Monthly Archives: April 2014

Three Reasons Why Healthcare Professionals Should Embrace Social Media

social-mediaOver the past few months, I’ve had the opportunity to blog about an extensive list of topics. From concierge medicine, to improving communication about the ACA, I have learned a lot about current healthcare regulations and trends. I am grateful for the opportunity that I’ve had to blog and encourage all of you in the healthcare field to seriously consider adding to the conversation. Before beginning my blog, I understood the professional networking benefits of LinkedIn, but used Twitter, Facebook, and other social media platforms more for my own amusement than building a personal brand.

Overall, healthcare professionals were initially slow to join the social media party, but have recently made up for it in a big way. This week, FierceHealthcare reported that when Twitter launched in 2006, only 23 healthcare professionals set up accounts. Today, approximately apparently made up for it in a big way. This week FierceHealthcare reported that when Twitter launched in 2006, only 23 healthcare professionals set up accounts. Today, approximately 75,000 doctors, nurses, pharmacists and consultants post 152,000 tweets a day about healthcare policy, research, individual medicines and disease treatments. What is it about Twitter that’s so appealing to healthcare professionals? How much information can they actually share with a 140-character limit?

Within those short messages, medical professionals can share journal articles, as well as links to studies, blogs and share their own points of view. They can also have longer conversations using short tweets. Emergency room physicians, for example, can ask for thoughts about a particular case and instantly receive advice from doctors all over the world in real-time. Healthcare professionals seem to have embraced the openness of Twitter and feel that they can collaborate so much more easily with different professionals. Twitter also gives doctors the opportunity to share knowledge with nurses or pharmacists in open channels that just didn’t happen before inside hospital corridors.

While most of the more seasoned healthcare professionals are still at the start of the social media phenomenon, people who were born into the world of social media are now becoming medical students and graduating as nurses and doctors. Using these open platforms is a completely natural thing to do. For those healthcare professionals who have yet to venture into the world of Twitter, here are three reasons to get started:

1.  The opportunity to learn from colleagues. The platform allows you to collaborate with professionals all over the world.

2. The opportunity to share your knowledge. Healthcare professionals find it richly rewarding to share their expertise with others.

3. The opportunity to improve public health. The platform allows medical professionals to share their knowledge of topics such as vaccinations and correct misinformation that often exists on the Internet.

And for those still reluctant to become active users, may I suggest taking small steps–start following some interesting healthcare blogs or popular Twitter users.

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Communicating ACA Regulations Effectively

death-by-powerpointIn some of my first blogs, I wrote about some of the characteristics of the Affordable Care Act. As I’ve continued working in the health insurance field, I’ve noticed that not everyone has received the same amount of training or communication from their supervisors regarding important regulations. Employees need specifics about the ACA and health benefits in general, especially during this confusing time. They should be taught exactly how the ACA will not only affect their jobs, but their own company benefits. In this blog, I will outline some tips for how to communicate healthcare reform to your employees.

One option is to do the bare minimum. While the government encouraged companies to provide written notice about new marketplaces, there is no requirement for employers to make sure this content is easy to understand and engaging for their employees. Even those without HR experience know that this bare-bones approach isn’t enough.

Another option is to turn to the old-school lunch seminars and piles of printouts to provide employees with additional information. This is a feasible approach and one that most businesses will turn to, but it has also been proved to have limited impact. How many employees truly understand their benefits when they’ve seen just a PowerPoint presentation or read a brochure? My eyes tend to glaze over as I read page upon page of PowerPoint slides or handouts.

My advice is to encourage a new school of thought. Many employees nationwide want to learn more about their benefits. Leaders should use this opportunity to educate and engage with workers through the channels in which they expect to receive information. Consumers have quickly become accustomed to accessing content on their smartphones, laptops and tablets. They expect important information to be tailored to them and easy to consume—like short-form videos they find on YouTube and Vimeo. Plugged-in consumers make for plugged-in employees; so companies have to reconsider their traditional communication approach.

