Big shoes | Quadruple Aim | Rick Rubin

The legislature is in a quiet stage, where the 4 to 8 legislators finalizing the budget close the door to everyone, including other legislators. But we have plenty left to watch, including a smart commentary by Rick Rubin, value payments by CMS, and the hidden emotional toll on providers.

DJ 5 Things Signature

1. Video: Rick Rubin, OneHealthPort

This is a very smart observation, and a tremendously astute critique.  Rick Rubin, CEO of OneHealthPort joins State of Reform to talk about how health care reform likes to add layers rather than take them away. He says this logic is counter to other industries that view innovation as streamlining the customer experience.

“There are a lot of steps that have been taken [in reform] which individually make sense, but when you add them together there is a collective burden of complexity I think the system is choking on a little bit,” said Rubin.


2. CMS brings value payments to Puget Sound

On April 1, CMS will launch its episode-based payment initiative for hip and knee replacements in the Puget Sound region. Medicare providers in the state will be evaluated and compensated for the first time based on value, not volume, for this service.

Joint replacements cost the Medicare program about $7bn in hospitalizations. Costs can vary up to 100% across geographic areas. The success of 67 national test markets will help set the tone for CMS moving Medicare away from fee-for-service.

foundation for healthy generations event

3. The rise of the Quadruple Aim

This is a heartbreaking story. It’s about Kim Hiatt, a Seattle Children’s nurse who made a fatal error in treating a toddler. The emotional toll the mistake took led to the taking of her own life. Nurse Hiatt’s story raises an important question of how well our health system is taking care of the emotional health of its care givers.

No one is perfect. 14.7% of medical residents reported making a medical error in the last three months. But, NIH has suggested that failing to support providers inhibits progress towards the Triple Aim. That’s leading to talk of the fourth aim – thus a Quadruple Aim – related to strategies to support providers. 


4. Big shoes to fill

Eric Earling is one of the most astute observers I know of in connecting the dots between policy, communications, and health care. He’s leaving his role as VP of Corporate Communications at Premera to try something new in New Orleans. It’s an important loss for Premera. We couldn’t be more proud of the authenticity with which he’s living his life. Check out his blog for the story.

Likewise, Mariella Cummings has retired from her role as CEO of Physicians of Southwest Washington after 16 years.  Mark Adams bid farewell to his CMO role at CHI Franciscan to be the CMO at PeaceHealth.  And Vice Chair of the Senate Health Committee Bruce Dammeier (R-Puyallup) will be leaving the Senate to run for Pierce County executive. 


5. Apple sets its sights on health care

Monday, Apple leadership spent 8 minutes talking about the launch of their new iPhone and 10 minutes talking about the company’s entrance into health care. Google tried entering health care. So did Intel and Microsoft. It turns out it isn’t so easy for tech companies to find success in the sector.

Apple VP Jeff Williams explains how CareKit, on open source platform, has a different strategy. CareKit opens the doors for partners like Johns Hopkins Medicine and UCSF to develop the health care apps they need for things like Parkinson’s treatment or post-surgical care. He commented, “We think the possibilities here are limitless.” We’ll see.