Marcus Pierson, MD: Payment Realignment

More on Our Meeting with Policy Makers In Washington, D.C.

Fri, 21 Feb 2003 02:53:03 GMT

When we (Rebecca Bryson--patient, John Hayward--CEO of PeaceHealth, and Marc Pierson--Exec of Perusing Perfection in Whatcom County) went to Capital Hill to present our ideas for consideration last week we created a "one pager" to leave behind. You may find it interesting. Obviously, it is brief, hopefully concise, but not complete. It may be useful to explain Pursuing Perfection to friends or acquaintances. It is a MS Word document.

Premier has been helping Whatcom county advocate our position in Washington D.C. They they reported on John Hayward's participation in a National Health Policy Forum meeting on Capital Hill in Washington, D.C. last Wednesday. The news article is captioned "CEO of Premier owner PeaceHealth: Breakdown of health system silos would go a long way toward sustained improvement of patient care." Rebecca Bryson and I, along with 15 others from other Pursuing Perfection sites were in the audience. This forum and our meetings with our Congressional Members was arranged by Robert Wood Johnson Foundation through their CONNECT group.

CONNECT--First Trip to Washington DC to meet our Members of Congress

Sat, 15 Feb 2003 19:56:12 GMT

Robert Wood Johnson Foundation's CONNECT PROJECT guided meetings in Washington DC this week. Six of the seven US pursuing perfection sites met with their congressional members. The Whatcom county team consisted of Rebecca Bryson (patient), Marc Pierson (me, project executive), and John Hayward (CEO of PeaceHealth). We met with Senators Patty Murray and Maria Cantwell and with Representatives Rick Larsen and Jim McDermott. The meetings were informational and well received. Each member agreed to work with us to learn more about what we are doing and to lend their support to comprehensive clinical quality improvement efforts.

There was also a meeting with the National Health Policy Forum. The subject was "Pursuing Perfection in Health Care Delivery: Insights from Innovators". There was good attendance by congressional staffers and health agency leaders. Donald Berwick, MD, led off and presented context for the briefing. Honor Page, the mother a patient with cyclic fibrosis spoke next. She gave the patient's or consumer perspective on the current status of health care as well as on her interactions with Pursuing Perfection project at Cincinnati Children's Hospital. Next was Dr. Brian Rank from HealthPartners, Bloomington, Minnesota, explaining the frustration and challenges from the perspective of a physician leader pursuing perfect care in today's environment. Finally John Hayward spoke about the need for change and his rationale for the work going on in Whatcom County, WA, as well as explaining his personal commitment to transformational change in his organization.

Rebecca, John, and I all felt like the relationship building with our congressional members is off to a good start. As you all know, for the improvement that we have started to be sustainable, both Medicare and Medicaid will need to become more flexible in matching payment to innovations in care. Our short and long term goals will be some small appropriation to help cover the short fall on our start up of this transformation, then a demonstration project that will provide the needed flexibility to this county. Ultimately the payment structure of Medicare and Medicare will need to be modified based upon the successes of the demonstration projects.

Click on this link if you would like to study most current recommendations by the Institute of Medicine to CMS (medicare/medicaid) for demonstration projects aimed an transforming health care and aligning payment. Four out of five proposed types of demonstration projects are highly aligned with what we have already begun with Pursuing Perfection and Robert Wood Johnson Foundation.

Systems Dynamics Model, RWJF National Advisory Committee's comment

Sat, 13 Jul 2002 23:34:51 GMT

The "systems dynamics model" that you have built with two consultants is a breakthrough. This model would be of help to every Pursuing Perfection site, and gives a new tool to the industry for exploration of the "business case for improvement."

Two powerful ideas for pursuing perfection

Sat, 29 Jun 2002 16:43:50 GMT

1) Patients truly at the center, "radical patientcentricity"

2) First design the healtcare system that is needed. Then and only then, design the payment system to support the idealized system design.

Too frequently we have tried to create as system through manipulation of the payment structures. That is like trying to make a marionette dance through strings held by puppeteers who can't see each other, can't see the marionnette and don't agree on the dance.
Only by working together can we get the dance steps right. This is the first order of business if we are to improve the patients' and providers' experience, and deliver the needed quility and value.
In our Pursing Perfection project will use group systems dynamics modeling and simulation to design the dance for a couple of chronic diseases first.

Sustainable innovations require that they recieve the funding from the replaced process.

Wed, 26 Jun 2002 03:57:24 GMT

Payers must help with the redesign or it will not be possible.