Here are some tips for using health care reform as an opportunity to engage, educate and empower your staff:

  • Don’t overwhelm with too much content. Because health care reform is multifaceted, HR teams understandably want to convey every last detail to employees. However, shorter bursts of information are much more digestible, particularly in a digital-driven world.
  • Build a strong foundation. Crafting a powerful message around the ACA as it relates to your organization will outline for employees what information they actually need to know. Discuss your approach and, if possible, test it early on to see what resonates.
  • Don’t leave it to government-driven communication. Workers are likely reading and hearing about health care reform from many sources. Mandated communications dictated by the government may cause more confusion if HR does not carefully deliver a message that is tailored to the organization. Make sure your employees are not in the dark by providing supplementary materials to mandated notices.
  • Toss the textbooks. Don’t talk academically or politically about health care reform. Instead, use your organization’s voice, language and tone, and communicate in a style that your employees already know. Deliver high-level information on how the law will affect them in a format that will work for their job and lifestyle.
  • Reach employees where they are. We live in a digital world where people are plugged into smartphones, tablets and computers all day long. Communicate with workers through the medium they are used to: information on a screen, with a variety of action, and a narrative. Consider making information easily accessible through an Internet or intranet connection, which works for people whether they are tuning in at the office or reviewing benefits packages with family members at home.

Healthcare reform has changed the benefits for millions of people. Leaders should know their employees and their needs better than the government does. Communicating about the ACA’s effect on benefits isn’t merely about delivering information required by the law; rather, it’s about empowering employees to make smarter decisions about their benefits and helping them to become better health care consumers. If you need more communication regarding the ACA, please encourage your leader to help you understand how the regulations affect you.

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Changing Hospital Culture…Part I

service cultureHow does one define culture? Culture consists of group norms of behavior and the underlying shared values that help keep those norms in place. For example, why does almost everyone show up to work between 8:55 and 9:05? Is it because management has mandated it, or that people are afraid that they will be fired if they don’t? That’s just the way it is. It’s a group norm. People are generally hired who embrace the values of a particular company’s culture, including the value of showing up to work and meetings on time. Because culture can be so entrenched in our respective workplaces, it’s virtually impossible to change. While it isn’t easy to change the culture of any company, in this blog, I will take a look at some strategies for changing floundering hospital culture.

Hospitals need to create a culture of continuous learning, teamwork and transparency to keep workers, and therefore patients, feeling safe and happy. With a positive workforce culture in mind, hiring should be based on attitude and fit. A hospital system in San Diego incorporates its values of respect, quality and efficiency into the interviewing process to ensure the facility remains a great place to work. Implementing your culture early in the hiring process is a key step in ensuring a culture of patient safety to prevent avoidable patient deaths. Joe Kiani, founder of The Patient Safety Movement Foundation said, “Creating a culture of safety begins with one solution, one commitment, one hospital, one act of kindness and love, and one patient at a time.”

A healthcare system must also implement regular feedback mechanisms in the early stages of an employee’s tenure. The organization should check in with new hires after 30, 60, and 90 days, using these opportunities to assess whether the recruit is adapting to and thriving in the organization’s culture. The healthcare system should also continue to provide ongoing training and development, giving refresher courses about the vision and culture every 12 to 18 months. With leadership’s support, these engaged employees become ambassadors for the patients’ priorities.

In addition to ensuring the most competent employees are hired, many health care systems also aim to deliver a high level of customer service. Unfortunately, many systems are falling short on that goal. Truly improving service demands a culture that intentionally champions a focus on the patient. Managers must be equipped to drive employee engagement in their departments.

