Among thought leaders in occupational medicine, three of the most influential have to be Ed Bernacki, Gideon Letz and Jen Christian. All three are speaking at a workers comp conference in San Diego in early February, along with Barry Eisenberg, Exec. Dir of ACOEM and Larry Yuspeh of the Louisiana Workers Comp Corp. (LWCC developed one of the first physician-centric delivery systems in WC). Conference details are here.
The conference is sponsored by HCN, a firm working in the WC space. HCN will waive the registration fee for Managed Care Matters readers; email dparkerAThcn-usDOTcom for details.
Note – Neither my firm nor I have any relationship, business or otherwise, with HCN or any of their principals. This conference looks to be different in that it has a strong clinical focus, a concentration that is missing from other trade functions.
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I’d love to believe that Ed, Gideon, and I are thought-leaders, but if we’re so influential, what’s the evidence we’ve had influence? To date, very little. The marketplace is still focused on maximizing discounts off unit pricing. The payers who ARE interested in outcomes are coming out with tactics that smack of economic brutality instead of partnership in their approach to healthcare providers.
I agree that we three are visible, ardent, speaking about fundamental realities and trying our best to be heard and have that make a real difference. Each in our own way, the 3 of us advocate the development of WORKING relationships focused around hurting fewer people and wasting less money. We want to drive health-related employment situations towards better outcomes by building relationships based on shared commitments and aligned commitments and incentives — INSTEAD OF GREED — between payers, employers, and providers.
Joe, every one of your readers needs to remember that almost all healthcare providers chose their profession out of a desire to do good and be helpful — and to make a good living in the process. But for most, money is secondary, and simply supposed to accompany the former. And, a core precept of healthcare is being a professional, rather than a vassal. Blunt threats and other attempts at domination by a “customer” represent a threat to the core integrity of the provider.
While I endorse Jennifer’s 60 Summits project, I think her post is an over-simplification of what’s going on in the market right now. Payers care very much about outcomes – in fact, I’d argue that for most employers medical treatment costs are often secondary to getting injured workers back on the job (an attitude that’s been exploited by some providers, and part of the reason we have micro-processor controlled ice packs, but that’s a different blog). I think we’d all agree that RTW is an important outcome, but out there in the marketplace it’s not something payers get offered as a key distinction between providers, and some groups who claim to attain better outcomes don’t in fact get them when you actually look at the data. In the absence of information, the world looks at price – and the current Death Star alliance between Coventry and Aetna is not likely to lead to anything other than more focus on discounts. I’d be happy to buy a network that shows me quality and outcomes, but talk is cheap – show me the data.
Having been involved in recent hospital negotiations also causes me to dispute Jennifer’s assertion that providers consider money as “secondary”. We’ve had plenty of blunt threats and attempts at domination directed our way.
I don’t consider this type of dialogue productive – but Jennifer’s point about building working relationships is something I can endorse.