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By Jonathan Burroughs
The Centers for Medicare & Medicaid Services’ (CMS) bundled payment initiative for joint replacement surgery likely means it is just a matter of time before such forms of finance are normalized in healthcare delivery. Bundled payments can reap significant savings when well executed. Euclid Hospital, a member of the Cleveland Clinic healthcare system, was able to perform lower extremity joint replacements at 9.8 percent below the cost target set in a CMS demonstration project that began in 2013. The average length of hospital stay also dropped in some cases more than 20 percent, from 3.4 days to as low as 2.67 days. Cases of catheter-associated urinary tract infections were completely eliminated. As a result, Euclid Hospital saved $362,818 beyond the initial target, while CMS saved $159,571. Patient experience surveys also improved. But how does a medical group, hospital or healthcare system succeed in transitioning from fee-for-service to bundled payments? Teamwork is a big key, say several top physician executives. “With payment bundles, the providers are focused on well-defined segments of patients with similar needs. Whether or not the work they are performing is surgical or non-surgical, you need great teams where people are really working together, have to deliver value, have to be technically excellent and give patients a great experience as well,” said Thomas Lee, M.D., chairman of the Geisinger Health hospital system. Yet there is even more important pre-clinical teamwork that has not yet been performed in many healthcare organizations. That is creating a bridge between hospital/healthcare system management and the medical staff. Sachin Jain, M.D., chief executive officer of CareMore Health, a Medicare Advantage health plan and provider in Cerritos, Calif., observed that the financial, management and clinical teams of healthcare organizations often don’t trust each other. Moreover, he believes physicians “don’t ever learn a lick about financing healthcare” unless the opportunity is presented to them directly. “No one ever went to medical school to be a deliverer of value-based healthcare,” Jain said, “but to to treat COPD and other diseases.” Andrew Agwunobi, M.D., chief executive officer of the UConn Health system in Farmington, Conn., believes that succeeding in a bundled payment environment requires a nexus of high quality care, incremental but steady financial improvements, business growth and customer service. However, there is one significant problem: “Physicians are too disengaged,” Agwunobi said. He added that there are currently misalignments in the agendas between clinicians and management, and even a misalignment in the incentives available to cut costs and improve outcomes. That leads to the overarching question Agwunobi said many physicians ask: “Why should I do anything different?” Jain has a similar view: “Physicians have difficulties consuming change,” he said. Given their training and backgrounds, Agwunobi noted that data is critical in changing the hearts and minds of doctors. Any compelling vision toward a shift in bundled payments is going to have to be based on hard data that is “bulletproof.” But that shift should not pivot specifically on hard savings projections. “Don’t start by saying your initiative is going to save $10 million,” Agwunobi said. Such a firm commitment can lead to concerns among clinicians that the quality of care is going to suffer to reach that goal. Instead, he recommended communicating a more flexible target, say $5 million to as much as $20 million. “That will help everyone look for every way to implement cost savings while keeping quality intact. And you can probably get more out of that than you think,” he added. Education Can Help To try and better engage physicians with management, CareMore has created a special academy to provide educational opportunities to physicians on healthcare delivery and business, with a particular focus on recently on-boarded doctors. Although UConn Health has not gone that far, Agwunobi has recommended that management do its best to try and educate physicians on their terminology and jargon. “You have to explain all the business terms. They’re embarrassed if they don’t know, and they’re not going to ask what a FTE (full-time employee) or an RVU (relative value unit – a factor in determining employee productivity) is,” he said. At the same time, management also needs to bone up on the clinical operations within their organizations. According to Jain, nothing is more disastrous for trust building than having a manager mention to medical staff that he’s heard the cardiac catheterization lab is important to the ongoing operations of the hospital – what does it do, exactly? As silly as such a scenario sounds, Jain said it happens more than is expected. “Managers need to spend some time shadowing clinicians,” he said. Poring over patient data and preferences together can also help. This leads to what Jain calls “micro-insights” – which can help drive incremental changes in how care is delivered to CareMore enrollees. One example: Older patients are worried about preserving their teeth so they can continue to eat solid foods. They are significantly more likely to visit their dentists multiple times a year than their doctors. As a result, Jain said CareMore is experimenting in merging oral and medical care visits. That could lead to better control of chronic conditions and therefore improved performance in a bundled payment environment. Such work is difficult and complicated. But it must be performed in order for doctors, hospitals and other healthcare providers to be able to effectively accept a flat payment to perform specific clinical tasks at a consistently high level of quality. “I believe teamwork in almost every area of medicine is going to be a very important competitive differentiator for providers,” Geisinger’s Lee said. Looking for your next healthcare speaker? Get in touch with us at the Capitol City Speakers Bureau today to make your healthcare event a success!
