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Vol. 20 No. 1
| November 2011
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Greetings!
All of us are facing budget constraints, so the days of going off on a conference junket just for the fun of it are over. The conferences that are specific to on-site clinics are in Las Vegas and Orlando, and they line up with the winter months, so just being warm increases their appeal.
However, we think you should really look closely at content and speakers to see if there is a direct connection between what the conference offers and what you need to know. What will you come away learning? We think networking is fine, but the conference should have several features before you consider spending any money (or valuable time) on attending. Ask yourself these questions: (1) Is there anything new and different at this conference that I could not get from simply a literature review? (2) Who is going to be at the conference that I might consider to be a valuable networking contact? (3) Is the conference well managed and well organized?
Time and money are precious commodities, and you might want to look things over carefully before using either. You might also want to branch out to an area in HR, such as contracting or health care population management that will challenge your thinking and contribute to your overall understanding of the industry in which all of your clinic activities have to operate, co-exist, and succeed.
Lest you think that I am downplaying the offerings of the traditional "on-site conference" organizers, I would point out that each of their parent companies have great offerings relating to ACOs, managed care, population management, etc. HBCE and CHVI both have speakers that highlight on-site projects and programs. Everyone is talking about value these days, be sure to get your ROI out of any conference you attend. |
News You Knew - Access Is The Reason For ED Abuse
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Crain's Business (New York) reported on comments made by Dr. Michael Kamali, Chair of the University of Rochester Medical Center's Department of Emergency Medicine, at the recent ACEP meeting in San Francisco. He studied utilization through the ED to check the assumption that people might be using the ED unnecessarily because they lack insurance, do not have a primary care doctor, or both. Not so, he found.
His research shows that most of these patients do have doctors, but the physicians are too busy to see them. Of the hundreds of emergency room patient visits his team reviewed, no one had a true medical emergency. They had rashes, menstrual cramps, colds, and other lesser maladies. More than 80% of the patients were insured. "The majority of them had called their primary doctors before they came to the emergency department," Dr. Kamali said. "We feel it's quite possible they were referred to the ED just because their primary care doctors have tight schedules and couldn't make time to see them."
Insured patients with limited access to a PCP results in unnecessary and costly emergency department visits. When we surveyed employers who initiated on-site programming, we were impressed that many (over half of the employers contacted) had indicated "access" as a primary issue for them and for the beneficiaries of their health benefits. This is only going to get worse in the next few years as millions of underinsured and uninsured enter the health care market under health reform. |
| BP Opens Houston Facility In Record Setting Time | | |
Once in a while, a new site opens that looks like it has it all. BP just opened such a site - primary care, pharmacy, dental, optical, imaging, rehab, EAP, the works. This is in addition to an already impressive wellness program and a benefit program that is robust by any standard. We reported briefly on this in past issues, and you will soon be able to review visuals of the facility on our companion Web site.
Not news, you say? No, sites are opened routinely around the country, and many have multiple service lines. The real news here is the timing and the project pacing, which is - in our experience - unmatched by any other project of this scope and scale. Construction and vendor selection was fast-tracked and, from inception to execution, took only seven months. This is largely due to the skill of their project management team, headed by Greg Dagley and Karl Dalal. The on-site programming is managed by Take Care Health Systems (Walgreens).
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Same Old Thing - Only Different!
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In most newsletters, we hope the editor is looking around for new things. There is plenty new in health care, and we are always fascinated by the new clinic installations, the new technology, and the new ideas. Sadly, most of them produce the same old results. Modern Healthcare recently reported some new results using the same old tools.
The toughest population management challenges are often managed by people with little money or technology, but with intense dedication and some solid thinking. We have often said that "to predict the people who will be admitted in any upcoming period, take a look at who was admitted in the past." Hospitals are trying to use statistical algorithms to solve the same problem. Which patients will be re-admitted, and how can we care for them better so they aren't re-admitted? It is, as you know, a huge issue in health care today.
In the article, "Healthcare's Moneyball," Modern Healthcare reports on a study in New York with Medicaid patients at Bellevue where patients were paired with a case worker and a housing authority representative. Hospital visits for that cohort of patients dropped by one-third in 12 months, saving New York Medicaid $5,080/patient after deducting project expenses and an increase in outpatient costs. One quote in it worth repeating and memorizing is "Nothing good happens when you go to the hospital," per John Billings, Director of the Center for Health and Public Service Research at New York University's Robert F. Wagner Graduate School of Public Service.
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Sometimes, a quote says it all. We love the one from Kenneth E. Thorpe, Ph.D., Chair of the Department of Health Policy and Management at Emory University, after he and his colleagues reviewed a new Blue Cross/Blue Shield America action plan: "I have pilot fatigue. We don't need another [government] pilot where we wait 12 to 15 years for the results. We know what works, and we need to do it now."
Everything you are planning has been done and tried before. It was called something else, or it was done in a different venue. The best ideas are the ones that someone else has tried and implemented badly - take their experience and build upon it, and your program will succeed where they failed.
Sincerely,
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