Some might say that there's no juice left to squeeze from the cost of providing care, but a new report from PricewaterhouseCoopers' Health Research Institute says health leaders are going to have to try.
"The primary emphasis for all healthcare organizations in the year ahead will be on reducing costs and creating greater value in the health system, a focus that will have a domino effect from one sector to another, and (will) redefine roles, responsibilities, and relationships," says David Chin, MD, a partner and leader of the institute.
The report, entitled appropriately enough "Squeezing the Juice Out of Healthcare," lists 10 issues of concern for health providers, including insurers, hospitals, physicians, pharmaceutical and life-sciences companies, and even community groups and municipalities.
1. Reducing Costs. Hospitals, physicians, and other providers will have to squeeze every penny out of their operations, including renegotiating contracts with suppliers on everything from food to medical devices and pharmaceuticals. "All reform will be in the context of future spending, particularly in light of Medicare and Medicaid absorbing an increasingly large part of the GDP," according to the report.
This will mean increasing reimbursement pressure, with physician practice models beginning to adapt. Payers will grapple with Medicare Advantage reimbursement leveling, and perhaps fees or taxes on insurers. Pharma will be more intensely restricted in its marketing activities and data usage, rebate changes and at the same time, maintaining its $80 billion contribution agreement with the Obama administration.
2. Regulatory Change. Dozens of new agencies and grant programs, reimbursement, and pricing pressures, with increased governmental oversight, will impose new requirements on healthcare providers.
The proposed Physician Payments Sunshine Act would require pharma and device companies to disclose consulting fees paid to physicians, health insurers, pharmacists, and others. Non-labor costs can make up half of most hospital expenses, and executives say they're scrutinizing purchases in areas of biomedical engineering, energy, security, and even parking as places to cut. Even food and nutrition services are on the chopping block, as are laundry and linen services.
3. Incentives and Value-based Purchasing. Fewer than half of providers have implemented all but the most basic electronic health record functions.
2010 will be a double-bonus year for physicians who act quickly to take advantage of government incentives to adopt electronic medical records and e-prescribing (See MicroMD under 'Spotlighted products' on the BAC Medical Marketing homepage). Those who do not will face potential penalties later. This new carrot and stick model indicates the government's changing role from a 'passive payer' to an 'active buyer,' according to the report.
4. Focus on fraud. With an estimated $1.6 billion in savings said to healthcare fraud detection, prevention, and recovery, healthcare organizations will need to tighten their internal controls. Pharmaceutical executives now face jail time for off-label marketing violations and hospitals are looking nervously at the Centers for Medicare and Medicaid Services Recovery Audit Contractor program.
5. Technology. Stimulus funds from 2009 are boosting broadband funding, with an eye to converge technology and telecommunications companies. For example, Verizon's Telehealth Collaboration Services Initiative provides remote consultation and technology for continuing medical education and virtual encounters for hospitals, physician practices, labs, and government agencies. GE Healthcare and Sprint are partnering with San Antonio's Methodist Healthcare to create a wireless infrastructure for anytime communication.
6. Prevention. Pharmaceutical and life sciences companies will be more involved in promoting prevention and seeing results in patient outcomes. "In 2010, expect to see greater alignment of incentives between pharmaceutical companies, payers, and providers," as well as retailers to address education, clinical effectiveness, product safety, wellness, and compliance, according to the report.
7. Physician involvement. Doctors will seek greater stability and electronic connectivity. Accountable care organizations will require all providers to reevaluate their relationships, operational infrastructure, payer contracting, and overall funding models.
8. Alternate care models. Expect an increase in the number and scope of services offered outside physicians' offices and hospitals, perhaps even in workplaces and retail health clinics. Home health services, enabled by technology, will be given a boost through e-mail, telehealth, and remote patient monitoring.
9. Disaster planning. Another wave of H1N1 will put more pressure on public health outbreak response, vaccine supply and distribution, better communication, consideration of bed capacity, sick leave policies, and the role of funding mechanisms and contingency plans.
10. Social responsibility. Community-oriented health services and consumer access will involve neighborhoods and municipalities in an effort to promote personal responsibility. Many of these efforts will continue to be boosted by grants, such as the Indiana Tobacco Prevention and Cessation group and the AARP Blue Zones Vitality Project in Albert Lea, MN, which seeks to prolong life expectancy by at least two years.