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By John O'Leary. This was originally posted on JohnOLearyInspires.com. When John O'Leary was 9 years old, he suffered burns over 100% of his body and was expected to die. He is now an inspirational speaker and bestselling author, teaching more than 50,000 people around the world each year how to live inspired. John's first book, ON FIRE: The 7 Choices to Ignite a Radically Inspired Life was published March 15, 2016. John is a contributing writer for Huff Post and Parade.com. John is a proud husband and father of four and resides in St. Louis, MO. Order John’s book today anywhere books are sold.
It’s not about you. These are the first four words of one of the bestselling books of all time. Through the principles put forward by Rick Warren in The Purpose Driven Life, we are reminded that in order to discover what most stirs our heart, ignites our passion and elevates our lives: We must begin with the surprising truth that it’s not about us. In other words, to gain the best of our lives we must let go of the reigns and stop believing that it’s all about our lives. While visiting with my friend Matt Emerzian recently, he shared how embracing and living this paradoxical truth changed his life. Let me share how it might change yours, too. Upon graduating from UCLA with his MBA, Matt got a dream job. Hired as a senior vice president at a major music marketing company, he worked directly with the biggest celebrities in the world. Matt was extraordinarily well-compensated and spent his free time hanging with the biggest names in showbiz at the most exclusive parties. He was on top of the world. Yet he felt as if he was at the bottom of it. Matt found that all of the success, parties, and fame did nothing to fill a gaping hole in his life. He was unhappy, unfulfilled and became clinically depressed. After numerous counseling sessions, he was given a simple book to read to help him on his path to give his life more meaning. The first four words surprised him: It’s not about you. This viewpoint was one that this athletic, handsome, successful Hollywood guy had never even considered. Until that point in his life, candidly, it was all about him. In asking his counselor what it meant and how to live it, Matt was challenged to participate in a simple volunteer activity. A week later he was given another volunteer activity. Week after week, Matt found himself spending a couple hours every Saturday serving food in shelters, repainting decrepit houses or simply picking up trash. To his surprise, it became his favorite part of the week. Slowly, Matt realized he’d invested his time, energy and career thus far on things that didn’t make a significant difference. He decided to change his life to ensure he was focused on things that mattered. Matt slowly shifted into an inspired, selfless, generous guy who savored his time investing into the lives of others. What began as a simple weekly exercise from his counselor, became one of his favorite hobbies. Today, his service has blossomed into a global movement, impacting more than a million lives and a daily reminder that every person matters. Want to achieve greater success, impact more deeply and savor an even better life than the one you have today? Want more vitality, vibrancy and joy? Me too! Start with the simple, surprising reminder that it’s not about you. It turns out the greatest returns in life are rarely discovered in what we receive, but in what we give. Because, ultimately, we don’t long to be merely happy. We desire to be useful, honorable, and compassionate. We yearn to make some difference. What better time to start than now. This is your day. Live Inspired. Looking for your next healthcare speaker? Get in touch with us at the Capitol City Speakers Bureau today to make your healthcare event a success! By Zonya Foco
How many parents out there are relieved that the early morning rush to school, followed by the nightly homework struggle, is almost done for a while? Only to realize in just a few short weeks that kids are filling their time with way too many hours of “screen time” (that’s TV, computer, games and all hand held devices combined), and saying “I’m bored!” And so the new summer stress ensues! So, to help you raise healthy, well-balanced children in both mind & body, here are five “Frazzle-Free Sure-Fire Solutions” for helping your kids continue to grow and mature over the summer months... 1) Set up a daily routine for success: K.R.’s FIRST! Starting day one of vacation (or soon thereafter), establish their summer morning routine of “KR’s” (Key Responsibilities). List on the bathroom mirror what MUST be done every morning BEFORE any screen gets turned on. Go beyond the usual brush teeth, get dressed, make bed, eat breakfast, and house chores. Also add things like these:
2) Healthful eating tip: Include a fruit and/or vegetable at every meal or snack. As soon as your kids are old enough to “grab their own snacks,” teach them to include a fruit or vegetable each time. Because, ask any kid, a granola bar and a box of crackers makes a fine snack. NOT! A granola bar and some carrots, or a granola bar and an apple makes a fine snack. In fact, adding the fruit or vegetable makes it so much easier to NOT eat the whole box of crackers. Funny how that is! And if you are including a fruit and/or vegetable every time you eat...guess what? You are automatically consuming the amount of fruit and vegetables that every health organization recommends! 5-13 a day! 3) Teach them to do chores cheerfully and reliably. Post on the refrigerator a chore list that is expected daily of each child. Include thorough descriptions so they are done as complete as you wish. Establish weekly “allowance” and remember to pay it. Determine with your kids a reasonable deadline to get the chores done each day, and follow through with a consequence if they are not complete. Hint: banning screen time for 24 hours works like magic! 4) Teach them about working this summer. How about nudging out boredom with opportunities for your kids to gain practice and confidence in becoming “employable?” The bonus is that you get some great work done around the house! In addition to expected daily chores, also post a “jobs for hire” list. Yes, put those jobs on your wall that you would love to have done, along with how much you are willing to pay for it. (Of course, make them age appropriate, and post the age requirements for each). Include how the job is to be done (like an official job description), with what kind of attitude, about how long it should take, and how much it will be paid. Include the requirement that payment will follow a passed “inspection.“ Don’t worry if kids don’t jump on the job right away. After a few weeks of “being off“ school, that novelty will wear off and ideas about what they can do with the added money are bound to take on new desire. Job ideas could include (if these aren’t already chores):
5) Teach them about saving money this summer. Financial advisors always say to teach kids the discipline of saving money the minute they start getting money. If your child is allowed to spend 100% of all they are given, they risk becoming young adults who do exactly that. Consider the policy of giving 10% to church or charity, depositing half of what’s left in the bank for a car (they’re so gonna want that when they turn 16!) or college, and putting the rest in their wallet to either spend now, or put toward something bigger that they really want. This teaches kids to be givers, savers and enjoyers of money, but all in a balanced way. These principles ingrained as a child last a lifetime! I hope these ideas help! HAPPY FRAZZLE-FREE SUMMER PARENTING! Looking for your next healthcare speaker? Get in touch with us at the Capitol City Speakers Bureau today to make your healthcare event a success! By Colette Carlson
As a professional speaker, I’m always stressing the value of mindful, genuine communication in building effective business relationships. So, it’s no wonder I get excited when I hear of companies ready to step outside their comfort zone to put this into practice. That’s especially true when corporate leaders show they’re willing to break out of outdated roles (e.g. the upper-level executive who floats in a lofty sphere above the rest of the employees, with no time for the problems of, say, those customer service operators making $14.00 per hour on the front lines). For years, the traditional power hierarchy within corporate America has had a built-in arrogance that blocked authenticity and positive human connection. Today’s leaders are smarter. Many are willing to be more down-to-earth, realizing that a connection with their teams is necessary in order to further their company’s goals:
Whether your goal is to bring bright new employees onboard, or sell your business’s latest and greatest product to customers, the key to success for any business is human connection. And it looks like the world is finally catching on! Looking for your next healthcare speaker? Get in touch with us at the Capitol City Speakers Bureau today to make your healthcare event a success! By Laurie Guest
One area that receives the lowest scores when we conduct a guest encounter audit for a client is the lack of smooth transitions during the transaction. Imagine a track relay team: one runner has the baton. As he approaches the next runner, they stride in unison for several lengths. He then passes the baton without losing stride. When a Transition Does Not Work Let’s say we follow a couple into a bank. They are greeted by a teller at a teller window, and they explain that they want to see a loan officer about buying a car. They share the story of car shopping with the teller who nods, smiles, and listens. However, when she phones the personal banker, she only says, “Somebody’s here to see you.” A failed transition. A dropped baton. When a Transition Works Again, our couple enters the bank. They share their car shopping story. This time, a teller calls the personal banker and says, “I have a couple who would like to see you. Are you available?” She then escorts them to the office and makes a transitional introduction. “Amy, I’d like you to meet Ted and Martha Brown, clients of ours. They would like to talk to you about a car loan. Ted and Martha, this is Amy Thompson, one of our personal bankers, and she will be happy to provide the information you need.” If the teller is unable to leave the counter, then the same message can be communicated by phone without the formal introduction. When the personal banker comes out of the waiting area to greet the clients, she needs to communicate that the baton was passed. “Good afternoon, Mr. and Mrs. Brown. I’m Amy Thompson, your personal banker. Please follow me to my office.” Once in the confidential space, she continues, “Mary tells me you’re interested in getting a car loan, and I’m happy to help you with this.” A successful transition. A smooth baton pass. A transition that works leaves a favorable impression. Transitions by phone are also important. Have you ever called somewhere knowing that the first person who picks up is not going to be the person to answer the question you have? In order to transfer you to the right person, they ask you to tell the long version of what you need. When you’re done, they say, “One moment. Let me connect you.” And then you have to start all over! Better service would sound like this: “After getting enough information from you, I’m going to call and give a summary to the staff person who’s going to help you.” After the staff person makes a smooth baton transition, the next person in line to take care of you would say, “Mrs. Larson, this is Kelly in the billing department. Mary tells me that you have a question on your last statement. I have it pulled up here on my screen. Let me just confirm that I have the right account, and we’ll see where that extra charge is coming from.” That is a smooth transition. Put Transitions in Place Put professional, planned transitions in place using these simple steps:
