Experts

When it Comes to Health Care, What Matters Most to Consumers?

Introduction from Bernadette Loftus, MD

Introduction from Bernadette Loftus, MD

Anyone who has had to choose a health insurance plan knows how confusing the process can be, even with the help of a friendly human resources professional. For the millions of Americans purchasing their coverage through exchanges, the process can be even more daunting.

Many consumers struggle to determine which plan is going to provide the best value – the coverage they need at a price they can afford. Dozens of organizations and publications – from the National Committee for Quality Assurance (NCQA) to Consumer Reports – rate health care plans each year. Some of these rankings are meant for the average consumer, but many are for industry insiders – laden with clinical terminology and detailed beyond what most people want to know.

On October 28, the Mid-Atlantic Permanente Medical Group and the Center for Total Health hosted what we hope to be the first in a series of events examining how we can translate these often technical ratings into something more consumer-friendly and how best we can get those ratings into the hands of the consumers.

Helen Burstin, MD, MPH, FACP, from The National Quality Forum, and Margaret O’Kane, from NCQA, set the tone for the day, reminding us that the patient must be at the center of all the industry does – not just care delivery. We must seek to provide our patients with the information they want in a way that is meaningful and accessible for them, while remembering that health care is a personal experience and much of what matters most cannot be measured. Dr. Burstin reminded us: Not everything that counts can be counted; not everything that can be counted counts.

Consumer Voices Panel

Consumer Voices Panel

Kaiser Permanente’s own Bernadette Loftus moderated a panel to understand what counts for consumers. Doris Peter, PhD, of Consumer Reports, emphasized that people can handle data.

“Just look at ESPN,” she reminded the audience, daring them to find a website with more data collected.

Dr. Peter and her co-panelists, Tina Reed of the Washington Business Journal, and consumer Iris Molotsky, agreed that uniform, consumer friendly terminology is a key step to making quality ratings more accessible for consumers. Ms. Molotsky, the president of Dupont Circle Village, a neighborhood association in Washington, DC, emphasized that “even well-educated, well-read, well-traveled” members of her community are confused by the complexities of standard health care language.

This sentiment was echoed by the last panel of the day, featuring the chief health officers of the District of Columbia, Maryland, and Virginia, as they lead their populations and health departments in the second open enrollment on the exchanges.

Great connections were made during the Mad Tea Party

Great connections were made during the Mad Tea Party

Leadership Perspectives: Good Health Starts Where You Are

Editor’s Note: Today, we launch a recurring feature on the Center for Total Health Blog. “Leadership Perspectives” is a collection of guest blog posts from Kaiser Permanente leaders all about why we need to take a Total Health approach.

Today’s guest author is Elisa Mendel, national vice president of HealthWorks & Product Innovation for Kaiser Permanente, who shares her thoughts on place-based health.


 

How much time would you guess you spend at work each year? Would you be surprised if I said it’s something like 2,000 hours?

Elisa Mendel, VP of HealthWorks & Product Innovation for Kaiser Permanente

Elisa Mendel, VP of HealthWorks & Product Innovation for Kaiser Permanente

Compare that to the time we spend with our doctor — maybe 15 minutes once or twice a year? That’s why place-based health is so important. At its core, good health starts with us — where we live, work, learn, and play.

That’s one of the reasons Kaiser Permanente partnered with leading national organizations to launch Thriving Schools. The idea is that schools are the hub of every community. Our work in schools focuses on four key areas: healthy eating, active living, school employee wellness, and a positive school environment. One of the active living programs is called Fire Up Your Feet. Fire Up Your Feet’s fall campaign launches October 1, and it encourages kids to walk to school with their parents, giving them much-needed exercise and some quality time together.

Another initiative I really love combines the childhood enthusiasm for play with the workplace. It’s called “Instant Recess.” A manager or wellness champion schedules time with their team —usually about 10 minutes. Everyone stops what they’re doing, and one of the team members leads the group in dancing and exercise. People are moving, getting their blood pumping, and laughing together. It’s had amazing results, because when you’re doing the chicken dance with your supervisor, suddenly things feel a little less stressful.