What healthcare systems urgently need are clear intentions and strategies at the leadership level. These will determine whether a service mindset can exist within a hospital. What’s more, getting employees engaged and connected to this mission will ultimately determine whether they live out that mindset each day. A recent Gallup poll found that a service-centered culture requires:

  • a committed leadership team that champions a philosophy that is aligned with service
  • employee commitment to providing outstanding service and quality
  • the strategic alignment of the organization’s plan, policies, and procedures with the goal of being service-focused
  • an established process to document and disseminate organizational knowledge and efficiencies
  • an ongoing commitment to improving performance and using proven tactics

After proper onboarding, a healthcare system must align its human resources policies to encourage service excellence and hold employees accountable to the standards. Managers must be equipped to drive employee engagement in their departments and held accountable for action planning and knowledge sharing. Aligning these activities with the hospital’s larger strategic plan and organization-wide goals is crucial and should be transparent from leadership down to the front line. One of the greatest challenges in any modern and multi-location system is that pockets of excellence exist, but best practices are rarely shared across units. Maintaining open and intentionally structured communication is a means to spread great customer service across an organization.

As I was writing this blog, I realized that the subject of culture is too broad for one post. In part two, we will pick up where we left off. In the meantime, please check out this great example of how a floundering hospital culture was turned around.

Thank You for Reading!

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Healthcare Trends to Watch for in 2014

pfeile-trend-marketingWhile most of my blog posts have covered some of the more recognized effects of the Affordable Care Act, it isn’t just about insurance coverage. The legislation is also about transforming the way health care is provided.  As caregivers and insurance companies have wrestled with the new rules and regulations, a new era of competition has been ushered in. Services and business practices are in turn generating substantial industry shifts that affect all links along health care’s value chain. In this blog post, I will shed some light on what are anticipated to be the top trends this coming year.

1. Evolution of Pioneer ACOs: Many providers are moving quickly to implement accountable care organizations (ACOs). As providers work to improve their way to shared savings payments, there should be a more intensive focus on the biggest health care consumer: those with multiple chronic conditions. As part of the approach to managing these patients, providers will need to develop care pathways for better managing chronic conditions and behavioral health needs, with an eye toward lowering hospital utilization, including inpatient bed days, length of stay, admissions, readmissions, and ED visits.

2. Impact of ICD-10 transition: Overall, providers have been slow to move forward with the conversion of ICD-9 to ICD-10, but the October 1st deadline is fast approaching and there is no indication that CMS will further delay the implementation date. One study suggests that 74 percent of providers haven’t made plans for end-to-end testing with external entities. These providers could be subject to a potential cost of $1 million to more than $15 million.

3. Turnover of hospital CEOs: Latest statistics show that healthcare experiences higher CEO turnover than any other industry. Please read my prior blogs, “Battling Hospital CEO Turnover…Parts 1 & 2” for more information regarding this trend.

4. More hospitals become insurers: Population health management and Medicaid expansion have pushed some providers to expand their healthcare services and start offering insurance plans. Many non-profit community health centers have entered the market as more people become eligible for Medicaid and states move enrollees into managed care plans.

5. Health Coaches: Health coaches function like a personal trainer in a gym; they’re there to motivate, challenge, inspire, and listen. They complement medical professionals providing care; they get to know the patient one-on-one and keep clinical staff apprised of issues that wouldn’t come up in a doctor’s appointment, including financial struggles, problems with housing, family concerns, or any other obstacle that could stand in the way of someone following a prescribed care plan. And because the position does not necessarily require a medical degree, health coaches can be drawn from a diversity of settings.

6. Increase in Telemedicine: Research firms estimate that telemedicine applications will double from $11.6 billion in 2011 to over $27 billion in 2016. Driving the growth is the need to make care more convenient, so patients can be monitored and coached to health anytime, anywhere.

7. Health Incentives: This trend is being driven by two forces, both spurred by the ACA: the ability for employers to increase the dollar value of wellness incentives from 20 to 30 percent of total coverage, and increased private insurance costs.

Further elaboration on these trends as well as some additional trends can be found here.


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Reducing Healthcare Facility Readmission Rates

ReadmissionIt seems like a nightmare scenario; a patient is treated and released from your healthcare facility only to return weeks or even days later. What happened? Was there some sort of medical error that caused a HAI? Was the correct surgery performed…on the correct body part? Recently, the Affordable Care Act instituted the Hospital Readmissions Reduction Program, which requires the Centers for Medicare and Medicaid Services to reduce payments to hospitals with excess readmissions. Readmission is defined as “an admission to a… hospital within 30 days of discharge from the same or another… hospital.” These penalties make it more important than ever for hospitals to take a proactive approach to prevent readmissions. In this blog post, I will take a look at some strategies that healthcare facilities can use to decrease their readmission rates.

