Denver Medical Study Group

“California Voters are Thinking about the Fundamental Values Associates with Single-Payer but Almost Zero Voters have Thought About the Policy Implications.”

I have been out of the loop the past two weeks on vacation back to my “roots”. While I was gone, some news came out from the New York Times on May 25th. The article summarizes political talk in California about Single-Payer Health Care in California.

It brings back some memories of the 2016 Amendment 69 here in Colorado.  The concept is frequently titled “Medicare for All”. It is interesting reading to hear what could happen in California if it becomes reality there.

To check it out click the link below:

https://mobile.nytimes.com/2018/05/25/business/economy/california-single-payer.html

Chris Hadley
President and Founder
Denver Medical Study Group
denvermedicalstudygroup@gmail.com

“Leading Though Learning—-Healthcare Innovation & Reform”

 

Warranty or Money Back Guarantee?

 It’s shocking to hear about a medical clinic, hospital, or doctor’s office willing to give a money-back guarantee, but our understanding is that it is being done.  In fact there is one healthcare organization that started doing this several years ago, Geisinger Health Systems in Danville, PA. Dr. Glenn Steele, CEO Emeritus, began the concept as a “waranty” to patients for specific surgical procedures.

Other health system leaders have said “Don’t do the warranty concept.” However, “Proven Care” has proven to be the beginning of Geisinger’s most radical innovation. Followed by Proven Experience where patients can use a smartphone app to tell Geisinger about their experience. They can request a refund if they are unhappy with the care they received.

A program offering refunds to patients with no questions asked seems ripe for abuse. But that is not the case. Patients don’t really want money back. They want the System to recognize they did something wrong and make it right, according to the current CEO, Dr. David Feinberg.

The Denver Medical Study Group has invited Dr. Steele to come here and talk to the group about this on April 4, 2018 (Warranties, Value Based Care and Health Transformation Alliance).  You can register by clicking on the link below:

April 4th, Glenn D. Steele, Jr., MD, PhD., CEO Emeritus, Geisinger Health System

Thank you in advance for joining us on April 4th to hear what Dr. Steele has to share with us.

Best wishes,

Chris Hadley
Founder and President
Denver Medical Study Group
Denvermedicalstudygroup@gmail.com
303-249-5572

In preparation for our Feb. 21^st DMSG meeting with our keynote speaker, Jonathan Edelheit, CEO and Co-Founder of the Medical Tourism Association, we are looking for a Colorado hospital  or a large medical group that is involved with medical tourism. If you know of someone who is doing this either  internationally or domestically or would like to, we’d like to know.

This will be helpful in understanding how medical tourism, especially domestically, would work here in Colorado as it is around the country. May be a new source of revenue for your institution or practice.

One question that has been asked already by one hospital executive is “how do you define Medical Tourism?” Here’s the definition Jonathan responded with:

“Medical Tourism can be defined as multiple things, 1) international patients traveling inbound into the US, 2) Domestic medical tourism (aka Direct Contracting/Bundled Payments, RBP, which is the big trend with all the national employers (Walmart, Jetblue, Boeing, etc)  sending their employees to Cleveland clinic, Johns Hopkins, Mercy in Missouri etc. For some hospitals or large medical groups who aren’t familiar with it, I think they perceive it as something different than it is.  I look forward to talking to you more about it.”

Thanks in advance for your comments or suggestions!

If you are interested in attending our meeting on  Feb. 21st, you can register by clicking on the link below.

February 21st, Jonathan Edelheit, CEO & Co-Founder, Medical Tourism Association

Thanks to our DMSG sponsor for this meeting, Lowdermilk & Associates for their support of our DMSG Community and our speakers!

     Innovative Executive & Employee Benefits. Trusted.

As The Opioid Crisis Grows, What are The Latest Developments here in Colorado and the U.S.

 

As each day goes by, there is something new in the media and on the internet about the Opioid Crisis.  Colorado Public Radio on Jan. 19th talked about how Colorado got its Opioid problem —-“I don’t think you can overstate it. Pick a word, it’s as bad as you could get. More people dying every year than died in the entire Vietnam War,” said Rob Valuck, our keynote speaker at the Denver Medical Study Group meeting next Wednesday, Jan. 31st.

Last night, Rob was on a local news channel where he talked about a particular drug promoted by pharmaceutical companies for mental health issues that originally cost $500, now the price for the same drug is $1,500. As Rob shared about this drug, his point was patients weren’t going to pay out of pocket at the current price for this drug. So what happens when demand drops off, then there is an excess of the supply and price has to go back down. An additional issue Rob shared was this is the way drug manufacturers go out of business —by outpricing the market.

