical records. This simple tool is designed to nudge patients toward better health while encouraging providers to offer better care at lower cost.
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Here's another reason for states to expand Medicaid: preventing crime by mentally ill offenders. In the wake of the Newtown tragedy, many Americans wonder how we might do a better job preventing violence by disturbed, violent offenders. This is a huge challenge because it is almost impossible to predict that a specific individual will commit a mass atrocity.
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Desperate after a decade of trial and error to make the connection that could usher in a new generation of anti-HIV drugs, University of Washington researchers threw the scientific version of a Hail Mary pass.
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Henry Ford once said, “Anyone who stops learning is old, whether at 20 or 80. Anyone who keeps learning stays young.”I like to interpret Ford's use of the word “young” to mean “relevant and innovative.” Being relevant and innovative in our industry is an absolute must, and that is why the American College of Healthcare Executives is committed to educating all of its members—leaders in healthcare management—in a variety of topics and venues.
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As the 2013 Annual HIMSS Conference & Exhibition opens in New Orleans on March 3, I think of HIMSS07, our last conference in the city, less than two years after Hurricane Katrina.
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No one has been more effective than Sen. Chuck Grassley (R-Iowa) in promoting transparency in medicine. From 2004 to 2010, he investigated undisclosed conflicts of interest between physicians and pharmaceutical and device companies. His findings helped lead to the Physician Payments Sunshine Act. Beginning March 31, 2014, companies must report to HHS all payments over $10 to physicians; the payment information will be made publicly available the following September.
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Consumers have come to expect the conveniences that come with digital transactions. From checking clothing prices at multiple stores to keeping your bank account in your hand, the Internet in tandem with mobile devices has revolutionized the speed and ease of vast swaths of economic activity.But when it comes to healthcare, patients and providers continue to struggle with new technologies designed to bring these same conveniences to the examining room.
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Healthcare leaders in the midst of changing their business models to adapt to the Patient Protection and Affordable Care Act should consider the role that planning and designing facilities plays in addressing the challenges of a changing industry.
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With pressure growing on hospital systems to find new sources of revenue, many healthcare executives are turning to international patients as an attractive option.A substantial number of overseas patients are willing and able to come to the U.S. for diagnosis and treatment. They typically are patients with more complex disorders from countries where high-level specialty care may not be readily available. More importantly, they can afford to pay for their care out of pocket or have their care fully funded by their governments or private insurance.
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Most Americans know that healthcare is too expensive, and that we should get better value for our money. In fact, we spend twice as much on healthcare as other nations while getting about the same results.Working to stop rising costs—while continuing to improve quality—should be a national priority. And it has been for those of us in the private sector who have been working to transform our system long before the healthcare reform law passed.Unfortunately, there are still barriers to progress.
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Healthcare providers know that one of the principal challenges facing our society is caring for the vast number of aging Americans requiring healthcare. More than 10,000 people a day reach Medicare age, some of whom will develop multiple chronic conditions and account for a large share of Medicare spending. The strain will financially overwhelm an unchanged healthcare delivery system.
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Over the past five years, Kaiser Permanente Chairman and CEO George Halvorson, who will retire at the end of this year, sent a weekly letter to the 180,000 people who work for the nation's largest integrated healthcare delivery system. Every letter celebrated a particular success within the organization. The letters usually focused on care delivery. They have now been compiled in a book, KP Inside: 101 letters to the people of Kaiser Permanente. Here are excerpts from three:Celebrating our sepsis mortality reduction successesNov. 18, 2011
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When superstorm Sandy slammed into the New York metropolitan region, healthcare delivery was immediately challenged in unprecedented ways. Major hospitals, including those serving our poorest and most vulnerable New Yorkers, were severely damaged and forced to evacuate. Destruction to homes and property made hospitals that were still operational the only havens for those with no place else to go.
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The passage of the Patient Protection and Affordable Care Act and implementation of Medicare's value-based purchasing program have thrust the issue of patient experience to the top of the healthcare agenda in the U.S.For the first time, hospital Medicare reimbursement will be linked to patient experience metrics. Patients will be asked questions such as: “Did your doctor treat you with courtesy and respect? Did your nurse communicate in a way you could understand?” How patients answer will impact hospital payments. This process will affect nearly every hospital nationwide.
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