The “Cures” for What Ails You

The 21st Century Cures Act was signed into law on Dec. 13, 2016. It will, in all likelihood, be the final piece of health care legislation that President Obama will ever sign into law. It will bring to a close the legislative components of a presidency that has fundamentally sought to reshape health care delivery in this country. While books have and will likely continue to be written on the overall impact (and uncertain fate) of President Obama’s health reform law, I want to... More

Ready, Fire, Aim: The Risk of Unintended Consequences

The rapid increase in health insurance deductibles over the last several years is rooted in traditional microeconomic theory: raise the price of a good or service and demand will go down. The price elasticity of demand – that is, the rate at which demand decreases as price increases – is affected by a wide range of variables such as the availability of lower cost substitutes, the degree of latitude involved in the purchasing decision, and the amount of discretionary income... More

MSPB: Could It Be the Golden Thread of Health Care?

Everyone has points in their career that they recall with great clarity. One of those moments for me was in the fall of 2013 with the addition of the Medicare Spend per Beneficiary (MSPB) measure. As a nurse and quality professional, MSPB was like a golden thread that brings everything together: quality, safety, patient experience, inpatient and outpatient care, provider revenue and payer spend. Care delivery was finally becoming connected in a way that had the potential to engage everyone... More

Guns and Butter: Health Care Approaching an Economic Crossroads

Economics is fundamentally about choices. Some choices are relatively easy and others are agonizingly difficult, but in the end, we are faced with making choices. At the root of economic theory is the culprit that forces choices: scarcity. More

CMS’ Latest Update to Overall Hospital Star Ratings Doesn’t Fix Methodology Issues

As a certified data junkie, I have spent a considerable amount of time studying the composition of the CMS Overall Hospital Quality Star Rating program. While I understand and appreciate what CMS is trying to provide patients and the public at large, I am not a fan of the current methodology, which I feel doesn’t result in an accurate reflection of the quality of care hospitals are delivering across our country. More

Election 2016: The Only Thing Certain is the Uncertainty Ahead

On January 20, 2017, Donald J. Trump will be sworn in as the 45th president of the United States of America. He comes into this role after what many consider to be the greatest political upset in modern day history. The uncertainty ahead that many speak of is not meant necessarily in a positive or negative way, but rather speaks primarily to what happens when a self-proclaimed political outsider joins what is largely considered a “club” of lifetime politicians. More

The Secret Sauce to Labor Improvement in Health Care

In health care, clinicians have been trained that using safety checklists, watching for changes in vital signs and reviewing fluctuations in labs can catch a problem early or, even better, avoid it completely by taking a proactive approach. Success at these tasks is often rewarded with promotion to front-line leadership roles. However, many aren’t prepared to take on responsibility for planning, forecasting, coordinating and leading as many as 100 employees and maintaining high levels of... More

The Opioid Epidemic: How Joining Forces Can Turn the Tide

The U.S. is in the midst of a national crisis. In the past two decades we have seen increasing use, abuse and deaths associated with opioid medications. Here are a few disconcerting trends*: Prescribing opioids is on the increase. Approximately 20% of patients receive an opioid prescription for non-cancer-related symptoms or pain-related diagnosis in America. This 20% translates to approximately 259 million prescriptions or an equivalent of one bottle of opioids for every adult in America. More

Take a Team Approach to Managing Incoming Regulations

An alphabet soup of regulations, guidelines and standards, all competing for resources, some financial and almost all involving human capital to implement and execute, are coming at clinicians and hospital administrators faster than the F-18s that fly over my neighborhood in Virginia Beach. The speed and pace of change in our industry have managers’ and staffs’ heads spinning. The first challenge is staying on top of the information that is coming fast and furious while also... More

Unraveling of the Public Health Insurance Exchange Markets: Now What?

In the early spring, we smelled smoke in the public health insurance exchange markets. There were accounts of consumers stopping payments on their premiums and a few notable insurers were reporting financial losses. Those early signs of smoke have given way to a raging, 5-alarm fire that threatens to bring the roof down on the 11 million Americans who buy their health coverage on the exchanges—along with the doctors and hospitals who care for them. More