What a year!!!

As I reflect on 2011, from a health policy perspective, it has been quite a year indeed. Berwick is out, ACOs are in, and costs continue to rise. Employers are trying everything and corporate wellness and prevention is the "new green". The lines separating payers, providers and purchasers are blurring every single day as insurance companies buy doctor practices and hospitals too!! The New England Journal says Disease Management doesn't work and everyone believes one study based on the sickest Medicare patients only. It is increasingly difficult to separate out the "truth" from the background noise, especially as the noise gets louder and louder.

Personally, I am really looking forward to 2012 and the ongoing struggle to make health care more accountable, transparent, safer and more cost effective. I am confident that the Jefferson School of Population Health will continue to provide leadership in its research, teaching and dissemination agenda. Our journals, this BLOG, our Medpages column, our national conferences, continue to resonate with the key opinion leaders in healthcare across the nation.

I hope that you will continue to turn to us for informed opinions and solid evidence too about what is working and what is not. One thing surely still remains the same regarding the reform efforts and that is of course " No Outcome--No Income". I am convinced that the future belongs to groups that can make this pithy statement a reality for everyday practice. We are always interested in your views too. DAVID NASH

The American Israel Commerce Committee Meeting

This past week I had the privilege of playing co host for the American Israel Commerce Committee meeting on "Healthcare Information Technology". Nearly a dozen amazing young Israeli companies came to Philadelphia to make their "pitches" to raise money AND awareness about their work in the IT sphere of healthcare. Each firm did an incredible job discussing their software and related new tools for building a better infrastructure in our crazy business. The meeting was "bookended" by two panel discussions that I moderated. The first panel of experts tackled the question of "Funding Opportunities" and the second panel discussed "Power Collaborations". The keynote luncheon talk was delivered by David Jones Jr., my colleague and friend. David is the managing director of Chrysalis Ventures in Louisville KY and for many years, has been a driving force behind HUMANA as an active Board Member.

The conference drew more than 100 persons from around the Delaware Valley and the sprited conversations were peppered with Israeli wit and wisdom too. For such a small country Israel produces a disproportionate share of leading IT firms and being able to bring them to our home town was a real treat. The mission of our School of Population Health, and the mission of the AICC, were totally aligned for this important event. To learn more go to www.americaisraelchamber.com. We would welcome your feedback about any of the firms, or the content of the two panels as well. DAVID NASH

The 10th Annual Quality Colloquium at Harvard

For four days this week the leaders in the quality and safety movement from all over the nation converged on the campus of Harvard University for the 10th Annual Quality Colloquium co sponsored by the Jefferson School of Population Health. In the first morning of the program, three key leaders, including the CEO of the IHI in Boston, the National Patient Safety Foundation, and the AHRQ, set the tone for the rest of the week by challenging the audience to get further engaged in the movement.These leaders reminded us all that medical error remains the fourth leading cause of death in the US and more must be done to protect our patients from harm. The research presentations covered a wide range of topics including the latest research on safety improvement in both the hospital and the office setting. Others presented an update on the role of hospital governance in quality and called for a renewed commitment on the part of board members to this agenda. In the pre conference workshop, nearly 100 persons spent a day in a special "boot camp", with myself and my colleage Dr Ed Walker from the University of Washington in Seattle. Together, we gave a day long overview of the field and we too challenged the attendees to return to their home institutions with a renewed sense of energy and new tools to tackle the epidemic of harmful errors. Our team is already hard at work planning the August 2012 session!! I sure hope that you will think about joining us next summer. DAVID NASH

More on Accountable Care Organizations

The Jefferson School of Population Health just finished hosting a special two day invitation only advisory board on the current status of Health Reform. We had one dozen experts from all around the nation convene on our campus for a two day discussion of the details and an update on implementation challenges. It was sobering indeed!! At this juncture, I believe that most organizations are NOT culturally ready for the hard work of true accountability.The heart of a real ACO, whether with Medicare or commercial patients, is the realization that clinicians will have to self evaluate, measure what they do everyday, and be willing to engage in the gut bustingly difficult work of improvement. The "shared savings" may in fact be minimal, especially in the early stages. It will take a commitment to practicing based on the evidence and a willingness to benchmark performance against regional and national leaders. A tall order for any organization and in my view, most are not at all ready for this cultural paradigm shift. Who will make it---organizations with a hierarchical doctor culure, accustomed to profiling and willing to police members within their own ranks. The Ochsners, Geisingers and Mayos of the world will be able to make it work, very few others have the skill sets necessary at this juncture. Stay tuned for more posts from our amazing advisory board and for publications that will come from our deliberations together. DAVID NASH