However, if your team is not accustomed to proper transitions, you may need to have a few practice sessions. Work to find the right sentences to use, and make sure that every team member understands his or her role in the pass off. Soon it will be second nature in your sales process, and the positive customer service reviews will be sure to increase. Looking for your next healthcare speaker? Get in touch with us at the Capitol City Speakers Bureau today to make your healthcare event a success! By Ron Culberson. With a master’s degree in social work, Ron Culberson spent the first part of his career working in a large hospice organization as a clinical social worker, middle manager, and senior leader. As a speaker, humorist, and author of "Do it Well. Make it Fun.The Key to Success in Life, Death, and Almost Everything in Between", he has delivered more than 1,000 presentations to associations, government agencies, non-profit organizations, and corporations. His mission is to change the workplace culture so that organizations are more productive and staff are more content. He was also the 2012-2013 president of the National Speakers Association and is a recognized expert on the benefits of humor and laughter.
Do you like suspenseful novels or movies? How about mysteries or thrillers? I do. And what I like most about these kinds of books and movies is being surprised by a discovery at the end of the story. I still remember being stunned by the final scenes in The Sixth Sense and Primal Fear. In each, the conclusion unveiled a discovery that totally changed my understanding of the story up to that point. Recently, I heard a meditation instructor say we should approach people and situations as “mysteries to be discovered.” What an interesting concept. Can you imagine how different our lives would be if we went into every encounter expecting to be changed by the mystery we discover? I think it would lead us to being more open to every situation and would eliminate pre-determined opinions that typically prevent us from truly experiencing the reality in each moment. For instance, do you remember the first time you saw a natural wonder or an amazing tourist attraction? Whether you were looking at the Grand Canyon, Michelangelo’s statue of David, or The World’s Largest Ball of Twine, you probably just wanted to stand there and take it all in. We hardly have words to describe experiences like that. Well, except when we’re looking at the ball of twine. I’m pretty sure in that situation, most of us are saying, “Dang, that’s really big.” What is it about these encounters that affects us? Is it the magnitude of the Grand Canyon or the beauty of the statue of David? I think it might be the mystery we hope to discover. We want to know when the Modest Canyon became the Grand Canyon. We want to know when Michelangelo looked at the statue of David and decided it was complete. And when it comes to the Ball of Twine, we simply want to know why? We look, we ponder, and we ask questions to better understand the experience. Perhaps this is how we should travel through our lives—with the expectation that a wonderful discovery is waiting around every corner. But how do we do that? First, we must eliminate our pre-conceived ideas and open our minds to whatever the moment brings. I know this is easier said than done so here are a couple of examples to illustrate the concept. Discovering People A few weeks ago, I went to our local auto parts store to buy replacement blades for my windshield wipers. A young man was standing behind the counter and in front of the counter, there was an older man sitting on a stool. As I approached them both, the older man said, “Good morning. What do you have planned for the day?” “Well, I’m on my way to work,” I said. “I remember what that was like,” he said with a chuckle. As we talked, I found out that he had retired from his job as a maintenance supervisor in the transportation division at the University of Virginia. I told him that I attended UVA in the 1980s, and we compared notes about the way things used to be. He asked what I did for a living. I must admit that I always dread this question. I usually describe myself as a “motivational speaker” or an “author and humorist”—since most people understand those terms. But sometimes, it sounds like a pretend job and I feel a bit awkward when I say it out loud. Nonetheless, I told him that I was a motivational speaker. The young man behind the counter smiled and said, “Oh, I listen to motivational CD’s all the time. Our company brings in speakers like that for our regional meetings. I think their presentations are really helpful. Do you ever speak to companies like mine?” And there you go. I did not go into the auto parts store that morning expecting to find a business opportunity. In fact, I wasn’t even sure if I’d find the right windshield wiper blades. My mind was