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August 25
2023 Diversification With Braided Funding
2022 What Employers Want For Employee Health Care
2021 The Sustainability Top Ten
2020 The Behind-The-Scenes Process Of Making Integration Work
2019 VA Awards Triwest Healthcare Alliance $26 Billion Contract For Vete...
2018 The Rate Squeeze—How ‘Should’ Rates Be Set?
2017 The Winding Path To Provider Partnership
2016 Riding Trends, Like Riding A Horse
2015 All Integration Is Not The Same
2014 How Significant Are New Opportunities To Serve Veterans?
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Permalink Reply by Paul Terlemezian on
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2014 How Significant Are New Opportunities To Serve Veterans?
I choose not to oppose anything that is intended to provide service to veterans - unless - it does not work. Is it possible to challenge something intended to help veterans without sounding like a challenge to veterans?
We allow veterans to have preferred service at sporting events, airlines and other publicly available services. Why not do the same thing with healthcare? Are their services available to veterans that are not available to the general public?
What would happen if the VA system were absorbed by the public health care system?
The objective would be to provide a better level of health service for everyone and to offer it a lower cost to veterans. What obstacles would prevent this? What concerns am I missing?
Similarly with education - are we better off providing veterans access to training at veteran only institutes or are we better served by allowing veterans access to the best training available at a lower cost than non-veterans?
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2015 All Integration Is Not The Same
"Integration is one of those buzzwords that everyone is talking about – but the meaning of the term can vary significantly. The federal Substance Abuse and Mental Health Services Administration (SAMHSA) defines integration as “whole person care that focuses on overall health; creates partnerships across all aspects of health; and is facilitated by a variety of clinical, structural, and financial arrangements and community supports that remove barriers between physical and behavioral health care” (Healthcare Integration In the Era of the Affordable Care Act). That definition is so broad that it lacks meaning (see What’s In A Word? A Lot, If That Word Is “Integrated”)."
As one gains more experience with the health care system we learn about conflicting approaches between two health care providers - our cardiologist favors our use of a daily aspirin - our gastroenterologist does not. And many years ago I experienced a heated debate between a medical professional and a psychology major.
When I hear about holistic medicine - treating the whole person - and when I understand the negative impact of stress on our health - it makes me believe that there does need to be integration - "easy to say - hard to do."
The same is true with education - we want to expose the learner to the best knowledge possible - but if that knowledge cannot be applied it will be lost. What do we know about the conditions must likely to lead to success (with training or health care?) How can we assess these conditions before applying the process (of education or health care) and then apply the process most likely to succeed? This is more than just assessing the individual - it is assessing their environment (their manager, their peers, the "other" factors that impact their performance) and providing integrated services.
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2016 Riding Trends, Like Riding A Horse
“Trends, like horses, are easier to ride in the direction they are going.” – John Naisbitt
What were the training industry trends 5 years ago?
What do you want the trends to be 5 years from now?
What are they today?
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2017 The Winding Path To Provider Partnership
"...policy and incentives trickle down from payer, to health plan, to provider organization, and to clinical professional."
- Payer = Client
- Health Plan = Expectations set by provider
- Provider Organization = Internal or external training entity
- Clinical Professional = Instructor or Instructional Designer
Do you agree with my analogy? With healthcare and learning - is there a potential for a disconnect between the professional who delivers the service and the individual who benefits from the service? If not - why do you believe not? If so - why do you believe so?
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2018 The Rate Squeeze—How ‘Should’ Rates Be Set?
"This drove me nuts as a provider, and led coalitions of providers to attempt a legislative end-run around rationale executive branch rate setting. The outcome was arbitrary rates unrelated to costs, with generalized across-the-board percentage increases, which weren’t enough overall. But we took it as a small victory only to return again the next year."
How are rates set for internal and external learning?
With much of our economy the open market sets the rates. With closed markets (i.e. internal training providers) - how do we assure that we are investing properly? With open markets (i.e. external training providers) how do we factor the cost of evaluating and comparing prices vs. results?
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2019 VA Awards Triwest Healthcare Alliance $26 Billion Contract For Vete...
"The Region 4 contract is valued at $25.9 billion over one base year and seven option years. The territory covers all or portions of the following states: Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Texas, Utah, Washington, and Wyoming. VA's CCN will allow veterans who are unable to receive care at the local VA medical center, either due to a lack of availability, long transit, or . . . "
Why would the VA outsource such a large contract? https://en.wikipedia.org/wiki/TriWest_Healthcare_Alliance
What are the pros and cons of outsourcing?
What skills are needed to make the build, buy, partner choice? How are these skills acquired?
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2020 The Behind-The-Scenes Process Of Making Integration Work
What obstacles might be faced by those who wish to offer integrated learning?
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2021 The Sustainability Top Ten
What are the top ten (or perhaps two or three) things that our industry is known for doing quite well?
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2022 What Employers Want For Employee Health Care
What do employees really want from the learning opportunities we offer to them? What do our customers really want?
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2023 Diversification With Braided Funding
What are the pros and cons of specialization?
What are the pros and cons of diversification?
How might w achieve the best of both?
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