October 2017                                                                                                                             Issue No. 4
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Fee-For-Service to Value-Based Payment Transformation: Provider Strategies and Readiness - Part 4

Fee-For-Service to Value-Based Payment Transformation: Integrating Medicare and Commercial Payors While Embracing Medicaid - Part 5

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

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Congratulations to the Leonard Davis Institute on its 50th anniversary, which is being celebrated by a year's worth of events, including the action-filled "Shaping the Future of Healthcare" symposium to be held October 5 - 6, 2017! It promises to be THE healthcare event of 2017. There will be keynote speakers across the healthcare spectrum and breakout sessions that will make it difficult to decide which to attend, but all of which will leave you smarter and better prepared to address the many and myriad challenges which are healthcare in 2017: 
          • Leveraging Innovative Healthcare Models to Serve Vulnerable Populations 
          • Predicting the Future: Transforming Big Data into Smarter Care 
          • System Redesign and the Healthcare Workforce 
          • The Future of Payment Reform 
          • Strategies to Advance Population Health 
          • Shaping the Future of Medicare 
          • The Future Landscape of Children's Health 
          • Behavioral Science and Health 
          • Value Frameworks in the U.S. 
          • Risk Adjustment and Measuring Quality

I'm also happy to announce a new standing column, "To Your Well-Being," a series of articles from integrative health and well-being experts at Canyon Ranch in Lenox, Massachusetts. As is their guiding intention for their guests, I invite you to explore "The Power of Possibility."

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
On July 28, 2017, Senator John McCain cast the deciding vote to sink legislation that would repeal the Affordable Care Act (ACA). Diagnosed with brain cancer the week before, Sen. McCain shocked DC by bringing the Senate's efforts to repeal the ACA to a screeching halt. That was four days ago as I type these words; the CSPAN video of McCain motioning "thumbs down" is still replaying in my head. 

July 28th also happened to be ten years to the day from when I touched down at PHL to start Wharton pre-term. The only thing I remember about that day was being greeted by slate-colored smoke billowing from the oil refineries off 291. An inauspicious start, sure, but had I known what to expect of the next two years, I would not have been concerned.  Read more.
openwide The Philosopher's Corner
Contributor:   Amanda Wyatt, WG'17
This eclectic standing column features insightful musings, words of wisdom, life lessons, and stepping stones to business success. This month's philosopher is Amanda Wyatt, WG'17. She joined the Marketing Rotational Program at Pfizer in New York City after graduation this year.  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. 

slip Not a Freudian Slip:  The Happiness Trend - A Healthy Pursuit or an Obsessive Quest? - Part 2
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. 

The unhappiness of not being happy. Does this constant pursuit of happiness make us unhappy? In Part 1, we learned how being happy has positive impacts to our health and longevity. One might translate that fact into thinking we should be in constant pursuit of happiness. Should we be focused on happiness all of the time? Can we buy more happiness or could we be doing more harm than good by endlessly trying to weave happiness into every ounce of our lives? 

Column Editor: Lisa W. Clark, JD'89

The opioid crisis has grabbed headlines due to its horrific effects on the lives of addicts and their families, friends, and communities. Less well-understood is the impact of the crisis on employers, yet they will have to be part of the solution including through increased drug testing. Various initiatives have been introduced to combat the crisis by different levels of government.  Read more .

SuccessDownloading Success: Executive Succession and Leadership Development - Part 1: Careful Planning Avoids Disruption and Fuels Corporate Continuity
Contributors:   Bob Clarke and Joe Mazzenga
In Part 1 of this two-part series, we explore the executive succession planning (or lack thereof) landscape and the opportunities for leadership development it can represent if undertaken strategically and effectively.
The hospital had waited too long. Greg (not his real name) had been the CEO for many years, but when he announced his retirement plans, there was no one waiting in the wings to take his place, no one who had been groomed for just this moment. 

Greg's story is a common scenario that, unfortunately, is replayed every year in provider and payer organizations across the U.S. In a recent survey by the National Association of Corporate Directors, 55 percent of organizations admitted their succession plans were informal, and 6 percent had none at all.  Read more .

DIY To Your Well-Being: Beyond the Headlines of "Getting Cut"  
Contributor:  Rich Butler, MS, USPTA

Let's settle this debate.  If you were asked to select the most important muscle in your body what comes to mind?  The answer might depend on whether you are posing on your beach towel, firing away on the golf range, or tossing that kettlebell around.  The 'core' would get some votes.  Certainly your primary movers like the quads or the lats for the cross country skier might receive some support.  But the muscle I would choose is rarely seen yet can produce the most profound outcomes.   Read more .

