Straight TalkA weekly update from management on the issues that matter most. Jan 4, 2018 At the start of each of the past eleven years, I have shared my predictions for NCH and the healthcare industry. We are challenged with decreased resources and increased expectations. Our goal should be caring for ourselves and the next generation while downplaying the next election cycle. Objective quality transparency will grow.—Centers for Medicare and Medicaid (CMS) is committed to quality, with a focus on fifty-seven, well-defined criteria in seven categories (mortality, safety, readmission, patient experience, effectiveness of care, timeliness of care, and imaging). Patients can accurately compare one hospital system to another. Where you get care matters. www.medicare.gov/hospitalcompare/search.html Leapfrog is also an objective source for safety and quality, whereas other of the “quality measurers” lack transparency, depend on past reputation, employ marketing, and are difficult to understand. Another group of “top 100” hospitals bogusly includes many hundreds of designees and requires honorees to pay to publicize grades. Using objective CMS metrics, many of the most venerable institutions became the most vulnerable. Previously iconic behemoths are aging-out of existence and cannot objectively demonstrate quality, whereas younger institutions like NCH—financially healthy, community supported, and academically aligned—have a top 5 star ranking. Only five systems in Florida and 7% in the nation share a 5 star status. NCH’s goal is to maintain our top ranking. Prevention will accelerate.—Arguably, more important than being a repair shop, alert healthcare systems should be focused outside the four walls of their institutions. NCH is the sponsor of the very successful Blue Zones Project for Southwest Florida. We have been recognized as the healthiest and happiest community in the nation for the second year consecutive year; adding 0.2 years of life-expectancy is unique in America. Sadly, for the first time since 1963, the nation’s overall life-expectancy has decreased for the past two years. Single-Payer Insurance will gain acceptance.—Even though no individual or system alone can determine changes in healthcare policy, what we have now is clearly not working. Interestingly, Medicare although not perfect has an 80% approval rating from those covered. Healthcare is the largest industry by far in America, consuming 17.8% of the GDP at $3.2 trillion dollars and growing. If U.S. healthcare were a nation, it would be the fifth largest in the world behind the U.S., China, Japan, Germany, and ahead of the United Kingdom. The U.S. perennially ranks last of the eleven most developed nations in healthcare. http://www.commonwealthfund.org/publications/fund-reports/2017/jul/mirror-mirror-international-comparisons-2017 An efficient single-payer system focused on prevention and employing behavioral economics to motivate citizens would improve health, lower costs, cover everyone, shrink waste, and better utilize limited resources. We could fund education, rebuild infrastructure, grow programs to modernize the workforce, buy down debt, and do other productive projects for everyone’s well-being. Rice bowls would be broken because the tobacco industry would be vanquished and the health insurance industry would be transformed. Big Pharma would be challenged on its pricing of new and existing medications, while many other costly services would be asked to prove efficacy or be eliminated. In sum, this year has only three major predictions, but each is monumental as we strive to help everyone live a longer, happier, and healthier life. P.S. DO YOU HAVE A COLLEAGUE OR FRIEND WHO WOULD BE INTERESTED IN UPDATES? Please enter their email address at nchmd.org/straighttalk, and we will add them to our complimentary mailing list.