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Drinking From a Waterfall
Merit Smith
Vice President & Director, Health Care Practice
In this edition of Nolan's Trend Line, we offer some
tips to help executives track and manage the vast
amount of information that is emerging following the
passage of the health care reform package. This is
the first in a series of Trend Line e-news that will help
health care organizations understand and respond to
reform.
Begin by thinking about health care reform as
a "Public Policy Life Cycle." This is a simple model
with key phases:
- Policy Development. This is the
phase where
ideas are developed by think tanks, trade groups, and
advocates. It is the land of white papers, books, and
speeches. This phase focuses on "what should be
done and why." At some point, ideas come together
and move into…
- Legislation. This is the process that
reduces
ideas into very specific proposed legal text and then
uses a political process to decide if the text will
become law. This phase of the model is the most
complex because it mixes "what should be done, why,
and how it will be done."
- Rule Development. Increasingly, laws
aren't the
end of the process but rather an input to another
process where laws are implemented via rules and
regulations. This stage of the process has many of
the characteristics of the first two phases: advocacy,
hearings, multiple proposals, deal cutting. This stage
is the most detailed and focuses largely on questions
of "how will the law be implemented?"
- Litigation. The courts can get involved in a
variety
of ways but most frequently they come into the
process as rules are being developed or
implemented.
What we've described here is an ideal model, but
health care reform is currently a bit of a jumble. Even
with a final law in place, there is still an ongoing
debate about Policy and this is impacting future Rule
Making. All phases of the model are in play and that
makes it harder for executives to follow issues.
Use
this model to bring some order to the chaos:
- Begin by creating an 'issues' list. You'll find it
easy to think of dozens of topics but start with only a
few, and then gradually expand the list to include
others.
- Suppose you need to better
understand "exchanges." What do you do?
- Get an e-clipping tool like Evernote. As you
come across relevant items, Evernote them. Label
your Evernote categories Exchanges:
Policy, Exchanges: Legislation, and so on.
- Set up a Google Alert on "Insurance Exchanges." It
will find articles, speeches, and all sorts of Web
items. Briefly scan them. If you want to keep any of
them, clip them to Evernote. You will find that scanning
the Alerts can be done very quickly, and you can
modify your Alerts to make them more or less
specific.
- You will be amazed by the volume and diversity of
items that are flowing to you. If you aren't getting
enough information, perhaps your alerts need
fine-tuning or you may need to seek out new
publications
or information sources that are directly focused on
your topic of interest. Fee-based subscriptions
typically yield higher-quality information, but I
encourage you to try before you buy.
- If you aren't getting a consistent flow of information
on your topic, a ten-minute Google session with your
key words can yield a great deal. You can also call
your trade group, your actuary, law firm, or Nolan
(800-248-3742) for help in finding the best available
information on your topic and identifying sources of
information that will keep you current.
In the coming weeks, we'll give you ideas on
applying the information you gather. We will offer our
perspectives on where to look for the opportunities
and challenges that will arise, and how elements of
the reform package may impact your operations and
commerce model.
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