At the Helm

Insights for the C-suite

4 things you need to know about the House GOP plan to replace the ACA

Eric Cragun March 7, 2017

On Monday, House Republicans unveiled the "American Health Care Act" (AHCA), which would repeal, replace, or adjust some elements of the Affordable Care Act—but leave many elements of the ACA intact.

Our early assessment of the bill suggests some key themes for providers as they navigate changes to the health care industry, including potential increases in uncompensated care and an accelerated shift toward consumerism. However, the proposal has been public for less than 24 hours and faces a long road before any elements would become law, key caveats for any discussion of the legislation.

We will continue to provide more analysis as we learn more and as the bill evolves. Join us next Friday for a webconference on the legislation and/or attend one of our remaining Health Care Advisory Board National Meetings, where we'll be discussing the plan and the no-regrets priorities for health systems, regardless of what happens in Washington, D.C.

Register for the March 17 webconference

Here are four things providers need to know about the House GOP plan:

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How to assess the decision to switch EHR systems

March 1, 2017

by John Kontor, MD

With almost any industry, there are a few companies that have the majority of market share. We're all familiar with the dominant players in the EHR market, those top 10 systems who hold the 80-90% of market share year to year. According to market research Epic, Cerner, and Allscripts currently top that list.

I can't tell you how many times I get asked, "Should I just switch to Cerner or Epic or Allscripts?" by health IT executives whose health system uses an EHR other than one of these major systems. Health system leaders should take a close look at their current situation alongside their short and long-term objectives to determine the right answer for their organization—with only a little consideration for what's popular in the market.

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151 years and 3 ACOs later, here's where Tom Zenty is taking University Hospitals next

by Eric Larsen, Managing Partner, and Liz Hughes, Managing Principal February 22, 2017

Welcome to the "Lessons from the C-suite" series, featuring Managing Partner Eric Larsen's conversations with the most influential leaders in health care.

In this edition, Tom Zenty, CEO of University Hospitals, talks to Eric and Managing Principal Liz Hughes about how Tom knew he wanted to go into health care administration at age 15, why he has a Charles Darwin quote in his office, and how his system is approaching the "new age of consumerism."

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5 things providers should know about new HHS Secretary Tom Price

Eric Cragun February 10, 2017

Early Friday morning, the Senate voted 52-47 to confirm Tom Price as Secretary of the Department of Health and Human Services. Here's what providers should know about Price and how his time at HHS might affect their strategy.

Secretary Price now assumes leadership of a department that controls over $1.1 trillion in annual federal spending and includes CMS, FDA, and NIH, among other agencies. The Senate Finance Committee will hold a hearing next week to consider the confirmation of Seema Verma, President Trump's nominee for CMS Administrator. The president has yet to announce his nominees for FDA commissioner and NIH director.

In his new role, Secretary Price clearly will have a significant impact on the health care industry. So what should providers know about Price and how his time at HHS might affect their strategy?

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Our vision for transforming health care: It starts with you

Robert W. Musslewhite February 2, 2017

All of us who work in health care are well-versed in change, and this year has ushered in a period of particular uncertainty—and opportunity—for our members. That's one reason why I'm eager to share with you the vision for our work in 2017 and beyond.

As always, your challenges are our challenges, and your goals are our goals—and now we are better positioned than ever to help you tackle them.

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How to interpret Trump's executive order regarding the ACA

Eric Cragun January 23, 2017

On Friday—in between the inaugural parade and inaugural balls—Trump issued an executive order that directs federal agencies to take steps to ensure the government's implementation of the ACA minimizes the burden on impacted parties (individuals, states, etc.).

The order instructs agencies to "waive, defer, grant exemptions from, or delay implementation of provisions" that place a "fiscal burden on any State" or that impose a "cost, fee, tax, penalty, or regulatory burden" on stakeholders including patients, providers, and insurers. Importantly, the order states that any changes should be made only to the extent "permitted by law" and should comply with the law governing administrative rule-making.

The order does not, however, provide specifics on next steps or provisions that will be reexamined. Predicting how agencies and their new heads will respond to this order is impossible at this point. The quick take is that the order is best viewed as a symbolic step reaffirming Trump's focus on repealing the ACA and an effort to show that he is keeping his campaign promise to deal with the ACA on his first day.

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Health policy outlook: What we know and don't know

Eric Cragun January 9, 2017

The 115th United States Congress convened last week, and President-elect Donald Trump will be inaugurated on January 20. In the two months since the election, there has been much coverage of Republicans' preparations and early steps to repeal and replace the Affordable Care Act (ACA).

However, despite all the chatter, Republicans have not reached consensus or announced details on their plans, and the path forward is shrouded in much uncertainty. At this point, most reports are more speculative than substantive.

Even after Republicans start releasing legislative text in coming weeks, uncertainty will persist to some degree as Republicans continue to figure out process and details of repeal, and begin navigating the challenges of developing and passing a replacement plan.

In that light, below is a summary of what we know and what remains unknown at this point in the process. Many of the questions our Chief Research Officer Chas Roades proposed in the aftermath of the election remain open.

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Why the EHR is crucial to NYC Health + Hospitals’ mission

John Kontor, MD January 5, 2017

Early in my clinical career, my care team tracked and managed our diabetic patients using spreadsheets, and even then, it felt like we were using technology well to support our care goals.

However, it wasn't until the industry broadly adopted more advanced EHRs that I realized the vast opportunity for health IT to revolutionize health care, and transform a health system's core strategies to deliver on a mission of accessible, quality patient care.

Nowhere is this more evident than in the story of NYC Health + Hospitals, the largest public health system in the country, as they embarked upon one of the biggest EHR implementations ever.

When NYC Health + Hospitals asked Advisory Board to help, we knew we had a deep bench of experts that could pull from years of experience in health IT and would take this work personally, like my colleague Ed Marx who is currently serving as NYC Health + Hospitals' interim CIO.

Advisory Board partnered with NYC Health + Hospitals through their Epic implementation, supporting their mission to provide care to all of New York City, with the first two facilities successfully going live in April 2016.

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