Contributor:  Sandeep Puri, WG'99 

Digital Health funding crossed $8B in 2016, according to a report by Startup Health. Almost 160 patient/consumer experience focused companies received funding in 2016 - between 2-3X as many as other subsectors. Most of the companies in this space are targeted to the healthier, wealthier, and more literate segments of the population. It makes sense from a purely economic perspective - target the easier-to-engage segments that have a higher propensity to pay. 

But, what about from the public health perspective - will these investments in digital health help bend the cost curve and improve health outcomes for the population as a whole? I doubt it. Twenty-five percent of the U.S. population lives in rural areas where the socioeconomic conditions of the population create a huge demand for healthcare, and, at the same time, a unique challenge for delivery of healthcare.  Read more .

 GrowthFrom the Halls of Academia: The State of Social Responsibility in Corporate America
Contributor:  Stephanie Watts, PhD 

When those in healthcare gather to socialize, talk may begin with some light banter about shows to stream on Netflix and best new books to read. But when weightier matters are raised, the subject of corporate America often comes up. The healthcare community has long been aware of the negative externalities (i.e., consequences) of corporate behavior - environmental toxins, workplace stress, teen anorexia, to name a few. And clearly corporate money is having a powerful impact on our political system. But vilifying all corporations is simplistic and divisive. Corporations exhibit a vast range of behaviors reflecting the values of those running them. This article discusses how to discern the better ones in terms of their impact on a number of aspects of public health.    Read more .

Contributor: Beverly Bradway, WG'91 
It was October 26, 2003 when Lisa Belkin put words to a growing societal trend describing "The Opt-Out Revolution." The women she was referencing were in their late 20s and 30s, armed with impressive undergraduate and graduate educations and fully engaged in promising careers while competing handily alongside men.  Thanks to the hardworking feminists before them, many of the barriers to achievement were largely removed. "The polished and purposeful women" were well-equipped to run the world. Yet, after ten or fifteen years of hard-charging careers, new trends surfaced as many of these high-achieving women with great potential were suddenly re-evaluating goals, placing greater value on their role with family and a need for balance, and putting careers on hold.  As Belkin stated, it was becoming "a revolution stalled."  But the opt-out revolution seems to be giving away to a new revolution of opting back in.  Read more .

Contributor: Paul Tirjan, BA'89, WG'01 
Just over a year ago, I embarked on a new journey into the realm of collaborative alliances among not-for-profit integrated healthcare systems. The proliferation and maturation of this type of non-merger partnering organizational framework has led to the formation of SRHO (Strategic Regional Healthcare Organizations), the national association, earlier this year. My organization, AllSpire Health Partners (AHP), a founding member of SRHO, has five health systems, thirty-six hospitals, ten thousand physicians, seventy-five thousand employees, and serves a community of greater than ten million residents. Certain fundamental principles must be observed in the behavior of alliance members to build the kind of trust that enables them to endure. The extent to which these principles are evident in all aspects of these collaborative relationships determines the corporate culture of the enterprise and impacts prospective members, employees, patients, business partners, vendors, regulators, and the general public in our communities.  Read more .

Contributor:   Lisa Soroka and Wren Keber 
Ideally, value-based payment (VBP) arrangements are designed to financially reward physicians, hospitals, and health systems for achieving positive health outcomes while simultaneously decreasing or, at minimum, maintaining costs. In this installment of our value-based payment series, we will look at various 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 .

Contributor: Griffin Myers, MD MBA 
In 2017 healthcare leaders are focused not only on administrative efficiency but also on achieving the triple aim: improving the patient experience of care (including quality and satisfaction), improving the health of populations, and reducing the per capita cost of healthcare. And according to the Institute for Healthcare Improvement, the National Committee for Quality Assurance, and the American Medical Association, there's a growing recognition that interdisciplinary, team-based care has a role to play in achieving those ends. So how do we reconcile the old model of "physician versus administrator" to the new model of team-based care?    Read more .

Teamwork and collaboration across disciplines is often expected, but rarely taught or explicitly promoted.  In Coaching 2.0, the leader is central, but the focus expands to the actions of the broader team and the structure and resources needed to tackle the organization's most critical priorities. In other words, what does the business need to succeed, and how do we re-orient the leader, the team, and the ways in which they work together to make success possible?   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.