Where has 2022 gone? I wanted to express well wishes for the New Year because after this issue of the South Florida Hospital News and Healthcare Report, I will next talk with you from the 2023 side of the ledger. Wow!

If you are reading this, you still have time to register for our largest annual event, the South Florida Hospital & Healthcare Association’s Annual Meeting and Dinner. We will all be getting together on December 8th at the Signature Grand in Davie to reflect on 2022, thank friends and volunteers, meet new friends, and to celebrate the coming holidays. There is still time to register to attend this event and you can do so by going to our events page and to this event (https://www.sfhha.com/events-page/#!event/2022/12/8/annual-meeting-dinner ). Just go to sfhha.com, click on the Events tab and then scroll down to the Annual Dinner. Then, click to register. I am hoping to see you there.

Well, let’s start with Disney. Recent financial losses prompted Disney’s Board of Directors to make a change in leadership, bringing back Bob Iger to replace Bob Chapek as Disney CEO. Problems, both internal and external, made necessary the change with Disney also dealing with the issues of transparency and value.

Healthcare isn’t alone in trying to explain pricing while at the same time delivering on the value proposition. If we learned anything from the most recent election, the cost of living is important and the cost of healthcare is an easy target.

I foresee that price transparency will continue to be an issue and that, as an industry, we need to do a better job educating the general public about the importance of quality healthcare and how it is paid for. In a recent newsletter from Paul Keckley, he said that, “The working age population made the difference in Campaign 2022: they’re directly impacted by the health system’s lip-service to affordability and inept actions toward price transparency. They’ll act on their frustration in subsequent elections.”

In 2023, the SFHHA will be more engaged in both of these areas. Seemingly, regardless of administrations, the issues of price transparency and value are not going away.

November New Members

  • Vivian Health – Nursing staffing company
  • Hanger Clinic – Provider for Prosthetic & Orthotic providers
  • Dade Institute of Technology and Health – School of Nursing/Technology

 



I can’t believe it, November is here! Where has this year gone? In our “Years of Pandemic 2”, we were able to return to having some face-to-face meetings and programs but, we aren’t back where we were; more work needs to be done.

As you are reading this article, we have completed our 29th Annual Golf Tournament (October 24th) (for those of you who attended—thank you) and we are looking ahead to our last major event of 2022, our annual meeting and dinner.

This event with be on December 8 at the Signature Grand in Davie. It is one of our larger events drawing approximately 250 guests to hear about our association’s activities and to network with old friends and make new ones. If you have been looking for an event to support where building relationships is important, this is the event for you.

You can go to our webpage (www.sfhha.com) and click on the events tab and then scroll down to December 8 to register. Ask around and talk to anyone who has attended our annual dinners in the past and they will tell you that this is the one event that you need to attend.

November 2022 is also the month and year that Broward Health Imperial Point turns 50 years old! Opening its doors in November of 1972, the doctors and staff of this 204-bed hospital have been caring reliably for both their patients and the local community. Congratulations to Judy Frum and the whole Broward Health team.

Broward Health Imperial Point – HAPPY BIRTHDAY!



Wow, a lot has happened over the last several months. COVID-19 has temporarily been displaced by Monkey Pox, the brutal heat of summer continues, we are in the heart of hurricane season, and the economy, shocked by international and national events, has displayed tendencies that concern us all.

As the president of a hospital and healthcare association, I try to keep well informed. One of the sources that I rely on is the Atlanta Federal Reserve (FED). Healthcare organizations are concerned about our financial stability and, thus, I rely on the FED to give me some perspectives. So, here is what they say in their most recent report.

Let’s be honest, the last two years have been tough! For the next few years, I will continue to believe that “so goes the price of fuel, so goes our economy.” I might change that belief when the majority of cars on our roadways are quiet and non-polluting, but that is a few years off.

Continuing supply chain issues, more cars and trucks on the road, and the invasion of Ukraine have led to the increased cost of fuel, which then impacts manufacturing, etc., etc. Add to that result the fact that some producers chose to increase prices with the intent of getting back some of the earnings they lost in 2020/2021 and you have the perfect recipe for inflation. Unfortunately, what small steps we made in improving wages over the last two years will likely in the short run, be eaten up by inflation.

Seasonally adjusted real GDP growth, in a purely mathematical model, was estimated to have declined to 1.6 percent from 1.8 percent (after the release of the most recent report on retail sales). The pumping of the brakes by the FED is having an effect. The survey of market participants expects the FED to increase the federal funds rate by another 50 to 75 basis points to continue to cool the economy. To you and I this means that the price for us to borrow money (interest) will continue to rise and may delay our decisions to buy that new car, house, or major appliance. There will be similar valuations made by businesses to determine if they are going to expand, replace worn-out equipment, or develop that new product or drug using more expensive money (their estimated rate of return for these investments might no longer make sense when compared to higher interest rates).

In reading the minutes from the most recent Federal Open Market Committee meeting, it appears that the consensus is that there will be moderation in inflation. Shockingly, that this decline is tied to falling commodity prices for many things but, most notably, oil! The feeling was that the reduction in the rate of inflation would be even greater in 2023. I think we can also credit the commodity markets returning to normal for this improved result.

If we are looking for a positive aspect, we can certainly point to reduced inflation and the fact that the unemployment rate has stayed relatively the same from March to April. This is consistent with what we are seeing every day, we are in a tight labor market.

It seems like the FED acted earlier than most other economically developed countries where their central banks are just now applying the brakes (except Japan). What I take from this report is that it is going to be another tough year where the healthcare community will need to rely on the wise use of its existing resources and technology while the economy continues to adjust. I hope that by the time we get to this time next year, the situation will have stabilized, and we will see the inflation rate back at the 2 percent target.

