April 2017                                                                                                                             Issue No. 2
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Fee-For-Service to Value-Based Payment Transformation: Provider Strategies and Readiness - Part 2

Fee-For-Service to Value-Based Payment Transformation: Integrating Medicare and Commercial Payors While Embracing Medicaid - Part 3

Fee-For-Service to Value-Based Payment Transformation:  Successful Population Health Management - Part 4

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I am excited to announce a new column - Download Success - which will provide readers with information and guidance regarding both organizational and individual growth and development! Content will be contributed by premier executive search firms, with our inaugural article "A Setup for Success: Developing Physicians to Become Organizational Leaders - A Holistic Approach" by Bob Clarke, CEO of Furst Group and  NuBrick Partners, in collaboration with Joe Mazzenga, Managing Partner of NuBrick Partners. Thanks to Kate Reed and the Career Development Committee for your collaboration in helping to bring this new offering to the table! 

The issue also welcomes back Dr. Harris Contos, DDS, WG'80 as a contributor with his timely article "Health Insurance at Ground Level," which provides one view inside the Affordable Care Act in his interview with Karen Marriner, a licensed health insurance agent in California. 

Lastly, just a reminder about "The Entrepreneur's Playbook," which will
focus on entrepreneurs and start-ups across the spectrum of the industry. We would love to
hear your story, so if you are interested in contributing an article please contact us at 
whc_e-magazine@whartonhealthcare.org and complete this
template .

Z. Colette Edwards, WG'84, MD'85
Managing Editor

To learn more about Colette, click here.

presidentThe President's Desk
Contributor:  John Harris, WG'88
In times of uncertainty (like now) it's easy to put our heads down and worry about navigating a complex policy and business environment by doing what we think is right for our organization. But we are called on to do more. Not as Republicans, Democrats, or Independents, liberals or conservatives, but as healthcare industry leaders and professionals.  Read more.
openwide The Philosopher's Corner
Contributor:   Kate Reed, WG'87
This eclectic standing column features insightful musings, words of wisdom, life lessons, and stepping stones to business success. This month's philosopher is Kate Reed, WG'87.   Read more .
We'd love to hear from you and invite you to click here to participate in future editions.  Column Editor: Z. Colette Edwards, WG'84, MD'85. 

Column Editor: Lisa W. Clark, JD'89

Last year, St. Jude Medical and Abbott Laboratories announced they were engaged in negotiations for Abbott to purchase St. Jude Medical for approximately $25 billion.  The deal closed on January 4, 2017, a week after the Federal Trade Commission announced it would approve the acquisition, which has been subject to an intensive antitrust investigation.  The timing of the FDA's Safety Communication, which was issued five days after the deal closed, is interesting, suggesting that obtaining the FDA's agreement to sign off on Merlin@home™'s cybersecurity issues may have been related to the deal.  Although the St. Jude's Medical Merlin.net™ Patient Care Network was only one of St. Jude Medical's product lines, the discovery of the cybersecurity issues during deal talks could not have been welcome. Not only did this discovery result in an FDA investigation but in a significant dip in stock price after an outside party uncovered and announced the vulnerabilities.    Read more .

SuccessDownloading Success: Developing Physicians to Become Organizational Leaders - A Holistic Approach
Contributors:   Bob Clarke and Joe Mazzenga
The healthcare environment has experienced continuous and tumultuous change for a number of years. There is no question that change is the one constant that can be expected for the foreseeable future. What is required during times of upheaval is leadership. Leaders provide hope. It is at such a time as this that physician leadership is especially vital. Yet the phrase "physician leadership development" doesn't appropriately describe what needs to happen as doctors take on executive roles. Leadership development is not something that is done *to* physicians to enable them to fit into the organization and embrace the executive mold created for those who would lead the company. The organization itself must be renovated to adapt to the new leadership required of a new era.  Read more .

