July 2017                                                                                                                             Issue No. 3
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In Upcoming Issues
Fee-For-Service to Value-Based Payment Transformation: Provider Strategies and Readiness - Part 3

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

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This issue welcomes John Barkett, WG'09 as the incoming President of the WHCMAA. You can hear from him in his first President's Desk article as well as a Philosopher's Corner offering. John has been very active on the WHCMAA Board and has been a major force in planning for the October WHCMAA Alumni Healthcare Conference for the past 2 years. 

Hope all enjoy the trip from San Antonio to Mumbai and locales everywhere in between as we continue to provide insights, career development guidance, and up-to-date information on the latest trends and fundamentals across the healthcare landscape!

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

To learn more about Colette, click here.

presidentThe President's Desk
Contributor:  John Barkett, WG'09
It was the first week of school and Dave Kerwar was giving me the quick bio: he's from New York, went to Hamilton College, worked at Broadlane. "What's Broadlane?"  I asked. "It's a GPO." "Uh huh... What's a GPO?"

I'd come to Wharton wanting to gain a better understanding of how money flowed in our healthcare system.  Group purchasing organizations, I learned, offer providers discounts on the $100B of supplies they buy each year.  And now I had a classmate who could teach me their ins and outs. I'd come to the right place.

This is half of the magic of the Wharton Healthcare Management Program:  your classmates are up-and-coming experts from every corner of the healthcare system.  The other half?  These experts become your friends.   Read more

slipNot a Freudian Slip:  The Happiness Trend - A Healthy Pursuit or an Obsessive Quest?
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. We'll consider how our digitally connected mobile and media- infused world could be damaging our happiness level. Lastly, we will uncover what characteristics can be strengthened or enhanced to boost our happiness (traits like empathy, compassion, kindness, gratitude, etc.) and subsequently our health and well-being.    Read more .

openwide The Philosopher's Corner
Contributor:   John Barkett, WG'09
This eclectic standing column features insightful musings, words of wisdom, life lessons, and stepping stones to business success. This month's philosopher is new WHCMAA President,  John Barkett, WG'09, Senior Director of Policy Affairs for Willis Towers Watson Exchange Solutions.   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

As the healthcare reform debate rages on, the public is grappling with macro questions - "How can we spend less?" and personal concerns - "How can I and my family get the care I need and want?" Given the financial unsustainability of our current system, the debate focuses on cost issues, and so we look for structural solutions like lifting mandates on insurance coverage, replacing the provider fee-for-service reimbursement model with one based on quality performance, better deploying technology within the healthcare system, and making Medicaid a State block grant program.  Underlying these discussion points is the issue of who gets what, otherwise known as rationing.    Read more .

SuccessDownloading Success: Emerging (and Sustainable) Healthcare Leadership Roles
Contributor:   Paul Bohne
When I speak with healthcare executives about career ambitions, I caution them not to get too fixated on any one position title. I like to encourage executives to look around and consider positions that will allow them to grow and find meaningful work. This is especially true in healthcare today since roles - and titles - are changing. On that note, allow me to highlight five executive titles that I see gaining significance and importance in healthcare, no matter what the unpredictable future holds. These are positions that seem to have sustainability - once created at an organization they will be around in good times and bad.   Read more .

DIYMedical Transportation Benefits Management  
Contributor:  Beverly Bradway, WG'91

When the need for medical transportation arises, families often have no time to plan, and it's the clinician, facility, or circumstance dictating who the transportation provider will be.  As a result, patients, their families, and insurers are exposed to inconsistent practices and the unpredictable fees levied by independent and unregulated providers. This is an all too common occurrence in the currently frag-mented state of the medical transportation industry. The risks in medical transportation are growing as use of air and ground ambulance for medical transport increases.   Read more .

This article is part of a series about value-based payment and its applications in the health care landscape. Part 1 provided an overview of the landscape. This second article in the series begins the review of provider readiness through a discussion of risk-bearing options for physicians, hospitals, and health systems. Value-based payment models continue to increase at an escalated rate in prevalence and variety, giving providers an increasing number and mix of options for entering into arrangements ranging from simple to complex and from low to high risk, all based on value rather than volume. Knowing how to begin assuming risk is complex - there is no one-size-fits-all approach.    Read more .

GrowthMoving the Culture from Individual Heroics to Systemic Value Creating a Culture of Value - Part 2
Although the direction of U.S. healthcare policy remains uncertain, the need to improve quality and experience while driving down cost remains a priority.  The value equation [defined as (quality + experience)/cost] touches every aspect of healthcare, and, while simple to define, it can be difficult to translate into action. Building value into organizational culture holds tremendous potential. In Part 1 of this series, we defined a Culture of Value as one where everyone, from frontline staff to C-Suite leadership, understands what it means to create value for patients, providers, and the system, including how to act in ways that enhance value from each of their respective roles. In Part 2, we share a case depicting a common healthcare challenge: how to orient the culture from volume to value.   Read more .

Humana's Bold Goal - to improve the health of the communities we serve 20 percent by 2020 because we make it easy for people to achieve their best health - has brought lasting and far-reaching improvements to multiple communities, with San Antonio leading the way. 

In our last article, we talked about how the community has embraced our Bold Goal efforts and the early momentum we achieved. We'd now like to showcase the gains made over the past year - with the help of our community and physician partners - in addressing the social determinants of health, like food insecurity, health literacy, and loneliness.  Read more .

Contributor: Viba Saligrama, WG'17 
This past spring break, three members of the Wharton Global Health Volunteers (WGHV) traveled to Mumbai, India to work with Swasth Foundation (Swasth). In India, "Health Shocks" drive 60 million Indians below the poverty line each year. Primary care can reduce the "Health Shocks" by 2 - 2.5 times, but inadequate public infrastructure leaves the urban poor without enough access.  Swasth is working to address this issue with a mission to create Health for All. They have built 18 low-cost, scalable, and patient-centric clinics providing one-stop access to high-quality, affordable services at less than half the market rates. Swasth plans to scale and build 50+ clinics in the coming years.  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.