April 2018                                                                                                                             Issue No. 2
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In Upcoming Issues
Fee-For-Service to Value-Based Payment Transformation: Integrating Medicare and Commercial Payors While Embracing Medicaid - Part 4

Fee-For-Service to Value-Based Payment Transformation: Successful Population Health Management - Part 5

Fee-For-Service to Value-Based Payment Transformation: Successful Population Health Management - Part 6

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CVS-Aetna. Express Scripts-CIGNA. Walmart getting into the ACO business. Healthcare continues to be the modern-day Wild, Wild West of our time, with no end in sight. The relentless change offers both challenges and opportunities. And, sometimes, even transformation. 

Stay abreast of the vibrating landscape with the Wharton Healthcare Quarterly, which continues to provide an eclectic mix of topics with a goal of: 
          • providing at least one article that will be germane to your work/life and/or 
          • offering insight into an area that may be completely new to the reader but important to one's knowledge base to stay up-to-date, relevant, and positioned to leverage moments and timing that can make all the difference. 
Happy reading!

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

To learn more about Colette, click here.

president The President's Desk
Contributor:  John Barkett, WG'09
The annual release of the National Health Expenditure projections is usually one of my favorite days of the year (sad...but true), but this February's release left me pensive. It wasn't the numbers themselves; 5.5% growth is what we've come to expect in healthcare spending projections. Rather, it was a perspective I read accompanying the release that left me thinking about my own career and those of my fellow Wharton HCM alumni. In his essay, the economist David Cutler argues there's nothing wrong with spending more on healthcare if we're happy with what we get, but how can we be happy when such high spending drives inequality and much of what we buy is waste?  Cutler is the reason I work in healthcare.   Read more

Slip Not a Freudian Slip:  The Happiness Trend - A Healthy Pursuit or an Obsessive Quest? - Part 4
Column Editor:   Connie Mester, MPH
This article series focuses on happiness and answers the question - does a constant pursuit of happiness make us unhappy? We will explore the importance of happiness and how it impacts our quality of life. 

This series of articles has focused on our happiness obsession.  In Part 2 we discovered that money and a constant pursuit of happiness doesn't really do the trick.  And, the misconception about constantly being digitally connected in Part 3 was proven to be more harmful than good to our overall happiness.  We uncovered, in Part 1, that happy people function better and are more productive and healthier, which could be fueling our quest to infuse more happiness and fulfilling moments into our daily life.  But how do we actually reach this pinnacle?  Read more.

cornerThe Philosopher's Corner
Contributor:   Bernie Zipprich, WG'16
This eclectic standing column features insightful musings, words of wisdom, life lessons, and stepping stones to business success. This month's philosopher is Bernie Zipprich, WG'16. Bernie is Senior Director of Enterprise Product Management at Welltok, a health tech company focused on consumer engagement.   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. 

affidavit Affidavit: Healthcare and the Law  - Innovation and Modernization: Reshaping FDA Regulation of Digital Health Solutions 

Over the last year the FDA has made digital health a priority and is modifying the traditional regulatory processes for digital health. Developers, investors and other stakeholders should follow these developments carefully.   Read more .

SuccessDownloading Success: Diverse Teams Deliver Innovation, Success, and Profitability 
A recent study by researchers from North Carolina State University and Portland State University found that corporations with policies that value women and minorities "are more innovative, value intangibles and human capital more highly, have greater growth options, have higher cash flow, and have stronger governance." In addition, the study demonstrated that diverse companies weathered the recent U.S. recession more easily. Studies also reveal that diverse leadership teams rely more on facts when making decisions and make fewer errors when dealing with those facts - they are more careful and deliberate in their decisions.

Yet diversity alone doesn't make inclusion an automatic result. As diversity experts have stated, "Diversity is being invited to the party. Inclusion is being asked to dance." 
Read more .

DIY To Your Well-Being : The Last Flight of Stairs
Contributor:  Rich Butler, MS, USPTA

In 1982 Dr. James Fries introduced a concept called "the compression of morbidity."  In the keynote address to the Institute of Medicine, he stated that one's ability to maximize the number of years they live with vigor and absent of life changing disease is related to lifestyle habits.  His point at the time was that, although we may not extend our life in years, we can minimize the amount of time that we are highly dependent, at the mercy of physical limitations, or frail.  Read more .

In this two-part series, Dr. Goldman explores the Affordable Care Act, approaches to stabilize the individual market, and a potential single-payer alternative. 

It is ironic that those who favor Managed Competition for Medicare generally oppose the ACA, while those who support the ACA are disinclined to favor a similar approach for Medicare. And that's where the current stalemate resides.  Read more .

GrowthMaking the Bet on Population Health Pay-Off: Realizing "Systemness"
In this series of articles, we will introduce a few tools and ideas for realizing "systemness" by defining and aligning strategy and leadership, integrating the clinical enterprise, and enhancing corporate services.

By systemness, we mean acting as one organization, with a defined and aligned strategy, a clinical enterprise that shares data, protocols, and resources, and an administrative infrastructure that enables the operating entities to cost effectively provide value to the population. Not surprisingly, health systems are struggling to achieve systemness. A 2016 Vizient report indicated there was more variation in care within each health system than between different systems. They also note the unrealized value is high.  
Read more .

Today, 75% of health plans offer telemedicine service reimbursement, and more than 15 million Americans received some form of medical care remotely in the last year. However, telemedicine is not as simple as "skyping" with a patient. Web-side manner, physical examination, clinical decision-making, documentation, and care coordination need to be adapted for a video platform, in addition to supporting a HIPPA-compliant technology platform. 

The top 5 urgent care conditions currently treated through telemedicine  services include allergies, cough, upper respiratory infections, sinusitis, and rashes. We'll discuss how telemedicine can be used to diagnose allergic rhinitis and improve care coordination with allergists.  Read more .

Contributors: Lisa Soroka and Wren Keber 
Entering into value-based payment (VBP) arrangements are designed to reward physicians, hospitals, and health systems for achieving positive health outcomes while simultaneously decreasing or maintaining costs. In this installment of our value-based payment series, we will look at some more characteristics of evaluation readiness to move away from traditional fee-for-service (FFS) payments and toward an alternative payment mechanism or some risk-bearing arrangement(s).  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.