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…”