fyi, here’s a copy of my PowerPoint presentation at today’s Healthcare Unbound conference.
The Twitter hashtag for the event is #HCU10.
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Healthcare is joining the network economy.
Let’s design strategy and business models for
success during upcoming industry disruption.
fyi, here’s a copy of my PowerPoint presentation at today’s Healthcare Unbound conference.
The Twitter hashtag for the event is #HCU10.
No tag for this post.by Jaan Sidorov, MD and Vince Kuraitis
The Medicare MAPCP (Multi-Payer Advanced Primary Care Practice) demo promised to be Medicare’s Biggest Change in 40 Years…
…but the emerging reality isn’t living up to the promise.
In this post, we’ll discuss:
1) The Promise
The sandbox metaphor was first used by the National Academy for State Health Policy:
For the 10 or more states that are active stakeholders in multi-payer medical home initiatives, the promise of Medicare getting in the sandbox with them and playing (a.k.a. paying) is an exciting proposition. The addition of Medicare as payer to some of these state initiatives may be the critical tipping point that results in widespread primary care delivery system reform in states by involving more practices, payers and patients. Continue reading “Medicare MAPCP Medical Home Demo: CMS Kicks Sands in the States’ Faces”
(click on the graphic to download the document)
Depending on the nature of the payment changes which are made, physicians may need to enhance their capabilities in some or all of the following sixteen areas:
1. Achieving sufficient patient volume to support a new or improved service.
2. Having sufficient upfront capital to design and implement a new or improved service.
3. Having the skills/experience to efficiently/effectively implement a new/improved service.
4. Having the ability to obtain and analyze data on the quality of services.
5. Having the skills/experience to improve the quality of services.
6. Having adequate resources to support high-quality service delivery.
7. Gaining access to external resources to support patient adherence and health improvement.
8. Obtaining and analyzing data on the variation in services per episode or per patient.
Continue reading “16 Capabilities Physicians Will Need to Implement New Payment Models”
No tag for this post.by Vince Kuraitis JD, MBA and David C. Kibbe MD, MBA
Pop quiz: Among early-stage companies that are successful, what percentage are successful with the initial business model with which they started (Plan A) vs. a secondary business model (Plan B)?
Harvard Business School Professor Clay Christensen studied this issue. He found that among successful companies, only 7% succeeded with their initial business model, while 93% evolved into a different business model.
So let’s take this finding and reexamine our human nature. In light of these statistics, what makes more sense:
We question many of the assumptions underlying HITECH Plan A. We also want to talk about the need and content for Plan B in a constructive way.
In this essay we’ll discuss:
1) The Need for HITECH Plan B
2) Questioning Assumptions — Issues to Reconsider in Plan B
a) Rewarding Incremental Progress
b) Addressing Root Causes for Non-adoption of EHR Technology
c) Questioning Health Information Exchanges (HIEs) as Building Blocks for the Nationwide Health Information Network (NHIN)
d) Catalyzing Movement Toward Modular EHR Technology
e) Focusing Incentives on High Leverage Physicians
f) Recalibrating Expectations for EHR Technology Adoption
g) Getting Bang-for-the-Buck in Achieving Meaningful Use Objectives
h) Comprehensively Revamping Privacy/Security Laws vs. Tweaking HIPAA
i) Maximizing Sync Between HITECH and PPACA
j) Leveraging Potential for Patient-Driven Disruptive Innovation
k) Promoting EHR Adoption Beyond Hospitals and Physicians, e.g., long-term care, home health, behavioral health, etc.
l) Dumping Certification
3) Summing Up
The Emerging Market in Health Care Innovation
Tilman Ehrbeck, Nicolaus Henke, and Thomas Kibasi
McKinsey Quarterly May 2010
McKinsey conducted research in partnership with the World Economic Forum to study the most promising novel forms of health care delivery and, in particular, to understand how these innovations changed its economics.
The Delineation of Home Healthcare: The Natural Evolution of a Healthy Industry
Wyatt Matas & Associates (investment bankers), April 2010
This whitepaper discusses the opportunity for home healthcare to become the center of chronic care disease management and identifies a particular business model that some more advanced companies are implementing.
EHR Software Market Share Analysis
Chris Thorman
Software Advice; May 14, 2010
A substantive analysis of a tricky market – physician EHRs.
Disease Management: Does it Work?
Jill Bernstein, Deborah Chollet, and G. Gregory Peterson
Mathematica Issue Brief; May 17, 2010
Mathematica revisits a debate that’s raged for over a decade:
by Vince Kuraitis JD, MBA and David C. Kibbe MD, MBA
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….or to be more specific, HITECH is synergistic with payment reform that could come from the recently passed national health care reform legislation — the Patient Protection and Affordable Care Act (PPACA).
We’ll keep this post fairly short and try to avoid many of the more divisive aspects of this topic. The need for healthcare payment reform is well understood on both sides of the aisle:
Realizing the full potential of health IT depends in no small measure on changing the health care system’s overall payment incentives so that providers benefit from improving the quality and efficiency of the services they provide. Only then will they be motivated to take full advantage of the power of electronic health records. Dr. David Blumenthal, New England Journal of Medicine, April 9, 2009
Continue reading “Is HITECH Working? #6: HITECH and Health Reform Objectives are Synergistic”
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by Dave deBronkart (e-PatientDave), Vince Kuraitis, and David C. Kibbe
So far this series has looked at HITECH participation by hospitals (grumbling but in the game) and physicians (wary, on the sidelines), kudos for ONC’s three major policy points, and how HITECH is already moving the needle on the vendor side. Today we’re going to look at the reason the whole system exists: patients.
It’s possible to look at the patients issue from a moral or ethical perspective, or from a business planner’s ecosystem perspective. In this post we’ll simply look at it pragmatically: is our approach going to work? It’s our thesis that although you won’t see it written anywhere, the stage is being set for a kind of disruption that’s in no healthcare book: patient-driven disruptive innovation.
We’ll assert that in all our good thinking, we’ve shined the flashlight at the wrong place. Sure, we all read the book (or parts), and we talk about disruption – within a dysfunctional system.
If you believe a complex system’s actual built-in goals are revealed by its actual behavior, then it’s clear the consumer’s not at the core of healthcare’s feedback loops. What if they were?
We assert that to disrupt within a non-working system is to bark up a pointless tree: even if you win, you haven’t altered what matters. Business planners and policy people who do this will miss the mark. Here’s what we see when we step back and look anew from the consumer’s view:
by Vince Kuraitis JD, MBA and David C. Kibbe MD, MBA
Most of the press coverage and attention to HITECH has been to the “buy” side of the market: The central question here has been: “Will doctors and hospitals buy and use EHR technology?”
Meanwhile — and much more quietly — the sell (vendor) side of the EHR market is already dramatically different than it was a year ago. We observe change occurring at at least three levels:
The latest Health Wonk Review is up at David Harlow’s HealthBlawg. David employs metaphors galore: death, taxes, baseball, and many more.
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