BAC Medical Marketing wishes all our current and future clients a very happy and healthy 2010!
The recently read one the best articles, written by Andrea Stone of Sphere (AOL News), about what the current healthcare reform legislation entails, both good (Santa) and bad (Grinch).
Being naughty or nice has nothing to do with it.
As the Senate prepares to work up to and maybe through Christmas to pass a healthcare bill, the emerging legislation is shaping up as a veritable gift list of goodies weighed down by more than a few lumps of coal.
The legislation is still far from a done deal. Whatever the Senate passes, if anything, must be reconciled with a House version before it can go to President Obama for his signature. That could take as long as until Easter.
Still, Santa may want to start packing his sled for:
Twentysomethings: They would get to stay on their parents' health care policies after they leave school, a time when many are out of work, don't get insurance at their jobs or can't afford to buy coverage on their own.
People with disabilities: Home care aides, bathtub grab bars, transportation and other nonmedical services would be covered under a long-term care insurance program known as the CLASS Act. Short for Community Living Services and Support, the program was championed by the late Sen. Edward Kennedy. But it also has critics, including Democrats, one of whom called it a Ponzi scheme.
Low-income people without kids: For the first time since Medicaid was created in 1965, poor and low-income people without dependent children will be eligible for the federal healthcare program for the poor in all states. Until now, only some states covered them and most on Medicaid have been low-income single mothers and their children.
Seniors with high drug costs: A last-minute addition to the Senate bill would close the "doughnut hole" in Medicare prescription drug coverage. That would save seniors who take a lot of medication up to $3,610 next year after their first $2,700 in prescription costs.
Drug companies: They can continue to block cheaper prescription drugs at the Canadian border and from other countries that sell identical medicines for less. True, “Big Pharma” had to help plug the "doughnut hole" (see above) in order to kill the drug-importation bill. Still, for the industry, this is one gift that will keep on giving.
The insurance industry: They will get millions of new customers under health insurance exchanges for people who can't afford coverage now. Plus, as an added stocking stuffer, they won't have to compete with a government-run public option thanks to their home state senator, Joe Lieberman of Connecticut, who deep-sixed the idea.
For others, the bill before the Senate could be the Grinch who stole Christmas:
Plastic surgeons and their patients: A five percent "botax" on elective cosmetic surgery such as face-lifts and tummy tucks makes it tough to transform this lump of coal into a diamond.
Seniors in Medicare Advantage: Both the House and Senate bills would cut billions in subsidies to private insurers who run these plans, which offer more services than traditional Medicare. Critics say the plans cost 14 percent more per senior than for those in traditional Medicare, who often buy "Medigap" plans to cover out-of-pocket expenses. Medicare Advantage seniors stand to lose such perks as health club memberships and free aspirin.
Union members: The so-called "Cadillac tax" in the current Senate bill would slap an excise tax on middle-class workers whose employers offer high-cost health plans. Many of those belong to unions that bargained away bigger paychecks in exchange for more generous benefits.
Low- and moderate-income workers with employer-paid benefits: Thought you were lucky to have health insurance through your employer? Think again. Under the Senate plan, workers with job-based coverage would get up to thousands of dollars less in subsidies than families with the same income who buy into proposed insurance exchanges.
Baby boomers: Uninsured adults ages 55 to 64 would have been able to "buy in" early to Medicare under a deal proposed after Lieberman opposed the public option. But he didn't like that idea either. So, short of the 60 votes needed to keep it in the bill, Senate leaders dropped it.
Governors: As Medicaid covers more people, governors already trying to cope with recession-depleted state treasuries worry they'll be stuck with spiraling healthcare costs mandated in the bill but not matched with federal funding.
Howard Dean: The medical doctor who made universal healthcare a central part of his 2004 presidential campaign won't be getting his wish this Christmas. With a public option stripped from the legislation, he would rather scrap the entire bill than pass a weak substitute. "This is a bigger bailout for the insurance industry than AIG," he said on ABC's "Good Morning America."
