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October 19
2024 Numbers Matter
2023 Behavioral Health Integration Evolves
2022 To Bot Or Not
2021 Can Performance-Based Compensation Be Part Of A Workforce Solution?
2018 LTSS Investment—& Restructuring— Speeds Up
2016 Are More Non-Traditional Medicaid Expansion Plans In Our Future?
2015 Using Analytics To Guide Medicaid Reform
2014 40% Of Commercial Insurance Reimbursements Tied To Performance Ince...
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Permalink Reply by Paul Terlemezian on
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2014 40% Of Commercial Insurance Reimbursements Tied To Performance Ince...
"About 40% of commercial health plan reimbursements to in-network provider organizations in 2014 are linked to value-oriented initiatives intended to improve the quality of services or to cut waste. This compares to 11% in 2013. About 38% of hospital payments, 10% of outpatient specialist payments, and 24% of outpatient primary care professional payments are value-oriented. More than half of the value-oriented payments made by commercial health plans put the provider organizations at financial risk for their performances. Of the 40% tie to performance incentives, a little over 1% had financial claims risk."
How can a win-win be structured into learning organization VBR? How is it possible (desirable) to reduce the potential for adversarial relationships between providers and consumer? How can this be assured?
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2015 Using Analytics To Guide Medicaid Reform
"What is the best path to making changes in health care policy and health plan design? There are many factors, but one essential ingredient is analytics. All health care payers are focused on the triple aim – that combination of better consumer outcomes, better consumer experience, and lower costs."
How do we design and adapt for all three in real-time?
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2016 Are More Non-Traditional Medicaid Expansion Plans In Our Future?
"...states are exploring a lot of different options. The latest iteration of the 50-State Medicaid Budget Survey from Kaiser notes that some of the most common cost control mechanisms being used by state Medicaid directors include more managed care, alternate delivery systems and payment models, more community-based care, and enhanced management programs for pharmaceuticals."
Is it desirable to have cross-company in-depth sharing of best practices? Could we collaborate cross-company on innovation initiatives? What are the benefits? risks? laws?
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"We recently reported on several important changes in managed long-term services and supports (MLTSS)"
What is long-term in corporate life? - a quarter? two-years? 10-years? Are we building and implementing 10 or 20 year professional development programs for our employees? Would you want to be part of one of these?
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2018 LTSS Investment—& Restructuring— Speeds Up
"Our recent coverage of private equity investments in the long-term care space just quantified what our team already noticed—investments, mergers, acquisitions, consolidations and other restructuring in this space is on the rise. The survey found that 38% of private equity executives planning health care investments over the next 18 months are considering investments acquisitions in the long-term care sector—defined as including home health, long-term care facilities like nursing homes and assisted living, and hospice services."
What aspects of long-term care are attractive to investors? What insights does this offer to long-term solutions in the workplace?
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Guidelines are useful - they do matter.
They can be used to avoid making mistakes - and suffering the consequences that occur.
They can be used to assure delivering outcome - and increasing the confidence that results.
There are three matters to "juggle."
- Following guidelines
- Avoiding mistakes
- Assuring outcomes
How do we avoid failing to produce the outcome because we were following guidelines or trying to avoid making a mistake?
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What is the difference between "Doing what you love?" and "Loving what you do?"
My Dad taught me the difference - it continues to be one of the most wonderful lessons I have ever received.
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2021 Can Performance-Based Compensation Be Part Of A Workforce Solution?
What motivates a learner to maximize the results that derive from their learning?
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2022 To Bot Or Not
What is the relationship between learning and loneliness? Might this vary between individuals or for an individual? What would we do if we and they trusted the correlation?
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2023 Behavioral Health Integration Evolves
Which of these do you think you are most objective when evaluating yourself?
- Athletic Ability
- Health
- Intellectual Ability
Why?
What insight does your answer provide regarding the challenges associated with addressing human performance?
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2024 Numbers Matter
All numbers?
Just the numbers that you choose to access?
Just the numbers that matter to you?
What percent of the numbers that exist do you have access to?
What is more important than numbers to you?
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© 2024 Created by Paul Terlemezian.
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