Here are 10 strategies for reducing readmission rates.

1. Understand which patient populations are at greatest risk of readmissions. Recent research suggests that Medicaid and uninsured patients are at greatest risk for preventable hospital readmissions.

2.  Manage chronic diseases effectively in the outpatient setting. High admissions equal high readmissions.  According to a recent article in the New England Journal of Medicine, there is a substantial association between regional rates of rehospitalization and overall admission rates.

3. Participate in incentive programs with payers. Hospital and health systems across the country have been enrolling or partnering in incentive programs with payers designed to incentivize providers to effectively drive down unnecessary hospital admissions. Pay-for-performance models, aligned with federal accountable care guidelines, are designed to incentivize hospitals and physicians to collaborate in efforts to reduce hospital-acquired infections and readmissions and follow evidence-based guidelines for surgical care and the treatment of heart attacks, heart failure and pneumonia.

4.  Stratify patients to align the appropriate clinical care.  Patients with chronic diseases should be stratified into high, medium, and low risk categories based on their age, socioeconomic level, education, co-morbidities, dependence on medication management, the frequency of their use of the emergency room, and recent hospital admissions.  The goal is apply the most appropriate intervention based on the patient’s needs and condition to optimize clinical outcomes and quality of life.

5. Ensure patients schedule a seven-day follow-up. Medical studies have suggested that patients who followed up with their physician within seven days of discharge were less likely to be readmitted to the hospital.

6. Implement a robust home healthcare program. Post-discharge care can also be a powerful mechanism for preventing readmissions. Research has shown that home healthcare, such as medical social services or home health aides, can be effective.

7.  Leverage technology innovation to improve team communication.  A simple recent innovation impacting patient care coordination is the ability of multidisciplinary members to text each other.  Other innovations include Carebook, an online networking platform which connects care providers to form multidisciplinary care teams, collaborate on safe transition plans for their patients, coordinate care, and engage patients and caregivers with a patient-centered after-care map.

8.  Ensure smooth transitions with a strong transition plan.  A key component in transitions of care for a patient returning home is the transition plan.  Develop the transition plan on admission with the family.  The plan should consider issues such as the home environment, whether the patient is physically and cognitively able to care for themselves, availability of support systems, and whether palliative or hospice support is appropriate.  It should ensure that there is a timely follow up visit with the primary care provider or case manager.  Also, the patient and family need to be educated at a level that considers language, educational level, and cultural preferences.

9.  Engage patient through telehealth tools.  An increasing number of organizations are taking advantage of patient portals and personal health records, and even more are using other approaches to engage patients in their care, including e-mailing, texting, and social media channels.  A system that allows patients to communicate with caregivers, perform self-care activities, and participate in health screenings, for example, can improve quality of care and outcomes, especially for patients with chronic diseases.

10.  Monitor progress with metrics.  Development of a scorecard that allows the healthcare team to evaluate the success of their interventions, track trends, and identify opportunities for program improvement is a fundamental component of any readmission reduction program.

There are signs that hospitals made headway in this ongoing battle. Not only have Medicare readmissions fallen for the second consecutive year, individual hospitals and systems nationwide found innovative ways to improve population health and reduce readmissions. Read this article that contains six readmission success stories.

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Battling Hospital CEO Turnover…Part 2

Connecting_Emotional_IntelligenceNow that we have an idea of the current trends facing healthcare CEOs, let’s take a look at some strategies for up-and-coming executives. Some of the most intriguing new hospital CEO candidates are emerging from the venture capital, private equity industry, finance and accounting, banking, technology, marketing and sales, not-for-profits, and pharma/biotech. Does this mean that Healthcare Administration degrees are no longer valued? Not necessarily.

