Good Strategy in a Fog of Uncertainty
Feb07

Good Strategy in a Fog of Uncertainty

There is no challenge like the challenge of creating a strategic plan in uncertain times. What do you do when you do not know what to do? That is a question that frequently challenges leaders. Over eight years ago, after Lehman Brothers had failed and the value of the stock market had fallen by almost fifty percent and we did not know if we were facing a deep recession or the second coming of the Great Depression, I was asking myself...

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What To Do When You Don’t Know What To Do
Jan03

What To Do When You Don’t Know What To Do

Are you wondering what you and your practice or hospital should be doing while living in the ambiguity of “repeal and replace?” Focus on getting better. That is the short answer. With or without the ACA the challenge to create  Care better than we’ve seen, health better than we’ve ever known, cost we can afford,…for every person, every time…in settings that support caregiver wellness  …does not go away. The Triple Aim long...

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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...

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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...

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Attorney General Maura Healey Leads Healthcare Reform
Oct15

Attorney General Maura Healey Leads Healthcare Reform

As a member of the Advisory Council to the Health Policy Commission in Massachusetts, I was very interested in following the internet broadcast of the annual HPC Cost Trends Hearings early in October. At the core of the presentations was a debate about healthcare costs. For me the high point came when Attorney General Maura Healey and her staff made the sort of leadership statements that suggested to me that she was not in harmony...

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Sustainable Universal Coverage
Sep09

Sustainable Universal Coverage

Last month CMS announced the results of the efforts of the Pioneer and MSSP (Medicare Shared Savings Program) ACOs for 2014. The headline made for compelling reading: Medicare ACOs Provide Improved Care While Slowing Cost Growth in 2014. This suggests that sustainable universal coverage is within our reach. Just in case you do not have the time to follow the link for yourself, let me help you appreciate the gist of the report. In 2014...

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Golden Age of Medicare and Medicaid
Aug05

Golden Age of Medicare and Medicaid

Medicare and Medicaid are now fifty years old. I suspect they are the two programs that much of the healthcare establishment still loves to hate the most. Lyndon Johnson’s  signing on July 30, 1965 of  the Social Security Amendments of 1965, created two landmark programs which—along with the tattered VA system—have represented the most “socialized” forms of healthcare in our society. The road to their existence was almost as long as...

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Another Hurdle Cleared at the Supreme Court!
Jun26

Another Hurdle Cleared at the Supreme Court!

  Thanks to the Supreme Court, healthcare reform has cleared another hurdle.  At 10:21 AM yesterday, as I was writing this week’s letter a banner appeared on my screen: NPR:Breaking News–Supreme Court Rules Obamacare Subsidies Are Legal Just seven words but a powerful message. Later I enjoyed looking at all the YouTube commentary on CNN. In particular I enjoyed the President’s words and the brief analysis of Jeffrey Toobin....

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