July 2018                                                                                                                             Issue No. 3

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Fee-For-Service to Value-Based Payment Transformation: Successful Population Health Management - Part 5 - Installment 2

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

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In addition to our standing columns and usual coverage of up-to-the moment topics, this issue is filled with articles which highlight the hope, promise, potential, and success that are possible even in the midst of all the challenges which exist in healthcare today and the foreseeable future. They inspire and also remind me of three quotes that are among my favorites: 

"Never doubt that a small group of thoughtful, committed, citizens can change the world." 
                                          ~ Margaret Mead 

"I am only one, but still I am one. I cannot do everything, but still I can do something. And because I cannot do everything, I will not refuse to do the something that I can do." 
                                          ~ Edward Everett Hale 

"The people who are crazy enough to think they can change the world, are the ones who do." 
                                                                                     ~ Rob Stiltanen

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
My hope for this year is that the WHCMAA helps you engage with the Wharton healthcare community.  Want to connect with fellow alumni?  Attend a WHCMAA sponsored event.  In the midst of a career change?  Let us help you connect with career development resources.  Looking to start a conversation? Join the Wharton Healthcare Knowledge Network or connect through one of our social media sites.  Read more

Slip Not a Freudian Slip:  Personalized Health Is Often Not Personalized or Health - Part 1
Column Editor:   Connie Mester, MPH
There is quite a bit of confusion and misconception about personalized health.  Many times, 'personalized' health doesn't consider the whole person, the realities of life, or a person's emotional state or mental ability to recover, heal, or change. And even though a clinical lens provides insight into significant advancements in treating injuries and illnesses, we are missing a major part of the equation related to making an impact on health outcomes.   Read more .

cornerThe Philosopher's Corner
Contributor:   Beverly Bradway WG'91
This eclectic standing column features insightful musings, words of wisdom, life lessons, and stepping stones to business success. This month's philosopher is Beverly Bradway, W'91. Beverly is a marketing and management advisor to national and regional healthcare companies and a co-founder of Opting Back In, a company which provides women with the tools they need to return to work in part-time, flex-time, or full-time roles and succeed on Day One.  Read more .
We'd love to hear from you and invite you to click here to participate in future editions.  

affidavit Affidavit: Healthcare and the Law  - The Healthcare Cloud - Legal Issues 

Contributor: Lisa W. Clark, JD'89

Cloud-based services are revolutionizing the healthcare industry and providing significant business opportunities. Consider the following: globally, the revenue generated for healthcare cloud services purchased by healthcare providers is predicted to reach roughly $10 billion by 2021.  But cloud services typically are commodity services with little differentiation between them, and are offered on a 'take it or leave it' basis, leaving healthcare purchasers with little or no opportunity to negotiate a cloud service contract that suits their specific needs, including, in particular, with respect to the privacy of healthcare data and the security of the cloud service that is being purchased.  Although the cloud services offered by the brand companies are well known, there are an increasing number of smaller vendors that may be more willing to negotiate terms.  This article provides some additional background of cloud services in healthcare and addresses the data privacy, system security, and other contract issues that are important for purchasers to consider.   Read more .

SuccessDownloading Success: Merging Priorities - Syncing Your Business and Talent Strategies
Contributors:   Bob Clarke and Joe Mazzenga
Many leadership experts say it's time to knock down the silos in our organizations. While this is true, let's first understand why that is the case. If we are to innovate and disrupt our industries and our organizations, our executives must learn to become more than subject matter experts, i.e., savvy visionaries whose overarching concern is the health and strength of the entire enterprise, not just their department. This is precisely where business strategy and talent strategy need to intersect and graft into each other.   Read more .

DIY To Your Well-Being : Quantity or Quality?
Contributor:  Rich Butler, MS, USPTA

What do you weigh? A small percentage of you know precisely. A larger percentage may have an educated guess, but it will most likely be an underestimation. And then there are those of you who don't want to know. Weight is taboo culturally; feelings of shame, regret, and disapproval are attached to it. Weight is kept private, hidden, and disguised. Weight is one of the first observations our primitive brain notes, yet it tells us little.  Weight, like age, is a vague reference of someone's health status. Think of all the reasons you chose the computer you did; I suspect weight was not one of them. One of the reasons might be because weight does not describe the qualities of something, just the quantity.   Read more .

Contributor:  Maurice Jones 

Last year, Randy Oostra, the CEO of ProMedica in Toledo, related an epiphany that changed the way he ran his enterprise. His insight came at a time when he and his staff were discovering just how many patients in ProMedica's network of hospitals experienced food insecurity. In 2016, 36 percent of families from under-invested communities who rely on ProMedica's services said they were concerned about having enough to eat. Randy understood that broad economic and social issues - the social determinants of health - had to be addressed if ProMedica was to fulfill its mission to create a healthier community. And he sought partners who shared this mission. That's when he reached out to my organization,  the Local Initiatives Support Corporation (LISC).  In March of this year, our companies announced a joint commitment to invest $45 million in Toledo's residents and unserved neighborhoods in ways that support the well-being of all people.  Read more .

GrowthThe Future of the U.S. Healthcare System - Part 2
In this two-part series, Dr. Goldman explores the Affordable Care Act, approaches to stabilize the individual market, and a potential single-payer alternative. 

Absent any fix to the ACA, and the likely increase in the uninsured rate, many people are now arguing that it would simply be better to cover "everyone" in a "single-payer system." But what is meant by "a single-payer system?" What are the pros and cons of such a system, and how could it be made to work in the United States?  Read more .

What does $60.50 mean to you? 

For one young man, it was freedom. 

Z was arrested at age 15 for armed robbery. He was not alleged to have touched a weapon or to have taken any items from anyone, but he was present during a robbery and was charged under conspiracy liability as an adult. He spent approximately 6 months in an adult jail pre-trial and then was sent to a juvenile placement for 5 months. 

Z lost one of the most formative years of his life behind bars - a year of high school when many young people, including us a decade ago, were studying for the SAT, playing sports and musical instruments, and thinking of college. Once he was released, $60.50 of his remaining non-waivable court costs kept Z on probation. The $60.50 prevented Z from attending class and basketball practice. $60.50.  Read more .

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.  

Consolidation is awash in the U.S. healthcare system. Last year saw 115 healthcare-related transactions - the largest number in history. As we wrote in the introductory article for this series, we see that tremendous potential exists in these partnerships, yet achieving that potential is incredibly difficult and, in many cases, falls short of expectations. In this article, we look at the power of using a systems-thinking lens to promote "systemness" through the creation of a shared purpose and a collective strategy.  Read more .

This article is part of a series about value-based payments and their applications in the health care landscape. This is the fifth article in the series and will be part of a two-part installment on population health management. 

The complexity of pluralistic payment environments represents a new wave of challenges providers and health systems face in managing business within each of their markets. Previous articles in this series examined the foundation of new payment models, including structure and characteristics of unique value-based payment (VBP) arrangements, expectations around provider readiness, as well as how high-performing networks are constructed. Installment 1 of this two-part article will explore and address critical business functions required for successfully managing a defined population under a VBP arrangement.  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.