First, relevant outside thinking makes a valuable contribution, enhancing business vitality, longevity, and sustainability. If you are a current employee within a hospital system, do not develop tunnel vision. Do not be afraid to pull experience from other fields to apply within the healthcare industry. Staying contemporary, revitalizing your brand, enhancing products, and expanding into new markets are all critical to making you more competitive.

In an exclusive interview with FierceHealthcare prior to his presentation at the American College of Healthcare Executives Congress, a young CEO was asked for advice that he could relay to future Hospital CEOs. First, Nicholas Tejeda, current CEO of Doctors’ Hospital of Manteca, CA related a compelling story from his first supervisor position, when a lab director said that he’d quit before reporting to Tejeda, Tejeda told the lab director, “I can work the rest of my life and not be as experienced as you and I will never be as good a lab director as you. My job is to identify how we measure your success, hold you accountable to that success, listen when you need resources, and, most importantly, to get you those resources.” This is a good example of the importance of managing communication and expectations about the reporting structure before you begin.

To help young CEOs–or those who may be new to the healthcare industry–learn from his experience, Tejeda offers four pieces of advice:

1. Communication matters: Appearances do count, he said, which means you can’t dress and act young. “You can’t have spikey hair when you are young leader. Don’t act like a kid. It’s the message that matters.”

2. Respect the past: Young CEOs need to learn from the past and integrate those lessons into future decisions, he said. “Often people want to dismiss the past and forget the shoulders they are standing on. Ask about the past but don’t lose sight of the fact that you are supposed to translate those decisions to the future journey,” Tejeda said.

3. But look to the future: “If people see you are doing things that benefit the organization in the long term, it will go a long way and they will begin to trust your decision-making and your willingness to work,” he said. “Don’t just do short-sighted things, like yelling, firing or making immediate cost-saving opportunities.”

4. Express curiosity: To overcome negative assumptions that staff will make about you as a young leader, take advantage of some expectations that work in your favor. For example, many staff think of young leaders as full of energy and eager to prove themselves. “If they expect it, allow it to be a tool and allow more experienced employees to implement what they want to do if it makes good business sense,” he said. Once staff see that you will take action and get organizational support for their projects, Tejeda said, even the youngest leader can quickly develop credibility and gain employees’ trust.

Other important characteristics of aspiring CEOs include emotional intelligence, communication skills, knowledge of game theory and industry history, as well as experience in organizational development and team building. Please read this article for more information regarding these topics.

Thank You!

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Battling Hospital CEO Turnover – Part 1

post-thinkstock-ceoAn interesting trend is currently happening within American Hospitals. CEO turnover has recently reached a record high of 20 per
cent, the highest since motoring this statistic began. In the next two blog posts, we will take a look at some of the possibilities as to why this is happening, current hiring trends, and what you can do to make yourself more competitive for senior management positions.

According to the president and CEO of the American College of Healthcare Executives, Deborah J. Bowen, “The increase in the turnover rate may be indicative of a combination of factors, including an increased number of baby boomers seeking retirement, the emerging trend toward consolidation in our industry, and the complexity and amount of change going on in healthcare today. The increase in the rate reinforces the need for healthcare leaders to work with their boards to ensure appropriate succession plans are in place.

As more baby boomers are leaving their executive positions for retirement, a great amount of pressure is placed on hospitals to find a worthy successor. Struggling hospitals in the hunt for the strongest talent are extending their searches to senior leaders from banking, financial, and manufacturing backgrounds as strategy changes devalue the skills of long tenured, hospital seasoned professionals. A recent healthcare executives’ survey said that the next generation of leaders would come primarily from the financial sector, with the hospitality field trailing closely.

Searching outside of the industry is not necessarily a bad thing, as many of these executives bring with them fresh insight from positions within a variety of sectors. An outside hire may not have necessarily developed hospital management skills from within or understand an organization’s unwritten rules at first, but that’s okay. As hospitals attempt to avoid bankruptcy, expedite smoother consolidations, overcome payment reform, and tackle productivity issues, a fresh face can be a welcome change.

