Monthly Archives: May 2015

Wellness Ownership and Spiritual Capital

#‎WellnessOwnership‬ – “Teachers College, Columbia University Dr. Lisa Miller’s core argument is that spiritual awareness is innate and that it is an important component in human development. An implication of her work is that if you care about social mobility, graduation rates, resilience, achievement and family formation, you can’t ignore the spiritual resources of the people you are trying to help…
the wisdom that we were once all strangers in a strange land and that we’re judged by how we treat those who have the least…
Dr. Miller defines spirituality as “an inner sense of relationship to a higher power that is loving and guiding.” Different people can conceive of this higher power as God, nature, spirit, the universe or just a general oneness of being. She distinguishes spirituality, which has a provable genetic component, from religious affiliation, which is entirely influenced by environment…
Public schools often give short shrift to spirituality for fear that they would be accused of proselytizing religion. But it should be possible to teach the range of spiritual disciplines, in order to familiarize students with the options, without endorsing any one.
In an era in which so many people slip off the rails during adolescence, we don’t have the luxury of ignoring a resource that, if cultivated, could see them through. Ignoring spiritual development in the public square is like ignoring intellectual, physical or social development. It is to amputate people in a fundamental way, leading to more depression, drug abuse, alienation and misery.” – #RESPECTDavidBrooks


UNsustainable: 1/3 of our $3Trillion annual health care spending is lost to waste, fraud, and abuse

“If getting the word out to consumers is limited to dropping high-deductible plans in their laps and letting them know they need to be better consumers, that’s not going to cut it…

Having individuals put ‘more skin in the game’ helps get folks to be more engaged consumers — but we need a better approach to improving public awareness of The Truth About Health Care…If the U.S. spent 1% of their annual healthcare spend on effective public education in this realm about the cost, and value, of the healthcare we get versus the healthcare we ought to want, the return — across health status, healthcare costs, and consumer and provider satisfaction — would be enormous, and well worth the price tag…1/3 of our $3Trillion annual health care spending is lost to waste, fraud, and abuse.” –

What Tech And Investors “Think” Outpatients Need…Really?

“(S)tartups are frequently competing against a consumer who is not interested in doing anything different to manage their health.

That’s why a direct to consumer approach may not be the best idea for entrepreneurs…

one panelist said, ‘We’re all waiting for the killer app. We have not yet seen the Facebook or Google of healthcare yet.’

Really? That’s not something I tend to hear from seniors (as just one example/s) — if only there were an elusive killer app…”

Wellness Incentives, and U.S. ACA and ADA Laws

“Wellness programs have been enthusiastically embraced by employers seeking to promote health and hoping to control costs. On April 20, 2015, program proponents received long awaited news: the Equal Employment Opportunity Commission (EEOC) issued a proposed rule clarifying how the Americans with Disabilities Act (ADA) would apply to wellness programs. Many large employers likely breathed a sigh of relief upon reading the rule, but the rule is not final and may reignite a longstanding debate over the appropriate use of wellness incentives…The Affordable Care Act offered support for the development and expansion of health incentives in a variety of ways, including by lifting the ceiling on health-contingent wellness incentives to 30 percent (close to $1,800 annually for an average employee-only plan) and inviting regulators to increase the ceiling to 50 percent if appropriate. In a 2013 final rule, regulators preserved the 30 percent ceiling as a general matter but allowed it to rise to 50 percent for programs targeting tobacco use…” –

The Blue Zones

“…research from extraordinarily long-lived communities–Blue Zones–around the globe to highlight the lifestyle, diet, outlook, and stress-coping practices that will add years to your life and life to your years.” –

Healthcare Reform and Wine Making

“(P)ayment reform is just a piece of the puzzle in driving better value and better quality in American health care and that much more needs to be done. Different readers likely had different reactions, but this Californian saw immediately where he was going…

On a recent trip through wine country with out-of-town guests, a friend quipped how nice it would be to own a winery in retirement. How hard can it be? You pick some grapes, stomp around a wine vat for a few days, put the juice in a barrel, add some yeast, and wait. But those who have ever had a subpar bottle of wine at a not so subpar price know that it’s far more complicated than it seems. As it turns out, the process of winemaking has a lot in common with the American health care system.