Just hold on folks, it is going to be another wild ride.

 



BY: Jaime Caldwell, President SFHHA

Usually, once every year, I take a few minutes to see what others are saying and writing about the future of healthcare. I had a few minutes last week and I looked.

I have written before on this same subject and there are many similarities between then and now. Two or three years ago, I remember writing about how AI (artificial intelligence) would benefit healthcare. I seem to remember the concerns back then were that AI would not displace workers, rather, that AI would be a supplement allowing workers to be more productive and to concentrate on duties that don’t lend themselves to an AI intervention. I also seem to remember that there was concern that we aren’t graduating workers with the skill set that they will need to coexist in an AI world.

Well, this year’s review of the literature captured even more discussion about the use of AI and blockchain in healthcare along with repeated concerns about the human interactions with technology. So, what might we be looking at in the near future?

Clinical mobility ranks near the top in terms of our future. “The digital hospital of the future won’t just be more efficient, but it will also deliver better care, be more affordable and more deeply engage patients in their treatment and recovery.” All the players in healthcare will be electronically connected, leading to a reduction in cost, improvement in quality, improvement in patient safety (reduced medication administration errors), and more providers will be using this technology to access predictive analytics to assist in the improvement of care.

The customers (patients) are part of this equation. Growing numbers of customers (77 percent) are comfortable with their healthcare providers using mobile devices in their care. There are also growing numbers of customers tracking their own health metrics through either their mobile phones or wearable devices. Perhaps even more important in this discussion, 95 percent of customers will be willing to share their health metrics with their providers.

Pharmaceutics will also play a significant role in this evolution. As we continue to refine the analytics used to analyze the mountains of health data we are collecting, trends will guide healthcare providers in the optimal use of pharmaceuticals to treat various diseases. “Researchers have trained machines to recognize distinct patterns that indicate how a person will metabolize drugs, enabling them to more accurately predict how effective medication will be. Using AI to determine if someone will respond positively to a given treatment is particularly useful in oncology and neurology, where researchers can help doctors select treatments specific to a patient’s needs.”

If you want to see change in healthcare, wait a day! Genomic analysis, robotics, AI in medical decision support, and, maybe, 3D printed tissues and blood vessels are right around the corner. So, what are people saying about the next couple of decades? The Economist brought together a panel of experts to look at just those long-range change issues. The results are regionalized (U.S., EU, Asia, and Other) and I will mention just a few. Some make perfect sense and others invoke concern. I think that most can see 3D printing as an up-and-coming technology with 3D printers able to create needed replacement organs. I think that nanotechnology also makes sense with devices and treatments delivered through that route. How about brain/computer interfaces? It seems to me that we are already proceeding along this path.

How about hospital redesign? We are clearly seeing that evolve even today. It won’t be long before hospitals will only treat the sickest of the sick, needing reduced patient room space and more space for the growing use of robotics and streamlined treatment processes with high use of technology.

With so many aging over the next couple of decades, more research will be focused on the aging process and how to create aging situations that incorporate increased monitoring and personal accountability.

Lastly, and one that creates some concern, in three of the four geographic areas, designer babies are identified by significant percentages as a focus of research. I guess that this is inevitable as our understanding of the data becomes better and better.

Change is inevitable and we will continue to live it every day!



Courtesy of Cleveland Clinic, “Value-based care is a simple and proactive concept of improving care for patients. With its core based on overall wellness and preventive treatments, value-based care improves healthcare outcomes and reduces costs.”

When you do a search for articles about value in healthcare, prepare to sit for a while, as the number of citations will be great (about 764,000,000 results). Needless to say, none of us has enough hours in a day, month, year or a lifetime to cruise through all that material.

Therefore, courtesy of Paul Keckley, let us take a shorter journey and focus on the value discussion dating back to the first identified value agenda created by the Affordable Care Act (2013), which Keckley labels “Value Agenda 1.0.” This value agenda included several pay-for-performance programs (retreads) and new alternative payment models.

CMS defines Value-based programs as those that, “reward health care providers with incentive payments for the quality of care they give to people with Medicare. These programs are part of our larger quality strategy to reform how health care is delivered and paid for. Value-based programs also support our three-part aim: Better care for individuals, Better health for populations, and Lower cost.” Think about the Triple Aim that transforms to the Quadruple Aim with the addition of health equity (or joy in work, if you are so persuaded).

It is against this backdrop that we change administrations (Obama to Trump) and along with this change in administrations comes a change in thinking about how to approach the goals expressed by the Triple and Quadruple Aims.

Keckley refers to this new approach as the “Value Agenda 2.0.” [2018] This particular agenda expresses the new leadership’s direction and implementation was accomplished by creating, “new alternative models and executive orders requiring price transparency for drugs, hospitals and insurers.”

In the review of the literature on the relative successes of both of these value agendas, the results appear mixed. Significant improvements occurred on the quality-of-care side of the equation and less so on the cost savings to Medicare side. Annual Medicare spending increases slowed over this period but did not hit the targets predicted before implementation. Then the pandemic hit.

Healthcare spending increases significantly and, “…public anxiety about health and wellbeing has spiked and health insurers and notable hospital systems are reporting record earnings.” Paul Keckley talks about the emergence of the “Value Agenda 3.0” now being driven by employers and consumers.

This new paradigm will exhibit a coming together of parties to create common definitions and goals, greater price transparency, more inclusive of all healthcare purchasers (not just Medicare), and increased scrutiny of private capital firms entering the healthcare vertical.

Look at 2022 as the year of collaboration with common goals like, “value will be more precisely defined and directly linked to lower costs for individuals and families.” Changes in healthcare will continue, keep your eyes open or you may find yourselves left behind!