ACO’s: Missing Accountability from a Very Critical Stakeholder

Wendy Lynch

First published 3/10/11 on the Altarum Institute Blog

Imagine you decided to run an Accountable Car-Care Organization.  The government announced you would no longer be paid on repairs alone, but for keeping cars on the road and out of the garage. You might contract with qualified teams of mechanical providers, from oil-change garages for preventive maintenance, tow-truck drivers for emergencies, to specialist mechanics for very technical repairs.  Next, you assemble secure, integrated information technology to track the care each automobile receives across providers and assign each license plate number to a vehicle-centered mechanical home. Finally, you determine specific outcomes and standards of practice to keep engines running better. Under ACCO rules, you are ready to start earning performance bonuses.  Right?

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A Small Detail Behind Wisconsin Protests Illustrates Why Big Change is Needed

Wendy Lynch

A doctor’s excuse is normally a harmless slip of paper. But in the heated debate over public bargaining rights in Wisconsin, it is a clear illustration of just how disconnected workers can be from the very cause for which they are fighting.

It’s a dramatic scene.  The Wisconsin legislative process has all but ground to a halt as democratic lawmakers actually fled to a nearby state and thousands of state workers picket and protest in defense of their right to bargain collectively.  The Governor insists that the state has insufficient funds to support union demands and wants unions eliminated or severely restricted.  The unions, in return, insist that they will negotiate in good faith to help with the budget crisis, and that they will be prudent with tax-payer money while times are hard.

Buried in coverage of the political theatrics, an interesting detail caught my attention:  Doctor’s notes for protesters spark controversy.

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Americans Use Fewer Health Care Services In 2010: What Will We Learn From This?

There were fewer visits to the doctor in 2010 compared to the year before. What does this mean? It depends on whose opinion one reads.

The facts: There were fewer doctor visits, lab-tests, hospital admissions, and lower overall utilization in first three quarters of 2010 than the year before (1). Visits were down 7% in the first half of 2010 compared to 2009. Despite predictions that utilization would rebound in the third quarter when deductibles were met, it did not(2), which has surprised many. Such a downward trend is a new phenomenon. Insurers have never seen this before, even during past recessions.

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Is a Good Education the Best Medicine of All?

Wendy Lynch

Originally published by the Altarum Institute.

Junior, do your homework so you can grow up to be big and strong.

There is an undeniable link between education and health, even as we age. More school translates to:

– Lower incidence of virtually every chronic disease;
– Longer life span; and
– Higher self-ratings of health at every age (1).

But why and how education makes us healthy is not as clear. Some advantages of book work are obvious: education allows you to get a better job, earn more, have access to health care benefits, and perhaps gain a better grasp of health information that allow you to make better decisions. All true, but none fully explain the positive effect that education has on health. It is more complex than these factors alone (1, p. 51).

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I Have A Holiday Wish: That We Muster The Courage To Reign In National Spending.


Originally published 12/14/2010 on the Health and Human Capital Foundation Blog.

‘Tis the season to wonder how to work off the extra pumpkin pie calories and pay off those Black Friday purchases! We know that a dollop of reality isn’t anyone’s holiday favorite, but it may be timely for all of us to acknowledge the belt-tightening our country must face as we approach the New Year. If social spending cuts in EnglandGreece, Spain, Germany and other countries are any prediction (12), some would argue that we are late in taking action. Is there hope that we’ll wake up and realize that now is the time to start trimming our national spending—even as we trim our tree—by making tough, necessary choices?

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Mandated insurance coverage means mandated cost. What do we really want to pay for?


Originally published here on 9/08/10 on the Health As Human Capital Foundation Blog

Have you ever tried to purchase cable television with just the channels you want to watch, and been told that you need to buy the ‘whole package’ to get service? Sound like your cell phone plan?

We often see private companies ‘bundle’ services to boost revenue or maximize their profit margins, and as consumers, we have to decide if we’re willing to purchase these sorts of arrangements. But what would happen if the government were to require the public to purchase a service, and then mandate a very expensive bundle of services without giving consumers a choice about what’s included? Welcome to healthcare.
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One Minute Left in the Game. Score: Patient Education 100, Patient Accountability 0


Originally published 10/05/10 at the Health and Human Capital Foundation Blog.

There is a sad irony in new healthcare reform provisions released last week. It rewards (or at least relieves financial pressure on) health plans for virtually every bit of educating, assessing, coaching and reminding it does with patients. Then, it penalizes them for trying to give consumers purchasing power.

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