No matter what stays or goes in the final bill, there's likely to be little holiday cheer for Senate staffers who may find themselves standing beneath the Capitol Rotunda instead of the mistletoe next week. That's because Senate Majority Leader Harry Reid has vowed to finish the healthcare overhaul before voters start thinking about the 2010 elections.
As they're saying on Capitol Hill, "Harry Christmas."
Marketing has the objective of trying to create attention to your business. Nevertheless, the marketing process has more than one purpose.
In addition to gaining the interest of your target clients, marketing also has the capacity to increase the sales and profits. Through effective marketing, any business owner can communicate and inform the target clients of what they have to offer, and convince them to finally purchase. This then results to an increase in sales and profits to the company.
However, marketing does not just stop there. It is not just about market research and getting to know your target clients, getting their attention, making a sale, or even successfully launching your promotional campaign such as your brochure printing. Again, it does not stop there. It is a long-term process that you have to nurture and maintain consistently.
What do I mean by this? Let us think of it as a personal relationship with a loved one. In order for us to maintain a good relationship, we need to work on it. We have to constantly communicate with the other person so that we do not lose touch. Communication simply makes it easy for us to be right on track and to remain connected with the other person. When we do not give proper attention to the relationship, we simply drift apart. Hence, the relationship may not be as meaningful as before.
It is the same with marketing. In order for you to remain connected with your target market, you need to be constantly in touch with them. You become responsible in managing and maintaining your campaigns to make sure that everything is on track. Without these things, your efforts would remain useless, no matter how outstanding or excellent your campaigns such as your print brochures. You simply become disconnected, leaving your clients and prospects indifferent to your efforts.
Furthermore, you need to be well prepared to implement each of the marketing strategies you have. It is great if all the strategies we launch would make our target clients less suspicious of the motives. We all know that an ad would always have an underlying motive, and that is to sell. Hence, all consumers will be expecting to find a marketing campaign to offer something that they need and value.
They would want anything they are going to purchase to be worth what they paid for. It is therefore very important that we reflect that in our marketing campaigns. Your brochure prints for example should be able to show a business that is valuable to the target audience. As a result, sales would increase and profits will definitely go upwards.
Being viable therefore rests on the marketing strategy we have. Being effective means that you are able to provide your target clients with whatever product or service they are looking for. Marketing is not just about letting them know who you are, what you can do, why you are doing it and what you have for them. It is also about letting them know that we are building a relationship with them to last for a long time.
Recently, I came across an article on the BBC web site about Robert Klark Graham’s controversial repository of genius sperm. In case you haven’t heard of this project, it was a wealthy eugenicist’s scheme to breed Wunderkinder by using only the finest sperm, hand-produced by the intellectual elite of the 1980s and 1990s, implanted only into the ova of the married and affluent.
What drew my attention was the list of comments at the end of the article. I was expecting the usual range of indignant comments about millionaires/scientists/Americans trying to play God, with perhaps one or two people sticking up for the pariah. Surprisingly, not a single comment had been posted (at the time of my reading) that disapproved of Graham’s project. Evidently the BBC readership is content to accept favorable genetic constitutions as marketable commodities. This is truly a unique marketing strategy.
What surprised me more was that one reader had written:
"In Britain most sperm is donated by students, especially medical students, so in all probability your 'donor' is going to be much brighter than average anyway.”
This was news to me. I cannot say that I had previously put much thought into the exact provenance of banked sperm, but I can see how it might draw students. It’s money for tugging old rope. And I suppose that medical students would be more likely than other flavors of student to consider selling their sperm because (a) they’re used to handling their own bodily fluids, (b) they hang around the kind of places where fertility clinics are advertised, (c) they have a pragmatic approach to recombining genetic material and (d) they have six years of student debt to pay off. Also, they tend to be a bit weird. I can understand how they might have come to be the stereotype of impoverished sperm donors, but is there any truth to the cliché?
As it turns out, the answer is no. Despite casual assertions on various web pages, including another BBC article, that most sperm donors are students (particularly medical), the Human Fertilization and Embryology Authority maintain that today most donors are aged over 30, with the most common age band being 36-40. However, 11 years ago nearly 70% of donors were under 30, with those aged 18-24 being the most seminally generous. The HFEA web site does not give a profile of the donors according to profession, so I cannot say how many of them were medical students.
