Richard Safeer MD

There's simply no evidence that 60 years wasted building vertically and horizontally integrated segregating, rationing and inequitably subsidized mega-profitable health insurance conglomerates, has improved most Americans preventive, medical, surgical or palliative care access, outcomes or costs. Captiating physicians reimbursement, enrolling everyone on highly rationed Medicare Advantage HMO's or inventing another hair-brained insurer-biased 'value based care plan' aint gonna fix the problem. Only by neutralizing the profits of the health insurers utilizing the tried and proven Bismark Healthcare Model will all Americans gain access to quality affordable private insured and private FFS manufactured medical care with better outcomes, costs and access than America. Germans, Swiss, Japanese, Netherlands and other capitalistic democratic nations enjoy this utility, why can't Americans? Read about Bismarck Model healthcare here: https://lnkd.in/evX8nur

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Health Policy and Muscle Memory What is muscle memory and what does it have to do with health policy? I had the enlightening pleasure of attending the Duke Margolis Annual Health Policy Conference in Washington, DC. The presenters were an all-star cast including, but not limited to, the Directors of the CDC, NIH, CMS and past HHS and state Health Secretary’s. The overall outlook they presented, particularly for primary care, was very optimistic. The discussion that really caught my attention was about the need for the healthcare industry to develop muscle memory for value-based strategies in order for sustainability. Their premise and corresponding concern were that the industry has had a lot of value-based programs introduced over the past decade but there has not been the degree of sustainable and broad-based value delivery cemented into the day-to-day delivery of care. This is a really intriguing point. Edward Deming proposed that “Every system is perfectly designed to get the result that it does” Webster defines muscle memory as “the ability to repeat a specific muscular movement with improved efficiency and accuracy that is acquired through practice and repetition”. With these definitions in mind, has the past decade of innovation in healthcare payment and delivery been designed to train that muscle memory that allows healthcare organizations and providers to function at peak performance in value-based care? I think the results, so far, provide a somewhat disappointing answer. As noted in the conference, there have been a lot of amazing innovations, but they have not yet been incorporated into muscle memory. In the early days of healthcare transformation, it was necessary to experiment with a variety of innovative models in order to get the basic elements of value-based care nailed down. The confounding issue over the past decade may have been the continued changes and tinkering at the policy and program level and the lack of consistency across payers that continually shifted the implementers and healthcare providers from settling into patterns that would allow that muscle memory to develop. As was said many times; “That was then, and this is now”. I heard a strong commitment from many of the important policy makers, leaders and influencers at this important gathering, to restrain the pace of new modeling (there was a recent bevy of models from CMMI, many of which are promising) over the next decade and allow the industry to settle into stable patterns. The innovation will not stop, but it will come from the training of that healthcare industry muscle to perform at a peak level, always improving and always competitive in the best sense of the word. More about the conference here:   https://lnkd.in/eSyUVEVx Yours in Health Howard

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Housing instability can contribute to long-term mental health disorders and exacerbate chronic conditions, compromising long term health. Further, these impacts are disproportionately felt among Black Americans. Research from the Elevance Health Public Policy Institute suggests that Medicaid health plans can invest in housing interventions and partnerships to equitably improve these housing outcomes, highlighting positive outcomes from an Elevance Health affiliated Medicaid plan in Nevada. https://ow.ly/7k2y30sC4CV

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🎧 Tune in this #NationalMinorityHealthMonth as Taylor Johnson and Meghan Kwiatkowski, MAIO, PMP, LSSGB, CPHQ dive deep into community engagement, leadership strategies, and navigating #socialdeterminantsofhealth. This #AMAStepsForward #podcast episode explores linking patients to vital resources and crafting actionable plans for private practices. Listen now and claim #CME! #SDOH

