Some low cost generic drugs that have “helped restrain” healthcare costs for decades are seeing unexpected price spikes of up to 8,000 percent. “If generic drug prices continue to rise, people all over this country who are sick and need medicine and will not be able to buy the medicines they need. (Senate sub-committee on Primary Health and Aging) An example: the antibiotic doxycycline hyclate rose more than 8,280 percent during a six- month period from $20 per bottle to $1,849 per bottle. (Associated Press, Nov. 21, 2014)

2,333,972 American military personnel had been deployed to Iraq, Afghanistan or both, as of Aug. 30, 2011. 711,986 have used VA healthcare between fiscal year 2002 and the third-quarter fiscal year 2011. 38 per 100,000 of these Veterans using the VA healthcare committed suicide during the latest data available. There is very little information about veterans who did not use VA healthcare. Compare that to 11.5 deaths per 100,000 for the general public. (VA’s Iraq and Afghanistan Veterans of America –Non-profit organization.)

$2,o77 is the average balance in health savings and health savings reimbursement accounts in 2014, compared with $1,356 in 2008. (Modern Healthcare, Feb. 2015)

“While there is a reported trend of physician employment with hospitals and health centers, we have seen some of those medical groups going back to private practice during the past two years. This phenomenon not only plagues medical group and physicians, it affects groups that join and merge with other private practices to form larger single-specialty or multispecialty groups. Unfortunately, many hospitals and medical groups believe that performing financial due diligence of a practice and then focusing on compensation considerations is sufficient to successfully negotiate a deal.” (“20-20 hindsight: Choosing hospital employment and returning to Independence.” Nick Fabrzio, PhD, FACMPE, FACHE; MGMA Connection Magazine, March, 2015)

The adage that culture eats strategy every day of the week is certainly true with integration.

The primary reasons for returning to private practice were the desire to stay involved in decision-making and ensure physician satisfaction. In hindsight, physicians said they wished they had spent more time talking about how decisions were made at the hospital and learning more about what their level of involvement would be before they sold their group. While compensation is often the primary motivation, it is a necessary but not a sufficient condition for successful relationships.

The prevalence and costs of Alzheimer’s disease are expected to grow substantially over the next few decades as the nation’s elderly population swells.

5.4 million; estimate number of Americans living with Alzheimer’s in 2012, a figure expected to triple by 2050. ( Alzheimer’s Association )

17.7 billion; Number of unpaid hours of care provided by relatives and friends in 2013 to those with Alzheimer’s valued at an estimated $220 billion ( Journal of the American Geriatrics Society)

$10,748; Average annual per-person payment for acute inpatient services for Medicare beneficiaries with dementia in 2013, compared with $4,321 for beneficiaries’ without dementia.

(CMS)

75 percent; Percentage of people living in a nursing home by age 80 who are expected to have Alzheimer’s. (Alzheimer’s Disease and Associated Disorders.)

Dr. Karen DeSalvo heads up the Office of the National Coordinator for Health Information (ONC). ONC Tenure: January 13, 2014 to present. Observations about ONC So Far: There have been five coordinators, (former ONC chiefs over the last 10 years). Former ONC chiefs have differing views “about the role of government and the ONC in a national HIT strategy generally. Everyone is trying to solve the same three issues. They are capturing data, freeing it appropriately and then putting it to use. And everyone sort of sees a different way to do it.” Dr. DeSalvo has been impressed with the reach that the regional extension centers have in communities. (Apparently she has not been talking to the individuals and looking at the data that I have.)

ONC’s Future: A top priority by the end of this year is to update the national health IT strategic plan and include provisions for patient-generated data. “The technology in that area, because it is so consumer and market driven, is advancing fast,” says DeSalvo. (Not true – it’s because of all the roadblocks and various silos impeding its progress.)

Bill Appling, FACMPE, ACHE, is founder and president of J William Appling, LLC.  He is a national speaker, presenter and a published author.  He serves as an adjunct professor at the University of Memphis and is on the boards of Hope House and Life Blood.  For more information contact Bill at j.william.appling@outlook.com.