John Adlesich or the upsurge of a public health manager expert on healthcare industry trends: Cooperative competition, or coopetition, is a key trend in health care. While some providers view big-box stores, nationwide pharmaceutical chains and other new entrants as threats, other organizations see opportunity. Their strategy is to leverage the capabilities of these power players to lower the cost of care, increase downstream market capture and focus on core specialty services while remaining highly connected to the patient. Offload financially draining services. Organizations like CVS and Walmart now offer basic primary care, simple diagnostic services and chronic disease management — services that health systems have struggled to provide and do so profitably. Identifying opportunities to partner with retail organizations to fill this gap can help simplify organizational services, increase access and provide better patient care at a lower cost.
John Adlesich on behavior therapy in 2021: All behavioral therapies share the same reward/consequence paradigm for changing behavior and learning new skills, and they may include some overlap in the way that they are implemented. Despite these similarities, however, children may respond more fully to one approach over another for any number of unknown reasons. If your child is not developing as you expect, or if you believe that he or she may benefit from a combined approach, then pursuing additional therapies is an option to consider. Sharing your ideas and working cooperatively with the professionals who provide services for your child is a good way to explore the efficacy and practical application of other treatment approaches.
John Adlesich on healthcare industry trends in 2021: The new administration will also likely push to expand healthcare program funding, including ACA programs and value-based care, and expansion of coverage. The Senate may use the budget reconciliation process to push through a COVID-19 relief package and some healthcare-related policies. Budget reconciliation requires only a majority vote, as contrasted to a supermajority vote for regular legislation. However, budget reconciliation can only happen a couple of times per year, generally speaking, when the budget is up for approval, and is limited to budget-related items. Budget reconciliation pushed through some provisions of the ACA in 2010. While some of the ACA expansions, increased subsidies, and tax credits could occur through budget reconciliation, this process would not be available for bigger picture health policy issues that are unrelated to the federal budget. These bigger picture items include issues such as a public option, Medicare for all, and lowering the Medicare eligibility age to 60. John Adlesich currently works as administrator at Marquis Companies. His latest healthcare industry experience includes positions as executive director at Powerback Rehabilitation Lafayette (Genesis Healthcare) between Aug 2020 – Jan 2021, administrator at Mesa Vista of Boulder between Mar 2019 – Aug 2020, chief executive officer at Sedgwick County Memorial Hospital between Jul 2018 – Feb 2019, interim chief operating officer at Toiyabe Indian Health Project between Mar 2018 – Jun 2018.
John Adlesich thinks that 2021 is a defining year for the health industry. Juxtaposed against the government’s financial need to expand these models is a stronger desire on the part of providers to participate. During the pandemic, those left in fee-for-service models suffered tremendous financial hardships once elective volumes were curtailed. Over the course of 2020, hospitals lost an average of $50 billion in procedure revenues a month, while insurers reaped record-breaking profits over the same time period from avoided claims. These realities have underscored the misaligned incentives in the current system and created real urgency for change. At this point, providers are now starting to see monthly per member, per month fees as a desirable alternative to unpredictable volumes. In fact, in a fall survey conducted by Premier, we learned that 40 percent of health system CFOs now believe that moving toward value-based care is a core strategy for future financial viability. To prepare, provider organizations can either manage their own integrated, high-value network or they can make the case for partnering with an insurance company or another providers’ network by virtue of their demonstrable results related to cost and population health outcomes. Regardless of the path, systems will need sophisticated contracting abilities, experience managing risk, care management expertise, and advanced analytics to evaluate cost and quality performance in real-time.