While we sometimes know what’s to blame for a bad bottle of wine—grapes ruined by heat, a drought, or the wrong winemaker—these variables are part of an intricate and delicate process that goes into creating a quality product. The same is true about the main culprits behind our broken health care system. We know that misaligned clinical and financial incentives are a problem, but the path towards a solution involves many factors, including market conditions, strong leadership, execution, and collaboration. Successful integration of these components has the potential to create the health system that Americans need and deserve.

The Grapes — Necessary But Not Sufficient

Just as starting with a good grape is a critical element of a quality bottle of wine, appropriate payment incentives are fundamental to achieving a high-functioning, value-driven health care system. It’s obvious that the way we have historically paid for care is wrong. Decades of fee-for-service payments to providers have rewarded volume over value and made “more is better” the default decision in health care…

From Grapes To The Glass

Terroir embodies many things: the climate, soil quality, elevation, and geology of the vineyard. In health care, if we look to payment models alone without considering the terroir—or the environment in which business is conducted—we have failed to consider several key questions:

How concentrated are local insurance and provider markets? Payment reform is unlikely to interest hospitals and provider groups with significant pricing power who are doing well under the status quo.

Are payers and providers in the market willing to go beyond contractual arrangements to engage in real partnerships, evidenced by joint governance models with equal representation? Self-interest works great in commodities markets; collaboration in pursuit of a common goal is more likely to succeed in health care.

Is the regulatory environment supportive of or antagonistic to payment reform? Rigid scope of practice laws and minimum medical loss requirements—just two of many examples—work against integration by codifying the status quo (or worse yet, the status quo of the 1960s).

The Skills And Expertise Of The Grower And Winemaker Matter Too…”

Is This How StartUps Are-Will Transforming Healthcare?

“When the Internet first emerged…it affected every industry except for two: education and health care. Why all but these two?

There’s large regulatory issues, long sale cycles, there’s very little incentive for anybody to change in health care…it was close to impossible to transform that industry without an incentive.

Eventually, one presented itself in the form of health care reform…”

California as model for Latino health insurance enrollment efforts?

“According to the analysis, the Affordable Care Act has helped expand health insurance to Latino populations (especially in California) but the uninsured rate remains high.” ––for-latino-enrollment-efforts

California Homeless Health and Housing Services

“The idea is to reduce health care costs and improve outcomes by better coordinating the care for the homeless, and to help find and maintain stable housing for them. It’s an innovative health approach…”

Shinrin-yoku (“Forest Bathing”) and HealthiER, LeanER Culture Change Managment Results

“Walking among trees makes us more relaxed, nicer people.
(Shinrin-yoku or “Forest Bathing” was developed in Japan during the 1980s and has become a cornerstone of preventive health care and healing in Japanese medicine. Researchers primarily in Japan and South Korea have established a robust body of scientific literature on the health benefits of spending time under the canopy of a living forest. Now their research is helping to establish shinrin-yoku and forest therapy throughout the world.

The idea is simple: if a person simply visits a natural area and walks in a relaxed way there are calming, rejuvenating and restorative benefits to be achieved.)

It should come as no surprise by now that walking among trees has health benefits. Shinrin-yoku or “forest bathing” is a (form of healthcare-to-wellness) practice in Japan, where people are encouraged to visit and spend time in a forest to improve their health.
“[S]tudies have confirmed that spending time within a forest setting can reduce psychological stress, depressive symptoms, and hostility, while at the same time improving sleep and increasing both vigor and a feeling of liveliness,” reports Mother Earth News. “These subjective changes match up nicely with objective results reported in nearly a dozen studies involving 24 forests—lower levels of cortisol and lower blood pressure and pulse rate.”
Just the smell of trees has health benefits. “Chemicals secreted by trees, known as phytoncides, have been linked with improved immune defense as well as a reduction in anxiety and increase in pain threshold,” reports Slate in an article on the health benefits of nature.
Studies have also shown that children with ADHD who play in a green outdoor environment, rather than an indoor or constructed environment, show a decrease in their symptoms.
Even just living around more trees means a healthier overall mental state. A recent study showed that Londoners who live near trees take fewer antidepressants.
Of course, being in a forest also means there’s a certain amount of exercise going on. Exercise is a proven solution for many ailments including fatigue, depression, anxiety, and of course, obesity.
Combining the benefits of movement with the benefits of a forest setting is an extra-strong prescription for many health issues.
If there is one good thing you’re going to do for yourself today, perhaps it should be heading out the door to go take a walk in a forest or a tree-lined park.”