closed off to the possibilities. My assumptions were like blinders and I did not even consider that my rural neighbors would have an appreciation for my so-called job. It was a good lesson—to be more open minded. And for the record, I seem to have this kind of mind-opening education way more often than I should at 56 years of age. Just saying. Discovering Experiences When we moved to central Virginia a few years ago, my brother-in-law Bob recommended a hike that he thought we’d enjoy. We filed it away on our Someday-We’ll-Do-This List but never got around to it. A few weeks ago, however, our kids were in town so we decided to try the hike that Bob suggested. Our destination was Spy Rock, a large rock formation located just off the Appalachian Trail. After parking the car, we headed up a somewhat boring access road towards the trail. After walking along the trail for a while, we then had to scale the side of the rock to get on top. It wasn’t really that treacherous but it did require some concentration. Finally, we emerged from the climb and were greeted with a 360-degree perspective of the mountains and adjacent valley. It was one of the most extraordinary views I’ve ever seen. Again, I had not anticipated the possibilities of this experience. What started as a somewhat unexciting walk in the woods turned out to be a truly spiritual experience. And I suspect that even our time on the access road could have been better if my mind was set on a different expectation—one of discovery. So, how do we avoid the routine, self-fulfilling doldrums and replace them with the newly discovered mysteries that lurk all around us? I think the simplest way is to continually ask ourselves, “What am I missing?” When we understand that our brains will switch to autopilot if we let them, it’s helpful to remind ourselves to pay attention. In fact, this is where most humor is discovered—by paying attention. Once I saw a sign next to a bowl of oranges that said, “Gluten Free.” Luckily, because I was paying attention, I didn’t miss this ridiculously obvious information. If you like the surprise endings in mysteries and thrillers, perhaps you can write your own script by opening your mind to the possibility of discoveries. In other words, as you go through the day, ask yourself, “What am I missing?”, “Where’s the beef?” or “Who let the dogs out?” You’ll be amazed by what you discover. Looking for your next healthcare speaker? Get in touch with us at the Capitol City Speakers Bureau today to make your healthcare event a success! By Karyn Buxman
As I began the interview for my podcast, I looked at his boyish grin and into his playful eyes. “My guest today is Chade-Meng Tan, and he’ll be sharing his insights on leading with levity.” Meng got a puzzled look on his face and said, “Levity? Oh, I thought we’d be talking about levitation. I guess I’ll have to throw out my notes!” “Uh-oh,” I thought. “This might be a disaster!” Chade-Meng Tan then tipped back his head and laughed. Perhaps I should mention that Meng is known as Google’s Jolly Good Fellow. “Leaders need to establish trust—and humor is one way of establishing trust,” he said. Recently retired from Google (at age 45), Meng is an award-winning engineer, bestselling author, TED talk presenter (check out his TED talk where he shares his insight: "Compassion Is Fun”), and Co-chair of One Billion Acts of Peace, which has been nominated seven times for the Noble Peace Prize. As a leader, he demonstrates that you can use humor not only to lead in your workplace or organization, but on a global scale. In your pursuit of better leadership skills you’ve collected an extensive set of tools: Focus. Vision. Values. Strategy. Tactics. Emotional intelligence. Goal-setting. Decision-making. Storytelling. Mentoring. Humor. Humor??! I’ve noticed that MBA programs rarely teach humor. And business books don’t extoll the benefits of humor in the corporate—or any organizational—setting. And that’s too bad, because humor is a tool that enhances many of the other leadership tools that you use. Humor enhances communication; bonds teams; improves retention; increases productivity; and improves profitability. The effectiveness of humor used to be anecdotal. But now it’s a scientifically proven fact that humor has physiological, psychological, and social benefits. Over the past several decades neuroscientists, psychologists, social scientists, and integrative scientists have been ferreting out the secrets of humor. Research from Wharton, MIT, and London Business School reveal the practical benefits of humor in the workplace. Even “The Harvard Business Review” acknowledges that humor is an important leadership skill. As a leader, you need a variety of tools that will help you better guide, direct, and inspire others: Your overall temperament and personal style; the manner in which you give guidance, instructions and reprimands; your ability to adapt your techniques to each person and each team you’re addressing (“emotional intelligence,” anyone?!); the tone of your voice; the different styles of communications for one-on-one interactions, for small group meetings, and for large audience situations; your flexibility, your writing style; your confidence; your level of expertise, and—your use of humor. A good leader knows that when humor happens by chance, positive things can happen. But a great leader knows that humor applied with purpose, intention and mindfulness can change the world. Looking for your next healthcare speaker? Get in touch with us at the Capitol City Speakers Bureau today to make your healthcare event a success! |
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