Even Colorado legislature is considering bills related to battling the opioid crisis in Colorado. One of the the more talked about bills in the news is SB18-022: Clinical Practice for Opioid Prescribing Bill. This bill will restrict the number of opioid pills that a health care provider may prescribe for an initial prescription to a seven day supply and one refuill for a seven day supply with certain exceptions.

Next week, Rob will describe the scope and impact of the opioid crisis here and in the U.S. He will help us to understand policy and program solutions being applied at the federal, state and local levels.  Then he will give three concrete steps to reduce opioid misuse in our homes and communities.

You won’t want to miss Rob’s presentation next Wednesday. You can register by clicking on the link below.

http://denvermedicalstudygroup.com/category/upcoming-events/

Sponsored by:

Colorado Medical Society
www.cms.org

 

When we started out the Denver Medical Study Group, the purpose was to become more knowledgeable in healthcare innovation and reform. That created a learning platform for our group and that is why we do what we do. That’s why we bring in speakers that we bring in because they are doing it, whatever it may be.

We have had discussions with our group about where the decisions are made regarding good healthcare. It was almost unanimous that the best decisions are made at the local level. For example, we have a medical group here in Colorado that is doing an excellent job of providing primary care for their patients. But their CEO felt the need to focus more on mental healthcare as it has such a significant impact on physical healthcare. It was a tough financial decision since mental healthcare reimbursement is not very good. The decision was made to move forward with psychologists and counselors to be a part of their patients healing process. It has been very successful and they are considering bringing in a psychiatrist as well.

This type of strategic planning that steps “outside the nine dots” so to speak, needs to be done by other medical groups as well—and it is! Part of the focus of the Denver Medical Study Group is to provide examples of how that is being done and see where it can be replicated. Come join us to hear more about what other groups are doing!

 

 

In an effort to increase the exposure of the DMSG as well as the presentations of our guest speakers, we have captured the vision of the DMSG Community on video. In the profile video, I have shared my perspective on healthcare finances and my commitment to the healthcare industry. Check it out on our web site’s Welcome Page. Watch the video and encourage others in your business network to do the same. By doing that, you will help us get the message of the DMSG “regarding healthcare innovation and reform” out as we go into 2018.

The video series has 12 video vignettes approximately one minute long. We will be sharing these over the next few weeks with our DMSG Community and with others who may be interested in joining us. We welcome your comments as they are important to us  and they will also help boost the traffic to our site. Thank you for your help and support!

Here’s the first video:

Chris Hadley
President and Founder

 

On October 16th, DaVita’s Chairman and CEO, Kent Thiry spoke to the Denver Medical Study Group. His presentation focused on DaVita’s strategy for the company’s leadership and culture. It was a very interesting and informative presentation. One area that our group was interested in hearing more about was related to DaVita’s Medical Group. However, not much was shared at that time.

As Paul Harvey used to say “and now for the rest of the story” that may have been “under wraps” at the time of our meeting.

Since our meeting in October, DaVita has been in the local news related to its Medical Group’s operations with managed-care practices in six states including Colorado and the apparent acquisition on Nov. 28th of Northwest Physicians Network, a Tacoma, Washington-based independent physician association (IPA) of more than 1,000 primary care and specialty care physicians.

Now in today’s Denver Post (see the link below), DaVita is selling its physician network to health services company Optum. The use of some of the proceeds will be to buy back company stock over the next one to two years and pay down debt and other general corporate uses.

Denver’s DaVita selling its physician network for $4.9 billion

 

There’s been a lot of talk since the AHCA bill was pulled by Paul Ryan last Friday, March 24th.

 

Only 17% of Americans liked the bill in a poll taken at that time. Some believe that the bill needs to be modified and resubmitted while President Trump appears to be refocusing his attention to other national issues due to the lack of support for this bill.  Looks like Republicans are beginning to work through some of the issues the ACHA bill brought to the surface. Some moderate Democrats are seemingly willing to work with Republicans to come up with a more bi-partisan plan or are at least talking about it. Keep an eye on this—more to come, I’m sure!

The ACA Survey Results from Our Feb. 23rd DMSG Meeting Share An Interesting Perspective on the ACA!

Meanwhile, as they say “meanwhile back at the Ranch” here in Colorado, Bob Smoldt, Associate Director of Arizona State University’s Healthcare Delivery and Policy Program and CAO Emeritus, Mayo Clinic, spoke to the DMSG on Feb. 23rd about “The ACA at 6+ Years—Now What?” Bob shared aspects of the ACA that have worked and haven’t worked as well as talked about other options that the Republicans were considering in an effort to “replace and repeal” the ACA.

After the presentation, Bob gave us a survey to complete at the meeting regarding 12 questions about the ACA . The survey’s results are below but the first question really tells the story about the vision that our group has. The question was “Choose one of the overriding approaches for the ACA—(a) keep the ACA as it is, (b) repeal and not replace it and (c) do an ACA replacement/revision. 90% of the group selected (c) “do an ACA replacement/revision”.  

