May, 2017 vol. 2 - In This Issue:
We have a lot of work to do to restore the faith of patients in those who hold the power in the healthcare system; namely, policymakers, payers (insurers; employers) and clinicians. Endless rhetoric and gambling with people's lives in the form of drastic cuts to benefits or coverage fails to take the long view. If we want a system that works --- no wrong door to access; focused on prevention and basic primary care; evidence-based; with shared financial responsibility based on ability to pay --- those in the power seat(s) need to ask patients and caregivers for perspective. Wouldn't it be refreshing if all the behind-the-scenes negotiating came out in the open and engaged real patients and caregivers in a citizen's forum? Those living the reality day-to-day likely have the best insight and potential solutions

CMS Press Releases Take on a More Political Tone

Releases mentioning the ACA emphasize negatives

The Affordable Care Act (ACA) is "driving up insurance costs and reducing choices." The American Health Care Act passed by the House will help the U.S. "move toward patient-centered healthcare instead of government-centered healthcare."

Lines from a Republican congressional campaign brochure? Remarks in a speech by President Trump? Nope -- those are parts of press releases issued by the Centers for Medicare & Medicaid Services (CMS).

Usually, press releases from CMS are pretty matter-of-fact, and the releases issued by CMS under the Obama administration seemed to stick with tradition.

The Internet Is Making Us Lose Trust In Our Doctors

How well do you trust your doctor?
Is seems that, at least for parents, a level of trust might be impacted by exposure to online medical information. A  study presented at the 2017 Pediatric Academic Societies suggests that doctor/patient trust and the drive to a second opinion--in a digital age--might be more fragile than we thought. In this study, 1,374 parent participants were presented with a vignette of a child who "has had a rash and worsening fever for three days."  The participants were divided into three groups, and the first two were presented with information related to the symptoms as computer screen shots.

A Whistle-Blower Tells of Health Insurers Bilking Medicare

When  Medicare  was facing an impossible $13 trillion funding gap, Congress opted for a bold fix: It handed over part of the program to insurance companies, expecting them to provide better care at a lower cost. The new program was named Medicare Advantage.

Nearly 15 years later,  a third of all Americans who receive some form of Medicare have chosen the insurer-provided version, which, by most accounts, has been a success.

But now a whistle-blower, a former well-placed official at  UnitedHealth Group, asserts that the big insurance companies have been systematically bilking Medicare Advantage for years, reaping billions of taxpayer dollars from the program by gaming the payment system. 

VA Chief Wants to Get Rid of Healthcare Deadwood

'Accountability' comes up repeatedly at hospital association meeting

Getting rid of under-performing employees and hiring more healthcare professionals are just a few of the ways that Secretary of Veterans Affairs David Shulkin, MD, wants to improve the healthcare provided by his agency.

"Part of what we have had to do is to say that not everybody has the right or privilege to work at the VA," said Shulkin at the American Hospital Association annual meeting on Monday. "When people lose their values, or deviate from our purpose or what our mission is, they lose that right." 

Stewardship at small hospitals: Stretching limited resources

Small community hospitals constitute a significant portion of the US healthcare system. In 2015, nearly three quarters of US hospitals had fewer than 200 beds. Every day, in rural and urban areas across the country, these facilities play a critical role in caring for millions of Americans.

And while data are limited on antibiotic use in these facilities, recent studies suggest that antibiotic usage in small community hospitals is not much different than it is at larger facilities. In addition, rates of drug-resistance appear to be similar as well. In short, overuse of antibiotics and emerging resistance is just as much an issue at small community hospitals as it is at large academic medical centers.   

I'm a doctor. When my mother was dying, I wish her doctors had told me the truth. 

Sometimes it feels like the great unspoken secret between doctors and nurses. The words that we dare not utter to patients and families. Perhaps it is our hope that we're wrong. Perhaps we dread providing unwanted news. Perhaps we don't want to face reality or extinguish our patients' hope.

As a daughter, I felt that sense of sadness and dread, waiting to hear the news that would not be told. It was September 1989, and I was only 20 years old and just beginning my first year of medical school. It was less than a week from my first exam when my mother developed intractable nausea and vomiting. After several days of suffering at home, she decided it was time to go to the hospital.    

RWJ report highlights opportunities for improving patient care

A study by  Rutgers Robert Wood Johnson Medical School found that Medicaid patients who most frequently visit New Brunswick hospitals are concentrated in nearby "hotspots," a critical first step to determine how to improve care and lower costs for some of the area's neediest residents.

From a total number of 45,316 patients who visited Robert Wood Johnson University Hospital and Saint Peter's University Hospital from New Brunswick and Franklin - the areas targeted in the study - researchers identified 1,370 who visited the emergency rooms five or more times in a two-year period, or had three or more hospital stays.     

Passion + Quality = Change That Matters
I embrace the powerful opportunities in our evolving health care landscape. I founded Momentum Health Strategies to be a catalyst for change through continuous learning, diverse engagement and thoughtful policy and practice initiatives. I deliver innovative, strategic thinking and a passion for improving the patient experience. My personal drive and dedication to high-quality results will help you navigate the competitive terrain you face and convert your vision to action.

Momentum Health Strategies

Jennifer L Bright, MPA
(703) 628 - 0534