Healthcare

Last week, the Department of Health and Human Services (HHS) and the Center for Medicare and Medicaid (CMS) revealed proposed changes to “modernize” and clarify regulations that interpret the Physician Self-Referral Regulations (Stark Law) and the Federal Anti-Kickback Statute. The Proposed Rule immediately highlights a focus on the transition to a value-driven healthcare system, which is in-line with the OIG’s priorities. 

The Community Health Needs Assessment (CHNA) can be much more than a regulatory obligation for nonprofit and governmental hospitals. Done well, a CHNA can strengthen the hospital’s position as a provider of choice. It can also elevate the hospital beyond its historical role as a provider of sick care to a hub for health and wellness services in the community.

Community Health Needs Assessments (CHNA), unfortunately for many, are conducted simply to fulfill the Section 501(r) of the Internal Revenue Code which requires a tax-exempt hospital to conduct a CHNA. Also, community health assessment is a prerequisite of public health accreditation under PHAB standards. As we have discussed in a previous blog, a hospital’s CHNA can achieve so much more than fulfilling a regulatory obligation.

Last week, the WannaCry ransomware attack hit over 150 countries and infected tens of thousands of systems worldwide. Among those victimized were England’s National Health Service, automobile manufacturers, and government systems. The worm’s ominous red ransom screen, informing the user that all files have been encrypted, was found on only on users’ desktops, but also on ATM screens, parking meters, digital billboards, and industrial control systems.

For the 1^st time ever, HIMSS (the annual meeting place for all things health IT) and ACLC (Accountable Care Learning Collaborative) held a joint conference, in Orlando, Florida.  Suffice it to say it was a HUGE (no pun intended, Mr. President) event with over 40,000 (yes, 40K) attendees and 1,200+ exhibiting companies. 

The main topic—transforming healthcare. 

Welcome to MACRA—the Medicare Access and CHIP Reauthorization Act. MACRA represents the end of a long history of perpetually delayed Medicare physician fee schedule cuts that were to be automatically triggered under the punitive SGR formula absent Congress’ annual postponement ritual. After providing for a series of annual physician payment increases, MACRA’s reimbursement methodology transitions to a value-based model that includes two pathways—the Alternative Payment Model (“APM”) and the Merit-Based Incentive Payment System (“MIPS”).

This commentary originally appeared September 20 on the HORNE Cyber Blog.

A breach of a healthcare provider can have a serious impact, both in terms of financial loss and patient confidence. HIPAA violations can involve fines of up to $50,000 per patient record, and in many cases, attackers are able to access all of a provider’s patient records.

There is growing recognition that the social determinants of health—where we live, work, and play; the food we eat; the opportunities we have to exercise; our ability to live in safety—drive health outcomes. Of course, there is a large role for health care to play in delivering health care services, but it is indisputable that the foundation of a healthy life lies within the community. To manage true population health—that is, the health of a community—hospitals and healthcare systems must partner with a broad spectrum of stakeholders who share ownership for improving health in our communities. 

For the C-Suite to become value added, the C-Suite level executives must become value added leaders within the organization. Senior leadership must learn how to recruit, train, nurture, maintain and retain these value added individuals.  For an organization to do more than just survive – to succeed, it must anticipate its customers’ needs and adjust its direction and momentum so that it is providing what the customer needs in a timelier fashion than its competition. Becoming an anticipatory organization guided by visionary leader is essential for growth. 

Leadership at health care organizations is being tested like never before. The move away from fee-for-service (FFS) to a patient outcome based model means management has to get clinical care teams collaborating in a whole new way. Your leadership style and the culture you help create within your organization will be the deciding factor in determining whether your facility survives, and potentially thrives, in this new dynamic.

So, no pressure. Just the success of your organization riding on your shoulders.

The good news is that if you are reading this it means that you recognize the importance of being a great leader and seek out information to build your skills. Half the battle is being aware that you have a management style and committing to building on what is working and improving what is not.