Another interesting statistic states that, 94 percent of CEOs coming from other industries indicated that they do not believe healthcare expertise is required for replacing other senior leadership members after a management overhaul. The same study also revealed the following:

  • The average tenure of a hospital CEO is less than 3.5 years;
  • Fifty-six percent of CEOs exits are involuntary;
  • Nearly half of chief finance officers, chief information officers and chief operating officers are terminated within nine months of a new CEO’s hire; and
  • Eighty-seven percent of chief medical officers are typically replaced within two months of a new CEO’s appointment.

As a current MBA student who has a desire to one day become a member of hospital senior leadership, it leaves me to wonder whether or not I should perhaps focus my MBA on a field other than healthcare management. What do you think? Please feel free to comment with your opinion.

Thank You!

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Five Simple Steps to Increasing Meeting Productivity

meetings-mainHave you ever felt like you were losing control of a meeting? According to some of my friends in the corporate world, they feel like this all the time. Tasked with running important meetings, when there are too many strong personalities participating, they can feel as if the floor is falling out beneath them. I imagine that meetings in the health care field aren’t much different. Most likely, each meeting is attended by a number of different professionals with varying graduate degrees and egos to match. In this blog post, I will take a look at how to increase the productivity of your meetings.

An article written by PC Mag contributor Jill Duffy outlines a few tips for increasing meeting productivity. First, we need to understand what kind of meeting that you intend to hold and then organize yourself and prepare for it accordingly. According to Ms. Duffy, there are four different kinds of meetings: Informational, Discussion/Collaboration, Check-in, and Working meetings. Most of the meetings that I have been attending lately are either check-in or discussion/collaboration meetings.

Discussion/collaboration meetings are otherwise known as brainstorming meetings. In this kind of meeting, one or more of the parties involved might work on the agenda. Information is meant to come from multiple people. Check-in meetings are regularly scheduled, usually around a particular project, which could be ongoing or have an anticipated completion date. While managing my project, we have weekly check-in meetings to make sure that all involved parties are kept up to date on problems, solutions, changes, and progress. One of the things I like most about these meetings is that they’re often very short.

Ms. Duffy continues in her article outlining five different ways to make meetings more productive. First, schedule quickly. If meetings are scheduled too far out, there is a chance that any pertinent information will no longer be fresh in your mind. Second, use a clear subject line. Ms. Duffy claims that having a clear subject line is key to everyone’s productivity. The subject line should indicate in a few words the general purpose of the meeting.  It can also help parties know what they need to prepare for. Third, have an agenda or goals. Every meeting should have an agenda or list of goals. The complexity of the meeting will help to determine whether or not the agenda will be explicit or implicitly stated in the subject line. Fourth, define the meeting leader. Some of the worst meetings have no clear leader. These meetings can often become extremely unproductive. Fifth, lose the technology, but do the demo. Before you waste your time creating a PowerPoint deck, ask yourself whether or not one is truly needed. If so, remember that slides should be used to keep people engaged and reinforce your points – not make them for you.

Please try any of these tips in your next meeting!

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Umm…Excuse me, you’re leaking.

Referral LeakagePatient referrals are an integral revenue generator for every hospital, clinic and caregiver.  Yet most facilities require the patient to hand-deliver referrals and do not adequately track the originating provider of said referral.  This leads to many issues including reduced coordination of care, loss of revenue, and a poor patient experience. A seemingly routine task during a physician’s day – referring patients to specialists and other care providers – now is being viewed more closely by hospital systems to improve patient management and volume.

Physicians, in many cases, do not consider network affiliation when referring patients to their colleagues.  But network affiliation can have huge implications for both the patient’s quality of care and the hospital system’s bottom line. Hospital organizations need to maintain, capture and improve volumes in order to build revenue and remain competitive. With the advent of Accountable Care Organizations, ensuring patients stay within the network has become even more critical to ensure the ACO’s ability to capture revenue.

Only by tracking referrals can an organization begin to understand and manage patient leakage. Targeted solutions can provide visibility into referral trends and standardize the referral process across the entire network, streamlining operations and communication with physicians.  These industry experts will uncover the importance of provider relationship management and solutions that can be implemented to put the plug in referral leakage.

