Just Got Word

Even someone without any media savvy would know by now that Obamacare is an epic failure.  This blog isn't about beating a dead horse as much as it is about the gap between government policy and government administration. What inspired me to comment on this maelstrom was an item in documents just released by the House Oversight and Reform Committee.  These documents reveal that Obamacare website (Healthcare.gov) was only equipped to handle 1,100 users a day before it was launched.  In a “Stress Test” conducted September 30 th , the document notes:             “Currently we are able to reach 1100 users before response time gets too high. “ When this number is surpassed, the system slows down.  How much it slows down is difficult to determine since the above text is vague.  No cycle time information, no information about how much time is added to do simple tasks, nothing.  What is know...

This has to be the most muddled topic on the "current events" registry.  Ask anyone what "Obamacare" means, and the range of responses might astound you.  I wouldn't know even know how to structure an opinion poll or survey on the subject.  Any relevant respondent "data" would be confined to the "open responses" section of the survey.  The only common threads I have observed are generally strong personal feelings about the subject and frustration mired in confusion.  Any organization that communicates group health care plan information is, by default, communicating Obamacare.  This can unwittingly attach itself to the weak link between the general public (which includes employees and covered family members) and Obamacare.  So anyone communicating to this audience must be aware of the underlying emotional stew.  It would seem prudent to develop a calming strategy along with the exchange of any factual information.  Just pumping out facts (...

Just Got Word LLC will soon publish an article in a selected trade magazine discussing organizational wellness opportunities, wellness obstacles, and what it all means within the context of Obamacare.  The problem is, with companies spending more and more money every year on increased premium payments, there is little or no money left over for wellness infrastructure investment.  So the 'pay for sickness' cycle keeps on turning, while everyone on some level knows what needs to be done to turn the whole thing around.  It's just a question of either finding the money to do it, or being very resourceful. Interested in learning how to launch a participatory or health-contingent wellness program with limited resources?  Watch for the article in a major HR trade magazine.

Some US employers are betting on a great deal of the Health Care Reform Act being repealed when (not 'if' -- at least to these bettors) the Democrats are swept out of office in the impending national elections.   So no need to make a lot of changes; after all, a good deal of it will be discarded anyway.   Whether or not this is a prudent strategy remains to be seen.   In the meantime, provision after provision of the Act is getting phased in while the repeal zealots continue to hold their breathe. We note that it has been since September, 2012 that the Act has required employers offering health insurance to provide a Summary of Benefits and Coverage ("SBC") to all employees.   Not to be confused with “SPDs” (Summary Plan Descriptions), SBC’s come with specific content and formatting rules.   While SPDs must be "understandable" and "plain-spoken" as mandated by ERISA, SBCs must be “short” and in “plain language.”   This is a new acronym basicall...

Even if the U.S. Supreme Court unwinds part of health care reform law, the changes occurring now aren't likely to recede because all of the dominant players in the health care industry are staking out new ground.  The driving forces are: cost cuts, care improvement and federal health-care overhaul preparation.  In many cases, this has blurred the lines between businesses that have historically been separated. Hospitals are slowly bulking up into huge systems, merging with one another and building extensive new physician work forces.  This reflects a continuing trend that dates back to the 1990s.  Hospital capacity in the United States has steadily shifted away from independent hospitals and towards multi-hospital systems.  Hospitals are getting into insurance-like setups (e.g., ACOs), including direct approaches to employers that cut out the health insurer. Insurers certainly aren’t dormant.  They are buying health-...

There is nothing simple about the composition of health care organizations.  This complexity comes from, among other things, a concourse of medical professions and other stakeholders (e.g., patients and government) usually with incompatible interests, perspectives and time frames.  Exacerbating the challenges for health care leaders is the well-known need to satisfy the insatiable demand for health care - with limited financial assistance.   Health care executives frequently face additional challenges because: they have disparate stakeholder groups health care organizations have multiple missions (e.g., provide health care to their communities, remain fiscally sound, and be a primary employer in the community) professionals such as physicians and nurses value professional autonomy, and their decisions have a huge influence on health care expenditures, and the information necessary to manage the change process is usually sparse and ...

Managing On a Strategic Level Health care organizations operate in an environment of rapid change, complex and varying regulations and impending health care reform. Many health care organizations do not employ physicians and face problems getting their input and involvement in strategic planning issues. Quality expectations are continually increasing and data availability is generally limited.  At the end of the day, health care organizations must overcome a number of problems in order to manage on a strategic level. Lack of Physician Involvement Many hospitals do not hire physicians as employees; these health care settings serve as facilities where physicians have privileges to admit and treat their patients.  Under these circumstances, physicians must be treated like customers rather than as employees, with even less available time for non-billable tasks such as administrative meetings and policy decisions.  In either case, physician involvement is a critical component...