However, I'd like to think that there are a disproportionate number of ten-year-olds running around today with unusual predispositions towards autopsying their dolls and palpating their playmates. These will be the doctors of 2020!
Malcolm Gladwell had an illuminating article in a recent copy of The New Yorker about an entity known as Chronic Traumatic Encephalopathy (CTE) which is a variant of cognitive dementia that develops in people who are subjected to repeated blows to the head (pugilists and football players especially). The article is debased slightly by the usual Gladwellian attempt to make a forced correlation between two seemingly unrelated topics (in this case dog fighting and NFL linemen), but it's a decent read nonetheless.
A recent study from Boston University delineates the pathophysiology of CTE as relating to abnormal deposition of the tau protein (whatever that is). Another study from the University of Michigan reports that former NFL football players develop early onset dementia or memory loss at a rate 19 times higher than the general male population between the ages of 30-49. There was even a sample from a teenage football player whose brain showed abnormal levels of the tau protein.
The bottom line is that football is an extremely dangerous activity. The dog fighter analogy is a stretch but these guys who play professional football for a living are indeed the gladiators of our age. Especially the interior linemen. And none of their contracts are guaranteed, that's the best part. These billionaire owners can cut a guy at any time, for any reason. Injury prone? Too many concussions? Out the door. So these guys play through it. They lace up their pads until they can't physically do it anymore. And too many of them are ending up like Hall of Famer and former Pittsburgh Steeler and Kansas City Chief Mike Webster after their playing days have ended. After retirement Webster suffered from amnesia, dementia, depression, and acute bone and muscle pain. He lived out of his pickup truck or train stations between Wisconsin and Pittsburgh, even though his friends and former teammates were willing to rent apartments for him. In his last years Webster lived with his youngest son, Garrett, who though only a teenager at the time, had to act as the parent to his own father. Webster's wife divorced him six months before his death in 2002. He was only 50 years old.
Webster is seen as an example of the difficulties American football players suffer when their careers are over. Other players who retired because of head injuries include Johnny Unitas, Merril Hoge, Troy Aikman, Steve Young, Joe Gilliam, Wayne Chrebet, and Al Toon, just to name a few.
OK, this isn’t as fun and sexy to talk about as cosmetic dentistry but it’s time to sound the alarm on one of the most common diseases around. It is GUM DISEASE folks and 75% of Americans have some stage of it.
Sadly, most people think that it’s normal when gums bleed. Well it’s not! If you washed your hands and they started to bleed, wouldn’t you get a little worried? Of course you would, yet most people don’t get worried about bleeding gums because no one is telling them that gum disease could be deadly! Well I am moved to start broadcasting this message far and wide and I’m also ready to do some serious intellectual battling with anyone that tells you something different.
The New England Journal of Medicine has reported that inflammation like you find in gum disease causes the liver to produce C- Reactive Protein (CRP) which is a better indicator of future heart attack and stroke than cholesterol. Think of all the fuss we’ve heard about cholesterol over the years and now imagine a heightened concern that actually causes people to return to the dentist. It now should be standard protocol for physicians to send their stroke and heart risk patients straight to the dentist to get their gum disease under control as their first line of defense.
And there’s more - Did you know that dentists play a role in identifying the five million Americans with undiagnosed diabetes? This is because diabetics are more susceptible to gum disease and that can cause their mortality rate to rise by a factor of 7.5. Patients that don’t respond to the best efforts to get their hygiene under control may have undiagnosed diabetes. Patients with diabetes must keep their gum health pristine to increase their chances of survival.
And there’s still more - According to Time magazine, University of Southern California researchers have reported that gum disease inflammation can quadruple the risk of developing Alzheimer’s Disease and that treating the inflammation could help stave off the disease.
Still more - The Journal of Periodontology (oral gums and bone) showed that pregnant women with high levels of bacteria in their mouth are at high risk for delivering preterm low-weight babies. Doctors believe that the bacteria from the mouth travels to the uterus and interferes with the pregnancy.
And finally - We have always known that gum infections of the mouth can spread to other parts of the body like the heart and even the brain! The news about gum disease and it’s connection to our overall health continues to come up again and again in research and medicine. It’s time to get deadly serious about the disease that most of the planet still does not take seriously!