Kaiser Permanente piloted this in various work settings — call centers, IT, and even the ICU. One of the ICU patients heard the staff doing this Instant Recess every day on the floor and she was determined to get out of bed so she could be wheeled out to participate in the fun.

There’s no limit to the benefits of healthy living. It can lift spirits and deliver real business results. One study in the Journal of Occupational and Environmental Medicine showed that employees who ate healthy and exercised regularly were up to 27 percent less likely to be absent from work for health reasons.

Good health is becoming a national movement. Find your “healthy,” and start to share good health close to your home.

Domestic Violence: It’s a Health Issue

October is Domestic Violence Awareness Month — a good time to pause and consider just how many people are affected by domestic violence and sexual assault. The numbers are astounding. According to the National Coalition Against Domestic Violence, an estimated 1.3 million women are victims of physical assault by a domestic partner each year. And one in every four women will experience domestic violence in her lifetime.

Adults aren’t the only ones affected. Every year, nearly 1.5 million high school students experience physical abuse from a dating partner. One in three adolescents is a victim of physical, sexual or emotional abuse.

This episode of Total Health Radio talks about what teen dating violence looks like and some of the warning signs parents and friends should be watchful for. Guest Nancy Schwartzman, the inventor of the Circle of 6 mobile app, shares ways that young women can both prevent and cope with sexual assault.

How are your kids handling the stress of heading back to school?

Understanding our kids’ physical health is one thing. Tuning in to their emotions can be quite another.

According to the National Institute of Mental Health, the number of children with a diagnosable anxiety disorder is now up to a staggering 25 percent. As we’re now a few weeks into a brand new school year, this might be a good time to pause and check in on the anxiety levels of the kids in our lives.

In this episode of Total Health Radio, we explore key questions around anxiety in children. In what way do symptoms of anxiety look different in a child than in an adult? How do we differentiate between a high level of stress and something more serious? How do we help our kids identify triggers? And importantly, we look at how we can best help our kids by becoming aware of – and getting a handle on – our own anxieties.

What Does Environmentally Sustainable Health Care Look Like?

It’s all you’ve ever wanted to know about the greening of health care!  In our earlier post, we told you about the recent publication of the book, Greening Health Care, by Kaiser Permanente’s Kathy Gerwig.  Today, we begin a series of excerpts from the book — and we start with an introduction and overview from the preface.

The very nature of health care is changing. Health care reform, clinical innovations, electronic medical records, social connectivity, technological advances, baby boomers’ expectations about quality of life, demands for price to align with value, and ways the environment contributes to disease are some of the factors behind the changes. These changes offer profound, new opportunities to address environmental issues across the health care sector and beyond.image

In this changing landscape, what does environmentally sustainable health care look like? Let’s take an imaginary visit to a hospital for a routine doctor visit. Approaching the medical facility, the first thing we notice is that the building is smaller than we expected. There is a convenient transit stop at the front entrance. And the parking lot pavement allows rainwater to filter through to be cleaned and returned to the aquifer. We notice that instead of lawns there are native plantings that minimize water and pesticide use.

There is a garden path that takes us by a stream that was brought back to life from where it was hidden in a concrete culvert decades ago. We enjoy the birds that have rediscovered this tranquil place. You notice a labyrinth and take a meditative respite.

Once inside, we’re walking on nonvinyl, nonpolluting material on the carpets and floors, and we notice how much natural light floods into the lobby and hallways from specially designed window glass, shades, and blinds that allow sunlight in while minimizing afternoon heat. The walls are painted in soothing colors and patterns that mimic the adjoining landscape. The energy efficient lighting fixtures glow with a pleasing hue. You see a plaque on the wall indicating that the building is carbon-neutral.

In the bathroom, the toilets and sinks are water-conserving, and the soap does not contain harmful anti-bacterial agents. The paper towels are made from 100 percent recycled, post- consumer waste, and the used towels go into a compost container. In the waiting room, the fabric on the chairs was selected to avoid harmful chemicals that can cause adverse health effects.

In the exam room, your temperature and blood pressure are taken with mercury-free devices. You notice the purple exam gloves used by the clinical staff. These are latex-safe for worker and patient safety, and they are environmentally preferable.