DIYWhy I am happy I am not an expert, and you might be happy not to be one too.   

I am not an expert. And, I am happy about it.  I have been a CEO, one with objective success when viewed with the conventional metrics of quality and financial performance, customer satisfaction, employee satisfaction, and longevity in the job. I practiced actively for 20+ years as a physician.  In addition, I have been a physician executive for over 30 years. And, in my retirement, I am a busy consultant, both paid and mostly unpaid.  Over my long career as a trained professional I have been asked for my advice based on my "expertise" innumerable times.  People continue to seek my advice. That is one of the main reasons that "not being an expert" is so important. Read more .

Managed care and risk delegation grew significantly between the 1970s and 1990s as a way to attempt to control costs, culminating in the shift toward health maintenance organizations (HMOs) in the 1990s.  The shift waned in the 2000s after failures due in large part to lack of adequate divisions of responsibilities among payors, providers, and institutions, and inadequate (in many cases non-existent) care management systems - critical to success in taking risk for populations. Patients (consumers) were asking for choice, while payors began refocusing on improving quality. However, as U.S. healthcare costs continue to grow, the Centers for Medicare and Medicaid Services (CMS) are now pushing providers and payors to balance managing utilization, proving the value of care, and ensuring the highest quality possible through "value-based payments" (VBP).  The rules for success in this new world of VBP are different depending on the player, market position, and current state readiness for assuming risk.   Read more .

 GrowthCreating a Culture of Value - Part 1
This is the first piece in a series of articles about creating a "Culture of Value" in your organization. In this article, we introduce the need for a Culture of Value in healthcare and introduce interprofessional collaboration (IPC) as the foundation for this work. 

Even today, as organizations launch so many efforts to improve value, the question of sustainable change remains. How can we create a "flywheel of value"- one in which the momentum for culture change propels sustainable results? We see creating a Culture of Value as a necessary component to meet the needs of both today's and tomorrow's population health efforts. Read more.

Contributor: Brian Holzer, WG'05 
Society teaches basic fire escape planning generation after generation, starting as early as preschool. Simple concepts are taught such as: 
          • Prepare for the event of a fire. 
          • Install smoke alarms for early fire detection. 
          • Focus on older family members with mobility limitations. 
          • Identify an outside meeting place. 

Thankfully, many of us may never have to experience a house fire. Yet, we teach our kids to prepare for this unlikely event. The same basic principles are largely ignored when it comes to planned or unplanned hospitalizations. As our loved ones age, hospitalizations are a likely event. Patients and families are not prepared. Read more.

Contributor: Harris Contos, DDS, WG'80 
Health policy in America, what is to be made of it...? Often it is described as pluralistic; pragmatic; a mix of the public and the private; "ecclesiastical, eleemosynary, entrepreneurial, elected" (as described by Bill Kissick); flexible; diverse, and perhaps most familiarly, incremental, implying that a national health insurance scheme, some form of a "Medicare for all" (now over 50 years since enactment), for reasons of both efficiency and equity, would ultimately come to pass in the United States. But with the election of Donald Trump, the political climate has changed, and rather than going further down the incrementalist path, or even pausing along it to regroup for the next step along it, incrementalism stands to be replaced with "decrementalism" (not seen since the repeal of the Medicare Catastrophic Coverage Act in 1989), an inchoate effort to undo the ACA, to be replaced by... well, no workable offering has emerged.   Read more .


Disclaimer: The opinions expressed within are those of the authors and editors of the articles and do not necessarily reflect the views, opinions, positions or strategies of the Wharton School and/or the University of Pennsylvania, and/or their respective organizations. Publication in this e-magazine should not be considered an endorsement. The Wharton Healthcare Quarterly e-magazine and WHCMAA make no representations as to accuracy, completeness, currentness, suitability, or validity of any information in this e-magazine and will not be liable for any errors, omissions, or delays in this information or any losses, injuries, or damages arising from its display or use.