John Adlesich or the growth of a healthcare manager expert about healthcare industry trends: Expand the market while improving community health. New entrants can be a force multiplier and increase the overall market for health services. Look for opportunities where your services could have a significant impact on community health and partner intentionally. For example, about half of women age 40 and older do not get screening mammograms. If mammography services provided by a large retailer were successful in motivating this population, the majority of women receiving in-store mammograms would not need follow-up care. However, many would require referrals for follow-up diagnostic exams and, possibly, treatment. Establishing a two-way relationship with that new entrant — sharing data and providing easy access to hospitals or health systems — could open the door to a potentially significant flow of new referrals.
John Adlesich on behavior therapy in 2021: Applied Behavioral Analysis is a highly effective method for mediating behavior across a variety of domains. The technique relies on the observation and analysis of the antecedents (A) of the targeted behavior (B) and the resultant consequence (C) of that behavior. Antecedents are sometimes referred to as triggers and are the first step in identifying the cause of a challenging or undesirable behavior. This ABC methodology provides a foundation for clinicians to develop a highly specific and thorough treatment plan. Professionals will use this observed data, along with information provided by caregivers and loved ones, to develop a plan specific to your child’s needs.
John Adlesich on healthcare industry trends in 2021: The California versus Texas case came to the Supreme Court from a federal appeals court. If the Supreme Court affirms the appeals court ruling, the case will go back to the federal district court to decide on the issue of severability of the individual mandate from the rest of the ACA. At the November 2020 oral argument, it looked like the Supreme Court, including one or more of the new justices, was inclined to honor the doctrine of severability, making it less likely the ACA will face complete repeal. Additionally, the new slim Democratic majority in the Senate (thanks to the Georgia runoff) makes it likely that Congress would fix the constitutional problem by reinstating the mandate with a nominal penalty. 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 an important year for the healthcare 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.