If you are here for a biopsy, your doctor will use a rigid endoscope (for minimally invasive surgery) which is steam sterilized to avoid the use of chemicals that are hazardous to the environment and to staff. Read More

Caffeine and Kids: What’s the Buzz?

As your kids head back to school, you may notice that they — and many of their friends — seem to be weighed down with nearly as many commitments as adults. How they manage that level of responsibility is worth considering. With the rise of coffee house culture, the popularity of soda, and the explosion of energy drinks on the market, the amount of caffeine consumed by teens and even younger children is on the rise.

If you are concerned about the caffeine habits of a child in your life, this episode of Total Health Radio can help. In it, Kaiser Permanente’s Michael Nelson, MD, shares the symptoms that signal your child might have a problem, as well as how to broach the topic — and what you can do to protect your child’s health.

Six Burning Questions Health Care Leaders Have about ACOs

ACO imageIf you ask health care leaders what they think about Accountable Care Organizations (ACOs), you won’t be short on answers, writes Samantha DuPont of the Kaiser Permanente Institute for Health Policy, in a recent article and video on the Institute website.

According to the Centers for Medicare and Medicaid Services, ACOs are formed by groups of doctors, hospitals, and other health care providers, coming together to provide coordinated high quality care to their patients.

Early ACOs have had mixed success, and in light of emerging research questions remain as to whether or not they will result in comprehensive delivery system and payment reform that is sustainable.

DuPont chronicles the six themes that emerged from the Institute’s work in asking leaders from across the nation their burning questions about ACOs:

1. What do ACOs look like today?

2. What factors will lead to ACO success?

2. Are current financial incentives strong enough to change provider behavior?

4. Will ACOs integrate with other types of caregivers?

5. Will ACOs successfully engage their patients?

6. What metrics will effectively measure quality?

Informing the Next Generation of Accountable Care Organizations

Some of the biggest buzz in health reform lies in the potential that Accountable Care Organizations (ACOs) have to help to reduce costs, improve care, and move away from fee-for-service to population-based payment.   But questions remain as to whether or not they will result in comprehensive delivery system and payment reform that is sustainable.

Joy Lewis, MSW, MPH, of the Kaiser Permanente Institute for Health Policy, attended a July 13th convening in Washington D.C., hosted by the National Health Policy Forum, that highlighted some of the successes and challenges of early ACOs.

Kaiser Permanente has been supportive of this movement since the concept was first introduced in 2009.  While not technically an ACO, many elements of our care system – such as use of electronic health records, team-based care, and population management tools – ideally will be a part of ACOs.

Read the Kaiser Permanente Institute for Health Policy Observation describing Lewis’ highlights of the meeting, which include tactics for improving quality, increasing savings and overcoming the fee-for-service chassis.

Advice for New Moms’ First Hours, Days and Weeks Following Childbirth

After the BirthTotal Health Radio has had straight talk about pregnancy and truth telling about childbirth.  But what about those first days and weeks after giving birth?  In this episode, we focus less on the baby and more on the changes you are going through during that time – what’s normal, what’s not, and what may surprise you.  Packed with tips for making new moms more comfortable and advice on how spouses and partners can best provide support, this show is valuable listening for expectant parents – and the people who love them.

For more information on this episode and for links to additional resources every new mom should have at her fingertips, check out the Total Health Radio website.

Walking the Talk: Despite Challenges of Implementation, Exercise as a Vital Sign Initiative is Thriving

EVS_Blog2_doc_patientIt is well known that 30 minutes of moderate physical activity, five days a week, can over the long haul minimize the effects of many chronic diseases. Kaiser Permanente has made it a goal to ask all patients their exercise information – How many minutes per day? How many days per week? – in an effort to help them become more active and therefore more healthy.

This initiative is called Exercise as a Vital Sign, and while it may seem simple for all medical assistants and primary care providers to ask their patients those two questions and record the data in the electronic health record, it is more complex than that. Even now, five years since the first members were being questioned, EVS continues to be a work in progress

Read Dr. Latifat Apatira’s article, the second of a seven-part series, about how enthusiasm for the project remains high, despite the challenges. Learn from experts why Exercise as a Vital Sign is at the heart of Kaiser Permanente’s Total Health strategic vision, where Total Health is defined as a state of physical, mental, and social well being.

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