So why is this happening?

  1. Excessive Specialization Options – over the last 40 years, specialties and sub-specialties for doctors have dramatically increased. Primary care providers have to spend more time learning and managing these groups and stay up-to-date with what types of treatment options are available to their patients.
  2. Referral Rates have increased – Physician referral rates have been steadily increasing, but only 35-45% of referrals for adult inpatient care, as measured by revenue, go to a partner hospital.

So How to Improve Referral Leakage?

  1. Reform your paper-based referral first – many experts suggest embracing electronic referral systems.
  2. Learn how to stand out – Create social media accounts to interact with your patients and showcase your support for the movement toward transparent and value-based healthcare. Perhaps even take a second look at your marketing strategy and redesign if necessary.
  3. Improve the patient experience – while word-of-mouth is important, patient still make decisions based on suggestions from their PCPs.
  4. Improve Physician Education – Educating physicians on who the other ACO providers are and why it is important to refer to in-network physicians is the first part of the equation to limit patient leakage. Additionally, it is important to emphasize that participating providers share in the same quality, experience and cost goals.
  5. Focus on patient education – Once the physicians understand the value of care coordination and who is participating in the ACO, the next step in preventing patient leakage is to educate the patient on how coordinated care will benefit them

When both physicians and patients understand the value of care coordination in an ACO, patient leakage is less likely to occur. Curious to learn more about ACOs? Check out the content contained here.

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Is There a Doctor In the House? Part II

In part 1 of this series, we took a look at a serious problem facing healthcare – clinician shortage. In this blog, I will take a look at some potential solutions. These solutions include, but are not limited to, the following: improving education, removing barriers to access, promoting efficient care delivery, and improving the practice environment.

MedicalEducationFirst, improving education. Many problems are endemic to professional training, and the terms and conditions of training and education should remain the responsibility of the professions. Educational financing should reflect a better balance between primary care and specialty practices, increasing graduates of all health professions and providing financial incentives for faculty. Health professionals should incorporate interprofessional education to increase efficiency and productivity, promote coordination of care, and hold training exercises in teamwork. Congress should also reevaluate the current Graduate Medical Education program. It is imperative to ensure available residency slots for the projected medical student enrollment.

Second, removing barriers to access. Scope-of-practice rules can contribute to the cost and inefficiency of the health care system, creating another barrier to patient access to care. In a national survey of physicians and nurse practitioners, a majority of respondents indicated that having more nurse practitioners would improve timeliness of care and access. While physicians are concerned with quality of care and, of course, a reduction in their market share, no evidence suggests that using APRNs negatively affects patients or physicians. Nursing, the largest segment of the health care workforce, should be “full partners” with other health professionals in the improvement of the health care system.

Third, promoting efficient care delivery.Human capital is the backbone of the health care industry. Providing health care is labor intensive, and recruiting and retaining a sufficient workforce are essential. Strengthening the workforce supply should be coupled with innovation in role and task allocation. Efficiency and productivity will expand the workers’ capacity to deliver high-quality patient care. To increase care coordination and improve work flow, professionals should pursue team-based collaboration. This means health professionals should define the necessary tasks of their own professions and be ready and able to delegate tasks outside of their profession to other personnel. Workforce shortages compel health care leaders to invent new ways to use limited personnel efficiently to meet increased demands.

Finally, improving the practice environment. Increasing retention will require greater incentives. Incentives should include a mix of public policies, such as reducing liability through tort reform, Medicare payment reform, and reduced federal tax rates. In the private sector, health care businesses will need to use the most effective methods of attracting, hiring, and retaining workers. Retaining talent will require extensive human resource planning and incentivizing through benefits, education and career advancement, profit sharing, and workforce protections. Active interventions to prevent work overloads and strategies for stress management will reduce attrition and costly replacements and ensure adequate supply. Workers need to be protected physically, emotionally, and psychologically to ensure a healthy workforce.

As we can see, there are many options that can begin to help alleviate clinician shortage. I encourage you to see what your own state is doing to help.

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