Operations

  • 08/30/18
    My favorite philosopher, Yogi Berra, once said, “If you don’t know where you are going, you’ll end up somewhere else.” It’s an easy argument to show that we continually end up somewhere else in our current health care performance improvement efforts, and most times that somewhere else is the land of no change. No matter the laudable efforts of many people, we seemed to get derailed in our improvement efforts by everything from unengaged clinicians to a lack of...more...
  • 08/29/18
    In the age of near-constant mergers and acquisitions, health systems are taking on tremendous costs in the form of third-party—or purchased—services. When a hospital or health system acquires additional facilities or a private practice, it inherits all of that entity’s contracted purchased services, including IT and telecom, clinical services, security, maintenance and more.more...
  • 08/22/18
    Something in the newspaper caught my eye recently, which triggered a sequence of free-association thinking that ultimately led to a mixture of concern and hope for the future of health care. It was an almanac reference to the last close encounter with Halley’s Comet in 1986. Named for an English astronomer who was born in 1656, the 6-mile-wide chunk of rock and ice hurtling through space at 158,000 miles per hour intersects Earth’s orbit every 75 years. Contemplating the fact that...more...
  • 08/09/18
    The House of Representatives has high-tailed it out of town for their annual August recess and the Senate will return next week to continue working through nominations and the government funding bills. That’s exactly as thrilling as it sounds, and normally, it’s a pretty quiet time here in Washington, DC.more...
  • 07/31/18
    Each year at the end of summer, just before the new school year starts, I make my way to South Bend, Indiana to play a round of golf with two old friends who are professors at the University of Notre Dame. One of the two, recently retired, is a renowned Dead Sea Scrolls scholar. The Dead Sea Scrolls, discovered in limestone caves in the Judean Desert in 1946, are the remnants of biblical manuscripts written 2,000 years ago. My golf partner devoted an academic career to studying them while...more...
  • How hospitals can be ready for the next outbreak
    07/20/18
    In August 2014, fear struck the globe, when the Ebola epidemic breached the continent of Africa’s borders and reached the United States. While proving to be a formidable opponent, the Ebola crisis was ultimately contained, but not before infecting two unsuspecting health care workers in Texas and claiming the lives of two others; both of whom contracted the virus outside of the U.S.more...
  • 06/26/18
    There are nostalgic movies that you always pause your channel-surfing to watch, no matter how many times you have seen them. For me, The Blues Brothers is one.more...
  • 05/23/18
    In 1960, the Harvard Business Review published a landmark article by Theodore Levitt entitled, “Marketing Myopia,” in which Dr. Levitt posed a defining question to American executives: What business are you really in? The article cited the failure by the railroads to recognize themselves as being in the transportation business, thereby enabling competitors from outside of the railroad industry to meet consumer needs with automobiles and airplanes.more...
  • 05/09/18
    I was walking on a bluff overlooking Lake Michigan just before sunset when the peaceful lapping of the waves was interrupted by what sounded like a swarm of angry bees. The hum alternately grew louder then faded. Glancing up, I saw not a swarm of bees but a hovering camera, held aloft by four vertical propellers, with blinking red and green lights. A drone. It was my first close encounter with one of the tiny airships and it prompted me to do a little reading about the phenomenon of private...more...
  • 04/30/18
    Many clinicians, myself included, recall CMS’ Sustainable Growth Rate (SGR) formula and Congress’ two decades of intervention to stop reimbursement decreases. In 2015, the Medicare Access and CHIP Reauthorization Act (MACRA) replaced the SGR formula with two tracks to choose from in CMS’ Quality Payment Program: the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs).more...