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Why big is bad in healthcare: Some interesting comments here on health system consolidation from Andrew Donahue, FHFMA, CPA, HFMA's director of health finance policy. Keep in in mind that this is someone who's extremely sympathetic to the hospital industry. First, he acknowledges that mergers "can lead to less competition, inferior service and higher prices" and goes on to say that the only driver of hospital mergers is private insurance companies giving better rates to bigger systems. In an accompanying interview on HFMA's "Healthcare Blame Game" podcast, Donahue goes even further: "Community healthy systems do not want to be megasystems...growth is not necessarily the strategic imperative...you lose local control." He talks about "megasystems" laying off local staff and cancelling contracts with local suppliers, both of which can be devastating to communities. "The corporate finger can slip off of the pulse of the local community when you have more bureaucratic layers, channels, and processes to navigate." This is a message that needs to be heard across the healthcare industry. Hospitals exist to serve communities, not corporate offices in distant locations. Corollary message: Private insurers, both for-profit and non-profit, have s***-ified the hospital industry with their contracting practices. #ethicalhealthcare #hippocraticcapitalism #hospitals #healthsystems #monopolies #antitrust

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Mark Your Calendar: Oct. 28-29 Advancing Behavioral Health and Policy Summit in DC https://lnkd.in/e5k-nfex Accelerate healthcare’s shift in the move from volume to value. Register now for the Advancing Behavioral Health and Policy Summit, produced in partnership with Association for Behavioral Health and Wellness (ABHW), October 28-29, 2024, in Washington, DC. Early registration is open! Act now to save up to $800 off the final on-site rates. Use promo code "SM2024" when you register.* Here's what you can expect in 2024: • Prioritizing mental health: Prioritizing mental health with the same urgency, resources, and emphasis on prevention as physical health • Advocating for policy advancements in mental health and substance use disorder treatment services: Engaging federal and state policymakers to implement and sustain policies that accelerate care access and treatment approaches • Investing in preventive mental health services: Shifting from a reactive to a preventive/proactive approach to mental health • Addressing barriers to integrated, coordinated, and immediate access to critical care: Closing the gaps in implementing an integrated system of care through enhanced education and clinician training • Building a resilient employee workforce: Accelerating leadership’s role and adopting innovative preemptive programs to destigmatize mental health challenges and enable timely access to mental health resources • Bridging the gap in access to mental healthcare among rural and underserved populations: Ensuring comprehensive care for diverse populations including those residing in underserved communities • Leveraging technological advances to optimize care diagnosis and support: Keeping pace and unlocking the potential of digital therapeutics, artificial intelligence, and other emerging technologies to advance mental health services and substance use disorder treatment • Cultivating and inspiring the “NextGen” behavioral health workforce: Incorporating creative recruitment initiatives while leveraging federal and state resources to address workforce shortage and create a more diverse workforce to deliver behavioral health • Delivering care with cultural empathy: Providing individualized and culturally – contexed care through an individual’s own experiences and circumstances #thINcvalue #behavioralhealth #mentalhealth #VBC #health #healthcare #healthpolicy *All registrations subject to review by the thINc team. Promo codes not applicable for government rates or vendors/solutions providers. Discount codes are only applicable to NEW registrations.

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This is WAY overdue. For anyone who has seen the value of a genetic counselor, be it from a personal pr professional lens, let congress know. If you haven't, let's talk. #genetics #geneticcounselor #health #medicine

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#ICYMI - Explore the underlying causes of social injustice and health inequity to unearth public health’s role in building healthier communities in NACCHO's Roots of Health Inequity course: https://lnkd.in/ezu_2qBE 

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HHS Releases Strategic Framework for a National Plan on Aging States have been developing multisector plans to better serve their older populations. Now, the federal government is enhancing these efforts with a national plan on aging. On May 30, HHS released “Aging in the United States: A Strategic Framework for a National Plan on Aging” to Congress. Developed by leaders from 16 federal agencies and departments through the ICC, this report outlines our nation’s approach to preparing for an aging population. It aims to improve the aging experience, create age-friendly communities, support family caregivers, and value the professionals providing in-home and community-based care. This effort includes the voices of older adults and stakeholders through the National Plan for Aging Community Engagement Collaborative, supported by West Health, The SCAN Foundation, and The John A. Hartford Foundation. Read the full report https://lnkd.in/eHkp2V6C 🌟 How do you think this national plan will impact our aging population? Share your thoughts in the comments! 🌟

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Sharing this helpful overview of #aging & #visionloss especially important for #caregivers & #familycaregivers. Understanding how and where to access important resources are invaluable to a caregiver’s toolbox!

