The Joy of Working in an Integrated System of Care That Is Continuously Improving
Apr11

The Joy of Working in an Integrated System of Care That Is Continuously Improving

I believe that better care that is economically sustainable and available to everyone while producing healthier communities without unacceptable personal sacrifices from individual health professionals is only possible in a professional environment and culture that respects the contributions of all health professionals. When I use the phrase “I to we” I am talking about everyone who is employed in healthcare from the staff that parks...

Pull
Anticipating the Future
May03

Anticipating the Future

I have been thinking a lot about the future lately. Years ago I concocted a quote that works for me by leaving out a few unnecessary words from a passage in The Age of Unreason by the British business guru and futurist, Charles Handy. The future we predict today is not inevitable. We can influence it, if we know what we want it to be…We can and should be in charge of our own destinies in a time of change. Our biggest problem is not...

Pull
Looking Forward with the Triple Aim
Feb25

Looking Forward with the Triple Aim

It is surprising that we have no good metrics to track our progress toward the Triple Aim. We have lagging numbers on what we spend as a nation and debatable public health indicators of gross population metrics. No one knows how many healthcare organizations have incorporated the Triple Aim into their strategic plans. We have very little to help us judge what organizations are accomplishing and no way of comparing their results to...

Pull
Lean Supports Healthcare Service and Leadership
Feb02

Lean Supports Healthcare Service and Leadership

It is paradoxical that despite all of the opportunities for professional satisfaction in healthcare,  one of the issues of greatest concern that challenges the Triple Aim is the emotional health and happiness of healthcare professionals. Healthcare is populated by very competent and caring people who chose their profession because of their desire to contribute to better care. Many of those same people are becoming disillusioned, angry...

Pull
The ACA, Five Years In
Jan14

The ACA, Five Years In

A recent article in the New England Journal of Medicine offers us food for thought as we contemplate the Affordable Care Act (ACA) at five years and look forward to its next challenges in 2016. If you have not read it, the article is entitled “Health Care Reform’s Unfinished Work- Remaining Barriers to Coverage and Access”, by Dr. B. D. Sommers from the Department of Health Policy and Management, Harvard T.H. Chan School of Public...

Pull
Healthcare Innovation in Vermont
Apr28

Healthcare Innovation in Vermont

I am now involved in a small way with the Vermont Healthcare Innovation Project that is the latest of several efforts in Vermont to move away from healthcare that is fragmented, inefficient and expensive. Despite efforts to move toward value-based reimbursement and the presence of three ACOs in the state (the largest, OneCare Vermont, sees about one hundred thousand Medicare, Medicaid, and commercial patients), the current system of...

Pull
The Future of Healthcare Payment
Feb26

The Future of Healthcare Payment

Healthcare payment models are changing. Since the passage four years ago of the Affordable Health Care act, even the total optimists have become somewhat frustrated with the ups and downs of implementation, and many progressives continue to call for even greater change, with new attempts at single-payer mechanisms that are unlikely to happen even if the Democratic Party were to control the Presidency and both houses of Congress....

Pull
Lean Leadership for ACOs
Jan10

Lean Leadership for ACOs

Last week I traveled from my new home in New London, New Hampshire to Farmington, Connecticut to participate in a leadership conference for a large physician group there. This group, like many physician groups across the country, is making that transition from the current reality of their total dependence on fee-for-service income to a future where they expect to be paid for quality and value. They know that to be successful in the...

Pull