ACA Survey Results of 2.23.17 DMSG Meeting Attendees

 I. Overall desire for ACA:

• Keep ACA as it is = 5%
• Repeal ACA, no replacement = 5%
• Do an ACA revision/replacement = 90%

II. With regard to specifics of what an ACA revision/replacement might entail, here are the group’s major suggestions in order of magnitude of agreement.

1.  92% would replace the ACA mandatory benefits list with a more flexible benefit approach.

2.  89% would keep the ACA, move for Medicare to Pay for Value (P4V), AND the vast majority of those favoring this approach would speed up the broad implementation beyond demonstration programs.

3.  80% would allow states the option of expanding Medicaid eligibility (but a majority of those favoring this approach felt that the federal funding should be at the traditional federal funding share of this joint federal/state program  (50 – 75% depending on a state’s poverty rate) rather than the ACA’s 90% for expanded beneficiaries).

4.  67% would keep the individual mandate, BUT nearly all of this group would significantly increase the size of the fine that uninsured people would pay.

5.  66% would repeal the ACA Medicare payment update cuts and replace that health reform funding with a limit on the tax free nature of employer provided health benefits.

6.  60% would keep subsidies for lower income individuals to purchase private health insurance (but a slight majority of those favoring this approach would reduce the subsidies to 300% of poverty level rather than the ACA’s 400%).  It should also be noted that 37% favored moving to a  refundable tax credit to all individuals (regardless of income) who do not get insurance from an employer, Medicaid, Medicare or other government program.  There were 3% who felt there should be no subsidies provided.

7.  57% would switch Medicaid to a per-beneficiary government payment to the states (a slight majority of the group favoring this approach felt all states should have a common beneficiary counting method while a slight minority of this group felt that states that expanded Medicaid under the ACA should have a higher beneficiary count).

8.  56% would repeal the ACA provision allowing individuals under age 26 to stay on their parents health insurance (thus increasing the number of young, healthy people who would be in the regular private health insurance pools).

III.        In addition there was a question about what type of US health system the individuals would desire regardless of whether the ACA existed.  These results were as follows:

• 43% would like a system similar to a revised ACA as shown above.

• 33% would favor a system where everyone in the USA would be on  private health insurance coordinated by a government designated body; no exclusions for pre-existing conditions; subsidies for low income; penalty for no insurance equal to the annual cost of least expensive plan.  No separate program for Medicare, Medicaid.  Basically put all on what Members of Congress get.

• 17% would favor a single government payer with private delivery of care similar to what Canada has.

• 2% would favor a single government payer and government delivery of care similar to the United Kingdom and VA.

• 5% outlined a separate approach of their own ranging from Health Savings Accounts for all to a system concentrating on healthy living rather than delivery of care.

What are Your Thoughts? Email us or reply below!

Chris Hadley
President
Denver Medical Study Group
5082 E. Hampden Ave., #158
Denver, CO 80222
303-249-5572
Denvermedicalstudygroup@gmail.com

 

“A Learning Forum for Leading-Edge Knowledge in Healthcare”

Over the past two months, we’ve had “key people” speak on behalf of and in opposition to Amendment 69. They have shared insight on the features and benefits of A69 as well as showing their passion about the amendment. The experience we had as we listened to Senator Aguilar, T.R. Reid and Jeff Helton in September and then Cody Belzley, Tashof Bernton, MD and Jill Vecchio, MD in October was as several of our attendees expressed “very thought provoking” and “enlightening”! “I learned more listening to these speakers and panelists than anything I’ve read!” If you attended, you know what I mean. If you weren’t there, we missed you!

The result of the vote was 79.6% against with 86% reporting at 6.54 a.m. this morning.

The “rest of the story” is yet to be told. Senator Aguilar was asked if there was a “what if….” Strategy if A69 fails this time around. She indicated that they have learned a lot from this campaign and would do things differently if and when they come back with a proposal in two or four years. So the issue of universal healthcare may continue here in Colorado in one form or another.

Vermont had attempted a universal or single payer healthcare system a few years back through legislative action but it failed due to inability to effectively implement the plan financially. However in January, Vermont will become the first state in the nation to move to a voluntary all-payer accountable care organization model according to CMS. The program will cover Medicare, Medicaid and commercial payers, requiring those who participate to pay similar rates for all services. It’ll be interesting to watch!

More on that and other issues at our DMSG meetings in 2017! Be sure to register for our December 8^th DMSG Annual Holiday Event at Children’s Hospital with our Keynote Speaker, Lt. Gov. Donna Lynne speaking on “The Future of Healthcare in Colorado”. You can register through the link below. (If you’ve registered already, Please disregard this request.)

http://denvermedicalstudygroup.com/december-event/