| Wellness is a Marathon |
March 2013
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The real opportunity in health achievement is to understand how health can be cool, how health messages can go viral.
I've been intrigued this month with a new author and his book: Jonah Berger, Contagious. Why? Because the headlines keep repeating that health care reform is on/off/on/off, but the fact is that HEALTH must go forward and expand. As Mayor Michael Bloomberg said recently, "2013 is the first year in history when there will be more people who die from too much food than the number who die of starvation." We simply must refocus our efforts, and understanding how and why messages are exchanged--and how we can use that knowledge to create HEALTH--must be our number one priority. Trying to control costs without preventing new outbreaks of disease is futile. Imagine trying to control the outbreak of polio by focusing on the costs of the treatment alone. What is clear to me is that folks spread some words but for various reasons, and often the original definitions become contaminated with new definitions, destroying the original intent. Take, for instance, "value-based" as it applies to health care. It has gone full-circle to now be used too often as a low-cost intervention, without regard to compliance that leads to higher functional performance. On the other hand, "tablet" seems to be taking on a new definition as a hand-held device for communication, no matter the manufacturer, so what's the difference in how "tablet" is used versus how "value-based," or "outcomes-based," is used? Does it relate to complexity? to messenger? or...?
To this end, I'm interviewing companies that purport to have innovation in Big Data; I'm tracking with a company that may well be positioning for an X-prize; and I'm interviewing and corralling true innovators in health promotion. These new innovators are measuring their work in healthy communities, including financial implications of health v healthcare. The US headlines are bereft of the amazing work going on in communities across the nation with folks who are eschewing the acronyms and, instead, are focused on "making our community healthier for people and business."
With new resolve, and after another of my invitation-only innovator summits recently, I have new data, new heroes, and new options for rapid innovation. I'll be at World Health Care Congress April 8-10 in DC, and I'm hoping to connect with you there.
Be well, Cyndy Nayer
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Cyndy's Voice
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I'll be at World Health Care Congress on April 9 at 2pmET, with new innovators and new info on Rapid Innovation. I hope you'll send me a note to share a cup of coffee with you!
[ps, I'll be sending out a coupon for your registration, so watch for it]
I do want to thank the folks from World Congress publicly for the stellar turnouts at the Orlando meetings: Onsite Clinics (where I keynoted and chaired) and Employer Health and Human Capital (where I keynoted--high heel roller skates were needed! LOL)Friday's closing session was standing room only. |
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LAUGHTER IS HEALTHY!
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Focus on Outcomes:
VALUE-BASED ECOSYSTEM and
WELLNESS IS A MARATHON | | |
Two key pieces in the Outcomes-Based Library are now complete. The first, Wellness is a Marathon, is an infographic review of the data in multiple surveys, showcasing the programs that are offered, the OBC that are inserted, and the levels of participation by the beneficiaries--and unfortunately, the responses range from less than 10% in so many instances. What the infographic doesn't tell you is that the higher levels of improvement are coming from the smaller companies, those under 5000 covered lives, and often under 500 covered lives. [That's what makes the website and these newsletters valuable to you...] 
The second is Value-Based Ecosystem, the laser-focus brief on defining out comes-based contracting and highlighting new snapshots of heroes working to use OBC to accelerate health outcomes. In early work with levers of value-based design, we defined 3 categories of levers: to improve prevention and wellness as a spotter of current risk; to reduce the natural progression of disease by identifying the emerging risk earlier and (chronic care management); and to guide beneficiaries to appropriate care (care guidance), which is not always cheaper care. In this brief, engagement and outcomes are optimized through value-based benefit designs and outcomes-based contracts for healthcare services, aligning metrics for success with an outcomes-based clause in contracts that re-focus service providers on the ultimate goal: the higher-functioning consumer who makes better health choices as well as better healthcare choices. |
| UPDATE ON MEDICARE READMISSIONS PENALTIES | 
Kaiser (KFF) reports that Medicare changed it readmissions formula, again. The good news is that readmissions have been falling, now hovering around 17.8% of all discharges (from a high of 19+% for the past 5 years). The penalties have been revised downward for many hospitals, saving hospitals approximately $10million. As a review: the government is looking at the number of heart attack, heart failure and pneumonia patients who return to the hospital within 30 days of discharge. Hospitals with more readmissions than Medicare expected given their mix of patients are penalized by losing up to 1 percent of their regular payments. The maximum penalty ramps up to 2 percent starting this October and grows to 3 percent the following year. Click on the logo at left to read more or to download the chart of revisions for hospitals across the US.
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| CONSUMERS DON'T BELIEVE CURBING MEDICAL CO$TS IS THEIR RESPONSIBILITY |
 | | hc consumers |
Do incentives work? There has been a lot of debate, and it's been a lot louder on LinkedIn, among other places. The goal of incentives is to increase participation and improve health and financial outcomes. The reasoning, like "Train the Puppy," is to use to the incentives to teach consumers to choose their health care and health lifestyles wisely.
But Health Affairs [http://content.healthaffairs.org/content/32/2/338.abstract] has published research that Kaiser Health News (click on picture at left to go to the article) has highlighted. The study shows that a majority of patients didn't want to factor costs into their medical decisions, nor did they want their doctors to do so.
What does this mean for us? It means that the trusted relationship is between the patient and the physician, and this is not new news. Every study for the past 10 years that has asked "who is the most trusted resource for medical information?" has shown physicians (and often care extenders) and pharmacists are the most trusted resources. In every survey that we've conducted in 15 years, River City (parent of CyndyNayer.com) has found that the biggest "Gee, I wish I could have done this better" response was: get the consumers/patients engaged more broadly, and get the physicians the info on benefit changes earlier."
Heads up: it's imperative that leaders in the workforce re-think how they are educating and incentivizing their workforces to choose more wisely. Legislating from the top down will rarely work; demanding cost comparisons will pale against the advice of the patient's physician.
This is another demonstration of the need to align the incentives between the physicians, the purchasers, the consumers and the payers: focus on the outcomes and include outcomes-based clauses in ALL of your service contracts, or find another service provider.
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End your newsletter with a kick — consider a postscript to reinforce one of the key product or service benefits.
Sincerely,
Cyndy Nayer
CyndyNayer.com |
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Join me at the 10th Annual World Health Care Congress in Washington DC on April 8-10
Watch for the preferred discount I'll be sending you!
I'll be bringing new ideas in Rapid Innovation, and I'm highlighting a new guest with actionable data to optimize engagement and outcomes. We are speaking at 2pm ET on April 9 Let's hook up!
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