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NPR: Advancing Addiction Treatment with Contingency Management  — April 19, 2024 Pittsburgh’s NPR station 90.5 FM WESA covers the first large county-wide launch of the highly effective Contingency Management (CM) model with public funding. https://lnkd.in/eRqUegN5 U. of Pittsburgh’s Community Care Behavioral Health is coordinating the full program from DynamiCareHealth.com. The $1.7 million contract will provide smartphone + smart debit card CM for 700 patients with opioid or stimulant use disorders. The program is funded by an Opioid Settlement Commission grant, a resource now becoming available to communities nationwide. Since opioids are increasingly mixed with stimulants, funds are being used to address both epidemics. In fact, the death rate from stimulants overtook that for opioids back in 2022. Yet, there is no FDA-approved medication for Stimulant Use Disorder and the only standard of care — CM — is rarely available. DynamiCare’s unique CM Guides will directly assist patients with multiple, integrated, evidence-based approaches. These include: Motivational Interviewing (MI), Cognitive Behavioral Therapy (CBT), Community Reinforcement Approach (CRA), and measurement-based care. Thanks to additional recent policy breakthroughs, all of these patient activities are promptly reinforced with $1,100 per patient in relapse-protective cash-equivalent rewards. DynamiCare has already been described in 6 controlled-trial reports in the peer-reviewed scientific literature as generating 2X (I.e., 100%) improvements in abstinence rates — from opioids, stimulants, alcohol, tobacco & youth nicotine vaping. #addiction #addictiontreatment #addictionrecovery #substanceusedisorder #asam  #nida #drugabuse #drugpolicy #qotd #harmreductionsaveslives #shatterproof #sud #oud #mat #evidencebasedpractice #recoveryispossible #overdoseprevention #overdoseawareness #harmreduction #drugaddiction #alcoholaddiction #alcoholism #ONDCP #substanceabuse #samhsa #csat #publichealth #publichealthmatters #drugaddiction #pear #reset

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"[T]he study revealed a significant shift toward wellness-focused communities, emphasizing a holistic approach to care and service delivery that prioritizes individuals’ well-being through more personalized and wellness-centered offerings." Great article on the future of senior living!

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What do you know about Person-Centered Care? To me, person-centered care means advocacy. It means options and empowerment. It means: Tools like Therapprove to select the right physical therapist for your child. Passionate patient advocates like Lori Schellenberg and Ashely Oaks BSN, RN, helping you navigate the complex health system. It means involving regional organizations like CICOA Aging & In-Home Solutions and home care services like Altra Homecare Group to make sure you're cared for well at home. And of course, smart solutions like Primary Record to store the medical data from the above services and help them communicate amongst the care team. To me, person-centered care lives far outside of the four walls of the hospital. It means involving small businesses and your local community resources to help. This is where I see the most hope and innovation in health care today. Kudos to all of you taking the plunge to improve lives in the name of person-centered care. #personcenteredcare #patientcenteredcare #patientaccess

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We are covering this study today in the MHA #HealthEquity Collaborative, but it's important enough to share widely. We need to recognize that social needs screening is new and will have unintended consequences that we all need to continue to monitor. This scenario is a great case study because it brings together social work, quality, risk management, physician education, and even ethics!

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#actcenterorg's "Rapid Evidence Scan" on Technological Interventions in Primary Care, answering the question: What primary care based technological interventions lead to improved health and patient experience? ACT Center scientists conduct Rapid Evidence Scans at the request of Kaiser Permanente Washington Care Delivery leaders to help inform important and strategic decisions. READ MORE here: https://lnkd.in/g5zw8AjG | #evidencebase #evidencescan #learninghealthsystem #healthcare #primarycare #technology #telehealth #mobileapps #patientportals #interventions #researchtoaction #caretransformation

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